What makes you nervous about or irritated with a new grad or orientee? - page 6

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... Read More

  1. by   Tweety
    Quote from oldiebutgoodie
    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

    We do all but #4 where I work. Those are very good ideas.

    My manager always asks me if I want an orientee or student, (probably because she knows I'll say yes.) Rencently I precepted a new grad, a student, and a new employee back to back and might have said "no, I need a break and want to work on my own for a few weeks" if there was a 4th one needing orientation. It's always nice to be asked and it's an honor to be chosen to precept someone.
  2. by   Thedreamer
    Hey guys,

    I just want to add my two cents. I myself am a nursing student. I am the type of student that color codes my text books with tabs and high lighters, has alphebetical note cards and I arrange my papers in order. That being said, threads like this really get to me.

    I pride myself on knowing whats in the textbooks and being able to recite them verbatum. However that is a BOOK. Real life is very different. It really kills me to see that so many nursing students think that just because they are book savey, also means that they are going to kick ass and take names in the hospital. Yea, some of them might. However, Im sorry to my fellow students but if your instructor says this is how we do it, DO it like they said. Dont argue, dont give them attitude, dont make your constipated face! They are doing it to help TEACH you how its done. You being the STUDENT.

    I have had countless times when I was in the hospital and something just wasnt adding up, and I couldnt for the life of me figure it out. Guess who I would go and talk to? My instructor. Its my belief that as much as you know in this field, and in life, you will ALWAYS be a student. Even the instructors are still growing and learning every day. Thats the nature of the "beast." I have no shame and going to ask the other nurses questions because I know they will help me, either through thier own skills and knowledge or finding it out for me by looking it up. The more you ask, the more youll know. And the more youll find yourself not needing to ask so many questions because youll have learned how to do the tasks asked of you.

    And yes I have been snapped at. Who cares! I find its best to diffuse a situation with hot coacoa People get stressed out very easily some days. If I have 5 minutes where I am all caught up on my work, it never hurt to go out of my way and make someone some hot chocolate or coffee to help them relax for a second and know that someone at least cares. I may be a student and we might be nurses(in trainning) but we are all human beings. Just because someone snaps at you doesn't mean they are going to eat you. 9 times out of 10 that mean comment or hurried phrase is just another way of saying, "Hey I could really use some help." Even small menial things mean alot to people o_O or so I have found.

    Oh and for Cookies sake, my fellow students, don't complain about cleaning bed pans and such :P You're either there to help this patient get better or you're not. I don't know about anyone else but MY nursing program teaches basics of health care first. Bed changing/Bed pans were part of that. Which means its in your scope of practice, so practice :P
  3. by   Roy Fokker
    Quote from Thedreamer
    Oh and for Cookies sake, my fellow students, don't complain about cleaning bed pans and such :P
    I don't have problems changing pans - saved me a few items on "patient assessment" check off list [Assess bowel movement, flatus, urine, skin condition]


    cheers,
  4. by   SaderNurse05
    Quote from oldiebutgoodie
    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
    AWESOME idea! Seriously, this could help with turn over related to bad initial experiences. What do the nurse managers think??
  5. by   PANurseRN1
    Quote from ruby vee
    i agree with both of you. a new nurse who doesn't ask questions or believe he/she knows everything is downright scarey!

    however, i'm wondering how long it will be before you're accused of being hostile to newbies or "eating your young." seems like that's what always happens to threads of this nature!
    yes, because we all know that any remotely negative feedback is the equivalent of voracious, jaws-like nurse-eating.
  6. by   PANurseRN1
    Quote from SethJ
    I had something happen in clinicals and I wasn't sure how to handle it. The Nurse had a great deal of experience, but she interfered with my IM injection. First she yelled at me for using the scoop and sweep technique after I drew up the medication. She claimed the needle wouldn’t be sterile? Then she told me to draw back an extra CC of air to “keep the medication in”. Finally she tried to move my hand and make me aspirate with the other (we were taught to use the thumb). I didn’t argue with her. After all, she was signing her name to the chart. I’m just a student.

    But, when I talked to my instructor, she told me to ignore the nurse’s “suggestions” and go with the techniques we learned. After all, we were being taught the most up to date ways to perform procedures and the procedures are evidence based.

    I'm just wondering how to handle this in future clinicals. What do ya’ll think about that? Any ideas?
    Right here is a perfect example:

    "My education is newer and evidence-based, as opposed to your outdated, outmoded education. Therefore, I'm just going to go ahead and do what I want to do and ignore you (but I'll be happy to leave you to pick up the pieces if my way doesn't work out after all.")

    And actually, there is evidence in favor of using the air-lock method for IM (0.1ml of air--helps to push the med deeply into the IM tissue and also clears the med through the needle). And either injection technique is acceptable.
    Last edit by PANurseRN1 on Jan 2, '07
  7. by   Becca608
    Thanks for writing that.
    I'm starting 2nd semester of my first year and while I was fine in the nursing home, I am terrified about starting our med/surg clinicals. I've actually been up all night worrying instead of sleeping and its 3 weeks away!
  8. by   RNsRWe
    Quote from JediWitch
    Thanks for writing that.
    I'm starting 2nd semester of my first year and while I was fine in the nursing home, I am terrified about starting our med/surg clinicals. I've actually been up all night worrying instead of sleeping and its 3 weeks away!
    JW, your post made me smile: I had nightmares through four straight semesters about clinicals. Sometimes the night before, sometimes, just for psychic fun I suppose, they'd hit on the weekend. Always, in all of them, I was desperately trying to find my patients, to get meds passed in time, to revive patients who were under my care but whom I had managed to neglect ("he's MY patient?!?"). I'd wake in a cold sweat, heart beating.

    And once I graduated, was working on NCLEX studies, I had no such nightmares at all....figured, "whew, done with THAT!" Imagine my surprise to find that once I began working as a 'real nurse' that I'd get some of those same dreams/nightmares back again!

    Only this time, I wasn't the student who was lost, but rather, the RN responsible and still unable to find that danged beeping pump, unable to get an IV start (and there would be, of course, a crowd of people waiting for me to do this).

    LOL, at this point, I don't have many dreams like this, they're rare, but I still remember.....

    All I can tell you, JW, is that you probably will lose a fair amount of sleep while you get through clinicals, and once you begin work later. Doesn't mean you won't do well, just that you're conscientious
  9. by   lashes
    I precept alot, and there isn't really a whole lot that upsets or irritates me about new grads. I had an awful preceptor and an awful orientation in ICU so I try to be as patient as I possibly can with my orientees. Questions-- YESS! Ask as many as you want.. If ur not asking questions, I will start to wonder why. The " I'm an ICU nurse , Im better than you" attitude seems to be common amongst many ICU nurses where I have worked ( not to offend anyone- I work there too ) regardless of being a newbie or not... So, I don't think the "know it all" personalities are restricted to just new grads. The whole orientation process is to make one comfortable with the unit, skills, MD's, etc and at the end of it all, we ( preceptors) want you to succeed and -- bottom line, we want to make sure that ur safe. I've found that most nurses, new grands and seasoned RN's, who don't ask questions end up making some big mistakes...
  10. by   Charlie409
    [I've found that most nurses, new grands and seasoned RN's, who don't ask questions end up making some big mistakes...[/QUOTE]

    First ..I have been a preceptor for a long time...I love it
    I tell every new nurse I get the same as some of the others...Ask me anything....No question is too silly or unimportant, and I mean it!
    I never correct in front of anyone, including other staff nurses
    I also hate the "I know"... if you do..great, consider this a review...
    I explain that I may say "let me show you how I do this" that is a signal for later discussion.
    But newbies... I also tell my new nurses, "If you feel we have a personality conflict, or you are haveing trouble understanding my teaching methods TELL ME!!! Don't get upset, don't undermine me, and don't quit" I will gladly make sure you get hooked up with a preceptor you feel comfortable with.
    I will not take it personally... I will consider it a good thing that you recognize a potiental conflict. I WANT you to succeed, or I would not precept. So listen, participate, talk to me later, pull me aside....do anything
    Lets take care of patients!
  11. by   kadokin
    Yep, that's it: Arrogance. What frightens me more is when I see it in veteran nurses. They've been around long enough to KNOW they don't know it all. Yet, some of them persist in believing that they do. It can be frightening. But, I guess we're all human, aren't we. :spin:
  12. by   Heart4RN
    I'm starting my 3rd semester of a 2year ADN program and have been a medical assistant for 14 years, worked in medical office, clinic and hospital settings. I have seen the great communication between MD's, RN's, FNP's, PA's, CNA's, etc. and horrible communication too. It all boils down to COMMUNICATION! Doctors that have been practicing for 30 years discussing a patient or situation with another doctor that has been practicing out of residency for a year, nurses with nurses, doctors with nurses and vice versa. I've also seen the other aspect of it when the person gets their head bit off. Again, it all boils down to communication and not being afraid to ask the question. In this field we, meaning ALL medical professionals, are in a constant learning environment. You may learn something one day and the next day, or even the same day, it may change. That's why flexibility is a huge attribute in a person that chooses to go into this profession. This ability to discuss a patients condition or how to do a bed bath whether with your preceptor or, when on your own, another RN shows that you are open to new ideas and criticism if you will. I think I lost track of what I was saying but you get the jest of it.

    May God Bless!
  13. by   bradleau
    I precepted a new grad who truly needs help and does ask for it. She is now part of the regular staffing. Doctors handwriting is something we all have had and still have problems. At least she asks. When I was checking her off on TLC and PICC line draws, she would have been in a fix if I was not the extra pair of hands. I signed her off with the notation to have another RN with her during her next 3 times drawing labs from those lines. One problem ...she did not understand the need to wear gloves while doing it. But she did follow my instuctions and suggestions. And I did tell her that she will occassionally find a troublesome line....and call for help. You can not learn everything during orientation. She is one who realises this will be an ongoing learning on the job.

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