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.
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.
Spoke with the manager today and told him that this floor wasn't a good match for me. I didn't feel like going through all the details with him because I didn't feel like it would really resolve anything. Honestly, it just feels like a relief that I don't have to deal with that nonsense anymore (there's more that transpired but I'm trying to remain somewhat anonymous on here so I'm limiting specifics). The manager said he'd give me a good reference and would help me get a job within our hospital system.
I have a nursing job to fall back on but am waiting to hear back on my "dream job". Like you, I won't tolerate that at this point in my life. I appreciate the feedback by the way.
My patient comes first. ALWAYS! Yes, I employ my customer service skills...but if my patient safety is compromised, I am a nurse first. Go ahead and let the family complain I am not the nicest......MY PATIENT IS STILL ALIVE AND SAFE! And so is my license...
Wow. We actually had some nurses name-calling a senior nurse a "crusty old bat."
I just can't get over how disrespectful that is.
You don't have to agree with her perspective. And you may not agree with it in 38 years. But hopefully, in 38 years, name-calling is no longer considered an effective mode of communication for you.
But then. I'm pushing "crusty old bat." So maybe I'm just a hater of "young and new nurses" too.
Specializes in Oncology; medical specialty website.
Wow. We actually had some nurses name-calling a senior nurse a "crusty old bat."
I just can't get over how disrespectful that is.
You don't have to agree with her perspective. And you may not agree with it in 38 years. But hopefully, in 38 years, name-calling is no longer considered an effective mode of communication for you.
But then. I'm pushing "crusty old bat." So maybe I'm just a hater of "young and new nurses" too.
The thing is, we turned what was a snipe into a badge of honor. Most of us experienced nurses aren't young-haters. We just don't believe in mollycoddling and spoonfeeding. Some translate that into hatred. Their problem.
I don't think the whole customer service thing is a trend, I think it's here to stay. People will die because of it, but as long as the paying (and dying) "customers" continue to return to be treated for their DKA and chest pain, instead of going to a facility the next town over, the hospital administrators will not care.
At this point, whether we like it or not, making our patients and their family members feel special is just as much a part of our job as providing them with medical care. While I know we have all encountered people who are impossible, the two are not mutually exclusive, and most of the time, it's not difficult to do both.
I think that often times, when a family member won't leave the bedside, it's because they are distrustful of what doctors and nurses are doing behind closed doors. It's important to start building trust as soon as you walk in the door, and I think this is best done by including them as much as possible, explaining as much as possible, and making them feel welcome in the unit. I actually say to almost everyone, "It's nice to meet you. I'm glad you're here! I know this has been a scary few days for you guys, and I'm so happy Mr. Whoever has family here to support him. It really makes a difference"
Sure, I'm laying it on pretty thick, but I almost never have any trouble getting people to step out when visiting hours are over. Not only that, but I am proud to say that I regularly have family members that will only go home to sleep when I'm the nurse. And I really, really think it's because I'm so nice to them from the start.
**For the record, my suck-up routine is completely fake. My favorite patient is an unmarried and childless fresh heart, who is intubated, on propofol, and unstable enough for there to be no chance of them getting extubated on my shift.
Specializes in ED, Cardiac-step down, tele, med surg.
The thing is, we turned what was a snipe into a badge of honor. Most of us experienced nurses aren't young-haters. We just don't believe in mollycoddling and spoonfeeding. Some translate that into hatred. Their problem.
What is "mollycoddling and spoonfeeding" to you? I'm just curious. If you mean that new grads and new nurses (even seasoned nurses for that matter) don't need a little positive reinforcement (a pat on the back) once and a while for a job well done, then I think you're wrong. If you are saying that new grads and new nurses (and seasoned nurses too) shouldn't expect some basic respect (the absence of eye rolling, sighing, inappropriate comments and passive aggressive behavior) or shouldn't expect a basic willingness to provide a helping hand when needed, I think that is wrong too. I think most people new on a unit (and some new to the profession of nursing) just want to learn and feel comfortable. The job is stressful enough without the extra drama and some of the hazing that goes on.
I apologize if I am reading too much into your comments and don't mean to offend you in any way. I just want a little clarification. And if you don't mind if I ask what are your expectations of a new grad/new nurse on your unit?
Specializes in OR, Nursing Professional Development.
And if you don't mind if I ask what are your expectations of a new grad/new nurse on your unit?
I know I'm not the one you directed this question to, but I'll take a stab at it anyway. I work in the OR, which for the vast majority of nurses is a completely foreign environment to anything they've seen in school or in their career if they've never worked in the OR in any capacity. One of the benefits of working in the OR is knowing the next day's schedule ahead of time. I expect my orientee to know the basics of what needs to be done for each case (positioning, what equipment is needed, etc) which is all basic information found on the surgeon's preference card and can easily be obtained the day before. They should tell me in the morning before the first case starts what their goal for the day is- such as focusing on preparing for the case or focusing on documentation or whatever goal they've chosen for the day, especially in the beginning stages of orientation when focus should be on small chunks rather than everything at once.
As for not spoon feeding or mollycoddling, orientees should be willing to do some preparation and studying outside of work time. That would include reading books and journal articles, visiting professional organization websites for specialty-specific updates, and similar activities. Instead of using me as their primary source of information at work, they should know where to find policies and procedures or other resources. It's one thing if one would come to me and say "I've checked the policies on the intranet, but I just can't find how to do xxx" and someone who doesn't take the initiative to try to find the information. At some point, that orientee is going to be working on their own and will need to know where to find things and how to do things.
Specializes in Oncology; medical specialty website.
What is "mollycoddling and spoonfeeding" to you? I'm just curious. If you mean that new grads and new nurses (even seasoned nurses for that matter) don't need a little positive reinforcement (a pat on the back) once and a while for a job well done, then I think you're wrong. If you are saying that new grads and new nurses (and seasoned nurses too) shouldn't expect some basic respect (the absence of eye rolling, sighing, inappropriate comments and passive aggressive behavior) or shouldn't expect a basic willingness to provide a helping hand when needed, I think that is wrong too. I think most people new on a unit (and some new to the profession of nursing) just want to learn and feel comfortable. The job is stressful enough without the extra drama and some of the hazing that goes on.
I apologize if I am reading too much into your comments and don't mean to offend you in any way. I just want a little clarification. And if you don't mind if I ask what are your expectations of a new grad/new nurse on your unit?
Yes, you read too much into it. I don't think it's expecting too much to be receptive to constructive criticism. New grads are going to make mistakes, and there's nothing wrong with a preceptor telling the grad what was wrong, then give constructive advice on how to improve.
Where in my post did I say that any of the things you listed were OK? Where did I say that creating drama was OK? Lately, there has been a spate of threads complaining about preceptors for all sorts of ridiculous things, including the preceptor not socializing enough with the new grad, even though the preceptor is said to be a good teacher who gives good feedback.
I would expect a new grad to look up the policy on a procedure before doing it. For e.g., if it's the first time s/he will be doing a blood transfusion, s/he should look up and print out the policy and read it thoroughly, not just say, "Mr. Smit in 203 needs a transfusion. What do I do?" I won't mind walking him/her through it as long as I see there has been some effort on the new nurse's part to be prepared.
I expect new nurses to have the humility to ask for help before they dig themselves into a hole so deep it's hard to get out. We all were new once, and none of us knew everything upon graduation. I also expect the new nurse to show respect to the preceptor, just as s/he expects respect from the preceptor. I expect that the new nurse won't sigh, roll his/her eyes, text friends, engage in passive aggressive behavior, nor refuse to help out on the floor when needed.
Where I worked, we didn't hire new grads, so it wasn't a problem. In fact, most of the units I worked on were closed to new grads. The last time I worked with a new grad was in the early 2000's when I worked in the ED. As I recall, she didn't need help from any of us because she knew everything straight out of school, even how to start an IV on an infant. That is, until she couldn't get the IV; then she begrudgingly asked for help.
I strongly object to several points in this rant! When I worked on an acute oncology ward we did not use the term 'difficult' relative, upset, anxious or distressed might get used. I have never discouraged a relative from staying with a dying relative and never would. The generalisation of lazy, rude nurses is tabloid news. Occasional failings by individual nurses cannot reflect the whole of the nursing profession.
This is a tangent, I know that....I suppose we all work in very different environments. I might expect an oncology unit to be a very different place than say, the ICU or the ER. When I was in ICU, most of my family members were upset, anxious and distressed. The ICU also sees a great deal of overdoses: meth, alcohol, heroin, etc. Many of their families were upset, anxious, and distressed. Occasionally some were violent, disruptive, and dangerous. Some friends of patients with gunshot wounds were not simply 'upset, anxious, and distressed.'
The vast majority of my night shifts, I have involved families in the care of their loved ones. But when they're sneaking in street drugs, or they've just taken a shovel to said loved ones' head...I have no problem getting my friends in security or the local PD to remove them.
Some of us work in areas of intense violence. Nurses see the finest in human nature, and the underbelly. I would love to tell you that I expressed lovingkindness and compassion for every withdrawing patient who took at swing at me. But I am neither Jesus nor Buddha.
Generalizations are just generalizations. Just as it's fair to say "some nurses suck." Yes. Some roofers suck. Some engineers suck.
tacomaster
125 Posts
amzyRN,
Spoke with the manager today and told him that this floor wasn't a good match for me. I didn't feel like going through all the details with him because I didn't feel like it would really resolve anything. Honestly, it just feels like a relief that I don't have to deal with that nonsense anymore (there's more that transpired but I'm trying to remain somewhat anonymous on here so I'm limiting specifics). The manager said he'd give me a good reference and would help me get a job within our hospital system.
I have a nursing job to fall back on but am waiting to hear back on my "dream job". Like you, I won't tolerate that at this point in my life. I appreciate the feedback by the way.