Staff shortages see junior nurses in leadership roles

Grace Oz · Oct 15, 2006

Hmmmmm, gives creedence to my steadfast opinion that hospital based training is the best way to go. Remember the days when we had Staff nurses? Remember the days when we had different levels of training, 1st year, 2nd year, 3rd year etc etc, and the more experienced mentored and helped the younger/newer nurses? Everyone worked as a team. Remember how cost effective it was to have many pay levels and it was fiscally managable to staff a hospital? I know this is sounding a bit like the song; "Remember the days in the old school yard ....." but nothing will ever convince me that today's way of training nurses really equips them for the real nursing workforce!

JMHO

Grace Oz · Oct 15, 2006

And, while we're at it, why don't we just permit a newly trained brain surgeon perform complicated surgery, because he's qualified to do so?!

A frivilous analogy I know, but you get the picture. It's fine to have the qualifications ........... it needs becking up with experience! Hence my earlier post re the staff nurses. They got be such only after several years of training and experience!

gwenith, BSN, RN · Oct 15, 2006

Grace - I keep thinking of the recent graduate who was "encouraged" to take on a remote hospital as DON (don't ask but there was lots of politics around it) 12 months later the hospital is being audited and he is on limited registration.

There are just so many pitfalls that even experienced RN's cannot avoid them all - hence the reluctance of those of us who know better to take on these jobs.

talaxandra · Oct 15, 2006

Dear NSW health department,

Clearly you think that the skilled nursing deficit is really a matter of numbers, and that a nurse is a nurse is a nurse. You can believe that putting a green graduate (even with a degree) in to key roles will work as well as having a nurse with years of experience. But even if you cross your fingers and wish really, really hard, it's just not so.

Love T

PS Dear ABC - why are you quoting the AMA? Are they more capable that the ANF of knowing what the effect of inexperienced nursing staff is?

Grace - I keep thinking of the recent graduate who was "encouraged" to take on a remote hospital as DON (don't ask but there was lots of politics around it) 12 months later the hospital is being audited and he is on limited registration.
There are just so many pitfalls that even experienced RN's cannot avoid them all - hence the reluctance of those of us who know better to take on these jobs.

Where to start? Forget the idiot/s who encouraged him to apply, and then gave him the job (not because they're forgivable but because they don't illustrate my point) - what does it say about the lack of a concept at least one recent graduate has about his skill level, the dearth of knowledge and experience he has, the demands of that level of position, the challenge of remote area nursing...

One of our grads this year (who is, I grant you, not typical) stated ten weeks into her grad year that she'd "learned everything there [was] to know" on my tertiary-level acute care multispecialty unit, and was ready to move to ICU. :uhoh21: Mm-hmm.

candysprinkles · Oct 16, 2006

experience counts definitely.

no matter how much theory and knowledge we've learned in uni...nothing beats experience really....and i've learned that...i couldn't imagine a new grad getting the "senior job"....(couldn't imagine myself, that's scary...:uhoh21: .)

gwenith, BSN, RN · Oct 17, 2006

Dear NSW health department,
Clearly you think that the skilled nursing deficit is really a matter of numbers, and that a nurse is a nurse is a nurse. You can believe that putting a green graduate (even with a degree) in to key roles will work as well as having a nurse with years of experience. But even if you cross your fingers and wish really, really hard, it's just not so.
Love T
PS Dear ABC - why are you quoting the AMA? Are they more capable that the ANF of knowing what the effect of inexperienced nursing staff is?

Yeah! I love that the AMA seems to have more credos than the ANF on issues - mind you at least the AMA IS speaking out on our behalf. I was pleasantly surprised recently to learn that NURSING figured as a standard in assessing units for medical training with the colleges. The college apparently objected to one team leader covering two units (small units that sit back to back). Nice to know that we do have back-up isn't it?

Where to start? Forget the idiot/s who encouraged him to apply, and then gave him the job (not because they're forgivable but because they don't illustrate my point) - what does it say about the lack of a concept at least one recent graduate has about his skill level, the dearth of knowledge and experience he has, the demands of that level of position, the challenge of remote area nursing...
One of our grads this year (who is, I grant you, not typical) stated ten weeks into her grad year that she'd "learned everything there [was] to know" on my tertiary-level acute care multispecialty unit, and was ready to move to ICU. :uhoh21: Mm-hmm.

Talaxandra one day I will post the story as I know it - frightening!! I was more or less involved as the blame was being flung around - they tried to blame me for the multiple problems at the hospital because I had travelled to that hopital to give one lecture (on CPR and cannulation) some 12 moths previously!!! (As I said very political and sadly the CEO at the centre of this disaster still works in a senior position in this state.)

As for the "gee this is boring I already know all there is to know" - well we have had a couple of grads like that (fortunately as you say they are a rare , rare breed) but at the time they were referring to ICU nursing!! Now perhaps I am a slow learner but I have been in this field some 20+ years and I still learn something new every single day.

bethem · Oct 17, 2006

I finish my degree in three weeks. There is NO way that I would be a competent, successful, reliable charge nurse at this time, or even in a year's time! It's downright scary. I'm just thinking of the ward where I work as an AIN. Some of those women have been nursing longer than I've been alive. It would be ludicrous to put me (or any other new grad) in a position of authority over them, even though those ladies have decided they don't want the hassle of being in charge. I wonder how the people saying that new grads are fine to be in these positions would feel if they were admitted to a ward where a new grad was in charge?

As to the "I know everything" new grads - hah! I know some very, very basic things from my degree. Truly, the day I find myself saying "I know everything about nursing", I'll quit. I don't expect that to happen. I think I'll retire before I 'know everything'. Wouldn't that be boring? I'd hate going to a job every day where I knew everything there was to know, and I was just doing the tasks I had to do. Shudder. Ah, those new grads are funny.

gwenith, BSN, RN · Oct 17, 2006

bethem - you just got voted as one of my favourite new grads!! Lesson 1 - never, ever be afraid to say "I don't know" or "I could learn more". There are toxic environments out there though that "disencourage" (is that even a word?) anyone from admitting that they do not know something. If you come across same recognise it, and if it is your first ward, work to get out of it. Such an environment is NOT the place for a new grad. We would go a long, long way toward solving some of the major problems facing health care if we could address this problem.

talaxandra · Oct 18, 2006

Um... discourage?!

The thing that cracked me up about our "yep, got it" grad's attitude is that I, who've been there about fourteen years learned something new the day before about my own specialty! And if you don't know whether ascites results from renal or hepatic failure then no, I don't think you're quite ready for ICU. (Clue: we're the renal unit. How many patients with ascites have you seen here?)

talaxandra · Oct 18, 2006

PS You're right, Gwenith - it is good to know that at least some in medicine are seeing that nursing has some impact on health care. Some of the students who rotate through my ward have elected to do a nursing shadow option for a couple of days - kudos to the curriculum coordinator and to those students :)

joannep · Oct 19, 2006

Well, I think putting younger people in charge is a reflection of two issues; firstly I agree the senior jobs are so demanding, often a combined CEO/Director of Nursing position (so they have saved money by combining two jobs into one); and secondly, younger, less experienced nurses are cheaper to hire and easier to intimidate by corporate.