This "us" vs "them" mentality....

Nurses Relations

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I've been reading through the posts from the last few days, and I'm completely astonished by the "us" vs "them" mentality that is showing up between the nursing students and the staff nurses.

Maybe I'm idealistic, but shouldn't we be trying to work as cohesively as possible so that we can combine forces and provide the best care possible for our patients? It seems to me like we're both equally to blame for the issues that seem to be going on. On one hand, it seems like nursing students need to be more willing to contribute and gain some perspective, realizing that while the staff nurse should *try* to teach us, it isn't their main focus. On the other hand, it seems like a lot of staff nurses are going into clinical situations with a negative attitude about working with students, which I really think can only make matters worse.

Can we really care for patients effectively if we're not on the same page and being professional to each other? I personally don't think so. I think that in any customer service business, having issues behind the scenes like this WILL impact the patient. And I'm so tired of all the finger pointing, because both sides are making mistakes. As a student, I am more than willing to admit that I have been less than enthusiastic when asked to perform something I've done a million times. It happens, and when I realize I've done it I try to change my attitude and do better next time.

Instead of all this negativity, why can't we just try to learn from each other, and accept and navigate the limitations of the time together? Students can learn SO much from staff nurses, and (believe it or not) once in a while a staff nurse can learn a new thing from a student. If we can accept that we're all (hopefully) intelligent individuals united in the fact that we chose nursing to help the patients, and see each other as imperfect people who face constrictions based on our role, it seems like everything would go more smoothly.

I know that it's not all nurses and students that are acting this way....it's just incredibly discouraging to see such a lack of teamwork from the members of this community. At the end of the day, all the students of today will be your coworkers soon, staff nurses. And students, soon we'll all have students that stress us out and make more work for us. Can't we accept that and learn from each other?

Sorry for the ranting....I guess my point is this:

Let's meet halfway.

Students: The nurses are stressed out and busy. Try to help. Ask what THEY want you to do. Tell them that you understand they are busy, but that you would appreciate anything they can teach you. SAY THANK YOU. Realize that it's about the patient. If that means that you miss getting to d/c a central line, there is always next time. If it means that you have to help out what with ADLS, I/Os, etc...realize that you WILL learn from that as well. Be grateful for the opportunity to learn anything you can, and always try to be understanding.

Nurses: Realize that a lot of students *do* realize that you don't want us around. We know that it's not your choice to have a student, but realize that we're not there to ruin your day. Realize that most students want to learn from you and value/idolize how much you know. We're sorry that we're often thought of as an annoyance or an extra task, because all we want is to learn from you so that we can care for our pts as well as you do.

Communicate with us. Today, I worked with a nurse who had 2 pts and was getting her 3 admits all at once. All it took was her saying to me "hey, I'm super busy right now. Can you keep an eye on pt 1 and 2 while I admit these new pts? I'll come find you when it calms down or if there is something I think you could really learn from". Seriously, 3 sentences and I was able to feel like I was helping and not simply being ignored. I don't care how busy you are, but communicating with your team (and a student is a part of that team) is such a priority.

Like I said, maybe I'm just idealistic. But from my experience with other jobs and life in general, if we can just take a deep breath and do our best to make the "behind the scenes" dynamics positive, it will help our patients. Because at the end of the day, that's what ALL of us really want, right?

Specializes in FNP.
But what if it's their dReAm to tAkE cArE oF pEoPlE????

They can work in customer service at Piggly Wiggly. Those customers need "taking care of" and these days it is not much different, lol. If it is really health care they want, they can do customer service at CVS or Walgreens. He//, they will have the last laugh, b/c there is little poop (I won't say no poop, b/c you never know) involved. ;)

In all seriousness, Nursing has got to stop accepting the lowest common denominator into our ranks. It is embarrassing.

And all this, because our society tells us "we can be whatever we want to be". The generation that was treated with kid-gloves is growing up in a time of recession and massive unemployment. A time where you can't be whatever you want to be.

:up::yeah:

Specializes in FNP.
Linear Thinker says," the reason nursing isn't respected is" ; my question for him/ her is, isn't respected by whom? That is a massive generalization.

By people whom don't respect nurses. :uhoh3:

Specializes in FNP.

Dudette, I skipped pages 2-8, but I didn't see anyone saying they knew it all on day 1. If anyone said that, I think they are misremembering the facts. ;) In any event, you are I are not talking about the same thing at all. I am venting about the apparently incredibly low standards for being accepted to and graduating from a nursing program and passing NCLEX these days.

I would agree that comprehensive orientation and support are critical to the success of the new graduate nurse, but that nurse has to have the sense that god gave a goat in the first place or all the hugs, rainbows and warm fuzzies in the world are not going to help. ;)

I only graduated about a year ago, and with the exception of our maternity clinical (and the L&D portion of that was mostly shadowing), we had our clinical instructor, assigned patients, communicated with the nurse, but were primarily supervised by the clinical instructor. I can't imagine being in a position where the staff RN has the sole burden of teaching the student: they presumably don't know you, your skills, what exactly you're allowed and have been checked off to do. Aside from being an immense burden for the staff nurse, I think it really short-changes the student.

I've had nursing students shadowing with me, and really enjoy it. I do my best to be friendly, talk through what and why I'm doing, answer questions, etc, but if I were expected not just to be a nurse they're spending the day shadowing but solely in charge of their learning for clinical on top of my other responsibilities...I would be pretty frustrated.

Specializes in Med nurse in med-surg., float, HH, and PDN.

Going through an ORIENTATION to a specific unit and a services particularities isn't the same thing as being a student. Even us '100 years of experience' nurses weren't just flung out on the floor all by ourselves 'on day one', but orientation was more about learning the forms and paperwork, routines and methods, not nursing practice per se. OJT should be where the practice is REFINED, not learned from scratch.

I don't think an expanded clinical +/or an internship is out of line for today's RNs. The scope of nursing has grown to such a degree, the jobs so downright unwieldy, that anyone would require a deeper, more extensive training. But I think it should be a school's responsibility, not a facility's staff-nurses. While staff can help you learn the job, the basics should already have been covered.

Specializes in PACU,Trauma ICU,CVICU,Med-Surg,EENT.
By people whom don't respect nurses. :uhoh3:

That's a low brow response from you,isn't it, Linear Thinker? I thought you prided yourself on your intellect. Perhaps you didn't understand the question :lol2:

In any regard,I am through with AN. To read so much caustic,sarcastic,bombastic drivel....well,it's just not fun.This is my 31 st year of active practice and the end's not in sight; I have spent the past 26 years in various ICUs on both sides of the country; I've have worked with hundreds of nurses and thousands of patients and their families; had some really tough situations,horrid shifts,worked with some,let's just say,less than charitable colleagues and many more wonderful ones.

But,here's the kicker -I haven't developed the hard-edged,aggressive,judgmental 'tudes that I routinely read here (interestingly enough,only in the General Nursing discussion). I'm generally kind and respectful to my peers,I seek advice when I'm unsure,I believe one can learn from others - including students. And I don't come in through the hospital's front door dragging a chip on my shoulder the size of Manhattan like so many of you. I've read many fine posts here,written by fine nurses, but the bitterness here is just not palatable,so...

I'm off to save some lives.... Ba-bye!

Specializes in FNP.
That's a low brow response from you,isn't it, Linear Thinker? I thought you prided yourself on your intellect. Perhaps you didn't understand the question :lol2:

I understood it. It was my droll way to indicate I thought it was a puerile question.

Specializes in Cath Lab/ ICU.
I think nursing needs to do a better job of weeding people out. Let's start with requiring some SAT scores comparable to the other professional schools, which means no more of this community college for RNs stuff. It's nonsense. Professionals have college degrees (don't bother with the "I know a BSN who is a terrible nurse" crap- you will not convince me). The NCLEX needs to be much harder, and much more expensive. CEU requirements need to be more stringent, as in more rigorous, and more of them. In addition, RNs should have to reboard every 5 years, just like physicians.

I honestly think if you weed out the lowest common denominator you will attract a higher caliber of professional, and then the money and respect will follow. I have said it before, and it isn't popular. The reason nursing isn't respected is because it is populated by people who simply aren't going to gain respect from other professionals. We need to get rid of them. Raise the bar, weed them out. I don't want girls who look and act like they belong on the pole representing nursing. I don't want Gomer Pyle representing nursing. I don't want idiots representing nursing. I don't want Jerry Springer guest material representing nursing. Raise the bar. Let's get rid of them.

You want nursing to be elite, start only accepting elite into the ranks.

Argue too strenuously with this, and I'm going to assume you fall into one of the Gomer Pyle or Springer categories. ;)

Amen!! I couldn't agree with you more!

OK. The unit I work on has some issue with this as well. There are a few things that cause problems. The biggest issue is that in some facilities the nursing student or student nurse interns or resident nurses are put on the floor at the same time. Any given day we may have a student in some capacity with each nurse including the charge nurse. This may be added to the fact that some of the staff are newer themselves and need help from the more expirienced nurses on the floor.

So from an expirienced nurse perspective it can be difficult. We are stretched very thin at times, and these days most times! I would never dream of not welcoming any new person to the unit or purposely being rude or not teaching something interesting. Since I once was a student I understand how one amy feel slighted some days or incertian rotations.

Some suggestions I have include: please do not start your first day on a new unit bad mouthing the last place you were from especially if its in the same facility chances are we know some of the nurses you are less than happy with and we expect you will say the same things about us when you leave...just a bad way to start out. Please do not feel we are being unfair by asking for your help with patient care many times it is the policy of the unit that our students help with things like baths, feeding, turning patients etc, and a good attitude goes a long way. We know you want to see the hands on nitty gritty tasks we do and have a chance to help with this and I ask daily if the newbys want to assist with dressing changes, help with a bedside procedure when the doc requests a hand, and I cannot tell you how many times I cant find one person to help when the help is needed...but I do hear multiple complaints that nothing exciting went on for anyone to see...well when oppurtunity knocks!...do you honestly think we have time to cram everyone elses agenda into our day?..we have to make time...take time and smile while we do it. Last thing do not stand around chatting and expect to be invited to each room...you see the nurse you are with moving..you move.

I remember how scarey new things were when I was a student. Do not refuse to place a foley or start an IV or do those things that take some time and expirience to learn...we know its tough but what is gonna happen when you are all alone and expected to do these things routinely. I can tell the difference between new nurses who jump at the chance to help and learn and those who avoid situations for fear of failure...it ends up causing issue until faced.

I apologize that nurses are so stressed. It took time for the staff to get to know each other and it takes time for us to know you also as a student and to understand your expectations from the expirience. I agree it takes alot of patience and understanding on both sides of this matter. In the end I love the students, the perspective is fresh and it adds variety to the day as well...but no one wants to be uncomfortable all day but it happens.:nurse:

That's a low brow response from you,isn't it, Linear Thinker? I thought you prided yourself on your intellect. Perhaps you didn't understand the question :lol2:

Does low brow mean something different in Canada than it does in the US? Because arguing for stricter admissions standards would, if anything, be elitist. Fart jokes and slapstick are low brow.

Specializes in ER.
Have a ball in your padded-staff situation...pray you never hit the floors as a staff nurse there. :)

Techs aren't allowed to do all of that in every state...you want those patients sent to your lovely little Nirvana of so many unlicensed staff??? :D

If you did bedside nursing, you'd probably get it- aside from just wanting to let someone else do the job....?????

And skills being required for assessment skills wasn't my issue- of course they're different. They need BOTH.

So...here is the reality of my job. The real, grown up reality. I have five patients at any given time, most of them fairly critical because this is the regional trauma center in a large urban center. There is one tech for 30 patients and the phleb covers closer to 100 patients. The phleb might draw labs on one of my patients at some point during my shift. The tech changes out dirty linens carts and hides somewhere deep in the hospital for the rest of the shift. (Unless it happens to be a nursing student who hangs about doing nothing related to actual tech stuff.)

Otherwise, I must do all of your precious skills for every single one of the countless patients I see. Draw labs, start IVs, foleys, NGs. Unless of course one of the unlicensed unsupervised med students does it...

While I do it, (and speaking of reality) I consider the fact that the hospital probably employs $10/hr phlebs and techs to draw labs and do other unlicensed skills because they don't want to pay me $23/hr to do so and I wonder how long until they bump the patient load up for me and start demanding that the tech show up to do the tasks. The REALITY is that it makes no business sense to pay me to do the work.

As for what other states protect, I am aware that plenty of states protect plenty of activities for nurses. I feel comfortable that sooner or later that will end or the decent salary that is associated with the same will erode as healthcare and really nursing advances past a lot of skills that really don't require a nurse to do them.

Do I mind doing the tasks? No. Its mindless work. It is similar to untangling my phone cord or unraveling string. I do "bedside nurse" in the ER and I do get "it." I just don't agree with it. that's the part you have dead right. The new grads don't need skills and I assume they start with none and caution them outloud in person (because I am a real person) not to get all hung up on what they can and can't do. It'll come in time but they need to be sure and holler if someone starts, you know, crumping.

To the poster who states ER needs the floor for throughput: As for where the patients go after they leave the ER, most return out the front door. I really don't care whether or not you accept report from me or "hold" your beds. I will just do what any professional does: document and calmly contact my supervisor. Its not my problem if you choose to interfere with the throughput in the ER and sensible calm people resolve these issues without judgment or reservation.

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