Over Confident GN's

Nurses General Nursing

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Specializes in Telemetry/Med-Surg.

I have only been precepting for a few months and I love it. I do however need some advice for one of my orientees. This person has no fear or messing up what so ever and feels she knows everything already (very scary) and the ironic thing is the orientees that are about pooping their pants with fear of making a mistake are doing really well; this one I can not even trust to draw up medications because I have watched her reconstitute things incorrectly after I have talked her through what she needs to do, calculate rates for IV medications incorrectly and try to hang meds without checking the compatability. She also does not do a name and date of birth check before meds I have to remind her, I found a pill on the floor and she insisted it was not from her med pass when the patient told me he dropped it after she gave it to him and walked out, thankfully it was tylenol. The list goes on and on. Besides this she used to be an aide and asked the other aides how it feels to have her in charge now :banghead: and she will shirk responsibilities that she feels are not "RN" specific. I would never treat any of my aides like this they work with me not for me and I tried to explain this to my GN. I am trying very hard to correct her in a positive manner and role model with the aides so she stops this.... it is not working. How can I approach her in a constructive manner without being abrasive. I don't want to make her orientation a negative experience and be looked at as one of those nurses who eats their young. Any advice from seasoned preceptors who have dealt with this type of new nurse before would be so appreciated.

Specializes in Oncology.

Talk to your unit's head nurse. It sounds like she needs to go. Generally if people are not receptive to constructive criticism things don't get better.

Specializes in Emergency Medicine.

Wow! In my opinion... tactfulness ends where patient safety is compromised.

If she can't be trusted to do the right thing pull her off the floor. Period.

It needs to be explained to her that no one knows everything and that patients get hurt when a nurse stops asking questions.

I would get her instructor involved, sit down for a 3-way counseling session. She needs some remediation at very least... then when she returns to the floor you absolutely observe EVERY aspect of her passing meds and patient care until YOU feel she is competent enough to handle tasks on her own.

I have seen this situation before and it's up to you to set her back a few pegs before someone gets hurt from an incompatible medication, wrong dose, or other mistake.

I know that you feel like you want to make her transition an enjoyable and comfortable one but just some people don't appreciate the opportunity to learn from the experience of others. I smell real danger here if uncorrected.

Specializes in Telemetry/Med-Surg.
Wow! In my opinion... tactfulness ends where patient safety is compromised.

If she can't be trusted to do the right thing pull her off the floor. Period.

It needs to be explained to her that no one knows everything and that patients get hurt when a nurse stops asking questions.

I would get her instructor involved, sit down for a 3-way counseling session. She needs some remediation at very least... then when she returns to the floor you absolutely observe EVERY aspect of her passing meds and patient care until YOU feel she is competent enough to handle tasks on her own.

I have seen this situation before and it's up to you to set her back a few pegs before someone gets hurt from an incompatible medication, wrong dose, or other mistake.

I know that you feel like you want to make her transition an enjoyable and comfortable one but just some people don't appreciate the opportunity to learn from the experience of others. I smell real danger here if uncorrected.

Unfortunatly our management team is not very receptive when told about the short comings of new nurses. It always gets pushed back onto us that well you need to show role modeling behavior and be understanding of them during this transition, and yes I agree she is way beyond that. I hate to say it but there is not much accountability on the floor which I work and we get very sick patients. I know a lot of how this is rectified will fall on the other preceptor working with her and myself. I know you have to loosen the reins at some point but I can't with this person at all, I am over her should with anything that could potentially cause harm, then after the tylenol incident I feel like I must be there all the time. I have been writing these things down, maybe I should meet with her after work and present it to her in black and white and tell her that she still needs to master the basics before she can master anything else and have her focus on just doing assessments for awhile and have her shadow me on the medications.

here we have an example of someone who shouldnt have graduated nursing school, wonder if she cheated her way thru?....it appears that it isnt that she is unable to learn, but chooses not to, (actually, she probably sees her way as the right way). she needs to be let go, canned, fired.,,,,,whatever term you want

If it were me I would set up a program with a series of competencies that she must meet to your satisfaction and have a meeting with her and let her know that if she doesn't meet them to your satisfaction then she is out.

I would document everything so that when the time comes to relay this to your managers they have no recourse but to let her go. If you feel that she is unsafe then it is your responsibility to protect the paitent. JMHO

nlhnurse1982.....I know you asked for seasoned nurses to comment but I am a new grad that would like to give you some encouragement.First off I think that you have very legitamate concerns with this nurse. I think its absolutely nuts that this new grad thinks she knows everything. Those are usually the nurses that get themselves into trouble. As a new grad I realize how much I don't know and therefore I should listen to the counsel of my preceptor and more seasoned nurses. If you present the information to her in a professional/respectful way then you won't look like one of those nurses who "eat their young." That term comes from nurses that are verbally abusive to younger nurses and it does not seem like you are one of those. You have objective information to present to her so hopefully she will understand that it is not your opinion but simply what you have observed. If she becomes defensive then I would just mention to her that you are being a patient advocate and that you are trying to help her become a better nurse. However, if she is completely resistant to it then yes she should be fired. A nurse (especially a new grad) that is unwilling to listen to constructive criticism should not be caring for patients and you definitely should not have the stress of precepting her. I hope everything works out. Good luck to you.

I am willing to bet that your facility has a probationary period, most likely 90 days, in which an employee could be terminated easily. Bring you concerns to your manager, tell her that you cannot do anything except monitor her actions, for fear of her doing something wrong and harmful. Put it in writing, too. Remind the manager about the probationary period, too.

Specializes in Oncology.

This is the reason I refused to work on the same floor that I used to work before as a CNA once I graduated from nursing school a year ago.

Instead, I found another hospital and started fresh and without preconceived notions about me. I did very well, even though I must admit I also made mistakes nobody whispered about me.

Wow interesting post,first of all kudos to you for being an awsome preceptor.You are an example of a picture perfect preceptor and we new nurses need mentors such as yourself who instead of pushing new nurses down approach them in a patient and respectful manner.I would suggest to you to set up a private meeting with this nurse and voice your concerns in very clear and firm manner and see how she will respond. You can always say something like that "I see a lot of potential in you and you may turn out to be a great nurses however I think that you appear to confident and you must realize that it takes years to go from novice to an expert and I dont really wont to see you fail instead I want to help you to become a successful nurse that I believe you can become.Approach her with a friendly manner,dont accuse her rather try to point into right direction.Yes at first she may feel like you are attacking her but there is a good chance she will understand that you are looking out for her. If that should fail then there is nothing really you can do for her and you should take it up to managers.

Specializes in Rehab, Sub Acute.

This is a hard situation... due to the fact that this GN dose not have her own license and is working under yours, therefore if she makes an error, you will be responsible for it. I would explain that to her and tell her that all nurses have their own ways of doing things, but while she is under your license, she will either do it your way, or she can just observe, because after all, it is your license that would be on the line if she dosent care enough to do things the right way. CYA and good luck!

i have had the misfortune of working with someone just like this, except she had already passed nclex and so was working under her own license. she was an er nurse and i came into contact with her as i would come to the er to pick up my ct patients. she was very vocal about everything she knew and even claimed to not have taken the plastic wrap off some of her nursing books in school. i was a nursing student and it was even obvious to me how very very scary she was.:no::no::no:

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