New nurse and feeling discouraged by older nurses?

[x28y31]

Hello everyone. I am a new nurse (about3.5 months). I know I am only considered a "newby", and a lot of the more experienced nurses may not feel like I know anything. I, myself, can admit that I know almost nothing and am still learning each and every day I am at work.

I love my job. I love working with my patients and learning more about their diseases and seeing their progress throughout their stay at the hospital. Throughout my 3.5 months at my job, I've definitely made some mistakes. I have let a patient's sats get down below 70 once. I learned to never let that happen again, should it get below 85, alert respiratory immediately. Learned my lesson, and I was grateful for it. The charge nurse that day pulled me aside privately and very nicely have me a teaching moment on it. There have been other instances where I have made a mistake (such as not documenting a temperature -- in order to justify blood cultures), and the charge nurse stated it was a teaching moment, and to take it as such. Again, I am very grateful for these moments. I am a new nurse, still learning...still very eager to learn and to do right by my patients.

Today, I went to work and I always go to work with a smile on my face. Like I said, I love my job. I worked with another nurse (older and more experienced), and a charge nurse (also older and experienced). I was discharging a patient, but prescriptions weren't filled out. The charge nurse told me to ask my patients about what they needed and I did, I got the patient discharged successfully. But it seemed like the charge nurse was upset with me. The patient needed a prescription for a blood thinner, and the charge nurse asked me what the blood thinner was for. I did not know off the top of my head (my fault, I should have known), and I told her I assumed it was because of a knee operation (I know, in nursing there should be no assumptions...but I was trying to do the best I could). I did not truly know how to find out why the pt was on that medication. And instead of helping me figure it out, the charge nurse looked at me with an amused and belittling expression on her face and basically ignored me.

The other older nurse then got onto me, because I had filled out discharge instructions on her patient. I had her patient the day before, and they had already had orders for discharge and I went ahead and filled out their papers. The nurse was upset because I had added on too many education leaflets about his medications. She asked me what was up with that, and I truthfully stated that I was told by another preceptor when I was orienting that if a patient were discharged home, to add all the medications leaflets to their discharge packet. The packet usually comes out to be about 60 pages long. A lot. But it was what I was taught. The nurse told me, "Well that doesn't make any sense. You're supposed to educate your patient about their meds and see specifically what meds they need leaflets for. Not ALL of them". Mind, she said it in a very condescending tone. And then her, and the charge nurse looked at each other, in a weird "this girl doesn't know what she's doing " sort of way, and I am pretty sure the charge nurse said something about me quietly....basically right in front of my face. I then saw the two of them gossiping at the desk, and I am positive I heard them whispiering about me.

Then I was giving report to the older nurse because we were low on patients, and I was PRN and sent home early. I gave the best report I could on her. I did not have time to look over patient history, so I went off what I got from report from the night nurse. One patient was reported to me to have had an MVA and TBI. I reported as such to the older nurse. I went to the desk to pick up my bags and I heard the charge give an annoyed face at me and tell the older nurse "That's not right. Scratch it off, he did not have an MVA. She doesn't know what she's talking about."

I left work in tears. I am a new nurse, and I try so hard to do well at my job. This is the first really bad day I have had. I have had othe rbad days, but today I truly felt like these nurses were almost ganging up on me. I do not mind constructive criticism. Like I said, I am a new nurse...I need it. But what I don't need is people talking behind my bad and gossiping about how I don't know what I am doing. I feel utterly discouraged, and I really hope this doesn't get to where I may lose my job. Even though today was a bad day, I still learned some things...I just wish they were conveyed to me in a more respectful manner, instead of having two nurses basically tell me I don't know how to do my job and gossip about me behind my back.

I know this type of stuff is actually pretty common in nursing. But any advice out there? Is my job in jeopardy? Should I try to talk to anyone higher up about this, or should I just take it as a lesson learned? I have not had any problems with any other charge nurse or nurse. Just these two ladies today, and I am almost confused as to why the work environment was so toxic today....Any advice would be helpful! Thank you so much in advance!

[SmilingBluEyes]

PS: get over the ageism fast or you will have problems. The "old" nurses, needing to work because retirement plans have been virtually torn apart, in many cases, are NOT going ANYWHERE any time soon, as they have no choice. Personally, I would love to hand the baton off to the younger ones, but I still have to work to pay bills and raise my teen daughter.( I would love nothing better than to retire and play and travel, not have to work).

[NICU Guy, BSN, RN]

Everything you're saying is correct, but as newbie yourself, perhaps you should reconsider the scolding tone.

There is a big difference between what she needs to learn as a new nurse and what skills she should have brought with her from nursing school. Like I said in my post, we were expected to know the pertinent info on our patient and as the clinicals progressed, we became quicker at finding what we needed to know before taking care of the patient ( I know she has 4-6 patients and may not have much time to review the charts, but that is the whole point of increasing your skill before graduating). We also had a graded head to toe assessment on a patient during clinicals. Maybe my experience was different and my instructor had the opportunity to teach us the skills that every new grad should know upon graduation. I just think that the older nurses were expecting a certain level of skills from her rather than bullying her.

[VANurse2010]

There is a big difference between what she needs to learn as a new nurse and what skills she should have brought with her from nursing school. Like I said in my post, we were expected to know the pertinent info on our patient and as the clinicals progressed, we became quicker at finding what we needed to know before taking care of the patient ( I know she has 4-6 patients and may not have much time to review the charts, but that is the whole point of increasing your skill before graduating). We also had a graded head to toe assessment on a patient during clinicals. Maybe my experience was different and my instructor had the opportunity to teach us the skills that every new grad should know upon graduation. I just think that the older nurses were expecting a certain level of skills from her rather than bullying her.

I have no issue with that, but the particular tack you took with her was very inappropriate. If/when you start precepting and start to deal with newbies, I would reconsider my approach because you will fail at it if you go about it as you've done here.

Also - the graded head-to-toes are nothing special - that's just about every nursing program in existence.

[Karou]

OP, I know you said you have been a nurse for 3.5 months, long have you been working?

I think a lot of your examples stem from a lack of time management, which will improve the longer you work. I remember when I first started I was so frantic at times that just making sure I administered all medications, did my assessments, and charted felt like I was asking for a miracle. There were occasions when I did not know why a patient was on particular medication (especially if it was only given on a different shift), and there are still times when I do not know my patients complete full medical history. Knowing this information gets easier the more you practice because you are able to look up this information faster and manage your time better.

You have made some typical newbie mistakes. Most of us did when we were new. I would advise you to work on time management. If possible, could you come in fifteen minutes early to look up health history and medications for your patients? If not then you should set aside 10-15 minutes at the start of shift to do this.

I didn't get ageism from the OP's post. I read it as she felt frustrated with herself (understandable to me) and felt like the more experienced nurses were giving her a hard time. I didn't get NETY from her post. But that's just my interpretation.

OP, these colleagues aren't out to get you. What you have described is a fairly normal culture for a unit. Suck it up, continue to smile, and do your very best. The respect of your peers will come with time as you prove yourself to be a competent nurse. Instead of letting your feelings get hurt or taking it personally, use it as constructive criticism. People will talk... They always do. If I knew half the things that were probably said about me when I started, I would be so embarrassed and red I wouldn't be able to show my face at work again.

[Karou]

Also never be afraid to say "I don't know, however I will find out and get back to you"

I don't mind if someone doesn't know, I do get somewhat cranky when its clear they don't know and fumble their way through it putting a patient at risk due to their knowledge deficit

This! OP, instead of saying, "I don't know", try saying, "I don't know, but I will look it up right now and find out". It is okay to admit to not knowing something. Just make sure you find out the answer, or at least try.

[OCNRN63, RN]

I get so sick of these posts where the OP blames all of her work problems on older nurses. Older nurses this, older nurses that. The problems with the new nurse's practice get glossed over because the real problem is these mean older nurses, not the new nurse being almost reckless in her practice.

Instead of complaining about the "older" nurses being mean, try listening to what they say, thank them for their input/suggestions, and try applying what they're teaching you. Do some reading when you get home; you can't learn this job just by going to work.

Oh, and this whole bit about "older" nurses? You're going to be one yourself some day, and along will come a young nurse who criticizes everything about you, with the emphasis on your age. I wonder how you'll feel when that happens.

[BostonFNP, APRN]

Why is your patient on an anticoagulant? For thromboembolism prophylaxis.

Learn to give the answer you know

Sent from my iPhone.

[BlueDevil, DNP]

I think everyone covered most of it well. New people are learning. No big deal. However, when you give false information in report for whatever reason, expect to be called out on it. I wouldn't have said it the passive aggressive 3rd party comment as that nurse did, I'd have said it directly to you. There really isn't any excuse for that. But you have lived through the ordeal and learned from it I trust. Take the understanding derived from the experience and put the rest behind you.

Good luck youngin'

[icuRNmaggie, BSN, RN]

chin up x28y31. You had a bad day, but you learned a few things, such as how not to speak to people. Your charge nurse was rude; she could have just said thanks for being honest but you really need to go look it up. Condescension is never acceptable in a professional work environment. Don't be that person.. I have always said that I would hate to be thought of as unapproachable or that someone would be afraid to ask me a question. Find someone who is a resource and who has her head on straight. If the CN does it again give it right back, thanks Sally, you're a real supporter. You don't have to take that stuff from her or anybody else.

See each patient as a learning opportunity. Look up meds and unfamiliar terminology. Pretty soon you will see the same old same old over and over and you will know exactly what to do. Your confidence will grow in time. Someday you are going to read this and say I shouldnt have let them get to me like that.

You can post questions and scenarios here anytime.

No one will ever fault you for calling a rapid response if your patient is in trouble. No one.

[NightOwl0624]

I've been a nurse for a little over five years now. I remember vividly my first days, feeling completely incompetent, and feeling like everyone around me must think I'm horrible. I have felt overwhelmed and very alone. I made a lot of those kinds of mistakes, and also tried to learn from them.

Now that I have 5 years under my belt, often times at work I AM the "older" nurse with "experience". I try to treat our new nurse with courtesy and respect, but I have become weary by the never-ending parade of new grads that cycle through our unit. It is exhausting!

So some thoughts from someone right in the middle:

Remember that the real world is nothing like the "nursing school world". You won't always have a complete handle on all of your patients, and it may or may not be your fault. You could get a crappy report, have admissions come at the start of your shift, have a patient go bad, and you may not have had the luxury of having 15 minutes to review the chart and orders before the $$$$ hits the fan! Do your best to stay focused and prioritize. Don't get defensive, if you don't know the answer to something look it up! If you don't know where to find the information, ASK! If you find yourself drowning, get help! Don't be afraid to call the charge nurse or call a rapid response when necessary. They are (supposed to be) there for a reason!

Be kind to yourself. You will make mistakes, you will learn from them. Every single nurse has gone through it, there is no escaping it!

Try to find a "older", "experienced" nurse that you trust to help you out. Don't assume that they are just being mean, they may be just as frustrated as you are - and may be frustrated with things that have nothing to do with you! When you do ask questions, listen carefully to their answer. If you disagree, say so (respectfully) and have a conversation. You can learn a lot, and they can actually learn from you, too! (Just don't assume you know more because you just passed the NCLEX)

I wish there were more experienced nurses where I work - I still need reinforcement and feedback, and I still have lots of questions.

Good luck! It really does take about a year, try to make the best of it!