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?
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 CCU, SICU, CVSICU, Precepting & Teaching.
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.
If the guy has HR on speed dial, your manager is probably already aware of the problem. I'd ask her to participate in the "Come to Jesus meeting." Or perhaps an assistant manager if you have one. If he's already involved HR, this is above your level.
OP, hope that you have reported your findings to management and hopefully management will arrange a meeting-even if it's for an action plan, where it can be presented in a way that the expectations are clear.; at this point it will be up to management and HR to sort it out
He's going to kill someone with that attitude! There was a chick like this who started at the same time I did, we were both new grads. She knew it all. It was all fun and games until she pushed a paralytic instead of the sedative out of the RSI box during a routine conscious sedation. Patients shouldn't have to suffer because of ego problems. Lay it all out with HR present, fill management in and hopefully something will be done before he hurts someone.
I would never sit with a person and try to set them straight. If you are supposed to train someone do just that, if they choose not to listen and or are breaking established protocols correct them. if they dont listen give feedback to management regarding their suitability to be employed on the unit, let them come up with a remediation plan.
HR 101: When disciplining, conveying, etc., always have a witness in the room. That other person could be your best advocate if something were to go sour. Two heads are better than one.
So with the benefit of hindsight in my career, I have realized that I was very likely the same kind of nightmare to precept. While I never had HR on speed dial or anything like that, I was at times way to cocky, didn't appreciate the wisdom of my elders, thought I knew more than I actually did, and alienated my co-workers from me. My couple of preceptors who sat me down and had some very frank conversations were a huge wake up call for me. It took me several years to repair the perceptions that others had of me, and some of my co-workers never did change their mind about me up until the day I left that job.
I would encourage the frank conversation. When I received mine, it was never framed with malice or any blame. They brought written accounts from my co-workers about things that I had done that had caused problems. At the end of the meeting we had a written action plan that I had to sign along with my manager. They had a couple of nurses who agreed to further mentor me, since I was off orientation. We had regular meetings and progress was documented on the action plan. It really worked for me, taught me a lot of humility and end the end made me a better nurse and a better co-worker for my peers.
I am a nursing student, so, full disclosure, I have no direct experience in this situation from which to draw.
Today, I am "working" on a project about horizontal violence within various healthcare settings. After reading this thread, I am reminded that like "ageism," workplace "bullying" can travel in both directions.
Here are some ideas that I would like to submit:
If you have a shift "post-conference" type debriefing with him, this might be the best time, if not, ask the new grad to plan on one at some time during the next time that you work with him.
During this chat, you might have some success by asking him a lot of questions. Maybe let him know that you and he will be meeting with management and/or HR the next day and you needed to do a pre-questionnaire.
1. What is the guiding goal toward which we make every decision? (I hope that he reports "patient safety") once that one is agreed upon all subsequent coaching should live under the umbrella of patient safety.
2. How he thinks everything is going.
3. When he thinks forward in the next couple of months, how does he see the course of the shifts taking shape. What will his days look like when his preceptor-ship is over? What about in 1 year?
4. How does he perceive the concept of team. When has he participated successfully on a team? How did that go? Is his experience going well now as far as strengthening his team participation abilities?
5. How does he feel that he serves to reinforce your hospital's mission statement in his daily work and relationship with the rest of the team on the unit?
I am sure that you could add many other questions to this list, but it's a start...after getting his feedback, you would then let him know how large of a gap there is between what he reports and what you have observed. Here is where you could insert specific examples of how the goals of the hospital and the team are not being met nor sought by his behavior.
Arrogant people are seldom cured, but if they are shown that they must collaborate with others to protect themselves and their own esteem they are sometimes tolerable. For example, sharing a story about how arrogant behavior led to an error that jeopardized patient safety, or maybe more important to him how it embarrassed the arrogant person.
Perhaps share with him that it would be in everyone's best interest that he becomes a valuable part of your team, but at this point it is his responsibility to pursue this and without that as a goal, you are fearful for his success long term.
People like this are dumb, plain and simple. I just got licensed as an RN today, but I have a job lined up in an oncology ICU. I have also been an LVN for 10 years, but you best believe I'm going to learn everything I can from my preceptor when I start working. There is such a big difference between my role as an LVN and what I will be expected of as an RN that I know I will be doing myself, my patients, and my coworkers a disservice if I go in there thinking I know it all. He doesn't even have the background of a licensed nurse to fall back on, and I would frankly be afraid to let him off of orientation if he doesn't change his attitude.
Thank you all for the extremely helpful words of wisdom and advice. Had a meeting with management and new grad. Everything including expectations and what to expect was laid out. It went well and was well received. We will see how it goes from here.
Thank you all for the extremely helpful words of wisdom and advice. Had a meeting with management and new grad. Everything including expectations and what to expect was laid out. It went well and was well received. We will see how it goes from here.
Ruby Vee, BSN
17 Articles; 14,051 Posts
If the guy has HR on speed dial, your manager is probably already aware of the problem. I'd ask her to participate in the "Come to Jesus meeting." Or perhaps an assistant manager if you have one. If he's already involved HR, this is above your level.