First of all, I want to state that I am not writing this to "poo poo" upon the nursing profession. I am hoping that by sharing my story:
A. I will feel better for having vented
B. I will maybe get some constructive feedback
C. Have a chuckle or two in the process
D. Maybe some of you will treat your new grad RN's better
I am a very type A, motivated person . I graduated near the top of my BSN class (I was class President) in May 2008 and was accepted to a prestigious MSN program in the same month. At that time, I had several offers but I accepted a new grad RN position in a CVICU. During my interview I felt I asked all the right questions (turnover rates, ratios, floating, etc.). I started my nursing career with a bright and positive outlook.
Flash forward to three months later. I just quit the hell hole. After working there for two weeks I found out the TRUTH...outcomes were the worst in the city for cardiac and stoke, new grad turnover rates were the highest, and I realized that their "culture of loving care" was just bs lip-service. I found out after I started that the cardiologist left, so I was seeing tele overflow patients ALL the time (wow, so not CVICU - and I turned down ACTUAL CVICU's for this job) and that it was all PAPER charting. There is a bs "PBDS" system that doesn't help the new graduate whatsoever. I sit there and take a four hour exam based off of videos of "clinical vignettes" and have someone critique me for two hours. Then I get back a card with ambiguous "concepts" to work on like "managment of care" and "sense of urgency". Excuse me, but I would argue that the seasoned nurse could always improve on these facets of nursing as we are always learning in this profession.
My first preceptor was a nice person. A former unit educator she was very well connected in the organization = politics gallore. All she did was tell me personal unprofessional stories about having sex with her internet boyfriend and how her soon to be ex-husband's love child baby mamma was causing drama. She spent all day on her PDA instant messaging him and put me into dangerous independent practice situations. One time she walked in on me in the process of changing tubing - huffed and puffed and told my nursing manager I had "exposed my patient's PIV to air and knowingly contaminated the system" BS!!!! What a crock!!! She later half-apologized when she realized I was indeed changing the tubing. Then she goes behind my back and tells my manager that I don't take initiative!!! *** she is a horrible PRECEPTOR and I am not going to lose my license because she is lazy. What makes me laugh the most is that she was a former EDUCATOR??? So I ask for a different preceptor --- what a joke process. Administration made such a big deal out of this and after several meetings later I had a new preceptor. The new girl was better but I was already at a disadvantage because she didn't really know where I was "at" and my manager didn't want me starting from scratch. Plus she was friends with my previous preceptor --- politics, blah blah.
NO TECHS here (grr)!!! I felt like the unit tech. The uncompetent new grad who "should be in med/surg her first year" - all I did was blood sugar, turning, oral care, baths, and gave po meds. If I was lucky I could titrate insulin. They sure didn't like it when I read their "ventilator pathway" and it stated to provide oral care q6...JELLO ever heard of VAP?...I got lectured about providing oral care q2 (i.e. waste of time/bad time management). Their equipment was so outdated and OLD I'd never seen pumps like this before and their philosophy on "back priming" makes me want to puke. Also, their "chart by exception" rule makes me nauseus. Yes nursing notes can be excessive but the rule of CYOB applies also. I had five "preceptors" tell me to "chart" differently. I can go on forever.
The thing that gets me the most is that I was humble, always on time, "fake" positive all the time after things started going bad, and went OUT OF MY WAY (even changing my schedule to DAYS). Why do nurses have a culture of "eat their young"? I worked so hard to put myself through school. I thought I went through "hazing" as a student, but I would venture to say new grads get treated WORSE than students.
So here I am. I think I need some sort of SSRI. I'm depressed, wondering if I went to school for the right thing, and wondering if I will ever find a good nursing job.
I don't know what else to say at this point. Thanks for reading!
I came out of college w/plenty of clinical experience, both before nursing school & in school. Graduated w/4.0 GPA, scored way above national average & highest in the state on nursing boards, etc. etc. etc. My instructors told me at graduation: "Now the REAL learning begins!" They were SO right. Book learning & theory is only a small piece of the puzzle- practical experience & developing that 6th sense takes YEARS. I was overwhelmed on my 1st job at a magnet (ie way over-rated) hospital- rec'd very little help from seasoned RNs and never had one preceptor for more than a few weeks-- after 3 mos of crying after every shift I left- for a smaller hospital, but the same pay & better hours. There I found my niche- a true teaching/sharing environment w/a couple of seasoned nurses who mentored me every step of the way-- I ended up being their charge nurse- and they encouraged me & were my biggest supporters. If not for those wonderful nurses I would have never had the courage to come back every day- they taught me how to survive in the "real" world! To them I'll be eternally grateful!!
I am sorry you or any new grad has to go through this. I understand because I went through almost the same thing. I had people telling me I was horrible when my patients loved me and requested to have me back the next night. I heard such things as you are the only nurse I have seen since the am or you are the only one who cares about my pain. That went on for 5 months until I got my new job. I am very happy in my new job so there are jobs out there where you won't be eaten alive. Yes, every job has at least 1 or 2 nurses that will try to exert their power over you. The only thing I can say about that is to stick up for yourself. Don't take the crap. There is no being timid and afraid in nursing because nurses and doctors sense it and they will pounce!! Take a stand and call them out on it and they will respect you. I hope you find that great job that you deserve. Good luck!
I was reading this post and the part that stuck out to me was, "There is no being timid and afraid in nursing because nurses and doctors sense it and they will pounce"!!
This is called bullying. People who do this usually have problems with their own sense of worth. Unfortunately it is the truth though. I am infuriated reading this. This is one of the things I cannot stand and when I hear "bullying" going on I quickly remind that person that they were once new and that NO ONE is perfect.
If a new nurse is timid or afraid it is because they lack confidence and seasoned nurses should be there to build them up and not tear them down.
Respect should be shown to all regardless of whether one is new or not. One should not have to call some one on it to get respect.
I am sorry this has happened to you. It has happened to me also. It is just sad when you have to be on the defensive with your own co-workers rather than working together as a team.
Specializes in CVICU, Burns, Trauma, BMT, Infection control.
Wow,as a seasoned nurse I can see the other side and I'm not condoning anyone being bullied or "eaten" But to see it from our side that we are already up to our eyeballs in work with high acuity pts who are usually actively trying to die,crashing,while the new nurse who may or may not be suited to this environment is looking for someone to ease her/him in.Also as for the timid,you have to be assertive to advocate for your pt because you know best what he needs and what is going on. I've had to tell physicians before that I didn't agree with their management and that we needed to do something differently or the pt would die. I only said that once,it's not anything I would say lightly but you cannot be timid and shy in this postition.
There's a lot of talk about what "should be" and whether or not it is "fair".You're right,it's not the way it is supposed to be. The pt are sicker/more responsibility less staff etc. And after all that when we've done our level best to guide someone brand new into a place that was challenging for me to start as as an experienced ICU nurse and we don't meet your expectations we have to hear about how we're "eating our young etc and so on". Sometimes we have to choose between a rapid response of pt rescue over a detailed explanation of what's going on to the newbie and believe me,it hurts me to not be able to have the time to guide someone like I WANT TO but that's just it. It's not always the experienced nurse's intention to be mean or anything. It's just an incredibly rapid paced environment that doesn't lend itself to teaching by the staff nurse. Then when you don't get the experience you think you should you are very quick to move on to another place and that hurts the place that just tried to orient you,the nurse who tried to orient you and so on.They used to have a nurse education/pt education nurse for each clinical setting to make sure that everyone is getting an appropriate orientation. I guess that this position has been cut along with all the others.
What I'm saying that instead of blaming each other,maybe we could try to work together the best we can.
Or maybe new nurses can start out in med/surg/tele//step down where you have more time to learn the skills necessary to be an ICU nurse without plunging directly into this area.
I am glad that my comments have incented you to examine yourself and your motivations. You may feel they were 'rude' but perhaps this is the first time you have received honest feedback which apparently you desperately need. You mentioned your original message was censored. I am not surprised by this and I know there are many experienced RNs out there who are shaking their heads in agreement.
As I mentioned, your fellow nurses have had YEARS of experience and know how to read feedback communicated in many ways. Perhaps your initial preceptor understood much more about you than you give her credit for understanding. To be a good nurse, you have to check your ego at the door and be willing to focus on your patients not yourself. Perhaps some day you will understand this point. Hopefully, you will have grown some and will listen more. Lots of your peer nurses have survived challenging assignments and have stuck it out for more than 3 months. They have something to teach you. Be receptive. Good luck with your next job at your next hospital or wherever you decide your skills will be best recognized.
I am glad that my comments have incented you to examine yourself and your motivations. You may feel they were 'rude' but perhaps this is the first time you have received honest feedback which apparently you desperately need. You mentioned your original message was censored. I am not surprised by this and I know there are many experienced RNs out there who are shaking their heads in agreement.
As I mentioned, your fellow nurses have had YEARS of experience and know how to read feedback communicated in many ways. Perhaps your initial preceptor understood much more about you than you give her credit for understanding. To be a good nurse, you have to check your ego at the door and be willing to focus on your patients not yourself. Perhaps some day you will understand this point. Hopefully, you will have grown some and will listen more. Lots of your peer nurses have survived challenging assignments and have stuck it out for more than 3 months. They have something to teach you. Be receptive. Good luck with your next job at your next hospital or wherever you decide your skills will be best recognized.
I agree that "to be a good nurse, you have to check your ego at the door and be willing to focus on your patients not yourself." I am proud of my accomplishments and in the ER; I am one of the few that have my BSN( with a high GPA) and am a PHN, but I dont bring it up at all. I dont want others to think that I feel better than them because im not. I have seen many new grads, even student nurse workers who do think they know everything. I loooove being a nurse...and no matter how much I mess up and dont know, I make it my goal to know more...As new grads, we dont know everything, no matter what degree we have. We need floor experience. I am working in a super busy county ER is Los Angeles and even though my unit has some bad and good preceptors, I will stick it out because the unit needs me, the patients are mostly spanish speaking and I want to be there to advocate for them. If us new nurses just keep leaving bad" units with "bad" preceptors who WILL CHANGE THIS? Someone must stay to end the cycle and teach the oncoming nurses how to be preceptors. I am actually willing to stay there and try to learn, even on my own, if I have to. I think this is what new grads need: confidence and motivation. ALSO, we need the "experienced" nurses to help us. WE NEED EACH OTHER...I know the experienced nurses need someone to be able to help them in crisis situations, but we need to learn how first and by making us feel "dumb" this isnt going to help. WE ALL started out new, not knowing anything, so we shouldnt make anyone feel incompetent due to this.
Specializes in CVICU, Burns, Trauma, BMT, Infection control.
I agree that "to be a good nurse, you have to check your ego at the door and be willing to focus on your patients not yourself." I am proud of my accomplishments and in the ER; I am one of the few that have my BSN( with a high GPA) and am a PHN, but I dont bring it up at all. I dont want others to think that I feel better than them because im not. I have seen many new grads, even student nurse workers who do think they know everything. I loooove being a nurse...and no matter how much I mess up and dont know, I make it my goal to know more...As new grads, we dont know everything, no matter what degree we have. We need floor experience. I am working in a super busy county ER is Los Angeles and even though my unit has some bad and good preceptors, I will stick it out because the unit needs me, the patients are mostly spanish speaking and I want to be there to advocate for them. If us new nurses just keep leaving bad" units with "bad" preceptors who WILL CHANGE THIS? Someone must stay to end the cycle and teach the oncoming nurses how to be preceptors. I am actually willing to stay there and try to learn, even on my own, if I have to. I think this is what new grads need: confidence and motivation. ALSO, we need the "experienced" nurses to help us. WE NEED EACH OTHER...I know the experienced nurses need someone to be able to help them in crisis situations, but we need to learn how first and by making us feel "dumb" this isnt going to help. WE ALL started out new, not knowing anything, so we shouldnt make anyone feel incompetent due to this.
I am glad that my comments have incented you to examine yourself and your motivations. You may feel they were 'rude' but perhaps this is the first time you have received honest feedback which apparently you desperately need. You mentioned your original message was censored. I am not surprised by this and I know there are many experienced RNs out there who are shaking their heads in agreement.
As I mentioned, your fellow nurses have had YEARS of experience and know how to read feedback communicated in many ways. Perhaps your initial preceptor understood much more about you than you give her credit for understanding. To be a good nurse, you have to check your ego at the door and be willing to focus on your patients not yourself. Perhaps some day you will understand this point. Hopefully, you will have grown some and will listen more. Lots of your peer nurses have survived challenging assignments and have stuck it out for more than 3 months. They have something to teach you. Be receptive. Good luck with your next job at your next hospital or wherever you decide your skills will be best recognized.
I went straight into a Surgical ICU straight out of nursing school 33 years ago. I had wonderful preceptors and learned much in my 3 years there. I switched to Hemodialysis and have remained in the renal field since 1978. I just left a job as Inservice nurse for 5 outpatient dialysis units in Northern VA. My advice to you is to ask for a written outline of your prospective employer's training/orientation program. If they can't produce that, they probably can't help acclimate you to your position either. It sounds like, the 'preceptor' was just someone who thought she could have other people do her work for her... how unfortunate for you.
Nursing needs intelligent, dedicated nurses.... please keep you chin up and keep trying. :redbeathe
My views on this thread are as follows. I have precepted numerous nurses coming to the unit I work. At one point in 1 1/2 years I only worked 2 months in which I was not precepting. That was stressful. I requested please can I take a break from this. I want to just come to work for awhile take care of my patients without being a preceptor. I was burnt out on teaching.
All ( newbies )have different backgrounds, and levels of experience behind them. Some with enough years behind them, that my role becomes more of transitioning them as to how the charting , reinforcing policy in our facility as opposed to where they have come from. How to find supplies, how to put in orders , the so called finer points.Perhaps I might need to assist them to hone their time management skills if needed. Others have come as new grads, that becomes a more intense experience as preceptor. I am then put into the role as preceptor (teaching or refreshing 101 basic nursing skills )first before we are able to transition to the next phase. Usually if they have either never done or only done once. I ask them to read policy on the steps to doing it correctly, after that, we gather the tools needed to perform this task. I will ask while in the supply room, do you want me to demonstrate this skill first and at a later time when the opportunity comes up you can do hands on. I often try different methods of teaching to find out how they learn best. As a frequent flyer preceptor, I have had fast learners, I have had those who need a lot of nuturing and confidence building ( no problem with this) I am good at that. I want someone to build skills and leave me feeling confident that they can handle the job. I also tell them realistically it may take 1-2 years before they fully feel confident. I say it as I truly believe it would be a fairy tale to tell them anything different. Ask me about the days I come across things that will momentarily shake my confidence in my ability to do, to juggle, to be all to eveyone that needs something of me whether it be my skills, or my shoulder to cry on. I always try and use constructive critism not negative feedback. I never turn in a report to the supervisor regarding the newbie that the newbie has not read first. My own style of teaching adapts based on the needs expressed by the newbie and how they learn best.
The crux of the issue as I see it. Why is being a preceptor not seen as cruicial to the retention of our nurses coming in no matter the level of experience and as such redesign how the assigments are given so that we have the time to teach, mentor, nuture our nurses under our guidance instead of the full patient assignment in addition to precepting. Our so called newbies ( no offense, I am simply saying someone new to our unit, not whether they are brand new grad specifically)are important to us. We have a 90 day time frame in which to get them up to par based on 3 ( 12 hour work shifts a week) That means within 36 working shifts. I need to get them to where they can handle perhaps as many as 8 patients with a cna. I would be lying if I said end of shift might mean having totals greater than that if you want to count patients discharged and admitted. I have had newbies in whom the chemistry between us did not mesh ( that did not mean I was not a great preceptor nor that they weren't a great newbie) in those few cases. I would go to our supervisor requesting they receive a new preceptor who's style of teaching might be a better match. I have had to request extending orientation for some newbies, again they were not bad newbies they simply needed more than the average time span and they deserved being allowed the additional time "before being thrown to the wolves "as I say.
:Newbie ( perhaps I failed you, perhaps it was simply chemistry or perhaps it is the system which failed us both )
You sound like a fabulous preceptor. Wouldn't it be nice if management recognized that precepting is a special skill which demands a differential, like at least an extra $5 to $7 an hour??
Thanks for the work you have done with new nurses. I wish you had precepted me!
I think newbies who are teaching old ladies how to suck eggs are dangerous, and I don't think the original poster meant that. Her main problem wasn't that she didn't try, but she sat down and put the two and two together: her main goal was to learn to be a better nurse for her patients, and rather than being guided, she was reported on. She has probably learnt more about the politics of the unit than about clinical procedures. That's not was she was after. in time she'll probably recognise it's importance and learn the rules of the game.
Nursing is one of those jobs where your co-workers become your family, due to the intensity and high acuity of the job. Yes, being assertive, good, confident, experienced, comes in time. And becoming part of that family takes time, as well. It's like having and educating a child, if you want, you don't just expect him to learn on his own all the time, you teach, and guide.
What I am arguing here for is not sympathy, but emotional maturity. Sometimes, I'm looking in disbelief at some of my colleagues and think to myself:had I been your mentor...:argue::banghead::banghead:just move, girl, do something, you're not a lemon! So I kinda know where you're coming from, without having the responsability. 90% of the time they just sit there because they don't KNOW what to do, and are scared that if they do something, it's going to make the situation worse. I'd take this a a prompt to indicate the shelf where the procedures are kept, or have a little chat when it's a bit quieter, but i don't agree with just crossing my arms and thinking:well, she'll either start swimming or she'll sink, I haven't got time for such silliness. Don't know how it works in the states, but in the uk the mentor qualification gives you a bit more money in the bank, it's part of your job. But you get this qualification on a voluntary basis.
Having authority is one thing, being an authoritarian is something else. years of experience entitles you to respect, the fact that I'm sitting there clinging on to your every word and action deserves no less.
. I graduated near the top of my BSN class (I was class President) in May 2008 and was accepted to a prestigious MSN program in the same month. At that time, I had several offers but I accepted a new grad RN position in a CVICU. During my interview I felt I asked all the right questions (turnover rates, ratios, floating, etc.). I started my nursing career with a bright and positive outlook.
:banghead::banghead:just move, girl, do something, you're not a lemon! So I kinda know where you're coming from, without having the responsability. 90% of the time they just sit there because they don't KNOW what to do, and are scared that if they do something, it's going to make the situation worse. I'd take this a a prompt to indicate the shelf where the procedures are kept, or have a little chat when it's a bit quieter, but i don't agree with just crossing my arms and thinking:well, she'll either start swimming or she'll sink, I haven't got time for such silliness. Don't know how it works in the states, but in the uk the mentor qualification gives you a bit more money in the bank, it's part of your job. But you get this qualification on a voluntary basis.
nickola
250 Posts
I came out of college w/plenty of clinical experience, both before nursing school & in school. Graduated w/4.0 GPA, scored way above national average & highest in the state on nursing boards, etc. etc. etc. My instructors told me at graduation: "Now the REAL learning begins!" They were SO right. Book learning & theory is only a small piece of the puzzle- practical experience & developing that 6th sense takes YEARS. I was overwhelmed on my 1st job at a magnet (ie way over-rated) hospital- rec'd very little help from seasoned RNs and never had one preceptor for more than a few weeks-- after 3 mos of crying after every shift I left- for a smaller hospital, but the same pay & better hours. There I found my niche- a true teaching/sharing environment w/a couple of seasoned nurses who mentored me every step of the way-- I ended up being their charge nurse- and they encouraged me & were my biggest supporters. If not for those wonderful nurses I would have never had the courage to come back every day- they taught me how to survive in the "real" world! To them I'll be eternally grateful!!