Positive Reinforcement during Orientation?

Pediatric Critical Care Columnist · Oct 20, 2008

I'm sorry that you're not getting any good vibes from your coworkers. There might be reasons (not excuses) for that, such as the overall culture on the floor, as you referred to obliquely when you said they're not friendly and most quit after orientation. But you should be getting feedback every day. When I'm involved in orienting new staff, new grad or not, I always end the shift with a review of the shift. I try to focus on the good things that happened without ignoring the areas that will need more work. The last person who was buddied with me (at the last minute for just one shift) did an outstanding job considering that I had to leave her to her own devices for a large part of the day. (We got two post-code patients from the peds floors the day before and had another one come in during our shift, with no experienced staff to take them.) I told her exactly that in so many words. There were things I suggested she try different methods for and some things I corrected her over, but at the end of the day, she did a very good job and needed to know that. I suggest that you ask people about your progress, since they're not volunteering. Talk to the educator and your preceptor about it. Tell them you need to hear how you're doing so you know what you're doing right and where you need to adjust. It's their obligation and responsibility to give you that feedback.

southernbelle08 · Oct 21, 2008

I would say ask!

I had two preceptors during orientation - one would give positive & negative feedback and the other would only give negative feedback. The negative helps, but it can really get you discouraged if you allow it. The preceptor that reviewed both positive & negative really helped me in more ways than she'll ever know. I would definitely ask though - you should be getting that during orientation!

NurseBrittney · Oct 21, 2008

If i ever precept I will make it a point to give positive feedback.

I received very little and often had to ask if I was doing things right. Its discouraging to not know either way.

Butterflybee · Oct 21, 2008

If i ever precept I will make it a point to give positive feedback.
I received very little and often had to ask if I was doing things right. Its discouraging to not know either way.

It is very discouraging. Alot of times, when I ask a question or am not going as quickly as I guess they think, they look at me as if Im crazy and respond in an extra loud tone with a hint of annoyance and lack of patience. It makes me afraid to ask but I know I have to.

Butterflybee · Oct 21, 2008

I'm sorry that you're not getting any good vibes from your coworkers. There might be reasons (not excuses) for that, such as the overall culture on the floor, as you referred to obliquely when you said they're not friendly and most quit after orientation. But you should be getting feedback every day. When I'm involved in orienting new staff, new grad or not, I always end the shift with a review of the shift. I try to focus on the good things that happened without ignoring the areas that will need more work. The last person who was buddied with me (at the last minute for just one shift) did an outstanding job considering that I had to leave her to her own devices for a large part of the day. (We got two post-code patients from the peds floors the day before and had another one come in during our shift, with no experienced staff to take them.) I told her exactly that in so many words. There were things I suggested she try different methods for and some things I corrected her over, but at the end of the day, she did a very good job and needed to know that. I suggest that you ask people about your progress, since they're not volunteering. Talk to the educator and your preceptor about it. Tell them you need to hear how you're doing so you know what you're doing right and where you need to adjust. It's their obligation and responsibility to give you that feedback.

Thank you so much for that information. I leave each day wondering how Im doing. Each day they are leaving me alone for longer and longer periods of time. Today I had half the shift to myself. Ive asked about my progress once, she looked at me like I was asking something out of the ordinary and then asked me why.."is everything alright?". Not too many nurses seem approachable where I work. Ive tried.

BUT, one person was nice enough though to tell me that it took them awhile to learn a specific task. Maybe that was her way of trying to encourage me. Today was just not a good day. It was the first time, that I like most of the ones before me, began thinking about finding a new job...elsewhere.

Is it really their obligation and responsibility....because Im not getting it.

Also do they really expect me to be as fast as the ones that have been here for years????????????????????????????!

Butterflybee · Oct 21, 2008

Also, forgot to mention, I am responsible for 30 pts ( on some days closer to 35).

Pediatric Critical Care Columnist · Oct 21, 2008

There's no way they should be expecting you to be as quick and thorough as someone who has done the job for a million years. If they do, they're out to lunch. It takes at least 1000 repetitions of an action for it to be second nature. When you think of all the new skills you're building and the time it will take to repeat them all at least 1000 times, well, you get the idea. Talk to your educator or manager. They have to lighten up a bit and they have to give you feedback.

Butterflybee · Oct 30, 2008

There's no way they should be expecting you to be as quick and thorough as someone who has done the job for a million years. If they do, they're out to lunch. It takes at least 1000 repetitions of an action for it to be second nature. When you think of all the new skills you're building and the time it will take to repeat them all at least 1000 times, well, you get the idea. Talk to your educator or manager. They have to lighten up a bit and they have to give you feedback.

The educator is great, she is so understanding but she is only one person. It is the overall climate at this facility. They dont care that Im a new nurse. Thank you so much for your encouraging words, they mean alot.

Sterren, BSN, RN · Oct 31, 2008

I started working as a nurse in May on one floor, and then switched to another floor a couple of months later. Ultimately I've had a half-dozen preceptors. Some of them give positive and negative feedback, some give only positive, some give only negative, and some give none at all. The ones I have had the hardest time with are the ones who give no feedback at all. At least with the others I have a basic idea of where I stand. Positive reinforcement really is helpful when you are new but I think there's value in the negative feedback also. I just can't stand being told nothing, I hate having no idea whether I'm doing well or whether I'm failing miserably.

I have never had a preceptor end the day with a review of the shift and I truly wish I had. That would be so, so valuable in organizing my thoughts and focusing my remaining orientation time where I need improvement. I have a couple of weeks left on orientation on my new unit and I would love to have that kind of feedback built up over the entirety of my orientation to see how far I've come and to know where I really need to push and focus before I am on my own. I wish I'd had a preceptor do that.

Mahage, LPN · Oct 31, 2008

I have almost a year now. I have one ast. nurse manager who is charge when she is on schedule, who thinks to help anyone learn that you always answer their question with a question. She drives me nuts! Before I go to her, I have thought it through and have come up with an answer that I want confirmed by her or else I haven't the foggiest. Other charge nurses are to the point. I have told her specifically that when I ask her a question I would appreciate a direct answer because I don't ask if I haven't reached a brick wall or just need confirmation.

I am still not real secure and I ask an awful lot of questions. Generally there is someone around in whom I have a lot of confidence but not always and it is sometimes neccesary for me to go to the charge nurse or the Ast. nurse manager if she is the one in charge, but I try to avoid going to her when I am in doubt unless it is a policy issue and then I try to avoid going to her. She is a big help when I get new patients in. She always puts the orders in and one of the part time charge nurses does anything she can to avoid putting orders in for us on new patients.

We have hired a lot of newer nurses since I hired in. I have had the honor of precepting also and generally this has been a great experience. I hope I have been able to teach them things that they needed me to. A lot of them come to me with questions as they know that I am never going to treat a new nurse like she is stupid and if I don't know the answer, I will help them find it.

I dread precepting students. I am comfortable with the new nurses but the students are a bit scary as they are really green. I didn't get any in the last batch but I am sure it will happen. I will just remind myself that I was a student not very long ago and try to teach them like my most effecting preceptors taught me.

Mahge

Butterflybee · Oct 31, 2008

I have almost a year now. I have one ast. nurse manager who is charge when she is on schedule, who thinks to help anyone learn that you always answer their question with a question. She drives me nuts! Before I go to her, I have thought it through and have come up with an answer that I want confirmed by her or else I haven't the foggiest. Other charge nurses are to the point. I have told her specifically that when I ask her a question I would appreciate a direct answer because I don't ask if I haven't reached a brick wall or just need confirmation.
I am still not real secure and I ask an awful lot of questions. Generally there is someone around in whom I have a lot of confidence but not always and it is sometimes neccesary for me to go to the charge nurse or the Ast. nurse manager if she is the one in charge, but I try to avoid going to her when I am in doubt unless it is a policy issue and then I try to avoid going to her. She is a big help when I get new patients in. She always puts the orders in and one of the part time charge nurses does anything she can to avoid putting orders in for us on new patients.
We have hired a lot of newer nurses since I hired in. I have had the honor of precepting also and generally this has been a great experience. I hope I have been able to teach them things that they needed me to. A lot of them come to me with questions as they know that I am never going to treat a new nurse like she is stupid and if I don't know the answer, I will help them find it.
I dread precepting students. I am comfortable with the new nurses but the students are a bit scary as they are really green. I didn't get any in the last batch but I am sure it will happen. I will just remind myself that I was a student not very long ago and try to teach them like my most effecting preceptors taught me.
Mahge

Wow, look at you precepting. I cant imagine for the life of me why any preceptor would make things more difficult for a new nurse than it already is. Ive learned though from the difficult preceptors how not to be w/a new nurse. I want to help and encourage them .