new RN's in specialty areas - page 4

I have been noticing many posts of new nurses being overhelmed. Many seem to be entering specialty areas soon after finishing their RN programs. Does anyone else see that perhaps a trend here that... Read More

  1. by   GadgetRN71
    Quote from Ann RN
    Do you have any idea what you are REALLY getting into? A year as a nurse apprentice is not the same as a year as a graduate nurse on a general peds floor. And I hate to tell you, but you WILL be working with adults - parents. They can be harder to deal with than adult patients. Orienting new grads has absolutely burned out the majority of the seasoned nurses where I work. It is extremely hard to do. You will not have the assessment skills you need to pick up subtle changes when your preceptorship is done, & IMHO that is not safe - for both children & adults. I believe a patient deserves the safest & highest quality care possible. And I'm sorry, but that is just not from a new grad in a specialty area.
    At my hospital, we were not "nurse apprentices"..we took a full assignment or in my case I ran rooms by myself. We had back-up though, in case something went wrong. I still believe there is nothing wrong in orienting new people when you are a seasoned nurse. If a seasoned nurse is getting "burned out" by showing someone the ropes then this is a nurse that needs an attitude adjustment at best and maybe needs to quit or take a leave , at worst.

    The argument can be made that sometimes, the experienced nurses get into a rut or fall into a thinking pattern of they don't want to keep up with trends, new ways to do things. They simply trudge along, doing things the way they were taught in NS 30 years ago. I believe patients deserve competent, compassionate and up to date care. I also believe we all learn from each other and we all have our place.

    I think of it this way, I don't believe a patient on a med/surg floor deserves a nurse who is merely putting in his/her time, with a view of leaving in a year to do what they really want to do.
  2. by   Ann RN
    Quote from NancyNurse08
    I have every intention of continuing in my specialty area as a new RN. It's where my heart is, and where I want to be. I have a lot to learn, but my co-workers are happy to teach me. They were all new once, too, and their co-workers had to teach them. Some day, I will be the one teaching new nurses. I'm really glad I don't work somewhere where nurses don't want to teach or help one another. That does not sound like an environment I'd want to have anything to do with.
    I'm trying to do this without being personally critical. I do not want to put all new nurses in the same basket, so to speak. You have been blessed to work in a unit where all the seasoned nurses are happy, no one is burned out & all is well. This is a rarity.

    Believe me, it's not that we do not want to teach or help new nurses - far from it. Nothing makes us happier than when we see a new nurse "get it". But there have been far too many times when we have seen a pt.'s care compromised because of a new nurse who did not "get it" & did not know enough to ask for help. We have seen critical labs missed & subtle clues that were not picked up. We have seen new nurses who had no critical thinking skills. And while we're precepting, it's OUR licenses on the line. Precepting is not easy - it's not just being there if the new nurse asks for help. It's anticipating, proactively teaching, monitoring, constructively critisizing, teaching more, evaluating, etc.

    So please try to understand our point of view. We're tired. And sometimes we just want to take care of our own patients.
  3. by   MikeyJ
    Quote from WitchyRN
    I think of it this way, I don't believe a patient on a med/surg floor deserves a nurse who is merely putting in his/her time, with a view of leaving in a year to do what they really want to do.

    Absolutely agree! There was a seasoned nurse of 25+ years who I encountered during my psych rotation. She did many years in med/surg followed by different ICU specialities and IMC, and eventually entered psych. She was asking a few of us what area we planned to enter after graduating and a said I was going to startin the PICU, another said she wanted to start in CVICU... and the nurse snapped back with "well, you need to put in your time on a med/surg unit.. that is how I had to do it when I graduated X years ago."

    Seasoned nurses had to essentially start out on a med/surg unit when they graduated but the profession has come a long way since then and I think nursing school has come a long way as well. That coupled with the nursing shortage allows for new grads to start in whatever specialty they want to start in.

    If a new grad is not happy working in a med/surg unit, there is no reason for them to put their "time" into that unit. They would be doing the patients and hospital more of a disservice than anything.
  4. by   MikeyJ
    Quote from Ann RN
    I'm trying to do this without being personally critical. I do not want to put all new nurses in the same basket, so to speak. You have been blessed to work in a unit where all the seasoned nurses are happy, no one is burned out & all is well. This is a rarity.

    Believe me, it's not that we do not want to teach or help new nurses - far from it. Nothing makes us happier than when we see a new nurse "get it". But there have been far too many times when we have seen a pt.'s care compromised because of a new nurse who did not "get it" & did not know enough to ask for help. We have seen critical labs missed & subtle clues that were not picked up. We have seen new nurses who had no critical thinking skills. And while we're precepting, it's OUR licenses on the line. Precepting is not easy - it's not just being there if the new nurse asks for help. It's anticipating, proactively teaching, monitoring, constructively critisizing, teaching more, evaluating, etc.

    So please try to understand our point of view. We're tired. And sometimes we just want to take care of our own patients.
    And once again, this is something you need to bring upto your hospital administration -- NOT the new grad. The hospital is the one who is offering these positions to new grads. The new grads did not walk into the HR office and demand an ICU position.

    I think new grads understand the seasoned nurses point of view, but again, these positions are open and new grads are HEAVILY recruited by hospitals to work in ICU positions. If a seasoned nurse disagrees with a new grad in an ICU position, go speak with your nursing administration.
  5. by   Ann RN
    Quote from WitchyRN
    At my hospital, we were not "nurse apprentices"..we took a full assignment or in my case I ran rooms by myself. We had back-up though, in case something went wrong. I still believe there is nothing wrong in orienting new people when you are a seasoned nurse. If a seasoned nurse is getting "burned out" by showing someone the ropes then this is a nurse that needs an attitude adjustment at best and maybe needs to quit or take a leave , at worst.

    The argument can be made that sometimes, the experienced nurses get into a rut or fall into a thinking pattern of they don't want to keep up with trends, new ways to do things. They simply trudge along, doing things the way they were taught in NS 30 years ago. I believe patients deserve competent, compassionate and up to date care. I also believe we all learn from each other and we all have our place.

    I think of it this way, I don't believe a patient on a med/surg floor deserves a nurse who is merely putting in his/her time, with a view of leaving in a year to do what they really want to do.
    We do not "trudge along". We are still learning, even after 30 years. We have to - things change. So please do not make the argument that we fall into a pattern. We take responsibility for our own education. And we do well. In no way do I believe that a new nurse getting experience on a med-surg floor is merely "putting in time". I applaud him/her for having the forethought to hone their time management & assessment skills while getting exposure to various treatments & procedures.
  6. by   Ann RN
    Quote from sistermike
    And once again, this is something you need to bring upto your hospital administration -- NOT the new grad. The hospital is the one who is offering these positions to new grads. The new grads did not walk into the HR office and demand an ICU position.

    I think new grads understand the seasoned nurses point of view, but again, these positions are open and new grads are HEAVILY recruited by hospitals to work in ICU positions. If a seasoned nurse disagrees with a new grad in an ICU position, go speak with your nursing administration.
    And once again, I am just trying to help new nurses understand how we sometimes feel. And why. Believe me, it is not a personal affront. It is not an attack. And if you think a seasoned nurse's humble opinion on who the hospital should hire matters, you're kidding yourself.
  7. by   MikeyJ
    Quote from Ann RN
    We do not "trudge along". We are still learning, even after 30 years. We have to - things change. So please do not make the argument that we fall into a pattern. We take responsibility for our own education. And we do well. In no way do I believe that a new nurse getting experience on a med-surg floor is merely "putting in time". I applaud him/her for having the forethought to hone their time management & assessment skills while getting exposure to various treatments & procedures.
    However, if a nurse absolutely despises working on a med-surg floor but is doing so because it will "hone their time management & assessment skills" -- I really don't think it is being effective. They are probably going through the motions to put in their time so they can do something they enjoy. Why not let them start off in an area where they are enjoying themselves -- they would learn a lot more.

    I would have no problem starting off in a pediatric med/surg floor; however, I despise working with adults and never will, thus if I were forced to work on an adult med/surg floor, I would merely go through the motions everyday to get my "time in".
  8. by   MikeyJ
    Quote from Ann RN
    And once again, I am just trying to help new nurses understand how we sometimes feel. And why. Believe me, it is not a personal affront. It is not an attack. And if you think a seasoned nurse's humble opinion on who the hospital should hire matters, you're kidding yourself.
    We (or at least I) hear you. I hear your concerns. I hear your frustrations. But the seasoned nurses (the ones I have encountered anyway, and some on this board) who are absolutely against new grads in the critical care setting don't really hear what the new grads have to say and their point of view on entering a critical care setting.
  9. by   MAISY, RN-ER
    There is nothing wrong with new grads or anyone else in a specialty area as long as the training is sufficient to identify and treat stablized patients or emergency patients.

    I am sure failure to rescue is occurring in every part of nursing, partially due to lack of knowledge, partially due to sicker patients, alot to do with staffing ratios and patient locations. My issue is that good old fashioned nursing skills have to be practiced in order to keep our patients safe.

    If you read the following account I posted-the nurses involved were new grads and 20+ year experienced nurses-good old fashioned nursing 101 and patient advocacy would have kept this a good situation. It is not.

    I am a new grad with 2+ years under my belt-in under 2 minutes I had a full picture as I saw my FIL after spending one day in med surg. Tons of staff had been in the room, but no one "saw" him. Learning a specialty gave me that skill-it may be too late for him....but, after I am done in this hospital, it won't be too late for others.

    We are all only as good as our education, work ethic and culture allow us to be.
    https://allnurses.com/forums/f8/asse...st-297375.html

    Maisy:stone
  10. by   HM2VikingRN
    I think the whole process of nursing school admissions has raised the overall cognitive level for nursing students. When I graduated from HS in 1978 if people wanted to become nurses it was pretty much an open door for entry into nursing school. Now with admission criteria so high it is almost easier to enter medical school than become a nurse. At orientation for my accelerated RN class the prerequisite gpa for NS was 3.6. My adviser (with a PhD) commented that she would not be admitted to nursing school today as an undergrad with that gpa screen.

    Look at the number of posters here on the site who are on 2 and even 3 year waiting lists to enter nurses training. I think the nursing school admissions process has literally selected for a group of graduates who have the cognitive skills and desire to enter specific nursing specialties. (Adding in BSN, direct entry MSN and accelerated BSN programs serving second career adults it acclerates this trend even more.) Thinking and training plans for new grads need to reflect this new reality.
    Last edit by HM2VikingRN on Apr 21, '08
  11. by   loriann
    When nurses say "I did my time in M/S and so should you," the picture I conjure is one of a prison where a person is expected to x, y, and z before he/she can move on.

    Seriously, I didn't start in M/S, never want to go there and never will. I don't think I'm a horrible nurse for not going and as long as a person continues to learn, ask questions, apply himself, I see no reason why a new grad can't be successful in a specialty area. Learning is something a person needs to continue to do throughout life, new or seasoned nurse.

    If you want to go into a specialty area, jump in, embrace it, read up in your spare time, and ask questions.
  12. by   RNperdiem
    Things were simpler once.
    Hospitals simply didn't hire new grads for speciality areas.
    The least popular shift on the med-surg floors were where you began since they were the only ones hiring.
  13. by   wooh
    Quote from WitchyRN
    I think of it this way, I don't believe a patient on a med/surg floor deserves a nurse who is merely putting in his/her time, with a view of leaving in a year to do what they really want to do.

    Not to mention, it gets old orienting new nurses over and over again on med/surg floors that are just doing their time until they can go where they really want to. Kind of like ICU nurses that don't want to orient nurses that are just doing their time on the way to CRNA school.

close