The Respect You Get

Ruby Vee, BSN

It's that time of year again. New nurses have started their first jobs and are experiencing the culture shock as they transition from student to nurse. Many of them complain that they are not getting the respect they deserve from their new colleagues. (Many of them complain about the respect they're not GETTING while being disrespectful of those same new colleagues, but that is the subject for another post.)

When a new grad starts in our unit, most of us our looking forward to the time when they're off orientation, a full member of the team and can help relieve some of the staffing crunch. When we meet a new grad, the default is respect. Here's someone that graduated from an accredited school of nursing -- and we all know what hard work that is -- and passed the licensing exam. They've been through the interview process and impressed our management team enough to offer them a job, and they've chosen to work with us. What is not to respect?

Almost without exception, the new grad who is not respected is one who has proven she doesn't deserve our respect. What do I mean, you ask?

Timothy was an orientee who was passed to me because he just couldn't get along with his preceptor. He had a very high opinion of himself, and had an extremely high confidence level. Such confidence in himself was really not justified. He had already failed the rhythm test and the vasoactive drip test and because I have a reputation as a good teacher, I was asked to step in. Timothy didn't pass the exams because he wouldn't study. "I'm through with school," he said. "I don't have to do that anymore." Instead, he expected me to spoon feed him the answers to the test questions so he could pass on his third try, and he wanted me to do that during the course of our busy shift caring for patients. He had no interest in UNDERSTANDING the rhythms or the vasoactive drips. He just wanted to pass the tests so he could "rock the ICU" with his awesomeness. He was fired four months in to a six month orientation because after four months caring for CTICU patients, most of whom had Swans, he could not identify that yellow thing coming out of her neck nor describe what is was used for. Timothy lost the respect of his first preceptor on the first day on the unit, when he told her she looked old and ought to retire. He lost my respect when he told me he wasn't going to study, and he lost the respect of the CNAs when he described them as "beneath him."

Inez started with the default level of respect. English was her second (or seventh) language, and she had some communication difficulties. Her charting was sometimes unintentionally hilarious. Our respect for her started ratcheting upward when she admitted that she was having difficulty with charting, asked for help with specific issues and began running her charting past her preceptors before putting it into the EMR. Very quickly we could see that she had a good grasp of the disease processes, the surgery involved, the drugs we used and the lab results. She learned from each mistake and never made the same one twice. Long before she finished orientation, even seasoned nurses were impressed with Inez's work and her attention to detail. When we discovered a charting blooper (the only kind of mistake she ever made), she'd laugh with us and then we'd correct the mistake together. Inez earned respect. Timothy threw it away.

The new grad who makes an error, admits it, and then sets about to correct it or mitigate the consequences to our patient earns our respect. The new grad who won't admit to a mistake, blames others for the mistake, justifies it or covers it up loses our respect. The new grad who doesn't understand something but who works hard to figure it out earns our respect. The one who won't ask the question loses it. The new grad who cheerfully greets housekeeping each morning and knows the names of the CNA's children earns our respect. The one who doesn't want to. Wipe blood off the floor or say hello to the housekeeper or CNA because "I'm the nurse and they're below me" loses it.

Some new nurses worked their way through school; others have never held a job. In most cases, they've never worked a REAL job before, and there may be things about the workplace and workplace relationships that they don't understand. We get that. But someone who is rude to other disciplines most likely will not be respected as much as they think they deserve. In most cases, when newbies aren't liked or aren't respected, it's not because of bullies in the workplace; it's because they have failed to understand and practice the basics of work place relationships. Many of us COBs have been in that position ourselves. AN is a wonderful place where you can bring that sort of problem to the forum and get real answers and good advice -- you just have to be willing to "hear it."

The Respect You Get

About Ruby Vee, BSN

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