Eat Young/Unhappiness - Mostly Med/Surg?

[RachieH]

Hi all,

I've been lurking for over a year and am always dismayed at the number of vent/I hate my job/nurses eat their young/this is a horrible job threads. I absolutely understand this is a forum for just such a thing, where nurses feel safe venting and I respect that. It is still a little alarming.

However, I've noticed a common theme, which is that a lot of this unhappiness seems to stem from new(ish) grads who work on med/surg floors. I don't recall ever seeing a new grad upset about the atmosphere on a Peds/PICU/NICU/Oncology/OR/ER atmospheres. I'm not saying those vents don't exist, I'm just saying I don't recall seeing them. I *do* recall seeing a few about nursing homes.

Am I right? Is it generally med/surg where people seem to be the unhappiest? I'm in pre-reqs, applying to nursing school later this year, for anyone who wants to know. I'm very curious.

[oramar]

This is just my opinion. The problems on med/surg are caused by managment thinking it is "just med/surg, if we staff short med/surg it is not a big deal". That is where I believe the problem lies. I mean all the problems with lateral violence and eating of young go back to staffing. General med/surg units are as good or bad as managment wants them to be. I think it is somehow related to reimbursements. Not sure of this but I think all the medicade/medicare, plus patients that will not pay at all tend to congregate on med/surg units which then lose money because they have chronic conditions which are not properly reimbursed. Contrast that with an ortho unit where most of the patients are covered by insurance that pay very well. I have seen much more concern about staffing by managment on units with specialities that are money makers. On money making units I see less unhappiness and backstabbing and young eating. AS I said this is just my opinion from years of observations.

[scrubsnhugsRN]

In my defense, I am talking about things like giving a blood transfusion, etc.

So you think a preceptor should ditch me when I am doing this?

Am I ignorant because I haven't done a blood transfusion before? Yes I have book knowledge regarding this, but is it the same as having the floor skills....this is what I am talking about.

Wound vacs, etc...am I wrong?

[burnay76]

I started working in a med surg float pool fresh out of school last may. I lasted three months before moving to med/surg telemetry at another hospital. I thought I disliked the float pool and would fare better if I was on a floor permanently. I really wanted to give med surg a chance for a while - get good at it before moving into psych (what I ultimately want to do). However, I am two months into working on the med/surg tele floor and here is what I find:

1) Nursing is tough and stressful (we all know that), it doesn't matter how good you are - you will still worry daily that something beyond your control is going to make you look incompetent or threaten your license. "Eating their young" is a coping mechanism to divert attention from them. It's like the bully is school who beats up the little kids to hide his own fears of inadequacy.

2) This fear is so prevelant in med surg because m/s nurses are expected to be jack-of-all-trades. This results in being a master-of-none. This isn't insulting, just that m/s nurses need to know so much, they cannot possibly know everything to the extent that a specialized nurse does in their specialty. Try explaining this to a court though when something goes wrong - it's not going to fly. Hence the fear.

3) Nurses are just mean people (I'm just kidding), but it amazes me how nurses can have two sides - the most compassionate individual in the world, and most back stabbing conniving individual in the world. I don't understand this at all

[Spidey's mom, ADN, BSN, RN]

3) Nurses are just mean people (I'm just kidding), but it amazes me how nurses can have two sides - the most compassionate individual in the world, and most back stabbing conniving individual in the world. I don't understand this at all

. . . such is the way of the human race I'm afraid - you'll find this in all walks of life.

steph

[nurseinlimbo]

As the last poster has said, it is being abandoned or chastised that is the problem. Experienced nurses take for granted that we will know how to do something that comes as second nature to them, and either assume we can do it, or get upset if they have to teach us how.

I am 3 iv starts away from being certified with my region, but have had horrible experiences while trying to learn. One nurse actually grabbed the supplies out of my hands and did it herself, humiliating me in front of the patient in the process.

I have also been told that the "unsafe" nurses should work in LTC. Does never being taught how to do something automatically make me "unsafe". I don't think so, I practice care in those things that I know how to do, can't help what I don't know how to do, aside from reading the policies and procedures and taking opportunities as they come up. I had only done 2 or 3 catheterizations before graduating and it takes more attempts than that to feel comfortable.

It's too bad that more nurses aren't good teachers, since that is a large part of their job, both to mentor the junior members of the profession and to educate patients.

[jjjoy, LPN]

It may be that many nursing programs graduate students without the kind of clinical experience that allows them to fully function on the floor as a new nurse. Whatever one thinks a nurse *should* be able to do upon graduation, you have to deal with what you've got and that may mean having to work with new nurses who don't seem adequately prepared.

That also means newbies have to deal with reality that many (not all!) general staff nursing positions involve dealing with poor staffing and poor attitudes from burned out/stressed out colleagues and an often sink-or-swim mentality.

[kitty=^..^=cat]

I'm certainly no nursing newbie, but I firmly believe that if a new grad wants to go directly into a specialty unit, that's where they should go. Sure, additional orientation and training may be required to establish clinical competence before the "cutting of the cord", but the payoff in the long run is that the nurse is more easily retained.

When I got out of school I went directly to work on a specialty floor -- I'd worked as a CNA at my community hospital on school breaks and had absolutely ZERO interest in working the floor as a staff nurse. I knew I probably wouldn't be as good there as doing something that I could "dig my teeth into" intellectually. Now almost twenty years later, although I have supervised and managed med/surg floors and provided plenty of assistance in those environments, I've never worked as a staff nurse in one, and that isn't such a bad thing.

In some cases I feel that med/surg experience can do more harm than good when it comes to developing necessary work habits and a good professional attitude. If a graduate nurse is already highly organized and has clear priorities, why make them take a step or two backwards?

[burnay76]

I so wish I could agree with Kitty, I want to - I really do. But "get at least 1 year m/s experience first" has been pounded so hard that saying otherwise feels like turning away from your religion. I pretty much know I was born and bred to work in psych/human services.

this is neither here nor there, but related to the topic. I remember is school how often we were reminded to respect your assistive staff because you are going to rely on them. I enjoyed working under nurses and felt I had a better relationship with them when I was assistive staff. Nurses are much harder to work with as peers - perhaps because respecting peers in never really addressed nor stressed

[RNSacht]

Very enlightening post llg. I think you pretty much summed it up. And you can use that scenario in any career field for that matter. I know for the most part that Cardiac Nursing is where I want to be for a NUMBER of reasons. I am not going to go work on the M/S floor just because an instructor thinks it may be a good idea. Some things you just have to do for yourself if you know it's a good fit. So in school, I am going to do an externship in a cardiology office or cardiac hospital (one just opened in my area) then hopefully just go on full time when I am done with school.

I just want to respectively let you know that even in cardiac nursing you will find a LOT of medsurg overflow. I kind of had the same thought, Ill go into cardiac nursing not medsurg, however daily I find that MOST cardiac patients are elderly and medsurg patients. Just thought I would enlighten you. Good luck with your future.:monkeydance:

[RNperdiem, RN]

In my first med-surg job there were 2 groups of nurses. One was the core group that had years of experience there. The second group was mostly new graduates who generally lasted a year(or less).

I remember feeling sympathy for the senior nurses there. It must be difficult to be constantly orienting new staff who will leave once they are able to really pull their own weight. I could see how a nurse there would remain distant from a new nurse for a while. While I was never "eaten" as a new grad. I was occasionally "nibbled" by the oncoming, overworked nurses.

[kitty=^..^=cat]

Back in the days when I was interviewing people for nursing positions, I always asked where a new grad wanted to be in five years. If it was ICU or ED and things seemed "right", I went ahead and encouraged them to start there. Same deal with those that wanted to go to anesthesia school or into flight nursing -- start in ICU or ED. (NICU is different - you have to start with the basics there, and there are probably other exceptions I'm not thinking of at this late hour.)

I'm a big believer in starting "champions" early - like athletes and musical prodigies... If potential, drive, determination, guts, will and belief is so evidently there, why not go ahead and put that person on a faster track "to the pros" like novice tennis players, golfers, and violinsts? It's the same concept whether you apply it to sports, academics, music or professional aptitude.