New Grads, then and now. What has changed?

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Specializes in Medicine, Geriatrics, Ambulatory Care.

Hello everyone

I am a new grad and like most (if not all) new grads here, has had a rude awakening to the realities of nursing. From what I've gathered, the learning curve is steep and it takes at least a year to not feel nauseous, scared and tearful before and after your shift. I felt like that in my full-time pregrad consolidation/capstone and that was only four months.

My question is for the wonderful, veteran nurses who graduated 30, 20 or even 10 years prior.

When did you graduate and what unit did you work at?

Did you feel prepared and ready to nurse when you graduated?

How was your education structured?

Any suggestions to nursing schools to help the new grads transition better?

I personally feel that the clinical experience throughout nursing school should reflect the nursing conditions in the real world - twelve hour shifts with the goal of having a full patient load by the end of the placement. Is this realistic? I was told in one unit that the real fun starts when the students have already left so lots of missed learning opportunities there.

I'm excited to hear from our experienced nurses. And thank you in advance for your insight :)

oh, honey, i am so afraid i'm going to disappoint you. but you did ask.:twocents:

other than a changed job market, there's not a dang thing different about you-new-grad-now and me-new-grad-in-nineteen-s, um, mumblemumble in terms of nursing school preparedness for the job market, tasks, organization, how to buy a stethoscope, or anything else i see new grads agonizing about here. rant spoiler alert-- get out now if you're easily offended.

the only difference i see, truthfully, is that i don't recall anybody in my cohort whining so much about how woefully unprepared they were and how mean the more experienced nurses are. we knew we had a lot to learn still, of course we did. we were nervous about hurting somebody or looking stupid. we hated working straight nights when our boyfriends/girlfriends worked normal hours. we were exhausted. came with the territory and we knew to expect that.

but the big difference? nobody had been telling us how ding-dang fabulous we were since pre-k, we didn't get medals and trophies just for showing up at youth soccer, we sure as heck didn't have helicopter/snowplow parents (the ones that hover and the ones that remove all obstacles) and we expected to work hard to make our way in the world on pretty much our own merits. we didn't worry so much about a sharp word of criticism beyond what we could learn from it; i don't remember that deep sense of "i'm a special snowflake, i can't take the heat" that i hear so much here. really.

and remember, dear, that the original article with that phrase "nurses eat their young" came out decades ago-- i seem to remember it as a letter to the editor or a short article in one of the nursing mags i read in the 70s-- but it's only this recent generation that has taken it so hard. i love students and new grads, i do, and i spend an inordinate amount of time trying to teach them and support them, they are our future, but honest to god, sometimes i wanna just reach through my screen and slap some of them silly! i hare recently read a spate of articles by psychologists starting to see twenty-somethings in their offices with vague anomie and insecurity; after a prolonged childhood and adolescence with said parents, they find themselves unsure as to whether they can ever make it on their own, whether anything they do is good enough, and they are deeply insecure.

it's not that i have no patience with that, so much, as with the parenting that made it happen. i spent years as president of a college parents' association trying to get parents to back the heck off and let their kids make their own mistakes now when it's safe so they'll know how later. i was not as successful as i would like, as evidenced by the psych articles, eh? "you're criticizing our parenting style!!" was something i heard a lot, as if that were a bad thing. that boinging sound you hear is my eyes rolling. yep, i sure am. and i have raised grown, productive, strong, self-reliant, loving adult kids of my own who would no more whine like this than, oh, fly to the moon. they just...get on with it. (and when one of their babies falls, they say, cheerfully, "you're ok!" and no big deal...and the babies learn that it's no big deal to fall if you get up and get moving again. good life lesson.)

but now, well, young adults, tough noogies. it's time to put on the big-girl and -boy pullups and get out there on your own. you're no more special than we were; your schools owe you no more support in "transition" than what we got: your degree and a receipt for your tuition. get out there and just get on with it.

Specializes in ICU.

Okay, I'm a new grad and try really, really hard not to act like the ones you just described. I didn't have helicopter parents and I try *really* hard not to be one to my own children.

I got pregnant at 19 dropped out of college because of complications with my pregnancy. Continued working as a dietary aide at the hospital I was working at since I was 17. My amazing daughter was born and I continued working at the same hospital. A position opened up as a UDC on telemetry and I fought for that job. I worked that job to pay for my own wedding when I was 21. I cross trained as a nurses' aide because I wanted more patient contact and learning experiences (plus my unit kept losing aides). Got pregnant again and kept working as a UDC/aide. Went back to nursing school at night and worked my butt off as the president of my class and mother of two little kids. I still kept working full time hours until I graduated. I worked at my hospital for 10 years before I took a job with my current employer. Yea, I ended up with a great job but not because my parents removed all my obstacles but because I fought through them and had a resume that knocked the socks off my employer.

So yea, there are new grads out there like the ones you described but honestly we aren't all like that. I have a few friends that are. I have a lot more that aren't. So with all due respect (your lesson in Acid-Base balances changed my life), don't make broad generalizations about all of us :D.

Yea, I made a post about how much I worry in the new grad forum recently. I, however, mentioned nothing about anyone being mean to me or "eating me", quite the opposite, I have been blessed with some amazing preceptors/teachers. I am in awe of the ICU nurses around me and do everything in my power to learn from all of them. I have been on my own since I was 18. I became a mom at 19, bought a house and married the love of my life at 21 and graduated nursing school at 27. Sure, I did some things out of order, but hey, I never had a dang thing handed to me. Now, I work hard to make sure my children will be strong and independent when they get out on their own some day.

Susan

P.S. Please don't be upset about my response. I just don't like being lumped in with some of these kids. Also, I realize that she asked you your thoughts on new grads as a whole, in which I don't disagree with you. I just wanted you to know that we're not all how you described (though I'm sure you do realize that).

I pondered this question until my husband read over my shoulder and said "you had no internet forums to discuss these things with other nurses.

Yes, I guess I struggled through my first year as a nurse without hearing about how others were doing. My nursing school classmates all went their separate ways upon graduation and I never kept in touch with them.

Specializes in Orthopedic, LTC, STR, Med-Surg, Tele.

I'm a new grad. I have to say, I'm either really lucky (doubtful) or just really awesome (HIGHLY doubtful) with orientation and being a new nurse in a hospital. I don't have these experiences where I leave work and cry in my car, or have serious difficulty managing my assignment, or when nurses (get ready for it) attempt to eat their young. I have good nights and bad nights, and have definitely made mistakes, been frustrated, and had hissy fits. But I learn something every single shift, and each time I go to work, I leave feeling a little more competent and knowledgeable.

I think there is a lot of hand-holding in nursing school. You have to be prepared to realize, just like GrnTea said, that you are not special, and you are not unique, and you are very very replaceable. Nobody cares about your feelings, you are there to do a job. You have to step it up and rise to the challenge. I remember a lot of times where I would panic inside and think, wow, how am I going to do this. It's like Jack said on Lost: Let fear in and take over for five seconds, but only five seconds. Then get back to work.

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

when i graduated -- close to 35 years ago -- the majority of nursing education was at the diploma level. i, through no prior planning or careful choices of my own, graduated with a bsn. i had about six hours of clinical a week compared with their 24 - 40 hours . . . big difference. and despite the multiple part time jobs i always had, i'd never had any hospital (or nursing home, alf, etc.) experience. the diploma nurses graduated and moved seamlessly into employment on the unit of their choice. i struggled in med/surg for two long, very difficult years before i caught up. despite popular opinion, i remember acutely what it was like to be brand new and not know a thing.

then, like now, some people seemed to catch on immediately without struggling (not me) and others had to struggle to learn each and every new skill. being a grown-up with a grown-up job was a challenge when i was 21 and wanted to go out with my friends.

thirty five years ago, though, i expected that i'd do what was expected of me. period. i was hired to work days and pms (7-3 and 3-11), weekends and holidays and i expected to be doing just that. there was no self-scheduling and requests were frowned upon. the nurse manager put out the schedule and you worked it. while you may have been unhappy about missing family functions or your boyfriend's fraternity party, you either found someone willing to switch with you or you worked it without any drama.

i expected that i'd be the newbie, that the fecal material would roll downhill and that everytime i made a mistake, someone would tell me about it and how i should have done things. and they did. i learned so much from the cnas and lpns who taught me the tips and trips that the rns just expected i'd already know. if someone commented on a deficiency in my practice, i concentrated on the message, not on their delivery and i corrected my practice. no one would dream of admitting to the manager that "suzie made me cry" because no one wanted to admit to being that weak and immature. as far as going to the manager to complain that suzie was picking on me? never would have happened. the manager had better things to do, and i needed to learn to interact with my colleagues on my own. and i did.

when i graduated from college, i had college loans and a car loan to pay back and a husband (not my best idea ever) to support. there was no safety net. i had to sink or swim, because mama and daddy weren't going to give me money or a place to live while i contemplated whether nursing was really for me, whether the grass might really be greener in the hospital across town or that other specialty or the unfairness of working both memorial day and the fourth of july. i didn't expect things to be fair at work -- and they weren't -- or easy. and they definitely weren't easy. there were days when i cried all the way home from work and all the way back the next day, but i did it privately.

these days, many of the new graduates seem to be entitled and immature. they still expect that things will be fair, that daddy will call and threaten the boss if they don't get the assignments or schedule of their choice (shocked me the first dozen times that happened), that the only feedback they'll ever receive will be positive and that they'll be rewarded just for showing up. believe me, i understand that all new nurses cannot be lumped together and they're not all like that. but significant numbers of them are -- and that's a trend that started catching on in the early 90s and has been snowballing since. horizontal violence, mobbing, bullying . . . all took place at about the same rate as it does now. but now, every negative interaction seems to be interpreted by many newbies as "young eating" even when some of us more seasoned nurses can see very clearly between the lines that the young in question asked for whatever he or she got. (if you're over the age of 8 and still believe that you can't get along with your peers because they're all jealous of your stellar intellect and amazing pulchritude, i mean you.) when i had problems getting along with my co-workers, i figured it was me and struggled to change whatever behavior they found objectionable. like whining about "at my old hospital, we did it that way."

we have a lot more "labor saving" technology now than back in the day when iv pumps were still a figment of someone's imagination and calculators were so expensive (and so large) nobody had one. we've crossed the line somewhere back, though, from "labor saving" to "labor generating" new technology. charting, for example. we "save" folks we have no business saving these days, and they're becoming an enormous burden on the health care system. "back in the day," when your 88 year old grandmother had a heart attack, she probably died. these days, some "miraculous" technology can save her so that she can languish in the icu for six months before dying slowly hooked up to all that technology. we spend the majority of our health care dollars these days extending someone's life by weeks or months -- most of which is spent in the icu -- instead of buying polio vaccine for the entire town and passing it out in the elementary school cafeteria on saturdays and sundays. these days we take care of the patient, their family and everyone who wants to visit freddy in the hospital after his drug dealer attempted to blow him away for nonpayment. in the olden days, family and friends respected the nurse, understood that our job was to take care of the patient and didn't make unreasonable demands about "colder ice" or "drinks for everyone." and if you took care of the patient and gave them what they needed (as opposed to what they wanted) everyone was happy. no one expected hospitalization to be a five star experience.

this is getting longer than i had anticipated. i think starting a new job or a new career has always been a struggle, but years ago we expected that and now too many newbies expect that the bumps will be smoothed out for them along the way. you can argue about whether "we're all like that" and whether you fall into the same category as everyone else . . . maybe you do, maybe you don't and maybe you do but you think you don't . . . but that attitude is not only far more prevalent these days, it exists.

i like precepting, i like newbies and i learn something new from every orientee i've ever encountered. i still remember vividly how i felt when i walked into my first job and knew nothing useful. but attitudes are very different now.

Specializes in Medicine, Geriatrics, Ambulatory Care.

I just wrote a lengthy response but lost it. rage*

Thank you for the discussion it has been interesting so far. I have to gather the strength to re-write my response all over again but thank you so far to the replies.

I pondered this question until my husband read over my shoulder and said "you had no internet forums to discuss these things with other nurses.

Yes, I guess I struggled through my first year as a nurse without hearing about how others were doing. My nursing school classmates all went their separate ways upon graduation and I never kept in touch with them.

Bingo.

What I wouldv'e given to have a "sounding board" twenty years ago when I went to a large ICU (handling cranies, open hearts... the whole shebang) position as a New Grad, and was given exactly 2.75 weeks of orientation and then left to fend for myself.

I was intelligent, made top marks in college, had good basic common sense, worked VERY hard to take care of my patients, and the staff were...mean, nitpicky and merciless. I thought this was "normal" as I just didn't know any better.

I made it a year and got the hell out.

I do not look on that experience as a "badge of honor" or even a rite of passage. I look back on it and to this day think, 'my good gawd. They had every opportunity to shepard and mentor a damned good baby-RN into the profession, but shot themselves in the foot with this whole "sink or swim we eat our young" mentality.'

Bullsh*t.

I wasn't there to be pampered, I was there because I loved ICU, to do my job well and learn.

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