Why Do I Care? - page 6
by Ruby Vee 20,121 Views | 109 Comments
Why do I care that new nurses leave our unit after less than two years -- often after less than one year? Why do I care, when they're adults. They're going to have to live with the consequences of being out of work, or having a... Read More
- 1Feb 2 by RNGriffinQuote from ThePrincessBrideWell, I'll rephrase that, your grandparents can't be from NYC. I have many family members out in Long Island & depending on where you were in the 30s-80s it was much worse than Brooklyn!Actually, my grandfather is from Long Island.
- 4Feb 2 by prnqdayQuote from RNGriffinPlease don't be sorry, because I'm not. That experience really helped me grow. I did defend myself and don't consider myself a victim at all. I just got tired of defending myself against childish behavior every single shift. Since then I've moved on, and I work in a better environment. We have a great retention rate and the morale on this unit is the best I've ever seen.I'm sorry this happened to you. But, I blame you for not advocating for yourself. If you couldn't tell the nurse who yelled at you to hurry while pulling your meds "I'm sorry but I am going to need some time to make sure my patients are safe", you won't be able to advocate for the patient with the physician.
I am certain you're experienced now. But, a lesson everyone can use is "You're only the victim to bullying if you allow yourself to be". I would have been more than happy to explain to my nurse manager why nurse dee didn't care for me, rather than I am quitting because of Nurse dee.
- 25Feb 2 by llg GuideMany of you have missed a key point in Ruby's series of posts. You are wrongly assuming that people are leaving her unit because of poor orientation, poor morale, bullying, etc. Her point is that an increasing percentage of new nurses have no intention of staying longer than a year or two no matter how wonderfully they are treated. A morale committee, etc. cannot solve that problem.
As someone who works with a lot of senior level nursing students and with hospital orientations ... I am seeing the same phenomena. The career plans of many new nurses involves "1 year at this first job ... then move on." That is causing a huge problem for the best hospitals/units who try to provide the support needed by new nurses. We don't have the resources to keep providing that much support to a constant flow of new folks. And that causes hardship to all involved and compromises the quality of patient care along with compromising the quality of the work experience.
That is why you see hospitals not hiring as many new grads as they used to. Is that what we want? Another possible solution is also being tried -- internships that pay extremely low rates to new grads until they are off orientation and pulling more of their own weight. Is that the solution we want to see? We need to discuss these things because they are the types of solutions that administrators have at their proposal. Higher pay, better schedules, easier work loads, will not solve this problem -- because. as Ruby is saying, those are not the reasons many people are leaving! (Sure, there are some terrible places to work and some people leave because of bullying, etc. ... but those are not the people we are talking about!)
- 3Feb 2 by dudette10Quote from Ruby VeeI wouldn't know. I'm not precepting a constant stream of new grads.Please -- if you have something to add about the subject of new nurses jumping ship immediately and how patient care is made potentially less safe, contribute it. I'd love to read it.
llg, your point is well taken. I too didn't take this as being a unit culture thing. I think Ruby has said before that her facility is well-known and attached to a major medical university. In my opinion, the resume boost that the ICU at her facility provides draws "stepping stone" nurses seeking to further their education. That is not something that can be changed, however, McLennan's post offers some concrete ways that the revolving door can be stopped. Hiring and interviewing practices need to be changed, and contracts need to be required. If the facility is such a high-profile, resume-boosting place to work (as I think it is), the contracts would not be a hindrance to recruiting good new grads. It might even make it more "exclusive" in that less openings would be available as people stay on to finish their contracts.
- 0Feb 2 by dudette10Quote from hey_suzIronically, there was an article on AN not too long ago that pretty much was disdainful of "hire for attitude, train for skill." I'll see if I can find it.One thing I have read recently (and I am not in a position to hire, fire, or anything like that) is: "hire for attitude, train for skill."
What I like about that is, as many of those responding here have brought out, is it brings out that if your intention is to leave in a year, or two years, why work in a place with such a long learning curve as ICU? A new hire should mesh with the culture where he or she is hired. Certainly, some people will leave after a short time due to other factors. By and large, however, people should be hired to fit into the unit.
ETA: I found it, but I don't know how to link the article to here. It's written by The Commuter, and it's called "Hard and Soft Skills." After re-reading it, I determined that my characterization of it as "disdainful" was colored by my impressions from The Commuter's other posts. In and of itself, it's not disdainful of the new approach to hiring.Last edit by dudette10 on Feb 2
- 1Feb 2 by canigraduateThanks, llg. I was thinking the same thing. My take is that people coming in and only staying a year is a trend that is not going to change, and is most likely going to increase.
Honestly, I have changed jobs twice in the past 6 months and it had nothing to do with the unit I was on and everything to do with outside events not related to my job. Try explaining that to a recruiter!
- 2Feb 2 by subeeThis ICU of Ruby's sounds way to intense for new grads. I was lucky enough to orient on a busy med-surg unit before ICUs fully bloomed. Every nurse who worked on that unit wanted to be a mentor to a new grad who ALL went through these precepted med-surg units before going to specialty units. In exchange for the high patient acuity (some on vents- no running water in 4 bed rooms)it felt better staffed because there were always orientees available who didn't count as staff members. Some of the floor RN's were working on MSN's (this was during the 70's) and WANTED to work with new grads. All this and I only stayed a year. It was two subways and a substantial walk. I left for a place four blocks from my apartment. Feeling very bad now 41 years later
- 8Feb 2 by libbyliberal(1) I stopped feeling a sense of commitment and loyalty to my employer when the defined benefit pension plan was eliminated.
There really is no incentive to stay in a position for the long haul anymore.
(2) I am tired of training graduate nurses who come in clueless and then act like the king of Siam after a year. I am tired of teaching what should be part of a basic nursing education and critical care nursing skills in six months or less.
(3) I deserve to be well compensated for having to monitor and try to educate a novice nurse in addition to a full assignment.
(4) I will no longer invest my effort and knowledge in a trainee who is too lazy to look up a med or procedure. I am so over it.
(5) Frankly, all I care about is my patients' outcomes and not getting my ass sued.