I Remember What It Was Like To Be A Terrified Nursing Student

I've learned a bit in nearly four decades at the bedside -- and I still remember what it was like to be brand new. Here's some wisdom -- and an invitation for my fellow senior nurses to add their own. Nurses Announcements Archive Article

I can assure you that despite my 38 years of experience, I remember vividly what it was like to be a terrified student or new graduate nurse on the nursing unit for the first time. Most of us old nurses haven't forgotten what it's like to be new; we've just accumulated a whole lot more experience and quite a bit of wisdom as well -- and we can tell you that sometimes things aren't precisely the way you think they are.

Sometimes your work colleagues really don't like you -- and sometimes the reason is that you're unlikable.

I can say this with some surety because I remember vividly what it was like to be a terrified new grad on the nursing unit for the first year. I was so scared -- of the patients, of my co-workers, of the doctors, of my boss and of making a horrible mistake -- that I was tense, humorless and generally unlikable. Once I accumulated some experience and some knowledge and was able to relax just a bit, people started liking me.

It wasn't that they were horrible people intent on devouring new grads. It's just that some new grads aren't very likable.

I know that you're loaded down with compassion and empathy and all that, but the patient who is throwing his food trays at you because he doesn't like his diagnosis really doesn't have an excuse for his behavior. Sure he's upset and scared -- I get that -- better than most of you do, because I've been there. But being upset and scared doesn't give you a license for physical (or verbal) aggression directed at others.

"Customer Service" is a trend that will eventually die. No matter how many patients have to die because of customer service first. It makes no sense to base health care reimbursement or raises or anything, really, on the "customer service" model.

A happy customer is someone who has everything his way.

Patients don't get to have everything their way.

A nurse who gives them cupcakes when their blood sugar is 699 or a big glass of water when they're on a fluid restriction or anything when they're NPO is likely to get a great survey but an unhealthy patient. And aren't we in the business of promoting health?

Families who insist that it's "their right" to be at the bedside usually aren't there to be supportive of the patient. And they usually aren't supportive of the patient. If I have to wake you up because your mother is calling your name and wants you to hold her hand, you're not being supportive.

If you're there to translate for your father who doesn't speak English, you'll need to get out of your comfortable nest and translate when we need to give your father directions.

If you want to sleep, go elsewhere.

And before anyone snaps at me that I clearly don't get it, that of course families have a right . . . understand that I've spent more time as a patient than as a nurse in the past two years. I get it.

The family member who wants to be at the bedside to support the patient will tell you that, not insist upon "their rights." Family members who TELL you that they're there to support the patient may not always have that clear and unselfish an agenda, but those who insist upon their "rights" are unlikely in the extreme to be anything approaching supportive.

Nurses wouldn't mind family being at the bedside if the family knew how to behave in public. But that's a whole another thread -- one that I've already started and one that I may start again, just for fun.

Specializes in Pediatrics, Emergency, Trauma.

I think what is missed a lot of times is the RESPONSIBILITIES that comes with rights; it's never one without the other, and it is to be assured that one isn't circumventing others rights. :no:

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I'll be glad when the "crusty old bat" thing falls by the wayside. I find condescension and patronizing to be so obnoxious.

The "Crusty Old Bat" thing will probably fall by the wayside when experienced nurses are no longer called such names by newbies who are certain they're being bullied or "eaten" with no evidence to support that.

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

Fact is, for years patients were tied down, lied to, tricked, or downright told off for speaking up about their rights in healthcare, and for years, they were consistently ignored. Because it was always "for their own good". Yes, patients make really bad decisions. Yes, they are impossible, hard to deal with, and downright stupid at times.

feedback to help improve outcomes down the road for everyone.

Do we have to like it all the time? No, of course not. But it's not something that needs to die entirely, that's for sure.

I guess I've missed the part where patients were tied down (except for their own safety), tricked, lied to or told off. I've certainly missed the part where they've been ignored. I must have had quite a sheltered 38 year career.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I agree with most of your post, OP. I have been in healthcare for awhile, and oftentimes I feel that too many visitors and patients mistake the hospital for a hotel. Usually, when I am in the patient's room and I have some spare time, I don't have a problem getting a visitor a drink or snack. However, I have had way too many visitors ask constantly for things, snacks all the time. Some seem to think that they are entitled to everything in our food galley. I take real issue when a visitor becomes more needy than the patient. I had one visitor who would ALWAYS ask for sandwiches and drinks. That got to be really old after awhile and it takes a LOT for me to get ticked off.

I remember when I interviewed for my current job that the assistant manager stated (verbatim) "you will feel more like a waitress than an aide." That really bothered me.

However, I strongly disagree with your second to last paragraph. I am very supportive of family members being at the bedside, especially with a confused or anxious patient. I have found many family members to be extremely helpful. I also feel that a family member has a right to stay at the bedside so as long as they aren't disruptive to patient care. Not too long ago, my mother rushed all the way across the country to visit her VERY sick mother. This was the second time my grandmother was on the verge of death. You bet she stayed at her mother's side. We didn't know if she was going to pull through. I know when the time comes, I want to be there until my mother's last breath, and I know she wants the same. I would be devastated if I missed my mother's final moments, and I would get the manager involved if the nurse told me I couldn't stay at my mother's side.

And I have been the patient before after a suicide attempt. You bet I wanted my folks with me!

Again, I will say that neither I nor most of the nurses I know have a problem with family being at the bedside to be supportive of the patient. (And I'd assume that you would be supportive of the patient if it were your family member.) What I have a problem with are those who are the bedside because it's "their right" and they have no intention of actually interacting with the patient. They aren't there overnight to get a good night's sleep (supposedly); they're there to hold the patient's hand when she is frightened, wet Dad's lips with the swabs left conveniently at the bedside, change the channel for Grandpa and tuck Grandma's blanket up under her chin. If all they want is a good night's sleep, they are unlikely to get it in the ICU. Good visitors understand that the patient comes first. Those visitors who want to be the center of attention are the ones I have issues with.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

Ruby, I just have to say that it strikes me that you dislike young people and new nurses. My perception is that you rail against them just as much as you decry their categorizing all older nurses as "crusty old bats."

In my observations, it seems like you dismiss contrary opinions as "you're young, you just don't know" or "you're new, you just don't know" without giving any credit for life experience or intelligence. And this is coming from someone who is neither young nor new, but just an observation.

Specializes in IMC.
Ruby, I just have to say that it strikes me that you dislike young people and new nurses. My perception is that you rail against them just as much as you decry their categorizing all older nurses as "crusty old bats."

In my observations, it seems like you dismiss contrary opinions as "you're young, you just don't know" or "you're new, you just don't know" without giving any credit for life experience or intelligence. And this is coming from someone who is neither young nor new, but just an observation.

Thank you! ! Some of the self-righteous nurses on here drive me nuts. That us why I rarely post on here.

Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

Just wondering, what were the personal attacks? Were you referring to my post, or something else? Just wondering because if it was mine, I would like to know where the lines are, because I did not think my post was in any way an attack.

Specializes in Med-Surg, NICU.
Again, I will say that neither I nor most of the nurses I know have a problem with family being at the bedside to be supportive of the patient. (And I'd assume that you would be supportive of the patient if it were your family member.) What I have a problem with are those who are the bedside because it's "their right" and they have no intention of actually interacting with the patient. They aren't there overnight to get a good night's sleep (supposedly); they're there to hold the patient's hand when she is frightened, wet Dad's lips with the swabs left conveniently at the bedside, change the channel for Grandpa and tuck Grandma's blanket up under her chin. If all they want is a good night's sleep, they are unlikely to get it in the ICU. Good visitors understand that the patient comes first. Those visitors who want to be the center of attention are the ones I have issues with.

I see what you are saying and I agree with this statement. But I don't take qualms with visitors who decide to stay over night so as long as they aren't disruptive or impeding patient care.

Specializes in MICU, SICU, CICU.

@scottprn

There are visitors who feel that having a family member in a Critical Care Unit gives them license to put an unfair social burden on the patient and berate abuse and harass the nursing and medical staff. The worst of the worst are those RNs who have never worked a day at the bedside, and it's easy to see why, they have no common sense and could never make it in the acute care setting. "What do those lines mean?" referring to the monitor. Sorry sir it took me twenty years to learn all of this, but don't worry he is under constant monitoring. I am great at deflecting inappropriate questions and attention seeking behavior.

We're on to you. I will turn the lights on ( a lot if I need to) and do my job as usual. This is not a hotel. How would you like having some guy sleeping in your work area? Some guy who freaks at every little beep just waiting to find fault so that he get the attention he so craves by complaining to administration. Heck I want to be reassigned so that I can get the **** away from you.

My responsibility is to the person in that bed, not you. Your insecurity and personal demons are not my problem. You make me not want to go in your Father's room at all.

@scottprn

There are visitors who feel that having a family member in a Critical Care Unit gives them license to put an unfair social burden on the patient and berate abuse and harass the nursing and medical staff. The worst of the worst are those RNs who have never worked a day at the bedside, and it's easy to see why, they have no common sense and could never make it in the acute care setting. "What do those lines mean?" referring to the monitor. I am great at deflecting innappropriate questions and attention seeking behavior.

We're on to you. I will turn the lights on ( a lot if I need to) and do my job as usual. This is not a hotel. How would you like having some guy sleeping in your work area? Some guy who freaks at every little beep just waiting to find fault so that he get the attention he so craves by complaining to administration. Heck I want to be reassigned so that I can get the **** away from you.

My responsibility is to the person in that bed, not you. Your insecurity and personal demons are not my problem. You make me not want to go in your Father's room at all.

Some visitors do behave inappropriately; I don't think anyone is arguing that isn't the case. I would think that in those situations, education, when possible, would be an appropriate first step. Of course, education does not always work. But why is an RN family member who doesn't work in acute/critical care who asks about the monitor being unreasonable? Did I understand that you perceived this question as attention seeking? I could understand someone asking such a question if they wanted to understand what the monitor was, and what it had to do with their family member who is connected to it. Not all RN's work in acute settings. People may lack knowledge, but their questions may be quite genuine.

To be fair, scottaprn had not slept for three days as his father had had emergency surgery. It is understandable that he would feel the need to sleep. According to his post he didn't demand that the nurse set up a cot for him, or request any special accommodation. You don't object to someone who hasn't slept for three days sleeping in a chair, surely? As a critical care nurse you understand the enormous pressure family members are under. He cares about his father and wants to be by his side to show his support. He helped prevent some medication errors, and he wants his father to receive good care. If he responds to the beeps from the equipment, why does that mean he is seeking attention for himself by complaining to administration? I could understand him complaining to administration if his concerns about his father's care were not addressed. In his post it sounded as though he was seeking appropriate care for his father. His father wants him there, and he wants to be there. His father may not live. Why are you upset with his behavior?

Yes, a nurse's responsibility is to the person in the bed, but as nurses we also have a responsibility to the patient's family if the patient wishes for them to be involved in his/her care, as his father apparently did. Patient care does not exclude the family, even when they are not the way we would like them to be, unless the patient does not wish for the family to be involved in his/her care.

Specializes in MICU, SICU, CICU.

Try spending twelve hours with someone who has to analyze and question your every single move, every beep, every saline flush and hearing "what are you doing" every two minutes despite repeated explanations and kindly saying "I need to focus on this right now"gets old pretty quickly.

Try saying he's okay he just coughed every ten minutes due to a low priority vent alarm.

Try spending 12 hours with some overbearing jerk who ignores you when you say excuse me and will not move aside so that you can perform basic nursing care, despite repeated explanations that in a Critical Care Unit you need a clear path to your patient in case you need to get to him in a hurry.

He probably caused those mistakes and near misses with his constant distractions and aggression.

Try spending the longest twelve hours of your life with a person who moves a recliner against an icu bed and stretches out the chair in only his underwear.

In conclusion, try spending 12 hours with a disturbed and paranoid individual with no manners, respect for women or relevant experience who has decided that he and only he is a good nurse and that he will dictate every aspect of your patients care, ready to freak out at any moment all while demanding a critical care nursing course. **** that.

Nurses do not override Advanced Directives but families certainly do.

All patients are full code for twenty four hours post op. If that was his issue he needed to address it with the surgeon, not harass and blame the nurse.

Frankly I have dealt with many a svotprn and his story makes no sense. He sounds unstable. I am certain that the nursing staff have a polar account of his behavior.

They must have had serious safety concerns to have to resort to having him removed by security.