Welcome New Grads!
The summer brings new nurses to workplaces everywhere. New and seasoned nurses would benefit from a look at the past. The way nurses are brought into the profession has changed and I believe not for the better. We have the opportunity to empower each other and overcome this deficit.
Summer is coming, and that means new nurses are starting their new careers. Believe it or not, that stress of school and the upcoming NCLEX exams will soon be but a memory. You have read the AN posts, you have asked your questions and your search for that perfect job will consume your days. You have also read about that NETY thing, so you will be on high alert for its signs. This reception for new professionals is not unique to nursing, but I think that the comradery of nursing school directly conflicts with the real world implications of workplace. I would like to prepare you for what you are about to experience and let you know that you are not alone.
New nurses today face a unique challenge that nurses a quarter century ago did not. Nurses used to graduate, normally with a job waiting for them, and you were a graduate nurse. NCLEX was something you studied post-graduation. Mine was a two day, 12 hour exam, and was administered on the same day in a large venue. The biggest difference? This exam was sat three to four months post graduation. Your employer patiently waited for results while you stayed on orientation. Results from these exams took ten to fourteen weeks and were mailed. Only then did you become a nurse and change from Graduate Nurse status. This was effectively a six month orientation. Employers were forced by NCLEX to ready their nurses into careers with realistic orientation periods. There was a nursing shortage then and employers wanted to make sure that they were able to fill positions so the long wait for licensure was seen as a necessary evil. Then computers invaded our lives.
Employers were never happy investing those resources for orienting unlicensed nurses. The risk of failing boards and quick turnover of nurses made for poor return on investment. The NCLEX decided to modernize to computer testing. This made testing unlimited. Where before, someone had to wait six months if they failed boards, now they can shorten that time period. Students must now study for NCLEX while studying for finals if they want to enter the workplace quickly. No longer were there any graduate nurse positions, all nursing positions were the same. This changed the focus and ownership of orienting our newest nurses from the employer to employee. Orientation was no longer differentiated for new and experienced nurses.
This shift in accountability caused a shift in dealing with mistakes. Errors were expected of graduate nurses and were met with a reprimand, but not seen as a disciplinary issue. Employers now see all nurses the same because they have license in hand, therefore new nurse mistakes are subject to the disciplinary process. This change made new nurses take an attitude of "fake it until you make it" because asking questions may make more experienced nurses doubt the abilities of that nurse. This has affected the workplace by discouraging loyalty and increasing turnover.
What to take from the above? As a new nurse, please look at the big picture. This is a career, not a job. Despite their outward appearance, most new nurses don't put it all together until the first year and aren't really comfortable until that two to three year point. Those times are full time hours, at least 1800 hours annually. Use your experienced nurses as rich resource. Most of us want you to succeed and have your back during crisis. When you find yourself in over your head, admit it. This is not unique to new nurses, those with a few years under their belt have the same moments.
Experienced nurses, please realize that these new nurses used to be you. They come with the same diversity as the world around us and will not approach nursing the way you do. Be open to the fact that a new nurse may enlighten you to something new. Take ownership of new nurses even if you are not a preceptor. That new nurse that you may have written off as not up to snuff is exactly the one that needs that. Remember criticism is more harsh than correction, speak to build up nurses who are unsure of their abilities, if for no other reason than that nurse may be your backup in the near future.
Nursing has shifted priorities over the last few decades. We have no control over that, but we do have control over how we train each other. Incoming nurses are our future and our seasoned nurses are our treasure. We are all in this together and making the best team means building each other up. NETY does not need to be the culture of a unit, it is all about our attitude.Last edit by Joe V on Jun 15, '18
About MrNurse(x2), ADN
RN who currently works in a SNF and school nursing. Had nearly three decades in critical care.
Joined: Sep '15; Posts: 2,164; Likes: 5,072Jun 7, '17This shift in accountability caused a shift in dealing with mistakes. Errors were expected of graduate nurses and were met with a reprimand, but not seen as a disciplinary issue. Employers now see all nurses the same because they have license in hand, therefore new nurse mistakes are subject to the disciplinary process. This change made new nurses take an attitude of "fake it until you make it" because asking questions may make more experienced nurses doubt the abilities of that nurse. This has affected the workplace by discouraging loyalty and increasing turnover.Jun 10, '17As a RN who was initially educated in the 3 year RN diploma program back in the early 1970s, we worked the final 6 months of school, as though we were staff members, taking charge of hospital units, but under the direction of an established RN. My first nursing job in Providence, RI, after a 3 day weekend off from school (oh, yes-I got an apartment right away and moved out of my home), I was taking charge of a surgical unit by the end of week #2. Everyone thought I had worked somewhere else prior to that job! Afterwards, I continued on for my BSN and MS, finally retiring in occupational health nursing in Sept 2016. So what I am thinking is for the new nurse to go in there, ears open, mouth shut, and learn all you can. Save your questions for the end of the day, or better the end of the week. Ask to do new procedures; i.e. IV starts, dressing changes, IV drugs, charge, etc. Yes, it is anxiety provoking but a learning curve too. You'll find after one year how you have grown from that very first day. Only you can decide to move forward, ask the questions, stay out of the hospital politics, and smile! Godspeed on your workplace journeys.Last edit by JoannieO on Jun 10, '17 : Reason: added the word "do" to Ask to __newJun 16, '17This is an interesting read. You are very correct about the race towards NCLEX and that coveted job afterwards. I secured a job in Feb during my last semester, graduated May 21st, tested (and passed!) June 13th and will be starting my job June 19th. It all seems like a blurr really. My employer offers a 3 month standard new GN residency and also a more extended 6 month residency afterwards (2 yr. contract require for this one). I was fortunate enough to have been able to do my final month long rotation on the unit I will be working at and feel like it's a great team! I am very scared to start this new career but I am also very hungry to learn and thrive in an environment that might or might not tear me down and reduce me to tears.Jun 21, '17I would like to congratulate all the new grads!! Starting any new job causes stress and anxiety. While I do believe that NETY does exist I don't think it is a widespread problem. I agree with Joannie that it is best for new grads (and new hire nurses) to keep ears open, mouth shut, stay out of the politics and learn as much as possible. I would also add that although they should ask questions, there are in fact dumb questions, so find out what you can on your own first prior to asking many many questions, but do ask if unable to locate the answer or if there is an immediate need. Also, please accept "constructive criticism" from experienced nurses as it is (usually) meant: to help you personally, and to help you not hurt your patients. I agree that it is probably harder now than in the past for reasons the OP stated and also because of increased acuity, customer service, more paperwork etc, and experienced RN's are not given the proper time to train. Good luck to you all!!!
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