Why Do I Care? - page 6
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... Read More
1Feb 2, '14 by prnqday, BSN, RNQuote from llgAgreed. I can see why this is so frustrating for seasoned nurses. I too, have been a preceptor and it does add quite a bit of stress. Ruby has been doing this for 30 plus years and you're right, change is easier said then done. My question is, should she start looking for a new career opportunity because it seems as though she is simply burnt out. I would be to after working over 30 years.That's a lot easier said than done. Changing the traditions of a profession are a lot harder than you may think. I am sure that Ruby has discussed these issues with her leadership teams. Everyone has. There are conversations going on about this topic all over the country. The problem is, the only solutions that people have found have been unpleasant and a bit controversial -- (1) Hire as few new grads as possible: (2) Require contracts in exchange for new grad orientations: and (3) Pay new grads very minimal salaries for the first several months to reduce their training costs.
6Feb 2, '14 by ProgressiveActivist"And then someone calls us mean and nasty, implies that we're just jealous of opportunities we haven't grasped for ourselves or says that the only reason we're against job hopping is because we're old dinosaurs who don't want anyone to have things better than we did. I have the job I wanted -- my dreaaaaaammmmm job. I'm happy with my life, with my job, with my colleagues. I'm exactly where I want to be. But I sure wish a few others would look a little harder, see what a great job this is and what a great place to work and stay awhile! "
(RVee's original post)
Burn out? I think not. But I wonder just how many people like you she taught how to function as a nurse. How about a little respect for the expert nurses who actually care about this profession?
10Feb 2, '14 by wannabecnl, MSNNursing is a profession with ill-defined pathways. I have read all these posts, and what I have gleaned is this: you are always going to have turnover, although for a variety of reasons.
1. Anyone who wants to be a CRNA has to work a certain amount of time (2 years, I believe) in the ICU in order to apply to CRNA school. That is an absolute requirement. If someone wants to go that route, what are they supposed to do--lie in their interview? Stay longer and prolong their education? I agree that this wastes resources training them as ICU nurses, but it is really their only option. Perhaps CRNA programs need to incorporate ICU training into the first few years so that the expectation of the unit hiring the CRNA-bound new grad is correct.
2. I've posted about this before, but while I disagree with med-surg being treated like nursing purgatory, it is a fact that a year or so of med-surg opens the door to other jobs within an acute care hospital. It just is. Again, make the pathways clearer, so that someone who actually wants to work in the ED/OB/whatever can just start there rather than wasting time and money training in med-surg and then leaving. OR, decide that all specialties require a year or two of med-surg, no exceptions, and then staff your med-surg depts to handle the training. It's like medical residency, or it should be.
3. Sometimes it's just a bad fit. I had this happen to me. My exit was precipitated by a life event, but truthfully, I was counting down the year from day one. What could have prevented it? I should have shadowed in the department before accepting the job; I would have seen immediately that it was not for me. I will never again consider a job without shadowing in the department; I even shadowed in my current department after having been there for clinical! Anyway, at the old job, I was willing to stick it out for a year, but that was probably as long as I would have lasted. Fair to the department? Maybe not, but how long do you want someone miserable working for you? In any event, I left before I cost them very much money, and it was a good outcome for everyone.
4. As I mentioned in 3, sometimes things just happen. We've gotten ICU nurses in our PACU because they just couldn't do the 12-hour shifts anymore. People leave our unit because they don't want to take call with little kids, childcare issues, etc. I left that old job because I had a family emergency that wasn't getting addressed because I was at work all the time. Yes, I am still a newish hire and I LOVE my job and have no plans to leave, but if something MAJOR happened with my family that necessitated a change, you bet I'd leave.
On a side note, please don't assume that all older new nurses are in it for the income. I make less now than I did in my first computer training job in 1993, and I LOVE what I am doing. If I wanted a desk job or a high income, I would have stayed in IT. Every day I get to look someone in the eye, put a hand on their shoulder, and tell them that they are through surgery and I'm going to take care of them while they recover. And then I get to do that, over and over. I wouldn't go back to my old job for one minute. I may be the exception, but I'm not the only one. Please don't give up on us old newbies!
1Feb 3, '14 by ProgressiveActivistQuote from prnqdayNice. How many times have you called a Rapid Response because your LPN/ADN education did not prepare you to stabilize a patient? How many times have you called for an ICU nurse to start an IV or read your EKG, run a stroke code or transfer your septic hypotensive pt or mix and bolus streptokinase and titrate Nipride Diltiazem Vasopressin Levophed and all while preparing for intubation and pushing sedation and paralytics and preparing for line insertion? Who responds first to your codes? You are so qualified to tell an experienced nurse how to manage the lack of a stable ICU staff! The next time that you need help, I suggest you just tell the expert nurse with legitimate concerns about competent and stable staffing that she can put up or shut up or start looking for a new job. I want to be there when she puts you in your place.If this is the case, then Ruby should discuss this with HR, her NM or whoever else will listen. Perhaps she can help develop a new interview process to help weed out applicants that have no intention of staying at the bedside for longer than a year.
Truth is, many nurses ( old and young), have no plans for staying in the bedside. I became a nurse at 20 and I'm now 25 years old and I honestly can say that I love being a bedside nurse. I have no plans of advancing my education other than getting a BSN to keep my bedside nurse job. Unfortunately, others nurses use the ICU as a stepping stone for their career advancement. This is NEVER change and will only get worse. Either Ruby can become part of the solution or she can continue working there under the current circumstances and "venting" on allnurses.com. I guess she can also start looking for a new job out of bedside. My point is, she has options. Once she gets sick and tired of being sick of tired of being a preceptor every six months then maybe she'll make a decision. Either she will continue to put up or shut up.
Yeah your facility should have an ICU of ADN graduates with 2 years of M/S and no ICU experience and no preceptors. Great idea.
0Feb 3, '14 by Ruby Vee, BSN, RNQuote from madwife2002Other than for the writer's initial shock at the concept, I don't think the article was disdainful of hiring for attitude, training for skill. I'll have to go back and read the whole thread.
7Feb 3, '14 by kungpoopandaCan somebody please explain what is so contemptible about wanting a well paid job? I see so many posts lamenting "They are only in it for the moneeeeeey". Is it so unreasonable to expect decent remuneration?
4Feb 3, '14 by LadyFree28, BSN, RNQuote from kungpoopandaIt is the fact they want money WITHOUT the work; everybody knows that we are NOT in this business for free.Can somebody please explain what is so contemptible about wanting a well paid job? I see so many posts lamenting "They are only in it for the moneeeeeey". Is it so unreasonable to expect decent remuneration?
1Feb 3, '14 by KCCO RNQuote from christina891As a New Grad seeking employment for almost 9 months now, I couldn't imagine turning down ANY kind of opportunity like that regardless of the circumstances, where I live it is beyond tough to find a job. I will be so grateful when I get an opportunity like that, I could definitely understand where your frustrations are coming from!
If you have been searching for a nursing position for 9 months then something is wrong. There are thousands and thousands of nursing positions needed to be filled across the country. If you really want a job in nursing you need to go out and get it or have someone look at your resume.
4Feb 3, '14 by BrandonLPN, LPNQuote from KCCO RNI think it really depends on your location.If you have been searching for a nursing position for 9 months then something is wrong. There are thousands and thousands of nursing positions needed to be filled across the country. If you really want a job in nursing you need to go out and get it or have someone look at your resume.
Nursing jobs are pretty easy to find in my neck of the woods, but I hear states like California this isn't the case.
2Feb 3, '14 by SHGR, MSN, RNQuote from Ruby VeeRubyVee, I did go back to read TheCommuter's Hard and Soft Skills article and I think you are correct-her initial reaction to the concept was surprise, but she seems to have agreed with it after hearing him out. But the crux of the matter is this:Other than for the writer's initial shock at the concept, I don't think the article was disdainful of hiring for attitude, training for skill. I'll have to go back and read the whole thread.
Quote from TheCommuterThat is not saying, either, that every nurse is going to thrive in the ICU or another high-tech environment, or that every nurse's skill set is the same. (I like to say that nursing is big enough for all of us, at least interest- and skill-wise). What it is saying, though, is that the hard skills/tasks are taught in nursing school and then polished and added to on the job, in whatever setting the nurse is hired...employees can be trained to perform the hard skills, but the soft skills come from within. For instance, an organization can easily teach someone to apply a wound vac machine, but they cannot train this same nurse to have empathy for others, communicate effectively, or change the selfish personality that she has displayed since middle childhood.
Soft skills are important enough to make or break a person's career because, although a pleasant person can thrive in the workplace without a high intelligence level, a very intelligent individual with hard skills will struggle in his or her professional life without polished soft skills.
Quote from TheCommuterI can't agree with this more. Bad attitudes are far more contagious than good ones. A once-good workplace that becomes toxic is difficult to turn around again.Soft skills are comprised of the personality traits, positivity, cordiality, work ethic, dependability, workplace etiquette, behavioral competence, emotional intelligence, reliability, communication style, personal habits, optimistic attitude, interaction, and unspoken social graces that come together to render someone a desirable employee.
8Feb 3, '14 by Marshall1Where I live it is not unusual for new grads to be looking for jobs for months up to or over a year. Most facilities around this area will no hire new grads. Period. Relocating, as some have pointed out, is not always an option.
As far as nurses leaving jobs w/in a short period of time, again, I can only reference the area where I live but most nurses end up leaving because what they were promised/agreed to (certain shift, pay, whatever) often ends up being changed. That is the #1 complaint I hear and why many resign or end up quitting. Right or wrong, not everyone who became a nurse was "born" to be one or is willing to put nursing before anything else in their lives - I like nursing, have been in it a long time, have my BSN and an MS and enjoy working BUT work will never be #1 for me - it's a part of my life but not my life. I would rather live modestly then spend endless hours at work, rarely seeing my family or being able to enjoy life a little. For me, life is too short to dedicate myself to an employer above all else. I don't begrudge those that do - it's their choice - but don't judge me if I don't feel the same.
Nurses also leave because they realize their dream of working ER, ICU, med/surg whatever is a lot different in reality than the fantasy they had or what they experienced when in nursing school. It's better nurse realize he/she is in over his/her head or simply knows the flavor of nursing they are in is not for them and move onto something that is more along their interest lines and free up a position for someone else. I work in home health..someone I work with recently (last 6 months) came on board. This nurse worked for the previous 11 yrs in a doctors office..she is overwhelmed and extremely stressed out by home health, the charting system, ever changing schedule, and more. Do I think she will last? No. It's not because she is a lousy, job hopping nurse, it's because this area of nursing doesn't fit w/her needs/personality/abilities..she was mislead by a few people early on that home health is easy and your days are short, you are kept close to your home as far as traveling, no weekends, no call.. she has learned its the opposite of all that.
I don't know what the answer is but I know that if she decides to leave, even though I spent some time training her, I won't take it personal or wish her ill will. People leaving jobs - even after short periods of time - is the norm now - like it or not.
2Feb 3, '14 by RNfasterIf particular organizations or particular units cannot keep nurses, management should examine the situation (truly anonymous surveys) and implement a retention plan (internal growth opportunities, better pay, better retirement options, better access to equipment/supplies, better scheduling, better staffing, better training).
I think it is unwise for any nurse, new grad, or not, to stay put when there are better situations to be had. By leaving my first two employers after less than a year each, I settled into a good situation where I have stayed put. Each time, I increased my salary (the last move increased it over 25 percent), benefits, and work environment (support, supplies, ethics).
I left unsafe places that poorly staffed, lacked supplies, and also pushed nurses to do unethical behavior (e.g., work off the clock, write physician orders without disturbing the physician), etc. I was shocked to see how many nurses at my first two work places found the situations acceptable.
I don't think high turnover can just be blamed on a "lazy" generation of nurses, etc.
I also found it interesting to learn (from this board) that the original Baylor plan was for two 12s - Sat and Sun - to be paid as full-time. I don't think - with the current economy - that we will see that any time soon, but I do think that nurses, by voting with their feet, can cause employers to rethink how they might increase retention.
0Feb 3, '14 by whichone'spinkWow, I would love a Baylor plan at my job. The closest thing I have is plain weekend status, 3 days a week. Which is full time, but oh to just work 2 12 hour shifts on Saturday and Sunday and still be considered full time, would be awesome.