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?

    • 157
      Teach them all you can and hope it sinks in. Set the bar high, do not allow for mistakes or excuses. Make them accountanble.
    • 14
      Give them the basics and let them figure it out on their own. They already know everything, so this is just a review, right?
    • 44
      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?
    • 114
      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?

112 members have participated

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 ER.

He needs education on how to get along with coworkers badly. He should know that when you are new you don't write people up while still on orientation. You let your preceptor know, and then stand with her if she chooses to do it. For the first year, you don't write anyone up unless it's 10/10 negligence, and even then, you want to be part of a group. Bring it to your charge nurse, and let her initiate the write up, if appropriate. That's because you don't know the unit culture, and you don't need a target on your back. You can be right, or you can be happy (and employed). Pick.

In the same vein, if someone wants you to observe something, or they offer to teach you something, you listen gratefully and thank them. Even if you already know. I've got 25+years in, and still do my orientation like that. You will make them feel useful and smart, and you'll have someone you can go to with questions, and you WILL have questions. You'll pick up tidbits from every person that make your life easier, and it's just polite.

I've been called in to the managers office for being a pushy ***** multiple times, and I write an incident report on a staff member only about once a year. I do incidents on bad equipment or processes almost monthly, so try to work that angle if you really have to report something. Your orientee has to back off a LOT or he's going to lose his job. Coworkers he's already written up are going to be looking for his mistakes, and they wont feel bad about pointing them out. I suggest a plateful of brownies, and a whole new approach on his next shift, even if he was totally right about the staff errors and a lot of sucking up wouldn't hurt either.

I see this is an old thread, hope it all turned out well.

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Statistically speaking, you should go ahead with option #1.

Option #1 has a p-value of 0.006, Standard Deviation of 2.12 and Standard Error of 1.50

The rest are not statistically significant.

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