What makes you nervous about or irritated with a new grad or orientee? - page 8
I've noticed alot of threads lately from new nurses who seemed quite stressed out, which I can totally understand, I've been there for sure. So I thought I'd start a thread from the other POV. This... Read More
Jan 11, '07Occupation: Re-retired Specialty: 42 year(s) of experience in NICU, Infection Control ; From: CA, US ; Joined: Dec '00; Posts: 12,425; Likes: 3,780When I was a new grad, I had good support from my co-workers. But I did have one problem: it took a few months to realize that I wasn't a student any more, and there wasn't always time to take a pt to a proceedure/exam and then stay and see what they were doing to "learn" about it. If finally dawned on me that I needed to get the work done first!
Jan 11, '07Joined: Sep '05; Posts: 1,277; Likes: 359Quote from new er nurseAh, yes, I DO remember! The preceptor I had was so good - she praised me for doing the smallest things properly - she was a very laid back, very knowledgeable person, and I still remember how dumb I must have been about some things. When I first went to school, we didn't have IV pumps, so mastering them seemed SO difficult - now I couldn't count a drip to save my life.A nurse once told me while I was still in school, "when you graduate you will find out how much you don't know". He was so right. Don't be afraid to ask questions. The know-it-alls are the most scarey! I especially see this in the ER with students. They don't need to start another IV because they started one yesterday. Guess what!!! Each start is different and you learn every day. When you think you know it all look out!!!
Jan 11, '07Occupation: RN Specialty: * Cardiology * Oncology * Medsurge RN ; Joined: Dec '06; Posts: 1,220; Likes: 855As an orientee almost 2 years ago, looking back I am so grateful for the patience, long suffering, and kindness shown to me by my preceptors...wow, they really were great!
I was such a poor new nurse that my department head decided it would be best to extend my tour of duty under the tutelage of an awsome nurse who to this day remains one of my heroes on my unit.
I have learned from my kind treatment as an orientee to treat students, aspiring nurse aides with kindness and consider them for little teaching moments...this is one way I show others what a super job my hospital did orienting me :+)
Jan 11, '07Joined: Jun '02; Posts: 14,198; Likes: 59,491Quote from colleennurse[font="comic sans ms"]quite frankly, many of us have been put off giving constructive criticism by the attitude of those we are trying to help. when you try to help someone with a gap you've noticed in their knowlege base or an area in their skills that is weak and they lash out at you for trying to help, you think twice about trying to help again. i pointed out an error in the way a new grad was totally her i & o's a few years ago, and she went off on me. i thought i was being calm, reasonable and focused on the is & os, not on her mistake. she told me that she was off orientation now, and i needed to butt out. the next day, the head nurse called me into her office to discuss "why you made wendy cry."quite frankly i wish i could get more constructive criticism, but when you are off orientation, it is hard for anyone to be watching me to tell me if there are things i could improve on. nursing is for sure like no other job i have ever had!
another time, i was trying to help a new grad figure out why his pumps kept beeping. turns out, he had heparin and lasix trips infusing through the same line, and they'd precipitated, clogging the line. i explained why they can't go together and helped him change the tubings. later, i overheard him on the phone telling his so that "this old witch just won't leave me alone. she jumped all over my case because my pumps were beeping. why can't she just worry about her own assignment and let me figure my own out!" when this sort of thing happens over and over, you get out of the habit of wanting to help!
Jan 11, '07Joined: Oct '06; Posts: 1,256; Likes: 66A lack of humility in nursing is a big obstacle to advancing. I know nurses like this, not just new grads.
Jan 12, '07Joined: Jun '05; Posts: 4monkeydance: I just could not resist responding to this thread. In my experience as a newbie, I never turned down interesting procedures, or any procedure. My issue was, without being a know-it-all, having an LVN with less experience than me showing me how to draw up a syringe or how to chart, duh, what a waste of time. another thing is the culture of each institution. Like the hospitals where practically every other staff violates good/standard nursing practices, like being asked to give injections or other meds with pre poured meds,for the convenience of another nurse. Knowing that patients were not getting baths, ambulated, or attention. Or all the staff take breaks at the same time leaving the newbie to deal with whatever develops. Anyway, I became seriously ill and now I'm retraining into another 'less stressful' field. I never felt supported at the end of my nursing career of 20 years when I was not strong physically. I felt like an old shirt getting tossed. It was frightening to me when I was a patient and totally vulnerable knowing what I know.
Now, I hope to find a nice job with decent pay after my retraining.
One more thing, karma caught up with some of the hospitals where I have worked. I read in the local newspapers about Federal and State investigations of patient care and government threats to revoke medicare and medicaid reimbursements and licenses. All I get is a hollow feeling while wondering how the patients are managing.
Quote from KellNYYep, know-it-all new nurses bug me. When I try to show them something (ie: "They're going to extubate Mr. Smith-why don't you go assist?" or "Mrs. Jenkins is going to have a c/s and btl, why not scrub in and assist or observe?") I get back "No, I saw one last week." or "We did that in clinicals."
WTH? Take each opportunity you can to learn. No one expects you to know everything. Nurses are never done learning. I can say with honesty that I've never seen two identical deliveries. Even now, I still learn something with almost every patient, be it better positioning for comfort...better technique for procedures...different emotional reactions...more words or phrases in Spanish...side effects to meds, etc.
Jan 12, '07Occupation: Open Heart and Trauma Specialty: 26 year(s) of experience in ER, CCU, DOU, L&D, PACU ; Joined: Nov '06; Posts: 29; Likes: 9I agree there is a great deal of extra responsibilty orienting new grads, but I love molding them into experienced nurses with caring hearts. Most days I have a new grad or reentry nurse to orient but I try to instill a sense of nurturing through my professional response to the many questions and obvious uncertainty they are experiencing.
It is wonderful to see a nurse grow into their role and become a confident colleague who in turn teaches what he/she has learned. I rarely get the "Know it all" new grad, but when I do I try to instill a sense of understanding that there are different ways to do most procedures and for now they are here to learn what we expect.
I think any nurse who has an uncaring attitude with patients or families bothers me more than anything. I can train you to be a good nurse but I can't change a lifetime of low self esteem and pain.
Jan 12, '07Joined: Apr '03; Posts: 7,569; Likes: 2,297Quote from banditrnAh, yes, I DO remember! When I first went to school, we didn't have IV pumps, so mastering them seemed SO difficult - now I couldn't count a drip to save my life.
YES!!!!!!! I have to use either a pump or dialaflow if the rate is ordered beyond a TKO or wide open!
Jan 12, '07Occupation: Operating Room Nurse Specialty: 5 yrs OR, ASU Pre-Op 2 yr. ER ; From: US ; Joined: Jun '03; Posts: 17,036; Likes: 1,008I'll randomly think of a few here that i've encountered in 2 years:
The ones that were more interested in flirting with the surgeons and MDAs than learning anything.
The ones that would learn one think, and then have an expert attitude about it.
The ones that made the remarks, during the case, that "this is boooooriiiiing" and then wonder why the surgeon's being so quiet to them.
The ones that constantly told "well at MY hospital..." stories. I understand thaht different places do things differently, and while it's an opportunity to learn something new, to hear those stories 31 (yes i counted) times in 8 hours is a little much.
Jan 12, '07Occupation: Operating Room Nurse Specialty: 5 yrs OR, ASU Pre-Op 2 yr. ER ; From: US ; Joined: Jun '03; Posts: 17,036; Likes: 1,008I think some nurses aren't cut out to be preceptors. Only those skilled at it should do it
One of my first preceptors grumbled the whole time about having to "deal with an LPN, LPNs don't even BELONG in the OR ANYWAY"
(Thank God she left)
She may have known the technical skills of the job, but her personality was such a downer. The ironic thing was that she was also a griper about the short-staffing and the lack of teamwork. Ironically both improved after she left.
Did i mention we have a big celebration at a local restaurant after she left. That didn't include her?
Jan 12, '07Occupation: Operating Room Nurse Specialty: 5 yrs OR, ASU Pre-Op 2 yr. ER ; From: US ; Joined: Jun '03; Posts: 17,036; Likes: 1,0083) Give them extra $$ for precepting.
Jan 12, '07Joined: Apr '05; Posts: 266; Likes: 194Here in Canada, preceptors do get extra $$ for precepting. My first preceptor out of school had never done it before, so had little teaching experience to draw from, and had herself only just returned from a 20 yr leave to raise her children. She was nervous, which made me nervous, and she never made it clear what her expectations were. To top it off, we were on a peds unit with 2 pts at Christmas time and did 12 hr nights. Not a lot going on. When I studied on shift, she was not impressed, yet she and her colleagues were doing crafts for the majority of their shift. I requested a new preceptor and worked with a Wonderful very experienced and centered nurse and had a great experience, even though the acquity on the unit was not very challenging.
Then, in the OR, my first preceptor was an anal retentive person with huge judgemental attitudes towards patients and people in general. She snubbed us in the hall, and her mood would shift from hour to hour, day to day. She's the one who screamed at me. Again, I requested a new preceptor and ended up with 3 wonderful older nurses, one of which I spent the majority of my time with and actually started to enjoy the experience. I thanked her profusely for her gentle way of allowing me to learn.
Anyway, I think that just as there are different personalities among students, there are also difficult personalities in preceptors and if you don't click it is really hard to make it work. I expected to be approached as an adult, not talked down to, and when I preceptored in the OR I expected to be treated like a NURSE but really didn't feel like I was respected that way (by the first preceptor).
Anyway, there is good and bad everywhere I've been, the key is finding a place where you can fit, where you are valued and where your opinion is counted. You will always have to let alot roll off your back, even in a good place. I have found that I enjoy working by myself, and both my jobs allow me to do that. I think I am probably better suited to 1:1 interactions with pts and families, maybe in homecare, teaching or private care/palliative care.
As far as Interleukin's comment about my hours, I work that much partly to pay of loans, and partly because both jobs don't consider that just because I wasn't at one yesterday doesn't mean I wasn't at the other. Both are very shortstaffed, and I was the only staff that either could turn to, or they'd be working doubles or 12's. Which resulted in me working 48-60 hours per week in the summer. I tried to make sure I had 2 days off every week, or a long stretch (3-4) days every once in a while. My point was more that they had so little consideration for how much I was doing.
Jan 12, '07Occupation: psych nurse Joined: Aug '05; Posts: 214; Likes: 23Quote from prmenrsI am glad that there are so many positive interactions with preceptors. My preceptor was wonderful as well. It was the other staff including the manager that were unkind and impatience. Which continued after the orientation was over. It was inhumane, I also lost my only son from an illness during the same time period. I will never forget how I was treated, I would never treat anyone the way that I was, ever.When I was a new grad, I had good support from my co-workers. But I did have one problem: it took a few months to realize that I wasn't a student any more, and there wasn't always time to take a pt to a proceedure/exam and then stay and see what they were doing to "learn" about it. If finally dawned on me that I needed to get the work done first!