How to deal with this conflict? - page 3

How does a newer nurse deal with another nurse who acts like the newer nurse doesn't know anything?... Read More

  1. by   Meriwhen
    Quote from drkshadez
    Ok maybe I took it too personal. But the experienced nurse asked me to make sure I told the patient side effects of a medication I have given 100 times at my previous facility. Also I have a reputation of not only telling the patient side effects, but also putting on the white board the side effects of high alert medications the patient is receiving in terms they understand (example: insulin: shaky and sweaty- call nurse)/ that's just an off the cuff example.

    No arrogance here. Always willing to learn and grow (not a traditional newer nurse with an arrogant I know it all attitude).
    Honestly: I would be grateful that, as a new grad, another nurse was looking out for me and had my best interests at heart by helping me develop my nursing skills. Even if I've given that medication 100 times before...because you never know, you may learn something you didn't know about that med during that 101st pass. Or on that 101st try, you may learn a better way to perform a skill.

    It's great that you don't have the know-it-all attitude. Few things are scarier than a new grad that believes they know it all, because a majority of the time, they really don't. And a new grad with an arrogant attitude really puts others off of wanting to help them. Being verbally smacked back with, "duh, I already knew that!" doesn't really encourage others to offer guidance in the future.

    And you will learn not to take things personally. I think we all took things a little too personally when we were new grads Even years down the road, I can still take the occasional thing too much to heart and have to remind myself that (unless there's overwhelming evidence to prove otherwise) it's not a personal issue.

    Quote from drkshadez
    To add to this: if I have a choice to sit and talk to a patient for an hour about their anxiety over a new diagnosis, or make sure someone's protonix po is given exactly at 11:30 at night, and it is 11 pm- I'm going to choose the former
    As you will start seeing, real-world nursing isn't the same as the ivory-tower world of nursing that you learned about in school and for the NCLEX. In THAT world, you easily have the option to spend an hour-plus to spend talking to a patient while everything else magically takes care of itself: no call bells ring, no medications are due, no other crises happen, and should a crisis happen, you have a cohort of coworkers willing to swoop in unasked and help out while you spend that hour-plus with the patient. The real world isn't that cut and dried.

    Don't get me wrong: I think it's fantastic that you're willing to make the effort to make such a personal connection with patients. There's a lot of nurses who won't do that. But remember that you can't lose sight of the larger picture of patient care. And yes, that larger picture does include the tasks and grunt work that may not always get to have the human touch added. Timely med passes are important, even if it's "just" Protonix PO. But with experience, you will eventually find that balance between the science of nursing and the art of nursing.

    For what it's worth, I'd rather have a nurse who was competent and skilled even if he/she needed to work on the human touch element a bit, than a nurse who is so wrapped up in the human connection that they don't realize they are to give me potassium by IV push.

    Keep doing what you're doing, keep willing to learn, and even if someone tells you something you already know/done/experienced/etc., smile and say "thank you." There's lot of great advice here and you seem to be open to considering it, which is pretty important for a new grad, even a "not a traditional" one

    I think you're going to be just fine.

    Best of luck.
  2. by   JKL33
    Quote from Meriwhen
    For what it's worth, I'd rather have a nurse who was competent and skilled even if he/she needed to work on the human touch element a bit, than a nurse who is so wrapped up in the human connection that they don't realize they are to give me potassium by IV push.
    A-MEN!

    Boy how infrequently do I come across someone who shares my thinking on this!

    When I'm a patient, give me a "meanie" (aka quiet thinker) who knows exactly what she's doing anytime she comes near me. PLEASE. The people in my personal life will cover the rest, thank you very much. Speaking of MBTI....
  3. by   Leader25
    The Hcaps question is have you always been told of side effects of your medications?I think your co worker was making sure you did.
  4. by   drkshadez
    Quote from TriciaJ
    You said yourself that your experience is limited.
    Ok just a bit of clarification I am sorry. Limited in time not in scope. I've given this med I used in this example 100s of times. I learned so much from my first year at a very large hospital but after my first year my wife and I went on vacation to the woods... I realized I needed something different. So I chose a regional hospital with the same company but with less drive time.
  5. by   drkshadez
    Quote from Meriwhen
    Honestly: I would be grateful that, as a new grad, another nurse was looking out for me and had my best interests at heart by helping me develop my nursing skills. Even if I've given that medication 100 times before...because you never know, you may learn something you didn't know about that med during that 101st pass. Or on that 101st try, you may learn a better way to perform a skill.

    It's great that you don't have the know-it-all attitude. Few things are scarier than a new grad that believes they know it all, because a majority of the time, they really don't. And a new grad with an arrogant attitude really puts others off of wanting to help them. Being verbally smacked back with, "duh, I already knew that!" doesn't really encourage others to offer guidance in the future.

    And you will learn not to take things personally. I think we all took things a little too personally when we were new grads Even years down the road, I can still take the occasional thing too much to heart and have to remind myself that (unless there's overwhelming evidence to prove otherwise) it's not a personal

    As you will start seeing, real-world nursing isn't the same as the ivory-tower world of nursing that you learned about in school and for the NCLEX. In THAT world, you easily have the option to spend an hour-plus to spend talking to a patient while everything else magically takes care of itself: no call bells ring, no medications are due, no other crises happen, and should a crisis happen, you have a cohort of coworkers willing to swoop in unasked and help out while you spend that hour-plus with the patient. The real world isn't that cut and dried.

    Don't get me wrong: I think it's fantastic that you're willing to make the effort to make such a personal connection with patients. There's a lot of nurses who won't do that. But remember that you can't lose sight of the larger picture of patient care. And yes, that larger picture does include the tasks and grunt work that may not always get to have the human touch added. Timely med passes are important, even if it's "just" Protonix PO. But with experience, you will eventually find that balance between the science of nursing and the art of nursing.

    For what it's worth, I'd rather have a nurse who was competent and skilled even if he/she needed to work on the human touch element a bit, than a nurse who is so wrapped up in the human connection that they don't realize they are to give me potassium by IV push.

    Keep doing what you're doing, keep willing to learn, and even if someone tells you something you already know/done/experienced/etc., smile and say "thank you." There's lot of great advice here and you seem to be open to considering it, which is pretty important for a new grad, even a "not a traditional" one

    I think you're going to be just fine.

    Best of luck.
    Thank you for this insight. I agree with most of what you said. But I need to flush something out here. I don't have time to go into the intricate details of how I provide quality patient care. At one facility, there was a nurse who was awful to patients and I'm not being subjective here. The patient and the nurse had a bit of disagreement and the nurse said to the patient "Well you don't like me you can leave AMA if you want." At the same facility we had a meeting where we were told discharges will happen within 72 hours of admission so that we can use that bed to generate more revenue for the floor. A patient of mine was about to be discharged in the afternoon and called me out of concern of blood clots in stool. Pages doc and they said they were keeping her and assistant manager asked me why said patient was still here because we need that bed.

    I have encountered patients who don't want that interaction. I am fine with that and just do what I can not just to save lives... but prevent harm and promote safety and comfort.

    So I am not knocking the technical skills or organization / tasks. Before I talked to the cancer patient, I made sure all my antibiotics were hung assessments were done and charted and the other 4 patients were taken care of before their next doses.
  6. by   Kooky Korky
    Quote from drkshadez
    Thank you. But I am not s traditional new grad. Real nursing to me is not technical skills or med passes or even being anal about organization. It's sitting at the bedside and talking to a patient about a new cancer diagnosis who just wants to give up on life - talking for an hour and in the morning patient decides to try therapy. It's comforting someone who has all these chronic diseases with a new diagnosis of heart failure and making sure you advocate for the plan of care they are to receive. It's listening to their story to understand the patient as a whole- not what their illness is and treating their illness safely or without question. It's defending your patient's rights no matter what the cost.?most patients I've encountered in just a limited -year time frame: LISTEN- really LISTEN to them - be mindful of their needs , goals, and preferences.

    I admit I could be wrong, but this is what my limited experience has taught me so far.
    It's not just listening to and spending time with the patient or just skills, organization, and meds.

    It's both.
  7. by   drkshadez
    Quote from Ruby Vee
    Where have you worked that you have that kind of time to sit and talk to a patient for an hour?
    In fairness, it was night shift and the daughter came out of the room and I promised to talk to him if I had time. I was done my first round of antibiotics on 4 different patients and routine meds + pain meds ... and it was 1130 pm so I had the time. More importantly, he was still awake.
  8. by   kbrn2002
    Quote from drkshadez
    Thank you. But I am not s traditional new grad. Real nursing to me is not technical skills or med passes or even being anal about organization. It's sitting at the bedside and talking to a patient about a new cancer diagnosis who just wants to give up on life - talking for an hour and in the morning patient decides to try therapy. It's comforting someone who has all these chronic diseases with a new diagnosis of heart failure and making sure you advocate for the plan of care they are to receive. It's listening to their story to understand the patient as a whole- not what their illness is and treating their illness safely or without question. It's defending yourcpatients rights no matter what the cost.?most patients I've encountered in just a limited -year time frame: LISTEN- really LISTEN to them - be mindful of their needs , goals, and preferences.

    I admit I could be wrong, but this is what my limited experience has taught me so far.
    If you have a job where you have the time to sit and talk to one patient in the morning for an hour that's awesome. But I am going to go with the assumption that you really don't have a job where you can sit with one pt for an hour without sacrificing the care of your other patients.

    Not that communication with your patients isn't important, but it's not the only thing that's important. Being proficient with a med pass and having the ability to complete all tasks in a timely manner are also important and in the vast majority of places we nurses work taking an hour out of a busy morning to talk with one patient just isn't doable.
  9. by   Horseshoe
    Quote from drkshadez
    Thank you. But I am not s traditional new grad.
    What do you mean by "traditional new grad"?
  10. by   klone
    Quote from Horseshoe
    What do you mean by "traditional new grad"?
    Yes, OP. You've said that several times. What exactly do you mean by that?
  11. by   Ruby Vee
    Quote from Meriwhen




    As you will start seeing, real-world nursing isn't the same as the ivory-tower world of nursing that you learned about in school and for the NCLEX. In THAT world, you easily have the option to spend an hour-plus to spend talking to a patient while everything else magically takes care of itself: no call bells ring, no medications are due, no other crises happen, and should a crisis happen, you have a cohort of coworkers willing to swoop in unasked and help out while you spend that hour-plus with the patient. The real world isn't that cut and dried.

    For what it's worth, I'd rather have a nurse who was competent and skilled even if he/she needed to work on the human touch element a bit, than a nurse who is so wrapped up in the human connection that they don't realize they are to give me potassium by IV push.

    Best of luck.
    I'd rather have the competent and skilled nurse as well, even if they aren't perfect at faking compassion. Compassion, empathy, hand holding -- all great. But competence comes first.
  12. by   Have Nurse
    I must admit that I agree with most of the posts here in response to your question. It takes time to win their trust. After all, you are a new grad and you don't know everything. But to be fair, neither do we.

    If you can, try to observe more and use the opportunity to win trust by taking initiative and asking questions, that can be a start. It doesn't taste good, but pride can be swallowed.
  13. by   cleback
    Ok, I get sometimes it's not what's said or done but the manner in which its said or done... and I have a feeling that may be what's going on between you and your preceptor.

    That said, I'd invite you to put yourself in your preceptor's shoes. Every nurse, no matter how long they've been a nurse, will have stuff to learn when starting a new job. The preceptor is tasked with showing how to perform THIS job, in alignment with unit culture and expectations. No one can just assume you'll know about suchandsuch a med, or you'll know how they perform med teaching there. Like other posters have said, they have to assume you don't know and go from there. It would be irresponsible for them to do differently.

    Anyway, I think your annoyance is normal for a new employee. Have a bit of patience and appreciate that they're not assuming you already know the ropes and are willing to teach. For anything that you don't agree with or would do differently, just keep in mind right now you're learning how they do things... when you're off orientation you'll do it your way.

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