Help! I have to precept a new grad who already knows it all....but not really.

Nurses General Nursing

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  1. How do you precept a new grad who knows it all?

    • Teach them all you can and hope it sinks in. Set the bar high, do not allow for mistakes or excuses. Make them accountanble.
    • Give them the basics and let them figure it out on their own. They already know everything, so this is just a review, right?
    • Give them the best orientation and knowledge you can, then scare them straight. Give examples of the nursing horror stories.
    • 0
      Coddle them. Tell them they are great. We are all winners, right?
    • Do you let them sink? And while they are sinking, step in to save them and the patient. Make them learn from their mistakes because they would not listen?

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I need your help! How do you teach a new nurse humility and respect along with the fact that they do not know it all? I love sharing knowledge. Being a nurse is a profession that I take seriously and have enjoyed...I particularly like to share what I have learned along the way. I have never been one of the types of the nurses "who eat their young". I have been an Emergency Department Nurse for 13 years. I have been a preceptor for a while, and I am having a bit of a difficult time with a new grad RN. And to be quite honest, I am beginning to get hungry and this new RN is close to being dinner, if you catch my drift.

This RN was previously employed in our department as a tech, and while the RN has learned a lot about the department, they did so in a non-nursing role. The RN has a tremendous amount of potential, but lacks the critical thinking, knowledge and skills that comes from on-the job training and doing in the RN role. While this RN lacks the critical thinking, knowledge, skills and prioritizing (just to name a few), what this RN does not lack is a tremendous sense of self and an overwhelming cockiness that is not well-received on the unit. This RN has already reported several senior nurses for what the RN deemed were "breeches in protocol" when, in fact, the senior nurses were 100% correct for the way they cared for their patients, this RN was just not aware of different techniques used by nurses for many years.

This new RN has already made very unprofessional comments and has degraded the techs and some new nurses in the department in numerous ways.

This nurse may possess some good theoretical knowledge learned in school and may have some good clinical skills, but I fear that the attitude of "I don't need to see this or that because I've already been there or done that as a tech" is going to be to the detriment of the patient.

Does anyone have any advice on how to help a new RN tone down the attitude and learn how to be a good nurse without alienating staff. I feel it is my duty to teach the RN how the Emergency department works, but it is an even bigger duty to the profession of nursing to make sure we help to develop well trained and well rounded nurses who know their limits and are team players. I was taught by one of the greatest nurses I have ever worked with, a nurse with over 40 years of experience and is still working, that the moment a nurse feels like they know it all, that is the time they should retire. I think that is solid advice.

Specializes in PACU.
Thank you so much. This guy already has Human Resources on speed dial for what he feels are "bullying behaviors" and "injustices" to himself. The scripting you have provided is great. I am thinking of bringing in a third party, that way I am covered. He would rather get people fired, than get in trouble and it is not a comfortable place for me to be in at this point.

Definitely CYA and have a manager sit in as a third party.

Thank you so much. This guy already has Human Resources on speed dial for what he feels are "bullying behaviors" and "injustices" to himself. The scripting you have provided is great. I am thinking of bringing in a third party, that way I am covered. He would rather get people fired, than get in trouble and it is not a comfortable place for me to be in at this point.

This changes my answer in the poll.

Specializes in NICU, PICU, PACU.

Well Then, isn't he a treat. I'd have him in with charge nurse, educator and manager. I just don't get people like this.

Wow. What a predicament!

I agree with the others who suggested a sit down meeting with a manager.

Keep us posted....

Specializes in MICU, SICU, CICU.

Cocky people are dangerous. Focus on the knowledge base. For example, does he know the half life of a pressor and how that relates to titrating-probably not. I would quiz him about every skill and intervention and then suggest some reading material. Privately I might say that you have managed to offend everyone with your arrogance and I think it would be for the best if you go work somewhere else.

Specializes in Med nurse in med-surg., float, HH, and PDN.

I agree with almost everything above in PP's. Y'all said it a lot better than I could!

I agree about having a witness there as the guy sounds like he could be slippery.

OP I am hanging on the edge of my seat; I hope you will come back and let us know how it went!

Specializes in Oncology; medical specialty website.
Thank you so much for such a great reply. It is actually a "he" and I will have that sit down.

I hate to say this, but the fact that he's a guy makes it even more difficult. He's probably trying to assert his "macho man" dominance over you.

I had a terrible exp. precepting a new grad when I worked in the ED. She knew it all; at one point she denigrated the nursing program I went to. (Which, BTW, was one of the top programs in the state; it was a three year hospital-based RN program. At the time I graduated, they hadn't had anyone fail NCLEX-RN in over ten years.) She went to an ADN program, and she lorded it over me every chance she got.

One night we had a very sick toddler who was brought to the ED. He needed labs, IV. I intended on having her start the line, but I would go back and help hold the kiddo. When I told her the plan, she said she didn't need my help. Right. Anyone who has ever tried to start an IV, let alone draw labs off it, knows that the kid suddenly seems to have eight arms and legs, all of them flailing. After a long period of time, she came out and grumpily told me (the inferior nurse) she needed me to get the IV because she couldn't get it.

I left that job, but many years later our paths crossed again when I took another job. In the interim, I had obtained some specialty certifications, and she was jealous of that. She'd get angry when a doctor specifically requested me to start an IV or do a procedure.

Fortunately, I got another job after a few years and I never had to see her again, and I was fortunate enough to work with a wonderful group of nurses.

Good luck with your "sit down" with this new nurse. I hope he simmers down.

Specializes in hospice.
This guy already has Human Resources on speed dial for what he feels are "bullying behaviors" and "injustices" to himself.

Sorry to be so blunt, but you're screwed. If you have the sit down, insist on a third party being present. Ask if he can be assigned to someone else, because I have a feeling he's going to drag any preceptor down the drain with him.

I just want to make one thing very clear, I love new nurses. That being said, I love new nurses who have the drive, excitement, passion, dedication and FEAR that is so necessary to embark on a nursing career. I remember what it was like to be a new nurse, and I am grateful to the amazing preceptors I had, who I still consider friends. We need to be able to rely on each other and support each other in the best of times and the worst of times. There are so many things that are taught beyond the classroom, and I enjoy sharing that knowledge. I have always been one of the nurses that new nurses could come to with the questions that we all were afraid to ask. No matter where in life a nurse is beginning his or her career, there is a period where it is necessary to be humble and absorb as much as possible from those who are willing to share their knowledge. Shelve the Ego. It's not welcome. Whether one comes from a ADN program or a BSN program, the fact of the matter is....you know very little until you have been in the trenches and pulling your own weight. Please treat everyone with the respect that they deserve. Nursing is not easy these days, and nurses who have continued to weather the storm of inadequate staffing levels, high census, no breaks, threats to health and safety, mandatory overtime, fear that you will lose your license because of staffing, time away from their families.....these nurses deserve respect, they have earned it. Sitting in a classroom and going to clinicals is hard, no one will take that away from a new nurse.. If you are a new nurse, you will get to the point of these veteran nurses, and when you do, you too will be offended when new nurses come in and do not pay the dues that they should.

Explain to your manager that this new nurse seems to know it all and probably doesn't need your oversight. You're quite fortunate to have the privilege of working with someone who naturally picks things up. Maybe you'll learn a thing or two from them?

If the person has HR on speed dial, why not WELCOME them to sit in on your little discussion. Might make him realize HR is on the side of doing what's in the best interest of the hospital, not the employee. He might need to know that sometimes, if the wheel squeaks TOO MUCH, it gets replaced, rather than greased.

Specializes in Med-Surg, Emergency, CEN.

I'm another one who has recently had an orientee like that. I ended up speaking to the nurse manager and having them orient with another preceptor as an objective third party/second opinion. They shared my concerns and that person is no longer in our department.

please do keep us updated! And good luck!

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