Orienting a new hire - issues - page 3

by teleRN08 8,357 Views | 34 Comments

i am currently orienting a new hire rn. i work on a telemetry floor at a community hospital. the new hire is from a large magnet hospitals respiratory floor and has 4 years experience. i have oriented her two nights and the... Read More


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    Also, she may have felt overwhelmed and needed a break.

    Matching her with someone closer to her own age is a good idea.

    I get the feeling that you don't like her much
    Last edit by stargazer88 on Apr 28, '12 : Reason: to change wording
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    When people feel threatened, they sometimes get "defensive" She knows you have the power that could cost her her job.

    Have you ever thought about the way you communicate?
    Do you talk to people in their 40's the same as you talk to 20 somethings? Do you talk to this nurse as a peer or are you more formal?
    Where I work now there is a BIG communication gap between the older (paper age) vs younger (computer age) nurses. They just don't seem to see eye to eye. They don't like each other much and it shows.

    I also wonder why you are talking to "someone who knew her from nursing school" rather than just the manager?
    Where I come from, that's called gossip.
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    Quote from stargazer88
    when people feel threatened, they sometimes get "defensive" she knows you have the power that could cost her her job.

    have you ever thought about the way you communicate?
    do you talk to people in their 40's the same as you talk to 20 somethings? do you talk to this nurse as a peer or are you more formal?
    where i work now there is a big communication gap between the older (paper age) vs younger (computer age) nurses. they just don't seem to see eye to eye. they don't like each other much and it shows.

    i also wonder why you are talking to "someone who knew her from nursing school" rather than just the manager?
    where i come from, that's called gossip.
    this is not my first time precepting. i have had great experiences in the past. i do not talk to her any different than i talk to any other peer i work with. i am precepting her, but i am not following her every move. i have told her, "i'm your back up, if you need me." i do check her documentation etc because that is part of my job as the preceptor, to make sure she is doing things correctly per our policies, etc. she has the ability to do the nursing tasks just fine, that is not the problem in the slightest. my concern was taking a break when a patient obv needed medication and attitude. i just feel as though the manager should know if i sense an attitude on day two of my precepting of her. i spoke to the manager and she was glad that i went to her, which is why we are having a meeting to discuss how orientation is going. i am just looking for the best way to approach this situation in the meeting.

    she has been precepted by 3 other nurses, unfortunately, each nurse only had her one day. i spoke with one of the three and she did state she noticed an attitude but was unsure if it was a one day thing or not.

    i have a close friend that i have known for years who i knew went to nursing school with her. i did not gossip with her at all. i only stated i was precepting her and my friend starting telling me her opinion of her back then. i did not disclose how i felt about her at all. but it was helpful to know if this was a new thing or not.

    thanks for your thoughts though :spin:
    Last edit by teleRN08 on Apr 28, '12
    JetBlitz and Merlyn like this.
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    The meeting is not the time to be nice. It is the time to state your observations.

    It is surprising that previous posters bring up the age discrepancy issue. It is a moot point.

    I have 30 years of experience, as a traveler.. I listen.. and listen hard.. to my preceptor.
    If your orientee is faking answers to cardiac issues... she is not competent to do the job!!!
    And dangerous to boot.

    Saw that situation before. The new nurse couldn't even apply leads correctly.. yet was very vocal about how the floor should be ran. In this particular case, she ended up getting caught by a doctor for falsifying documentation on a tele strip.

    The doc had security open the shredder bin... voila.. there it was. That nurse ended up getting the option to resign or be fired.
    Bottom line, you have raised huge red flags.. after only a few days... these problems you identified are only the tip of that nasty iceberg.

    Good luck.
    canoehead, Merlyn, hiddencatRN, and 3 others like this.
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    I think the entire problem is FEAR.

    I too educate nurses and support staff; it's amazing how once you establish the expectations w/out the FEAR factor, things change.
    Altra likes this.
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    You need to unload this individual. She will leave as soon as she finds something else...that's the type of person she is. I cannot understand how these people go through nursing school and do not get found out by their clinical instructors. Unload her, fire her, do whatever it takes to get rid of her. She's a burden on everyone and probably gossips behind your back about you. We had someone like this on our unit who left after a few weeks. She was downright horrible in every way imaginable. Then, she did not tell anyone she left, just did not show back up. She was lazy and would sit all night reading her magazines and occasionally help a patient. Do your unit and the nursing world a favor and unload her, find a new GN/RN that's eager to learn and move on. She's not worth your kindness.
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    Been there and done that! After we were concerned about a new hire that wasn't doing well and was having a bad attitude when questioned, we started digging into her references, etc! Turns out her license was fake! I almost threw up! I cannot stress enough to make sure they have the proper credentials! Best of luck! Some people are just attitude ridden. If it makes it hard on the patients, she may not fit on your unit.
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    I also think your orientee is afraid. She may be feeling overwhelmed by some situations and instead of saying she doesn't know, she is giving the attitude. I also precepted many during my years of nursing. One thing that I did whenever precepting was have a one on one chat with my orientee and gave them my opinions of 1)you are doing great in your assessment skills, do you feel that there is anything that you could do better in? 2)Here is some things that you need to work on (give her a written down list that you saw from that day(s) of observation) examples- 1)prioritizing and give her some ideas on improving it. (such as patient safety) 3)let her know again that you are there to help her. Maybe give her info on the doctors that will help her communicate with them, give her pointers on what is expected on your unit. Lastly ask her how she learns best, such as hands on, or show me first. Sometimes it is a matter of how she learns. Just because she has been a nurse for 4 years does not mean that she knows how to take care of patients on a cardiac floor. She may have resp down pat and for the most part, it sounds like she does have the skills for assessment, etc. When she is not giving a correct answer to something she should know cardiac wise, I would wait and then take her aside and ask what her rationale was for her answer? Give her time to answer, and if she just brings attitude with you, remind her that you are there to help her and want to make sure she understands what supports that rationale and what doesn't. Its all a learning curve and sometimes its hard to get under that shell that they have arround them for fear of being totally wrong and embrassed. I am sure that all of us were precepted at one time or another and each of us more than likely tried to put the best foot forward and also stumbled a few times our selves. I truly feel that you should sit her down and let her know what you have observed. Making sure you are positive on what she does great at and what she isn't so great at.
    I know it seems silly but it works if you take the time to do this after each shift so its fresh. Writing it on paper helps them to see what the issues is, some suggestions to help, if its a policy thing, make sure she knows where and how to find the policy and procedure books so that she can look it up for your unit. If its a defiant type thing, just let her know that you are there to see her fall on her face but to make sure she doesn't and can handle everything and anything with dignaty.
    I did this on everything that I precepted someone and I let them know first thing in the moring that I was going to be reviewing her notes, talking with her patients (such as is she recieving good care, is she getting her needs met, etc..I also told them that after our shift was over the pros and cons that I see that needs work on, and gave praise for all the things they did right.
    My point is that the communication between the preceptor and the orientee should be after each shift so that the orientee knows what you expect them to work on the next time. Then ask her if you can buy her a pop or a cup of coffee and walk her to her locker.
    Since you have been with her, I would do just that and see how it goes that next day. Many nurses do put on a front when they have worked elsewear for 4 years. You just have to gently remind her that you are at such and such hospital and this is the way it is done here. Continue to bolster her unspoken need to feel comfortable in what she is doing, she will get there but not with only 4 days of orientation. She needs to stay on orientation until she gets it. Good luck to you both.
    teleRN08 and Hoozdo like this.
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    Any update on the situation?
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    There was a definite improvement the next night. She stated most of her defensiveness was her being "overtired." I spoke with the manager again and she stated she still planned on having her come off orientation after the next night and will have a meeting with her in a week or two.. We will see.. I still have concerns over this because her bad attitude did come out again on the last night of orientation. We shall see how things go now that she is off orientation. I'll update in a week or two again.
    hiddencatRN likes this.


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