What makes you nervous about or irritated with a new grad or orientee?

[GardenDove]

I've noticed alot of threads lately from new nurses who seemed quite stressed out, which I can totally understand, I've been there for sure. So I thought I'd start a thread from the other POV. This shouldn't be an opportunity to be sarcastic or uncharitable, but maybe it can help a new grad to see the other side of the story.

I get nervous by a new nurse who doesn't ask questions. I also will have misgivings about a new nurse who asks a question and then argues with my answer. Also, a new nurse who knows it all makes me nervous.

I get irritated by a cocky new nurse. A little bit of deference and humilty is a good thing. But someone who grovels makes me unsettled. I also get annoyed if a new nurse is too bossy with the pts.

[EmerNurse, BSN, RN]

I am really not trying to pick a fight here or start an arguement....however, I must say that being a student...I have also responded with "I already saw that procedure" I didn't say that because I thought I knew everything about the procedure from seeing it once or twice.

The reason I said that was because I knew that we (my clinical group) had a very limited number of times actually at clinical facilities -and I wanted another one of my classmates to have the opportunity to see the procedure as well.

It has been my experience that only 2 or 3 students were allowed to view the "procedures" at one time---so it seems that the students who are a little more organized and where caught up (as best you can be) got to see all the "cool stuff". I tried to keep a mental list of who didnt get to see such and such or so and so...and if I had already seen it once or twice--I would try to give someone else that opportunity--even if it meant I had to cover there patients as well as my own. JMO

Hi Ohmygosh!

I don't think folks were complaining about students who want to share the experiences amongst their clinical group. Rather, new nurses who don't want to do what they consider "dirty" work (placing a foley, dropping an NGT, even help with a code brown, whatever) after they've done it once or twice - they'd rather let someone else do it.

When we're precepting a new nurse, we try to have her not only do things with "our" patients but also with others' patients when possible, so that he/she gets as MUCH hands-on as possible. I don't say "Susie RN needs a foley in her patient in room 5, would you like to do it?" because Susie is lazy or I want you to do the "Dirty" jobs you don't like. I want you to do it because you need to get to the point where these things are simply automatic. To have a preceptee tell me that he/she doesn't want to do it (while sitting at the station, "waiting" for whatever) because she's "already done two of them", is very annoying.

[Sheri257]

I'd also like to say something to all of the preceptors out there, especially those who get irritated with us new grads.

I don't know what it's like at other nursing programs but, by the time I graduated ... I'd been in at least a dozen hospitals and I'd worked with dozens of RN's. It's really difficult to adjust not to just being a new nurse ... but learning each hospital's system, each RN's system ... everything.

Every hospital different, the gear is different, the charting is different ... all of it. Then you're often in a situation where you're getting a different RN just about every week, and they want stuff done differently also. No two RN's are the same.

Something that one RN loved for you to do last week the next RN might hate next week. Chart it this way ... no, chart it that way. Oh ... no ... don't do it this way ... when the last RN insisted it you do it that way.

Not to mention, you've got different instructors telling you to do different things on top of all of that. It's a constantly moving target and you're just struggling to keep everybody happy.

So ... if we seem a little ditzy by the time we graduate ... that's one of the reasons why. We've spent the last two years walking into alien environments where just about everybody has different ideas about how to do this job.

The whole thing can make your head spin. It's really difficult to get handle on it. Because you're constantly having to say: Ok, what do they want me to do ... now.

:typing

[HeatherLPN]

What irritates me is the ones that are "too good" for "aide" work. If you are inserting a suppository and their brief is wet, change them, don't make them wait while you get an aide to do it. STNA's work hard and you can help them out by changing ONE brief, so get over yourself. It aggravates me when nurses come in and treat the aides like they are second-class. Yes, you may have more education and responsibility, but those aides deserve as much respect as you do. They have their job, you have yours, but you need each other to be able to take the best care of your residents, the very people who are the reason you have a job in the first place.

[oldiebutgoodie, RN]

Here's a solution to the "evil preceptor" problem...

1) Only have people precept who WANT to precept.

2) Train the preceptors.

3) Give them extra $$ for precepting.

4) Give them a bonus for every new nurse who makes it 6 months past orientation.

5) Don't give the preceptor/orientee a ton of patients until they are ready.

Of course, this costs extra money for the hospital, but I would bet that the cost of new nurses quitting after 3 or 4 months would offset the cost of paying the preceptors extra!

Oldiebutgoodie

[sissyboo]

I'm "only" a CNA. I've only held one job as a CNA in a Peds Unit. I kind of got the feeling that asking questions around the place was wrong. It's a small hospital and the unit wasn't extremely busy at the time. They almost looked annoyed when I asked a question and kind of complained that I was too slow. Yet I never had a patient/parents complain about my work! I actually had several compliments.

I did alot of my clinicals in the OB unit of the same hospital with several of the same nurses. I did really well there and didn't ask a whole lot of questions, because they explained things really well to the students. When I took a job a few months later in a different unit, but with many the same nurses (the two units kind of work as one, many of the nurses float back and forth), they expected me come in an know it all.

I kind of feel this is wrong! I think anyone providing care who has a problem with procedure should ask questions and many of them, if necessary!

[sissyboo]

Wow. I've kind of had this fear of orientation and precepting. Everyones comments are great. I'm glad I've seen a few opinions from both sides!

[Sheri257]

What irritates me is the ones that are "too good" for "aide" work. If you are inserting a suppository and their brief is wet, change them, don't make them wait while you get an aide to do it. STNA's work hard and you can help them out by changing ONE brief, so get over yourself. It aggravates me when nurses come in and treat the aides like they are second-class. Yes, you may have more education and responsibility, but those aides deserve as much respect as you do. They have their job, you have yours, but you need each other to be able to take the best care of your residents, the very people who are the reason you have a job in the first place.

There's always two sides to every story. I used to believe this also, because I used to be an aide. But now I'm not so sure anymore because this can also be a trap. I was delegating a lot of work to the aides because I had a ton of RN work that had to be done. One of them accused me of being a primma donna and not helping. I felt really bad because I used to be an aide, so I started helping more.

Well ... you go into the room and you think it's only going to be one diaper but, as it turns out, they've got non-stop diarrhea and it's an all day thing. The patient also needs water, a new gown, a linen change ... and the aide is nowhere to be found because you're helping. Before you know it, you're behind on your RN work and your preceptor is really ticked off.

Now ... you've got to go find the aide and get them to do their job. They still think you're being a primma donna when, in fact, you've got a lot of catching up to do because you helped them in the first place. So, I learned the hard way that I've got to get my RN work done first, no matter what the aides think.

:typing

[P_RN, ADN, RN]

I really had to think on this one. I want my new orientee to put forth an effort to be on time, be clean and smell good. You'd be surprised at what I saw on some young people.

I want them to question anything they don't understand. Heck I could go across the building and be just a confused by that unit as a new grad/emp is on my unit.

I want them to pay attention. One girl I remember I believe had butterflies for breakfast. She would go into a room with a purpose and get distracted by any shiny thing in the room-tv, book, magazine, anything would stop her dead.

I want you to TELL me if I am not being fair, too fast, too slow, not doing it the way they were taught.

And if you decide this unit is not for you, please tell me why and not just quit coming to work.

[RNsRWe, ASN, RN]

I have always asked questions, and lots of them. It has never worked against me, I always learned from them, and it let the person I was asking KNOW if I DIDN'T know something, or that I was obviously willing to be taught.

That said, I now have a charge nurse that HATES when I ask ANYTHING. I mean, if I don't understand why something was done a certain way, and ask about whether I was doing it wrong or if that other way better (or not), I get an exasperated "you ask too many questions! Stop questioning everything!". Very frustrating, since I have learned to severely limit my questions with her to what I absolutely HAVE to know in order to either not screw up, or do the right thing by my patient, or not have administration skewer me over not completing paperwork correctly.

If I don't ask the question, I risk the screw up (and a "why didn't you just ASK??"). If I DO ask, I get the rude and nasty comments about how I am too anal. I am not anal, I am conscientous. I am not claiming anyone has done anything wrong, I just need to know what *I* should do. And yet, she throws up her hands and (loudly) declares that I need to stop "being this way". Umm....the same way that everyone else I have worked with in the last few months has told me was a GOOD thing? That I have actually CAUGHT problems because of questioning things, and have learned along the way?

Frankly, she's making my life hell when she's on. The other charge nurses don't give me anything remotely like this kind of grief. It's gotta be just a personality conflict between her and I (I also have a sense of humor that she sees as sarcastic--unpleasantly so, apparently) that can't be worked through, and we'll always be at odds (how nice). She keeps telling me she's trying to "change how I think, to stop asking so many questions". Well, last time I checked, the way I think has done me very well, so I don't think it's my thinking that needs to change.

But what to DO about it?? Yeah, yeah: don't ask her a single question. Easy to say, but when you're new, there's only a couple of nurses on plus the charge, well, you GOTTA ask if it's important. And get ridiculed, I guess.

[Ohmygosh]

Hi Ohmygosh!

I don't think folks were complaining about students who want to share the experiences amongst their clinical group. Rather, new nurses who don't want to do what they consider "dirty" work (placing a foley, dropping an NGT, even help with a code brown, whatever) after they've done it once or twice - they'd rather let someone else do it.

When we're precepting a new nurse, we try to have her not only do things with "our" patients but also with others' patients when possible, so that he/she gets as MUCH hands-on as possible. I don't say "Susie RN needs a foley in her patient in room 5, would you like to do it?" because Susie is lazy or I want you to do the "Dirty" jobs you don't like. I want you to do it because you need to get to the point where these things are simply automatic. To have a preceptee tell me that he/she doesn't want to do it (while sitting at the station, "waiting" for whatever) because she's "already done two of them", is very annoying.

I understand where you are coming from ....even as a student I too have observed this behavior while at clinical rotations.

I have always tried to help out with whosoever needed help --LOL I think code browns have become my specialty! Anyway...as I said I try to help whenever possible --I'll do whatever anyone needs me to do as long as I feel relatively comfortable with the task. I figure it like this...if someone has a fire to put out and another fire or two smoldering--and I am sitting pretty---I might as well 1) get more experience and 2)give that someone else a break--I may be the one who needs help one day!--In my opinion if you can keep the unit as stress free for all involved--the better day the whole unit will have!

[HeatherLPN]

There's always two sides to every story. I used to believe this also, because I used to be an aide. But now I'm not so sure anymore because this can also be a trap. I was delegating a lot of work to the aides because I had a ton of RN work that had to be done. One of them accused me of being a primma donna and not helping. I felt really bad because I used to be an aide, so I started helping more.

Well ... you go into the room and you think it's only going to be one diaper but, as it turns out, they've got non-stop diarrhea and it's an all day thing. The patient also needs water, a new gown, a linen change ... and the aide is nowhere to be found because you're helping. Before you know it, you're behind on your RN work and your preceptor is really ticked off.

Now ... you've got to go find the aide and get them to do their job. They still think you're being a primma donna when, in fact, you've got a lot of catching up to do because you helped them in the first place. So, I learned the hard way that I've got to get my RN work done first, no matter what the aides think.

:typing

I see your point there. Luckily, at my facility I have wonderful aides, so they understand that I have my own stuff to do and just appreciate any help they get. I guess alot of that depends on your aides?

[TracyB,RN, RN]

MyBSN.... LOVE your avatar, the boxer pup. Gorgeous!!!

Anyway, I don't mind precepting at all. I find it fun & it keeps me on my toes to be sure I continue to do things correctly, but my pet peeve is someone who isn't interested in anything. Working in surgery has it's own set of challenges & running out of the room at every possible moment to use the phone, fix make-up or whatever just totally irks the heck out of me.