How do I request accountability and mentoring from staff?

carachel2 · Jan 22, 2006

Hi
I am a charge nurse of an ED and I have a problem. With this nursing shortage we have hired approx 5 new grads. Some are doing fine and some are still coming along, the problem is the senior nurses! You know the expression "nurses eat their young" ? Well I've seen it in action. Some would rather sit back and let someone fail than help them, and they would rather complain and spread the negativity about another staff member than actually step up and mentor these people to be great nurses. Please help with any advice on how to inspire these people to be the great nurses that they were. They don't realize they are shooting themselves in the foot, the new nurses will leave and then we will be training all over again. Please help me help the staff to retain these nurses!!!!
ccccc

Good preceptors are TRAINED to do so and ought to receive extra $$ per shift for precepting. It is a huge mistake to believe any seasoned RN (no matter how good they are) is cut out for precepting. They need to know how to identify learning needs and inspire critical thinking.

When I was a new grad in a CCU, I was with ONE preceptor for 3 months. I am in the ER now and seeing these poor new grads floating from one nurse to another every shift. It is unfair to everyone to do this.

I would start with bringing in a preceptor class, motivating them to want to be a preceptor and then making sure there is some consistency among them as far as which nurse is assigned to which.

melrina75 · Jan 22, 2006

at the company i work for, we have a mandatory precept class before anyone can become a precept. they then qualify for a couple extra dimes/hr/precept puch in. i know you cannot personally change that kinda policy, but i once worked on a floor where we were precept 1 new employee for 6-wk or 1 new nurse for 12wk. we volunteered to be precept (no volunteers then yes assigned orientees to most exp w/least complaints)orientee and precept has same schedule for that time period. if we were 'noted' as not precept "effectively" by any staff we would be slightly reprimanded because precept had become part of our job description. good luck - i know this can be a fuzzy situation!!

renerian, BSN, RN · Jan 22, 2006

Lead by example. Try to give them examples by having other nurses see you doing the same.

renerian

hollykate · Jan 22, 2006

It seems to me that it is beyond just the preceptor. One can have a great preceptor, but if the rest of the department is making catty comments and being snotty it's almost a given that the nurse will fail.

If it is only some nurses, it is probably worth having a one on one talk with each one personally. Most ED nurses feel undervalued all the time. Explaining that you value them for their experience, but you do not understand why they must behave in such a way to new staff. It happens also to new staff, not just new grads...This might give the experienced RN a chance to actually vent to you, as well. It is honestly very tough to have a department that has a large percentage of new grads/inexperienced people. In one ED I was in the number is approaching 20% and the staff are starting to react as if under stress.

By talking to them personally, you are making it clear that it is their behavior and not another persons. You also have the opportunity to explain your expectations, and an opportunity to listen. SOme of the experienced nurses complaints maybe valid.

Doing any sort of blanket meeting and announcement, generally is an invitation for everyone to ignore what you are saying.

Best WIshes.

Trauma Columnist · Jan 22, 2006

I work in a very large, busy ER where we hire new grads each and every cycle - this time its 7 new grads. We have few experienced nurses. It is very hard. However, having a private meeting with some of the experienced (but with poor attitudes) might focus some of the positivity to them. Telling them individually how much you, the manager, appreciate them goes a long way. Personally, I think its wonderful that you recognize the problem and want to attack it head-on. Got any openings for an advanced practice nurse? lol

ccccc · Jan 22, 2006

Thank you everyone for all your great advice and keep it coming!!

I totally agree with the preceptor plan and we do have that but some of the people are approaching 1 year in the dept and are still strugling in some way--or being targeted. I have only recently become the charge/manager and all these issues are coming to my door. Our ratio of new staff(rn's with less than 2 years ed experience and new grads) is about 40%, the thought expressed that the senior staff is losing the ability to cope is exactly what is happening. They are fed up with continuously having to teach someone something. But isn't that part of being a nurse? How can I help reduce the stressover this issue and explain that it will always be expected?

One staff member recommended putting the 1yr nurse who is still strugling with critical thinking back on orientation with a preceptor--would this help this person?--I don't really think so, I think it would be humiliating. I am addressing things one on one with the involved people, and giving it time to reevaluate, but things are not moving fast enough for some of the senior nurses---it's a catch 22 in a way.

Thank you all for your support and ideas, this was my first post and I really appreciate the advice and will utilize this awesome resource again!!

KatieBell · Jan 22, 2006

One year, and still not performing? I think it might be time to have a sit down talk with the person and see if thye reallyt hink the ED is a good fit with them.

40% non experienced people is too many, I'd try to actually work with recruitment to do some targeted advertising to get in some experienced people to shore up your staff.

It is a nurses job to teach, but I am not sure it is healthy to be in a constant precepting role each day. A friend of mine is doing this and she is very very tired after even a normal shift, it is actually a lot to ask of your staff.

mydesygn · Jan 22, 2006

Hi
I am a charge nurse of an ED and I have a problem. With this nursing shortage we have hired approx 5 new grads. Some are doing fine and some are still coming along, the problem is the senior nurses! You know the expression "nurses eat their young" ? Well I've seen it in action. Some would rather sit back and let someone fail than help them, and they would rather complain and spread the negativity about another staff member than actually step up and mentor these people to be great nurses. Please help with any advice on how to inspire these people to be the great nurses that they were. They don't realize they are shooting themselves in the foot, the new nurses will leave and then we will be training all over again. Please help me help the staff to retain these nurses!!!!
ccccc

We have paid preceptors as well. I think that having indivuals who specefically choose to be preceptors makes a world of difference. I know not all institutions will pay a premium for preceptors but perhaps presenting research from institutions that do regarding turnover and employee satisfaction might help. Look for indivuals who are sought as preceptors and are able to work with new staff. Perhaps offer them some incentive in terms of scheduling etc.. Indivuals precepting should not be in charge while precepting. The "nurse eating young" unfortunately is pervasive but I think it stops with leadership. You need to make it clear that constant criticizing for minor isssues will not be welcome in your office. This is the hardest thing to do is to discourage staff from reprting to you but ultimately if done well it will benefit all

1) Ask staff if they approached the indivual they are complaining about with theses issues (the usual answer is no)

2) Ask them how they would prevent this from happening (the usual answer is " I would have done this....)

3) State that you will set up a time where you, the indivual they are complainig about, and they can sit and they will make those suggestions to them (The usual answer is "Oh it wasn't that big s deal etc..)

4) State " You felt this was important enough for me to be aware however you apparently don't feel that it is important enough to let them know about. Part of being a professional is enabling the growth and success of your peers. One of those responsibilites is working together as a team to ensure consistency and success. Your knowledge is important and I would expect that it would be shared with all. Next time you present this type of information, I will expect that you will have discussed it with the indivual in question or if you don't feel comfortable approaching them directly, you will have written documentation that I can present to them. If they feel that you reported issues without the "full story" so to speak, I will set up a meeting for all of us to discuss this.

Taking the anonymity out of reporting and holding the indiviual accountable to substatiating any accusations they report will ultimately build trust among your staff. Our first thought is we feel like we will discourage staff form coming to us. By doing this you do not discourage the important items (if it is a serious patient care issue it will be reported) but you do discourage the petty reporting by making it clear that they will be held accountable to any accusations they make and will have to present them. You have to use your own discretion because sometimes anonymity needs to be maintained but ususally not. Also try reading "Hardwiring for Excellence" by Quint Studer, there is good information about managing up and eliminating anonymous complaints that does a better jo of illuminating these principles.

TinyNurse, RN · Jan 28, 2006

I'm on assignment in TN and for the first time ever i've seen "stuff go down"

nurses complain bout the new grad( 6 mos). it's sooo super sad to see someone talk stuff about a new grad, but refuse to help her. I remember the night this new grad had her first chest tube............i was also slammed, but i stayed with her, and talked her through it, let alone the conscious sedatiuon part of it. .............i am angered by nurses that talk smack, but won't help a young nurse. these are your future co-workers.........the people in the future that are skilled and will have your back........... wow

ednurse63 · Mar 3, 2006

talk about accountability..our hospital hired 3 new grads and we did not have a manager.these girls were thrown to the wolves as charge nurse for the 7p-7a shift i work every fri,sat,sun. i tried to pair up the grad with a senior staff nurse..work the seniors schedule..it worked for 2 out of the 3..the biggest problem is these girls have no CRITICAL THINKING SKILLS at all..MULTITASKING SKILLS...in one case no common sense..with the shortage these folks are warm bodies..what I do is when there is something interesting ie tablesaw injuries..their first overdose..i walk them thru it to show them the right way..they do not work my sched,so i ahve to grab them when i see them..we also so not have a Nurse Educator..so it makes it more difficult.some tof the "lifer's (employed more than 25yrs) do eat them up yum...and there is no changing these folks they actually need to get out of the ED but the union also makes it difficult..i try to be the best mentor i can when i'm their..and I know I'm giving them their best shot at being a good ED nurse