Do you think some people just "dont have what it takes"

[nursenatalie, ADN, RN]

I am in the process of orienting/precepting a nurse to our surgical floor. This nurse has been a nurse for 10 years, has a masters degree in nursing administration. The first day of orientation he makes the comment, he believes he will be an asset to the nurse manager on our floor because of his management experience. To make a long story short we are 5 1/2 weeks into this orientation process and I feel like I am beating my head against a wall. He continually neglects basic tasks such as noting orders, will NOT independantly review protocols I have printed for him and I believe he has no desire or ability to be a good staff nurse. His background is long term care and management, he has worked in multiple facilities and says he has worked some med-surg as an agency nurse. I have relayed my concerns to the nurse manager but because of his impeccable resume I dont think she is willing to see the problems. We are in the process of switching his preceptor but I personally dont think he has it in him. Do you agree, some people just dont have what it takes?

[soliant12]

I'm sure he has what it takes, but I think personally people with that background and education would much prefer to be in amanagement position rathr than the physical demands of bedside nursing.

[nursenatalie, ADN, RN]

I definately think his preference is management, I have warned my nurse manager to look out as I think he has his eyes set on her job. I am continually amazed at his lack of progression. For instance, had a pt with hgb of 6.5 (admitted because of chronic gi bleed) stable pt so after he received report from ER I told him to review the blood administration protocol. I checked the blood with him, advised him on the rate to begin blood then what to increase it to after 15 minutes without problem. I then left to answer a call light and saw him leaving the room. I reminded him that we stay with pt for 15 minutes and reviewed s/s of transfusion reaction. Roughly 45 minutes later I see that he is still in the room sitting in a chair charting. I ask him if everything is ok, pt looks ok, vitals fine and he said everything is good. I assume he must be catching up on charting or completing database. One hour and 20 minutes after blood has begun he peeks his head out the door and asks me when the one on one supervision ends. I gathered my composure and asked him to look at the protocol that is in front of him and he reads 15 minutes. I am just flabberghasted!

[froghair]

some people are good at theory and practice, some that are good at the theory side of things have no idea when it comes to putting it into practice

[99_99africa]

Concentrate on what you have to do, managers are observing all the time and making decisions. Make sure you don't loss sight of your goals while looking at others.

[llg, PhD, RN]

I think it is important to avoid expressions such as "not having what it takes" in these situations. That can set an uproductive tone to any conversations you have with him or with your manager. Instead, try an approach that "helps him find the best fit" for his particular talents and interests. That way, you become his mentor interested in helping him be successful in his career instead of his judge/jury.

I would also try to use some of those particular concrete instances to open up the conversation about his job performance. You didn't tell us how you are handling his difficulties -- except for reporting them. For example, in the case you described above, I would talk with him in private and ask his perceptions of your miscommunication. Did he not hear you say 15 minutes? Did he not read the protocol you gave him? Did he not understand it? After pointing out to him that you both told him and gave it to him in writing ... ask him what else he needed from you to understand. See if he recognizes his problem.

I think it is vital in this case to see if he recognizes that he is having problems. You imply that he does not ... but how does he respond when confronted directly (but kindly) with a mistake such as that one? If he is in denial, then you will have to keep bringing these concrete examples to his attention. If he is not in denial, then work with him to either solve the problem or find a better fit.

A few years ago, I was in a similar situation with a former manager/educator who had been away from the bedside for several years. She just couldn't get back into the pace of the busy NICU. But I helped her to see that for herself and helped her find a better fit in another unit within our hospital, where she has fit in quite well.

Remember: if he's been a successful nurse for 10 years, he probably has some ability to do something right. He might not be right for his current staff nurse position on your unit, but he probably has ability that your employer could use somewhere.

Good luck,

llg

[RosesrReder, BSN, MSN, RN]

I'm sure he has what it takes, but I think personally people with that background and education would much prefer to be in amanagement position rathr than the physical demands of bedside nursing.

I agree with you. :)

[nursenatalie, ADN, RN]

I think it is vital in this case to see if he recognizes that he is having problems. You imply that he does not ... but how does he respond when confronted directly (but kindly) with a mistake such as that one? If he is in denial, then you will have to keep bringing these concrete examples to his attention. If he is not in denial, then work with him to either solve the problem or find a better fit.

I couldnt possibly give all the details. I have confronted him with these things. For instance, after the blood issue I reviewed the blood protocol with him and asked him what happened in that situation. He was very defensive as he usually is and said he just had a lot in front of him at the time. This was his only pt. and as I mentioned she was stable and had probably been walking around like she was for a month or more. I have recommended a different floor

although I really dont think he is good for acute care at all. After 5 1/2 weeks, I see no progress. I usually train all new grads and new hires to my shift and have never had this many issues. I think that besides learning the basics it is essential to be conscientious and accountable, I see none of this in him and for this reason I say he doesn't have what it takes to care for pts on our floor.

[AnnemRN]

llg-I think that is excellent advice--I can remember when I did floor nursing that if I was off work for even two days it was difficult to get back "in the swing of things". I think it is important not to be critical and judmental as that will not create a confident nurse. I'm sure he can sense how you feel.

[NaomieRN]

I wonder why he wants to be a staff nurse if he had management experience. Why not become a head nurse?

[nursenatalie, ADN, RN]

Ideally, a "head nurse" would be able to take an assignment on the floor they manage. Don't you think?

[ColdFusion]

I definately think his preference is management, I have warned my nurse manager to look out as I think he has his eyes set on her job.

That strikes me as extremely inappropriate.

I think there's more to this story....