Why Actions Speak Louder Than Words and Why Researching Is Important

The first year of licensure is overwhelming and anxiety-inducing, but, ultimately, it should be a time of exponential growth into a competent nurse. To build confidence--and therefore competence--more quickly, extra work is often necessary for the critical first year. Using an example of what not to do, the author illustrates how growth may become delayed or stunted without it. Nurses Announcements Archive Article

Why Actions Speak Louder Than Words and Why Researching Is Important

I've been a nurse for almost a year now. I research and study at home because I want to know the whys of what I do and know the best practices. I have my own binder of P&Ps that I have printed off the work intranet. I don't know everything (who does?), but I work at knowing as much as I can.

We sometimes have agency nurses where I work, and they usually just need help with knowing where things are, unit-specific processes, and occasionally asking about a P&P. They have been great to work with, and they have definitely taught me a few things, too.

Actions speak louder than words.

One night, we had an agency nurse that I've never worked with before. She started out by proclaiming, "I'm a team player," and for some reason that would be proven throughout the shift, my bull**** meter went into the red.

1) During night downtime, she spent the shift with her head buried deep into Facebook and texts on her phone.

2) She never answered the unit phone.

3) As is my habit, I tidy the nurse's station and restock meds carts and make a reorder list during some of my night shift downtime. As I was doing this, the nurse was again busy with her phone, and I had to ask her for assistance.

4) As end-of-shift neared, we had to move one of my patients to make way for a dayshift admission that needed to be close to the station. As the charge was giving me the new room assignment, I mentioned that I would like help for the move because the patient had equipment and supplies and a lot of personal belongings that needed to be moved. The agency nurse looked at me, then went back to texting. Again, a deliberate request for help to her specifically had to be given to get the assistance from her. As we went into the room, she just stood there, unsure of what to do. "All of this has to go," I said, thinking that would be enough. Nope; no movement. "Please roll the suction machine and the IV pole to room 426." Ok, that was enough to get her moving. When I got to room 426, I found the suction and the IV pole outside the door of the room, and the nurse was nowhere to be found.

Researching and initiative is important.

It is assumed that agency nurses have a broad knowledge base and are adaptable to different units, and that they would refuse an assignment that was out of their skill set.

With the first question about a very common cardiac med, I answered it and asked her how long she had been a nurse. She claimed four years, but only one as agency. "I'm a med surg nurse--not a telemetry nurse--but they keep putting me in telemetry." "How long have you been assigned to telemetry?" I asked. "All the time for the past year," she replied. She went on to say, "I've asked for telemetry classes, but it hasn't been arranged yet." I gave her the name of the book I bought off Amazon when I first got my job and explained the the EKG basics class during my orientation didn't cover any more than the book did.

Somehow I doubt that she'll even Google the name of the book.

During report, I overheard her say more than once, "I'm not a telemetry nurse," when asked what rhythm her patients were in overnight. Not once did she ask any of the permanent nurses to help her read the monitor.

I got the distinct feeling she lacked confidence in her skills, but I also knew that she took no initiative to gain the knowledge that would increase her confidence.

I've put this in the first-year forum for one reason: To give you a tale of what to do and what not to do. After the first year, there is an expectation of moderate competence in your specialty. The first few months of my career was spent just becoming acclimated to what nursing really is, the P&Ps and unit-specific processes, increasing time management skills, and learning who to call and when to call. Researching and studying on my own helped accelerate my learning. Being able to pick up on what other nurses are doing was also very important. You don't have to stop everything and deliberately observe; just keep one eye and one ear open to what is going on around you. It all increases your own confidence. Being a team player requires confidence to get in there and get your hands dirty, rather than waiting for someone else to tell you what to do.

Your own initiative can make or break your career and your reputation among co-workers. If you aren't invested in your own learning, how can they be? Learning never, ever stops. Every shift, I come across something that I need to take a couple minutes to research at that moment or when I get home. It has built my confidence in my practice. It has also kept me grounded to recognize what I don't know and ask for help when I need it.

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dudette10

About dudette10, MSN, RN

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Specializes in Hospice / Ambulatory Clinic.

I'm not disagreeing with this per post say but it does sound a little holier than thou almost like your trying to bolster your self esteem by point out in detail the flaws of someone you don't really know. I'm an agency nurse. I love being an agency nurse but I do have situations where a staff nurse will assume I am incompetent simply because they don't understand that I'm talking about something on a slightly more complex level.

Good on you for going to extra mile. But don't make one person a scapegoat for your own ego.

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I do not understand why the OP feels the need to point out the shortcomings of an agency nurse when the same shortcomings can be found in many permanent employees at many facilities. If you didn't like seeing her face in Facebook, perhaps you should have given a suggestion on how she could better spend her time.

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Specializes in geriatrics, IV, Nurse management.

I hardly think the OP is using the agency nurse as a scapegoat. I work with a few nurses - not just agency nurses, but staff nurses who act similar to the agency nurse that OP is describing. I've been an RPN for almost 2 years. I research everything, clean and stock the nursing office in my spare time, and love reading the charts to keep up to date on everything. I follow agency nurses who come in for wound care, paramedics who come in for emergencies, and case managers to see how they present themselves to clients. I have met many nurses who care themselves the way OP does - striving to be the best nurse they can be. And I have felt the pain OP has, when a nurse who has all the experience behind them, but lacks the initiative to continue expanding on their learning. I do no know OP but I believe she was not using agency nurses as a scapegoat - rather pointing out flaws that can be noted in every field of nursing because each person is different.

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Specializes in Hospice / Ambulatory Clinic.

She was pointing out the flaws of others then pointing out the strengths of herself. I don't mind being proud of your strengths but not at the expense of others. You don't need to push someone down in order to build yourself up.

Reading that post just gave me an icky feeling rather than a warm fuzzy about a nurse going the extra mile to learn. Young nurses eating young nurses is something I see ALOT more than old nurses eating young nurses.

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I don't feel the OP was putting anyone down to build herself up.

The fact that it was an agency nurse has nothing to do with it.

It just happened to be an agency nurse that behaved this way.

I believe the point of the post was to stress to first year nurses to take the initiative to educate themselves.

I have never found any of dudette10's past posts to be arrogant and self-serving and I do not believe that is her intent here.

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Specializes in geriatrics, IV, Nurse management.
She was pointing out the flaws of others then pointing out the strengths of herself. I don't mind being proud of your strengths but not at the expense of others. You don't need to push someone down in order to build yourself up.

Reading that post just gave me an icky feeling rather than a warm fuzzy about a nurse going the extra mile to learn. Young nurses eating young nurses is something I see ALOT more than old nurses eating young nurses.

I feel she was more pointing out what is wrong in the situation. The nurse is playing on Facebook while other nurses are running around working. Why can the other nurse not jump in? I think she was more comparing herself to the other nurse to prove the point of the post. Maybe it is the way of the posting that I can relate to, so I don't see the icky or warm feeling. Maybe it is just my experience, but I see a lot of nurses being eaten despite new or old experience, and a lot of attitude in the field.

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Specializes in ICU.

I agree with Hygeine Queen. Sometimes I wish cell-phones and Facebook had never been invented. I, too, work with people who can't bother to look up from their cells to even acknowledge your presence, let alone do anything extra. I also wish to say that I don't understand how people graduate from nursing school without being able to read a basic rhythm. We had to learn this back when I was in an ADN program, years ago! During our clinicals, we had to know how to read what rhythm the patient was in, and document it. When I graduated, I had no experience in a hospital, period, other than clinicals, and I was hired as charge nurse for a telemetry unit! I had 5 days orientation, and you better believe I spent countless hours going over rhythms until they were set in stone in my memory. Today it seems that nurses get out of school, then expect to be taught everything in a 6 month orientation. What are they teaching in school these days? As for agency nurses, there are good ones and bad ones, and I have worked with some that were put on the "do not come back" list. We had one who had never heard of solu-medrol, and one who had never started an IV. (There is no intent to bash agency nurses, but this is the topic presented here.)

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Specializes in Med/Surg, Academics.

Thank you for all the comments.

It was not my intent to pick on agency nurses. This is really the first nurse I've ever come across, agency or co-worker, that has had a good number of years under her belt that I observed has not taken the initiative to improve her practice or act like a team player. I thought a lot about why. I felt that she lacked confidence, even after four years of being a nurse, and I thought about those things that have helped me build an iota of confidence in myself. You can't wait around for education to be provided to you; you have to do it yourself.

I've seen long-term (decades-long nurses) ask others for help and build their own confidence in tasks they might not have done since nursing school. I've seen and participated in stimulating debates about nursing interventions that have no policy associated with them. "What do we do in this situation? Why do we do that?" I just couldn't imagine this particular nurse doing that.

If you felt I was wrong or arrogant in using an example of what not to do, I disagree. I felt it was a powerful illustration.

I do want to make one thing clear: This is not and was not intended to be a diatribe against agency nurses, and I hope that the thread will not veer off in that direction. I suppose I could have written it without the agency modifier, and it would have carried the same message. Seeing the responses and anticipating that the thread will go the agency/anti-agency direction, I regret I didn't do that.

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Specializes in LTC Rehab Med/Surg.

I'm not the agency nurse, but neither am I the nurse who researches and studies at home.

I'm somewhere in the middle. Exactly where most of us land. That's ok with me. I kind of take exception when someone infers that where I am in the spectrum is inadequate.

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With six months into my first RN position, I too find it useful to do my own research at home. I am reading Basic Arrhythmias right now, so I can really be competent in my position and do the best for my pt. I have forgotten much of what was taught in school and I go back in my medsurge book to regain the knowledge. Also, since I desire to go into psychiatric nursing, I read from a psych. nursing book and I like to do ceu's when I have the time. So I think it is up to the individual to stay vigilant in learning. I too have seen nurses that read kindle at work and play games and I am thinking, "how the heck do they have time to do that", I mean I know I am slow at getting somethings accomplished but should not they be doing something pertaining to the job? But, I am glad that I am not the only one that studies away from work, I just am so busy at work I dont have time to do any extra research like I enjoy doing. Good post and I like the opinions

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Specializes in Hospice / Ambulatory Clinic.

If you felt I was wrong or arrogant in using an example of what not to do, I disagree. I felt it was a powerful illustration.

It would have been a powerful illustration is you hadn't followed up every example with what you did right. Thats my opinion on the matter and you are entitled to disagree. Sometimes things don't come across the way we think they do.

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