Experiened Vs New Nurse: An Ongoing Struggle

[All4NursingRN]

Ah yes the struggle between young and old, experienced versus brand new.

*which btw, I kinda see myself as being in the middle lol, not really totally novice, but no, not tenured, been a nurse for almost 6 years, but a RN for 2*

So yesterday I had a patient with hematuria, bad hematuria, passing huge clots, etc... Me (newer nurse) asks another nurse (very experienced) to kindly grab the foley/CBI set up as I'm inserting the IV because the patient is in extreme pain/bladder is hard and distended (the patient is at risk for bladder rupture.)

Experienced nurse says why am I going to put in a foley? Do you really think he needs a foley? She then tells me that he has prostate CA (which wasn't true, he actually had prostate surgery recently)

10 minutes later, in comes the attending, takes one look at the patient and says, this guy needs a CBI set up NOW! I wanted so badly to go back to that nurse and say SEE, I. TOLD. YOU. SO! but that would'nt have been right.

Not wanting to generalize and label all experienced nurses, but I often times feel that older nurses discredit how much we know. I always feel like they think it's their way or no way and that you are a know it all when you don't listen to them.

Especially some older nurses I work with have the attitude that I need to be listening to them or else I'm going to crash and burn, and if I try to interject my two cents they label me as hard-headed and know it all ish. I mean aren't I a sound nurse? Sound enough to practice? Sound enough to make informed decisions? and say yes or no to your advice?

Then you have some newer nurses who think they've got it all handled. New grad versus new grad is actually an issue too! Where I work they (management) try to act as though the nurses with a few more months of experience are so much more capable of handling triage or being in charge? Like really? what is really the difference in experience between someone who has been a nurse for 2 years and one with 1 year of experience? That varies dramatically from nurse to nurse.

Some of the new grads I work with are just way too know it all-ish, too aggressive, too anxious, and bossy.

You don't have to act like a know it all to be someone who actually knows alot.

I just think alot of experienced nurses undermine the intelligience of newer nurses, and too many new grads think they're the best thing since sliced bread, and VICE VERSA as well!

It's not always the amount of time someone has the word nurse behind their name that determines their competency or incompetency.

[Double-Helix, BSN, RN]

Don't you need an order for the foley catheter? Inserting a foley requires a doctor's order in my hospital, and unless the doctor had already been in to evaluate the patient and order the foley, one should not be placed. If you had an order, you could have come back with: "The doctor ordered it." (Unless you have standing orders for these sorts of things in your facility.)

I think your point is that there are bad co-workers in every field, of every age, with varying degrees of experience. Since we aren't likely to change these people, and they certainly aren't all going to go away, the best thing we can do is control our own attitudes and respond to everyone as respectfully as possible while ensuring safe patient care.

[All4NursingRN]

We have protocol sets, but for the most part, the MD was to see the patient right away and I called to get the setup ready. 10 times out of 10 we know what which MD will order and get it going/ready. This is the ER.

[OCNRN63, RN]

Don't you need an order for the foley catheter? Inserting a foley requires a doctor's order in my hospital, and unless the doctor had already been in to evaluate the patient and order the foley, one should not be placed. If you had an order, you could have come back with: "The doctor ordered it." (Unless you have standing orders for these sorts of things in your facility.)

I think your point is that there are bad co-workers in every field, of every age, with varying degrees of experience. Since we aren't likely to change these people, and they certainly aren't all going to go away, the best thing we can do is control our own attitudes and respond to everyone as respectfully as possible while ensuring safe patient care.

This.

I'm so tired of the "old v new" comments and threads that I am ready to take my eyes out with a melon-baller.

[OCNRN63, RN]

We have protocol sets, but for the most part, the MD was to see the patient right away and I called to get the setup ready. 10 times out of 10 we know what which MD will order and get it going/ready. This is the ER.

Yeah, well. I worked in the ED, and while there were certain things that were standing orders for specific dx., I, as an experienced nurse, would never initiate something like CBI on a pt. If I knew the attending was coming, I would have everything ready to go once I got the order. If not, then I would call STAT.

The "This is the ED" is not going to cover your butt if you proceed with a procedure, and the attending doesn't want it. It's your license and you need to protect it.

As far as your co-worker, I don't see that as an "experienced v new" nurse issue. Mediocre-poor co-workers come in all stripes.

[ClearBlueOctoberSky]

I think if you want to talk old vs new then it should go something like the conversation I just had...

New: Miss Demented LOL isn't acting right and her urine is concentrated and she has that UTI smell. I called the On-Call PA and received an order for a UA. We don't have hats but I was able to get her to walk to the toilet, but I couldn't get her to sit down so I could get a midstream.

Old: Did you get an order to straight cath if we needed to?

New: *Dangit!* No, I didn't think about it. I'm sorry.

From now on, you bet I'll get that order to straight cath if needed.

Old vs New is all about the experience it takes to do the job efficiently. You learn from your mistakes.

[All4NursingRN]

I asked the nurse to grab the foley/CBI setup, not insert the foley. I wasn't going to insert the foley knowing that the patient had recent surgery, but this patient's bladder was hard and distended and passing huge clots, and knowing in foresight what would most likely be done, I wanted to get the setup for the doctor who then came in and immediately inserted the CBI.

[All4NursingRN]

This.

I'm so tired of the "old v new" comments and threads that I am ready to take my eyes out with a melon-baller.

lol, please don't but if you're tired of this topic, why did you respond to the thread?

[Orca, ADN, ASN, RN]

It's a delicate balance. For everyone like you, there are probably a dozen who believe that because their book learning is fresher, they are somehow superior to those who have spent years on the floor..

[Despareux]

I never realized that once you're a nurse, you suddenly never have to learn anything ever again, new or old.

[OnlybyHisgraceRN, ASN, RN]

This.

I'm so tired of the "old v new" comments and threads that I am ready to take my eyes out with a melon-baller.

With all do respect: You are not that tired of them because you continue to read and comment on these threads. Just saying.

[Altra, BSN, RN]

All4NursingRN, you've had several threads regarding ongoing problematic interactions with your coworkers. I'm sorry you're in the situation you're in. I don't think it has much to do with experience levels - just with the particular personalities (plural) involved.