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  • Apr 2 '10

    Quote from maxthecat
    i disagree that having to prove yourself on a new job is unprofessional and/or an example of lateral violence. i've had to prove myself on every job i've ever had, nursing or not. i'd agree that having to prove yourself in two weeks time or you're out is ridiculous, though.

    at first i agreed that not allowing a newbie in the rooms of your patients was over the top, but the more i think about it, i can see situations where that might be expected, icu for one. good nurses are very protective of their patients, kind of like parents are protective of their children. if a nurse is unsure that you are safe around their patients, it is their duty not to let you near those patients if they can't be there to supervise. they may be totally wrong in their assessment, but they have to put their patients safety over your feelings. now, obviously, the perfect solution would be for them or for someone they trust to have enough time to go with you and make it a learning experience. but in the real world of short staffing that may not be possible.

    when i worked in picu one night i had a patient who i caught in the early stages of ards. i caught the worsening respiratory situation, notified the doctor, got orders, let the charge nurse know and guess what happened. the charge took that patient away from me and assigned me a new admit who was an easy patient that nobody wanted. was i mad?
    yes. i had made a "good catch" and had done everything right so far. i wanted to stay with my patient and learn. but i was a relatively new nurse to picu, we were short staffed as usual, and there was no one to supervise and apparently my charge did not quite trust i could handle the situation. the safety of the patient took priority over my feelings. there would be other opportunities to learn.

    in the interest of patient safety a nurse may speak sharply to you,to prevent you from making a boneheaded move. a professional nurse accepts this. i do not see it as lateral violence.

    now...there is no room for sarcastic put-downs, for hiding orders, for purposely giving false information to set up the new nurse, for harassing someone to the point of tears. that is unprofessional and has no place in nursing interactions. that is lateral violence. i hope someday that can be rooted out. unfortunately that's a human problem, not unique to nursing,and not unique to professions dominated by women, as those of you who have worked in other professions can probably attest. also unfortunately, many of the people in positions to root it out are some of the worst offenders. of course we have to keep working on this problem and working for a zero tolerance position.

    short version: if you're a little short and sharp with me in the interest of the patient, it's my responsibility as a professional to understand and not let my feelings get hurt and accuse you of lateral violence. if you're short and sharp because you are trying to "break" me as a new nurse, then i have every right to see your conduct as that of a _______ and call you on it.
    well said!

    i think most people have had to prove themselves on every job they've ever had -- even in the "b-flat" jobs we all had to get through school. that's neither bullying nor lateral violence. nor is speaking sharply to someone to correct behavior that is about to cause immediate harm to someone such as a patient or something (like the microwave you're about to start with a metal bowl in it, or the car you're about to back into a light pole because you're talking on your cell phone instead of looking back in the direction your vehicle has headed). and being sharp when you've been at work for 48 hours due to a blizzard or a hurricane and some newbie who just waltzed in after the disaster chastises you for forgetting to label the iv tubing you just changed when you've spent the entire time with double assignments because you're short staffed isn't abuse, bullying or lateral violence either. unfortunately, i've worked with a few people who consider it such. any negative feedback was construed as being "mean", and no matter what the feedback entailed, the way it was delivered was deemed more important than the content of the feedback.

    i was called a bully once because i "disrespected" a newbie who was about to defibrillate artifact in the presence of a perfect arterial line tracing. i told her calmly and politely that a shock wasn't indicated, and she went ahead and charged the paddles anyway. i'm afraid i "barked" at her then -- i said "stop!" she went ahead and defibrillated the patient anyway -- fortunately not precipitating the rhythm she evidently thought she was treating. and in the ensuing meeting with the nurse manager, i was called upon to defend my tone because i "made her cry." (nurse manager was a moron, too, but that's another subject for another thread.)

    i don't care what tone of voice you use; stopping someone from killing a patient is not bullying, lateral violence or being mean. of course negative feedback should be delivered privately and constructively in the calmest, most polite and positive terms you can manage. if you've tried that and the "victim" is about to kill your patient anyway, being abrupt or "barking orders" is not only acceptable but indicated. and occaisionally some of us are sharp when we're overworked, understaffed and lack sleep, potty breaks or meals. that's not ideal, but it's human. grow up and live with it.


  • Apr 2 '10

    Quote from maxthecat
    I disagree that having to prove yourself on a new job is unprofessional and/or an example of lateral violence. I've had to prove myself on every job I've ever had, nursing or not. I'd agree that having to prove yourself in two weeks time or you're out is ridiculous, though.

    At first I agreed that not allowing a newbie in the rooms of your patients was over the top, but the more I think about it, I can see situations where that might be expected, ICU for one. Good nurses are very protective of their patients, kind of like parents are protective of their children. If a nurse is unsure that you are safe around their patients, it is their duty not to let you near those patients if they can't be there to supervise. They may be totally wrong in their assessment, but they have to put their patients safety over your feelings. Now, obviously, the perfect solution would be for them or for someone they trust to have enough time to go with you and make it a learning experience. But in the real world of short staffing that may not be possible.

    When I worked in PICU one night I had a patient who I caught in the early stages of ARDS. I caught the worsening respiratory situation, notified the doctor, got orders, let the charge nurse know and guess what happened. The charge took that patient away from me and assigned me a new admit who was an easy patient that nobody wanted. Was I mad?
    Yes. I had made a "good catch" and had done everything right so far. I wanted to stay with my patient and learn. But I was a relatively new nurse to PICU, we were short staffed as usual, and there was no one to supervise and apparently my charge did not quite trust I could handle the situation. The safety of the patient took priority over my feelings. There would be other opportunities to learn.

    In the interest of patient safety a nurse may speak sharply to you,to prevent you from making a boneheaded move. A professional nurse accepts this. I do not see it as lateral violence.

    Now...there is no room for sarcastic put-downs, for hiding orders, for purposely giving false information to set up the new nurse, for harassing someone to the point of tears. That is unprofessional and has no place in nursing interactions. That is lateral violence. I hope someday that can be rooted out. Unfortunately that's a human problem, not unique to nursing,and not unique to professions dominated by women, as those of you who have worked in other professions can probably attest. Also unfortunately, many of the people in positions to root it out are some of the worst offenders. Of course we have to keep working on this problem and working for a zero tolerance position.

    Short version: If you're a little short and sharp with me in the interest of the patient, it's my responsibility as a professional to understand and not let my feelings get hurt and accuse you of lateral violence. If you're short and sharp because you are trying to "break" me as a new nurse, then I have every right to see your conduct as that of a _______ and call you on it.

    Max,

    While we are ALL patient advocates, I cannot think of ONE reason to forbid a new nurse from entering a room of another patient, unless of course the patient themselves has asked not to have that particular nurse in the room. Forbidding new nurses to go into your patients room is nothing more than a massive ego trip and power play.You area basically saying "You are not good enough, while I am." It is NOT the job of the average floor nurse to critique the new nurse on the floor period, but I see it all too often with the more seasoned nurses who feel it is their job to put them through the paces. It is the job of the nurse manager and the nurse educator. So many take it upon themselves to "break the new one in". Unacceptable. Your charge nurse made a decision based on safety, that is NOT an incident of lateral violence.

    Telling a nurse she cannot enter your patients room because YOU don't trust him/her is NOT OK. Nor is it ok to tell everyone on the unit from aides to the HUCS. I work on a floor where one nurse was doing this. She is the FIRST to complain that no one helps her, as she LOUDLY states that no one is to touch HER patients over her noon lunch when insulin is due. She puts students and new grads on notice all while gossiping to the docs and putting the new nurses down. Lateral violence at it's finest.

    Lateral violence is clear cut. Correcting a nurse on the spot and preventing injury is not lateral violence. Correcting a nurse on the spot, putting her down and then announcing the incident around the unit is.

    The long and the short of it is: You DO have to prove to your employer and the state board that you are competent, YOU DO NOT have to prove ANYTHING to your peers and co-workers. Any peer or coworker who is making you prove that you have a right to take care of your patients is perpetrating lateral violence period.

    Again just my based on the literature.

  • Apr 2 '10

    I do agree with trying to solve the problem first by talking to the bully. However, some places are so toxic that this can backfire..I started speaking up more and trying to talk it out(professionally, of course) and was told that I shouldn't have done that. I was told that this person is how she is and to just tolerate it. However, I chose to go to the union instead..this worked. BullyRN got written up.

    My point is that often, management not only tolerates this behavior, they encourage it. What we need to do is not let people ridicule the whole notion of changing these toxic behaviors. I don't buy for a minute that this is just part of the culture..this is ruining our profession, and it needs to stop.

  • Apr 2 '10

    Quote from DayOhioRn
    Originally Posted by qt2168
    Sometimes as the new nurse you just have to prove yourself to the veterans. Not everyone gives you the warm welcoming feeling until they know your not a complete clutz. When I was very new I was not even allowed to be in a certain nurses rooms. Now that I have proven myself she will ask me for help and has become much more approchable!
    We are talking about direct, malicious bullying in this thread, though (the New York Times article)

    No we are talking about lateral violence in this thread and having to "PROVE YOURSELF" to a older nurse is lateral violence. qt2168 has posted a valid point. To not be allowed in the rooms of a certain nurses patients is ridiculous and BAD BEHAVIOR period. I am conducting a study on lateral violence and it is NOT acceptable at all to put ANY new nurse through YOUR personal set of standards in order to see if he or she "measures up". Many nurses do this, and it is NOT professional.




    I disagree that having to prove yourself on a new job is unprofessional and/or an example of lateral violence. I've had to prove myself on every job I've ever had, nursing or not. I'd agree that having to prove yourself in two weeks time or you're out is ridiculous, though.

    At first I agreed that not allowing a newbie in the rooms of your patients was over the top, but the more I think about it, I can see situations where that might be expected, ICU for one. Good nurses are very protective of their patients, kind of like parents are protective of their children. If a nurse is unsure that you are safe around their patients, it is their duty not to let you near those patients if they can't be there to supervise. They may be totally wrong in their assessment, but they have to put their patients safety over your feelings. Now, obviously, the perfect solution would be for them or for someone they trust to have enough time to go with you and make it a learning experience. But in the real world of short staffing that may not be possible.

    When I worked in PICU one night I had a patient who I caught in the early stages of ARDS. I caught the worsening respiratory situation, notified the doctor, got orders, let the charge nurse know and guess what happened. The charge took that patient away from me and assigned me a new admit who was an easy patient that nobody wanted. Was I mad?
    Yes. I had made a "good catch" and had done everything right so far. I wanted to stay with my patient and learn. But I was a relatively new nurse to PICU, we were short staffed as usual, and there was no one to supervise and apparently my charge did not quite trust I could handle the situation. The safety of the patient took priority over my feelings. There would be other opportunities to learn.

    In the interest of patient safety a nurse may speak sharply to you,to prevent you from making a boneheaded move. A professional nurse accepts this. I do not see it as lateral violence.

    Now...there is no room for sarcastic put-downs, for hiding orders, for purposely giving false information to set up the new nurse, for harassing someone to the point of tears. That is unprofessional and has no place in nursing interactions. That is lateral violence. I hope someday that can be rooted out. Unfortunately that's a human problem, not unique to nursing,and not unique to professions dominated by women, as those of you who have worked in other professions can probably attest. Also unfortunately, many of the people in positions to root it out are some of the worst offenders. Of course we have to keep working on this problem and working for a zero tolerance position.

    Short version: If you're a little short and sharp with me in the interest of the patient, it's my responsibility as a professional to understand and not let my feelings get hurt and accuse you of lateral violence. If you're short and sharp because you are trying to "break" me as a new nurse, then I have every right to see your conduct as that of a _______ and call you on it.

  • Mar 7 '09

    There is an examination handbook on the certification website: http://www.nbcsn.com/examdefault.htm#preparation

    NASN published a prep book: Selekman, J. & Wolfe, L. (2007). School Nursing Certification Review
    http://www.nasn.org/store/detail.aspx?ID=67

    The 2006 School Nurse Textbook is recommended for preparation too: http://www.nasn.org/store/detail.aspx?ID=57

  • Oct 29 '08

    I passed the NCSN test on my first try. I used The Manual of School Health to study from. Then I wrote notes in the book and passed it on to colleagues who also passed on their first try. However, I do know at least 2 other colleagues who have not passed the test yet. It is not an easy test and its hard to determine what the answer is when you have to think Nationally vs locally when answering questions. Good Luck!!

  • Oct 27 '08

    With a score that close, you should do just great the next time. The new Certification Prep book should help as well as a study group.

    When I took the exam I had a flight to make and could not use the entire testing time, and as a result I did not dwell and second guess myself or over thin the questions.

    Good luck on the next exam and let us know how you do!!

  • Jul 18 '08

    The passing score should be in the website: www.nbcsn.com

    I think it is a 78 or 79%

    I would go over the study questions in the book - it gives you an idea of your strengths and weaknesses.

    They recommend 3 years of experience.

    If you read the journal, attend conferences, and use the new textbook to look things up, I'd expect you would do well, but do prepare, do study.

    I did not have one, but many recommend forming a study group.



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