How to teach an experienced nurse

Nurses General Nursing

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What is the best way to orient an experienced nurse? I am having trouble precepting a nurse with many years of experience because she is taking on an observer role rather than being involved in patient care. I have asked her if she is uncomfortable delivering patient care and she just laughs and says, "Nope, been doing it for years!" I have shown her where things are, how to chart on our computer system and what the policies are at our hospital. She was given 2 weeks of both hospital and unit orientation before being paired with me. Her nurse educator told me to let her do everything and just be there as support if she has questions, but when a patient rolls into the OR, she puts her hands behind her back and watches. I have prompted her to go ahead and deliver patient care, but she continues to just observe. I don't think it is my place to tell her how to be a nurse because she obviously knows how to do the job-she has been an OR nurse for 17 years. Since I have already asked her if she is simply uncomfortable doing patient care (she smiles and says no), and her nurse educator has released her to do patient care, I am at a loss. I have no idea why this nurse won't jump in and get involved with care. What should I do? I want to be supportive, but I also don't want to be patronizing. She has been at our hospital for a little over a month now. Suggestions?

Specializes in Trauma Surgery, Nursing Management.
I wonder if the reason she didn't like her new manager was her new manager noticed she was a slacker and was pressuring her to step up her game. Just a thought.

This was my thought as well.

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Specializes in Trauma Surgery, Nursing Management.
Whenever anyone says that they left somewhere because of management, I am a little suspicious that *they* might be the problem, not management. And I've left jobs because of management issues, too! I find more politically savvy ways to explain why I left until I know someone well and until they have the opportunity to get to know me well (not a good fit or a response that focuses on what positive things the new job has to offer or even they decided to move in a direction I wasn't interested in).

Keep us posted on what happens with this situation.

This crossed my mind, but I wanted to give her the benefit of the doubt. After observing what I have, I am inclined to think that she must have flown under the radar of former management for some time. I will keep you posted. I am seriously at a loss as to what to do. I have shared my concerns with her nurse educator and I am hoping that she will be able to handle further orientation sans my involvement. I have NEVER in my nursing career shied away from precepting someone. I actually love to teach. But this one leaves me scratching my head in confusion. I am showing her where to find things, I am showing her how to chart, and I am familiarizing her with the routines of the hospital. So I am just dumbfounded when I must prompt her to do the very basics. We had a pediatric pt one day who had never had surgery, was terrified, tearful and obviously needing some hand holding prior to induction. I was out of the OR, per instruction from the NE ("let her do patient care, Canes."), but could see what was going on in the room from the glass door. The nurse didn't do A THING. She went over to the patient with her hands behind her back and stared at her like she was under a microscope. I stuck my head in the door and said, "Nurse X, wanna get this scared girl some warm blankets perhaps?" She did, but my goodness...WHY did I have to remind her to do this very basic comfort measure? Do you guys think she is just nervous or something?

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Specializes in Step Down.

I cannot believe this is even happening!!! I'm a student and I jump at whatever experience I could get my hands on! I would be petrified to come off orientation in this manner. I would NOT want this "experienced" nurse as my nurse...!!! I hope she doesn't get through orientation.....she doesn't deserve it with the way she is acting. I would take her job any day!!

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canes, does your facility do evals midway through orientation?

i know that our facility does.

it's a means of touching base, discussing concerns/issues, and give/get feedback from employer/orientor/orientee.

if you haven't before, now might be a good time to start.

leslie

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Specializes in Trauma Surgery, Nursing Management.
canes, does your facility do evals midway through orientation?

i know that our facility does.

it's a means of touching base, discussing concerns/issues, and give/get feedback from employer/orientor/orientee.

if you haven't before, now might be a good time to start.

leslie

Hey girl-hope you had a wonderful New Year's.

Yes, we do have evals after rotations through each surgical service.

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What is the best way to orient an experienced nurse? I am having trouble precepting a nurse with many years of experience because she is taking on an observer role rather than being involved in patient care. I have asked her if she is uncomfortable delivering patient care and she just laughs and says, "Nope, been doing it for years!" I have shown her where things are, how to chart on our computer system and what the policies are at our hospital. She was given 2 weeks of both hospital and unit orientation before being paired with me. Her nurse educator told me to let her do everything and just be there as support if she has questions, but when a patient rolls into the OR, she puts her hands behind her back and watches. I have prompted her to go ahead and deliver patient care, but she continues to just observe. I don't think it is my place to tell her how to be a nurse because she obviously knows how to do the job-she has been an OR nurse for 17 years. Since I have already asked her if she is simply uncomfortable doing patient care (she smiles and says no), and her nurse educator has released her to do patient care, I am at a loss. I have no idea why this nurse won't jump in and get involved with care. What should I do? I want to be supportive, but I also don't want to be patronizing. She has been at our hospital for a little over a month now. Suggestions?

Stand back and tell her "you're up!" with a big smile...Maybe she doesn't want to work in front of you and just wants to wait until you're no longer watching?? I dunno...People can be weird, sometimes.....

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What is the best way to orient an experienced nurse? I am having trouble precepting a nurse with many years of experience because she is taking on an observer role rather than being involved in patient care. I have asked her if she is uncomfortable delivering patient care and she just laughs and says, "Nope, been doing it for years!" I have shown her where things are, how to chart on our computer system and what the policies are at our hospital. She was given 2 weeks of both hospital and unit orientation before being paired with me. Her nurse educator told me to let her do everything and just be there as support if she has questions, but when a patient rolls into the OR, she puts her hands behind her back and watches. I have prompted her to go ahead and deliver patient care, but she continues to just observe. I don't think it is my place to tell her how to be a nurse because she obviously knows how to do the job-she has been an OR nurse for 17 years. Since I have already asked her if she is simply uncomfortable doing patient care (she smiles and says no), and her nurse educator has released her to do patient care, I am at a loss. I have no idea why this nurse won't jump in and get involved with care. What should I do? I want to be supportive, but I also don't want to be patronizing. She has been at our hospital for a little over a month now. Suggestions?

Have you checked to see if she's really an RN??

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This crossed my mind, but I wanted to give her the benefit of the doubt. After observing what I have, I am inclined to think that she must have flown under the radar of former management for some time. I will keep you posted. I am seriously at a loss as to what to do. I have shared my concerns with her nurse educator and I am hoping that she will be able to handle further orientation sans my involvement. I have NEVER in my nursing career shied away from precepting someone. I actually love to teach. But this one leaves me scratching my head in confusion. I am showing her where to find things, I am showing her how to chart, and I am familiarizing her with the routines of the hospital. So I am just dumbfounded when I must prompt her to do the very basics. We had a pediatric pt one day who had never had surgery, was terrified, tearful and obviously needing some hand holding prior to induction. I was out of the OR, per instruction from the NE ("let her do patient care, Canes."), but could see what was going on in the room from the glass door. The nurse didn't do A THING. She went over to the patient with her hands behind her back and stared at her like she was under a microscope. I stuck my head in the door and said, "Nurse X, wanna get this scared girl some warm blankets perhaps?" She did, but my goodness...WHY did I have to remind her to do this very basic comfort measure? Do you guys think she is just nervous or something?

Reminds me of adult Asperger's....Seriously

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Specializes in ER, ICU.

Experienced doesn't mean good. Maybe she's been a terrible nurse for her whole, long, career. People who start out at the bottom of the curve sometimes stay there and just get really practiced at it. I was a preceptor for six years and these people would come by once in a while. Sounds like she can't cut it. You should say "so far, you haven't shown me that you can do this job. You need to show us that you can do this job or you won't be cleared for independent duty." This should raise a huge red flag. It sounds like she is just waiting for you to stop flapping your arms so she can get you off her back. Your program has to be willing to fail her from orientation, provide remediation, and clear written goals and assessments. If you tell her what she needs to do today, don't back off and let her chat about car seats. Make it clear her job is on the line. If she has potential she will make serious efforts to meet your requirements, if she doesn't then she should be fired. You might want to ask her why she thinks things don't seem to be moving forward. Maybe she just had a personal tragedy or something that is holding her back. She is passive-aggressing you to death. Best of luck!

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Specializes in Management, Emergency, Psych, Med Surg.

When was her last hands on experience and in what type of area? Was she at the bedside or in management? Once you determine this, you need to tell her that from now on, it is your show and I am not going to touch the patient unless you are killing them. Tell her that you have to see what she can do on her own. But you also need to determine if she is comfortable with you. Perhaps not. Have you had a sit down progress meeting between you, the educator or nurse manager and her. If she has been there for a couple of weeks now, it is time for a meeting.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

i think it's already way past time to have a serious talk with this lady, one that involves the educator and the manager. if she's not willing to actually do the job, she's not actually orienting. if she's not oriented, why pay her? leave it up to the manager to make it clear that if she doesn't start doing the job with you as back-up, she's out of there. good luck!

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Specializes in pulm/cardiology pcu, surgical onc.
.......We had a pediatric pt one day who had never had surgery, was terrified, tearful and obviously needing some hand holding prior to induction. I was out of the OR, per instruction from the NE ("let her do patient care, Canes."), but could see what was going on in the room from the glass door. The nurse didn't do A THING. She went over to the patient with her hands behind her back and stared at her like she was under a microscope. I stuck my head in the door and said, "Nurse X, wanna get this scared girl some warm blankets perhaps?" She did, but my goodness...WHY did I have to remind her to do this very basic comfort measure? Do you guys think she is just nervous or something?

I think it's more than nervousness. If she's experienced and has had more than a few weeks of orientation on this job she has a screw loose if she treats a frightened child like that. The thought that comes to mind which someone also mentioned is- is she really an RN?

Obviously you will get nowhere just having a private chat. Sounds like it's time to sit down together with the nurse educator before they waste anymore time and resources orienting her. Please keep us posted, this is very interesting.

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