Experienced Nurses Should Leave Legacies to New Nurses - pg.3 | allnurses

Experienced Nurses Should Leave Legacies to New Nurses - page 3

I have been a Registered Nurse for ten years. During these years, I've worked in many areas of nursing. My last position was Director of Nursing for Private Duty. I have attempted to mentor nursing... Read More

  1. Visit  studentdrtobe profile page
    0
    Quote from dudette10
    Someone mentioned upstream that residency programs are now the model of training RNs for a high level of care, but they fall short. Maybe the model needs to be rehauled. When a baby MD is trained, how often does he go "back to the classroom" for his training. NEVER! He is taught by doing, with multiple levels of practicing MD supervision.
    Actually, that's completely wrong.

    We "go back to the classroom" throughout residency training and beyond. During residency, we have mandatory conferences, grand rounds, journal clubs, and weekly didactics. Some residencies even have an entire day of the week dedicated solely to didactics and conferences. While, yes, it's not as much classroom learning as the first two years of med school, it's completely wrong to say that there's no classroom education beyond med school. Hard to keep up with changes in the basic sciences and mechanisms of pathophys/pharm/etc if you're only in the clinic doing hands-on work.
  2. Visit  RN58186 profile page
    4
    A number of years ago one of the RN's who oriented me to my first job retired. She was a wealth of knowledge and never too busy to answer a question. I remember looking at her on her last shift and saying "But you can't retire!! Who is going to teach the new nurses what they need to know?" She looked at me and laughed and said "It's like this. Jane taught me, I taught you. Guess what? Now it is your turn to teach the young ones." And so it continued. But that was years ago and so much has changed. The workload is horrendous, the demands have multiplied numerous times over. I don't work on an inpatient unit anymore, but I know the staff nurses don't have the time to teach the new nurses the way I was taught. I think that is sad really. I would not be the nurse I am today if it were not for the likes of those who came before me and shared what they knew with me. Things that I will never forget. I don't have the magic answer, but I wish I did.
    tewdles, SHGR, nursel56, and 1 other like this.
  3. Visit  Burn-Unit-RN profile page
    0
    I think that we all enter nursing for different reasons. The OP mentioned that it is his calling, which is very well may be. I will clarify for the OP that nursing is in fact a profession, however one of may have a calling into a profession. On my unit, I work with one nurse who was severely burned as a child and subsequently entered the nursing profession after the comfort and compassion she received from the nurses while recovering. The OP sounds like a very passionate and motivating nurse and as a new grad it would probably be a pleasure to learn from him.

    For those of you jumping down the OPs throat in stating that he would not consider it a calling if it were for minimum wage for free, that's not true. I volunteer on a homeless van 2 days per week which visits the poorest parts of the city to provide basic care for the homeless. I do not get paid for this. Could I pick up overtime at my job rather than do this? Yes. But I feel as though I have much to offer those who are not as lucky. Other nurses I work with volunteer in other respects. Just because you will not volunteer your knowledge and skills to those less fortunate does not mean others will not.

    As far as the points the OP is trying to make about new grad orientation, many of those ideas are skewed and idealized. When I started on my unit, it will difficult for the other nurses to help me while they were busy. Some of our full body wound care and dressing changes can take hours. When I have my own dressings as do the other nurses, we can't make more time out of a 12 hour shift for them to both help me and get their work done. However, it would be great to provide these lengthy 1:1 orientations, it's just not possible!!
  4. Visit  dudette10 profile page
    0
    Quote from studentdrtobe
    Actually, that's completely wrong.

    We "go back to the classroom" throughout residency training and beyond. During residency, we have mandatory conferences, grand rounds, journal clubs, and weekly didactics. Some residencies even have an entire day of the week dedicated solely to didactics and conferences. While, yes, it's not as much classroom learning as the first two years of med school, it's completely wrong to say that there's no classroom education beyond med school. Hard to keep up with changes in the basic sciences and mechanisms of pathophys/pharm/etc if you're only in the clinic doing hands-on work.
    Thank you for the correction. The didactics you speak of fall into my definition of "classroom," but the rest (except for journal clubs...not sure what that is) are expected of MDs throughout one's career.

    Our conferences of late consist of "customer service" programs. At my facility, nurse educators are holed up in their offices (doing what, I'm not sure...haven't seen one since orientation) except for a very good diabetic nurse educator who comes around quite often.

    The biggest point I was trying to make is your model of learning and the culture within the medical world that supports it. We don't have that consistently, and at some facilities, not at all.
  5. Visit  wooh profile page
    4
    Quote from dudette10
    Too many NMs feel that any nurse can precept without any reduction of workload or any special training.
    I've been told just to talk about what I'm doing as I do it. As if that takes no extra time.
    The ridiculous thing is, it's not just that we don't get a workload reduction for training. We'lll often get more work piled on because we have "help."
    tewdles, Hoozdo, DizzyLizzyNurse, and 1 other like this.
  6. Visit  nursel56 profile page
    2
    Quote from Burn-Unit-RN
    For those of you jumping down the OPs throat in stating that he would not consider it a calling if it were for minimum wage for free, that's not true. I volunteer on a homeless van 2 days per week which visits the poorest parts of the city to provide basic care for the homeless. I do not get paid for this.
    That's a wonderful thing to do, but I don't think we were talking about volunteering or giving back to the community. We were talking about doing a regular job that puts a roof over our heads and food on our table. Mixing those two things together sounds like an attempt to hint that people who rightfully expect a paycheck just aren't altruistic enough and that is not fair.

    I think you'll find it quite common that people enter nursing because of a transforming event they or a member of their family experienced. In my case it was the care my little brother received after he was was diagnosed with leukemia.
    Hoozdo and wooh like this.
  7. Visit  WildcatFanRN profile page
    1
    Quote from dudette10
    thank you for the correction. the didactics you speak of fall into my definition of "classroom," but the rest (except for journal clubs...not sure what that is) are expected of mds throughout one's career.

    our conferences of late consist of "customer service" programs. at my facility, nurse educators are holed up in their offices (doing what, i'm not sure...haven't seen one since orientation) except for a very good diabetic nurse educator who comes around quite often.

    the biggest point i was trying to make is your model of learning and the culture within the medical world that supports it. we don't have that consistently, and at some facilities, not at all.
    this model sounds good, but what hospital would be willing to put in that kind of educational support towards new nurses like they do for new md's? many places i've applied to tout the fact that they are teaching hospitals, meaning they have residencies for multiple medical specialties. some seem proud of the expertise and education they provide for their nursing staff as well as the baby docs, some not so much. i think it would be wonderful if hospitals were as eager to advertise how big their nurse residencies were as much as they are for their medical residencies. also, the baby docs have the support of thier profession.
    nursel56 likes this.
  8. Visit  nursel56 profile page
    5
    Medical education is so completely different. The strict pecking order involved there would have the "nursing eats it's young" people immobile with apoplexy.
    tewdles, RNsRWe, dudette10, and 2 others like this.
  9. Visit  wooh profile page
    3
    Quote from nursel56
    Medical education is so completely different. The strict pecking order involved there would have the "nursing eats it's young" people immobile with apoplexy.
    Goodness, can you imagine the NETY people going into the police force? "I have to walk a beat before I get to be a homicide detective????" Becoming an attorney? "They expect me to do document review before I get to sit first chair for a homicide?" (Yes, I watch too much L&O and only think about homicide. I especially think about homicide when I'm at work, is that bad?)
    Fiona59, DizzyLizzyNurse, and nursel56 like this.
  10. Visit  GinginRN profile page
    1
    I enjoy precepting others, however I do not feel everyone is cut out to precept. It takes patience, perseverence, and a good working knowledge base to be an effective teacher.
    Fiona59 likes this.
  11. Visit  studentdrtobe profile page
    0
    Quote from dudette10
    Thank you for the correction. The didactics you speak of fall into my definition of "classroom," but the rest (except for journal clubs...not sure what that is) are expected of MDs throughout one's career.
    It's where residents present articles and dissect them. Ex. the results of a large, potentially practice-changing clinical trial are published. A resident presents this data, along with a thorough background (which includes past clinical trials, retrospective studies, etc, and their pros/cons), the basic science mechanisms, their interpretation of the results, etc. And then, the presenting resident (and, often, the other trainees in attendance) are grilled with questions by the attendings (ex. "What would you do when a patient with XYZ comes in? Would you consider extrapolating data from this trial? What would your first step be? How would you proceed if the patient is refractory this your first-line treatment?", etc).

    It can be exciting, but downright scary! But, for the most part, they're very educational since it pretty much forces all the trainees to study so they don't look like fools in front of the entire department!

    Quote from dudette10
    The biggest point I was trying to make is your model of learning and the culture within the medical world that supports it. We don't have that consistently, and at some facilities, not at all.
    Yea, I agree with ya there. I love the medical education I've received so far and it has been, for the most part, very well-organized. We're incrementally given more and more autonomy as we progress through our training and show that our clinical decision-making is sound. As another poster mentioned though, there is a very rigid hierarchy in medicine and you have to conform to it. Attending > fellow > senior resident > junior resident > intern > med student. No ifs, ands, or buts. You have to put in the time and effort to work your way up the totem pole. You disagree, as an intern, with the treatment plan the attending decides on? Deal with it. Once you become a senior resident, you're much more likely to engage in academic discussions with the attending regarding the subtleties of patient care and convince them that your plan is just as good or better. The hierarchy is there as a way to provide appropriate level of supervision (based on where you are in terms of training) as well as being a net for catching mistakes.

    Additionally, residency spots get funding from Medicare. Not sure where the money comes/would come from for nursing residencies or whatever. And for more than a decade, Medicare funding for residency spots has essentially flat-lined.
  12. Visit  dudette10 profile page
    0
    Quote from nursel56
    Medical education is so completely different. The strict pecking order involved there would have the "nursing eats it's young" people immobile with apoplexy.
    Very true! Medicine and the military have a long history of hazing behavior. Nursing also does, to a certain extent.

    I think a modern nursing model similar to the traditional medical model could be created without the expectation of hazing behavior.
  13. Visit  dudette10 profile page
    1
    Quote from wooh
    (Yes, I watch too much L&O and only think about homicide. I especially think about homicide when I'm at work, is that bad?)
    Depends on your intended victims.
    wooh likes this.


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