Experienced Nurses Should Leave Legacies to New Nurses

[jasnms]

I have been a Registered Nurse for ten years. During these years, I've worked in many areas of nursing. My last position was Director of Nursing for Private Duty. I have attempted to mentor nursing students by explaining things to them that they may not have grasped in class. I remember what it felt like being a new RN. I had a lot of book knowledge but hardly any nursing skills.

I have seen experienced nurses refuse to help new nurses. I find this behavior appalling. I feel that we owe it to new nurses to teach them everything we know, so that our legacy of providing quality care is continued. Before I was DON, I usually was a charge nurse and preceptor. I encouraged new nurses to use the knowledge they had learned but also taught them nursing skills that they were unfamiliar or uncomfortable with.

Nursing is not a profession. It is a calling. We are there to provide healthcare to everyone. This healthcare must be above standard. I once went to work for a facility that did not fully orientate the nurses. They allowed new nurses to provide care to patients after only two to three weeks. As the head nurse, I asked the unit manager to please place certain nurses with experienced nurses to allow them to learn. But this never occured. I had to write so many incident reports regarding the substandard care that our patients were receiving. I actually was ashamed of this facility. I understand about nursing shortages, but seriously, let's teach the new nurses good habits to inculcate into their nursing practice. Let's teach them that all patients are our patients. I dislike the words, that isn't my patient. Let's take new nurses and even student nurses under our wings and show them the joy that nursing can bring.

As I have said, nursing is not my profession. It is my calling in life. I am tired of reading about nurses becoming burned out. If we teach them correctly the first time, they will be able to handle things.

I was very lucky when I was in nursing school. I had two nurses that I externed with. These nurses taught me everything that they could within what the law allowed. After I became a RN, I was fortunate to shadow several nurses who taught me so many things that I didn't learn in nursing school. This is the legacy we should leave to the new nurses. Let's help them reach their full potential.

As I look around at the open RN positions for most companies, I find it sad that nearly every ad states experience required. How can any nurse obtain experience if we do not invest in that nurse? So let's invest in the new nurses, teach them, guide them, mentor them, and let their superb nursing skills be the legacy we leave them.

[studentdrtobe]

Thank you for the correction. The didactics you speak of fall into my definition of "classroom," but the rest (except for journal clubs...not sure what that is) are expected of MDs throughout one's career.

It's where residents present articles and dissect them. Ex. the results of a large, potentially practice-changing clinical trial are published. A resident presents this data, along with a thorough background (which includes past clinical trials, retrospective studies, etc, and their pros/cons), the basic science mechanisms, their interpretation of the results, etc. And then, the presenting resident (and, often, the other trainees in attendance) are grilled with questions by the attendings (ex. "What would you do when a patient with XYZ comes in? Would you consider extrapolating data from this trial? What would your first step be? How would you proceed if the patient is refractory this your first-line treatment?", etc).

It can be exciting, but downright scary! But, for the most part, they're very educational since it pretty much forces all the trainees to study so they don't look like fools in front of the entire department! :)

The biggest point I was trying to make is your model of learning and the culture within the medical world that supports it. We don't have that consistently, and at some facilities, not at all.

Yea, I agree with ya there. I love the medical education I've received so far and it has been, for the most part, very well-organized. We're incrementally given more and more autonomy as we progress through our training and show that our clinical decision-making is sound. As another poster mentioned though, there is a very rigid hierarchy in medicine and you have to conform to it. Attending > fellow > senior resident > junior resident > intern > med student. No ifs, ands, or buts. You have to put in the time and effort to work your way up the totem pole. You disagree, as an intern, with the treatment plan the attending decides on? Deal with it. Once you become a senior resident, you're much more likely to engage in academic discussions with the attending regarding the subtleties of patient care and convince them that your plan is just as good or better. The hierarchy is there as a way to provide appropriate level of supervision (based on where you are in terms of training) as well as being a net for catching mistakes.

Additionally, residency spots get funding from Medicare. Not sure where the money comes/would come from for nursing residencies or whatever. And for more than a decade, Medicare funding for residency spots has essentially flat-lined.

[dudette10, MSN, RN]

Medical education is so completely different. The strict pecking order involved there would have the "nursing eats it's young" people immobile with apoplexy.

Very true! Medicine and the military have a long history of hazing behavior. Nursing also does, to a certain extent.

I think a modern nursing model similar to the traditional medical model could be created without the expectation of hazing behavior.

[dudette10, MSN, RN]

(Yes, I watch too much L&O and only think about homicide. I especially think about homicide when I'm at work, is that bad?)

Depends on your intended victims.

[RNsRWe, ASN, RN]

I especially think about homicide when I'm at work, is that bad?

LOL, I just assumed it was natural....