How to teach an experienced nurse

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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 Cardiac, Thoracic, Vsg, ENT, GU.
I agree she is probably just looking for an 'easy ride with pay' for a couple of weeks before she has to get going. Heck that is a great way to get a paid vacation.[/quot

Negative assumptions doesn't get you anywheres and it sure doesn't help someone who obviously wants and probably needs a job. There is NOTHING like POSITIVE strokes and thoughts to help a new nurse!!:)

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Specializes in Peri-Op.

Ask your nurse educator the alotted amount of time given for a new experienced nurse that is hired on. In my new place, which is larger than my old one, the orientation allowed is 9 weeks for a new/experienced OR RN. Some people are different and handle new jobs differently. I used to be VERY cut throat, if they werent getting it or seeming to get it within 3 weeks they were done..... That was a couple of years ago. Im on year 4 now, still a newb in somes eyes, but I am fine walking into a new hospital and doing any case assigned to me from open heart/vascular to ortho to eyes. I would prefer at least a couple of hours to see where stuff/supplies are stored and at least be shown how to log on to their computer system. After that I am good, leave me in the room alone PLEASE.

THEN on the other hand there are some nurses that take every day of their 90 day orientation for me to decide if I want to keep them. 9 weeks ago there was a new nurse with 15 years of trauma hospital experience hired. She is barely able to circualte a case as of last week without having a freakin panic attack.... she came from a teaching facility so there were people everywhere to do the real world circulators job. She really didnt know what different beds were, different video systems were, different irrigation systems, different positions....... anyway, she had people that did that stuff for her at her prior facility, must be nice RIGHT!!!

Well, she will just barely skate by her orientation period here with us. I was worried but took the high road with her and laid off of the cut throat mentality..... If your facility allows her to be cut early and you have a more promising prospect then by all means cut and run. I doubt they do though since the NE wants to keep letting her roll.

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I agree she is probably just looking for an 'easy ride with pay' for a couple of weeks before she has to get going. Heck that is a great way to get a paid vacation.[/quot

Negative assumptions doesn't get you anywheres and it sure doesn't help someone who obviously wants and probably needs a job. There is NOTHING like POSITIVE strokes and thoughts to help a new nurse!!:)

That's one of the big things, though - she's NOT a new nurse. She has 17 years of experience. She should be "getting" it sooner than this.

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Specializes in Psychiatric and home health Peds..

I have had to orient several nurses over my 15 years of nursing. The one's that have already done the job are the worse at times as they already think they know it all. If you are responsible for signing her off on an orientation check list as I have to do when I orient someone, tell her that if she does not perform the duties she needs to do that you cannot and will not sign her off. If you do and she cannot do the job it will make you look as though you did not do the job of training her. If she continues to not do the job and think that she can skate through orientation you need to let your manager know as patient safety can and will be effected when this nurse is expected to fly solo. The patients have to come first and from what you have said I do not think that I would want that nurse assisting in my surgery or anyone else's. If like most hospitals there is a probation period when first hired this matter could be solved quickly and this nurse let go or sent to another unit that may be more appropriate for her. It is hard for one nurse to have to do this to another but as nurses our responsiblity lays with the patients and not other nurses.

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Specializes in Trauma Surgery, Nursing Management.

Update: y'all...(pulling my hair out a la "Tommy Boy") she is not getting better. The situation is now going to our DON. I mentioned in my original post that this nurse told me that she decided to leave due to new management. My BFF works at the hospital that she left and told me that management cut her loose.

So now it is week 3 and she is still not doing patient care. I have refused to orient her further, and am hearing from other nurses precepting her that she is simply at a loss. When she is prompted to do something, she just stands there, smiles, and says, "I know." One of her preceptors came to me yesterday to vent because she was beyond frustrated. This preceptor is absolutely STELLAR in her gift of teaching. She is very patient, she is assertive and she takes into consideration that a new nurse is lost at times. The straw that broke the camel's back was when this nurse answered the phone, ended the conversation, and didn't hang up the phone. She just left it on the table. Her preceptor said, "Uh, you wanna hang up the phone?" The nurse said, "Oh I guess so."

I think that there may be something seriously wrong upstairs. She does not act nervous, does not act intimidated by the care itself, does not shy away from conversation...so I am out of reasons as to why she is acting the way she is. My guess is that come Monday, she will be OTD.

So my question now is this: why is management allowing these folks to be hired? Certainly references were checked. Right?

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Specializes in Psychiatric and home health Peds..

When an employer check refernces from another employer the pase employers cannot say anything negative. I have heard my managers say many times in the past "if you can't say something good you don't say anything at all". I would guess that if they cause someone not to get hired that fear of a law suit keeps them from saying anything negative. I don't know the age of this nurse but maybe she has some kind of medical condition that is causing her to behave this way. The nurses that are training her need to let management know that she is not capable of doing the job either because she can't or won't do it. Most places have a probation period in which if a person is not right for the job they can let them go or possibly place in a different department or postition. Good luck.

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Specializes in ER/ float.

I think that there may be something seriously wrong upstairs. She does not act nervous, does not act intimidated by the care itself, does not shy away from conversation...so I am out of reasons as to why she is acting the way she is. My guess is that come Monday, she will be OTD.

So my question now is this: why is management allowing these folks to be hired? Certainly references were checked. Right?

It sounds like she is on serious drugs! Benzo's ? Alcohol ? anti convulsants ? You don't forget to hang up a phone w/o a serious impairment going on. How about a brain tumor, CVA ? Just throwing ideas out there.

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Specializes in Oncology; medical specialty website.

Thanks for the update, canes. You've certainly given this nurse the benefit of the doubt.

BTW: Cool avatar. ;)

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Specializes in Trauma Surgery, Nursing Management.

RNTim, my guess is benzos. I dunno. I am at a loss, and thankfully it is out of my hands now. Management is going to decide on Monday whether or not to continue with orientation. *sigh.

OCNRN-I thought so too! Love the puppy giving a "paw bump"!

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Specializes in ER/ float.

You were more patient than I would have been. Fear not! you may have just saved a few pt's from serious harm.:)

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Specializes in geriatrics.

The whole thing just seems bizarre. If she isn't improving by now, she probably won't. I wonder how she has managed to survive this long in the workplace? Maybe something has happened. However, your patients must be the first priority.

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So now it is week 3 and she is still not doing patient care. I have refused to orient her further, and am hearing from other nurses precepting her that she is simply at a loss. When she is prompted to do something, she just stands there, smiles, and says, "I know."

but how does she respond when directed to, "you need to do a, b, and c", or "i am assigning you these 3 pts"...

what does she say?

i'm 'assuming' that she has been given imperatives.

leslie

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