New Graduate Nurses Require Support and Honesty, No More "Eating The Young"

[symondsbl]

I was inspired by all of the wonderful nurses I work with to write this and hope for more discussion. For some background, I am coming up on my third year of nursing. I started as a new graduate nurse on the same unit I work on now. It is a neuroscience intensive care unit that also handles trauma-surgery patients at a level 1 trauma center. Starting on my unit was intimidating knowing the high acuity of care it provides, but I was determined to thrive and learn. My determination was met with great support by my preceptor, who very plainly told me day one that the ICU is not for everyone. Her intent was honesty, and she reassured me that my success is her goal. I was never discouraged from asking any and all (read: so many) questions. She also told me something that I think was vital to our success, that she would never be mad at me as long as I did not lie. All mistakes were met with education and reassurance, not a form of hazing.

I have been told awful stories by other new grads about their difficult transitions to their units, and that they were affected by the culture of "eat you young" that nursing has been known for. Letting them drown in an assignment that was not appropriate for their experience level. Not providing guidance, belittling them for not knowing something, yet not being the resource the experienced nurse should be. They struggled during their three twelve hour shifts, having pre-shift anxiety weekly. Having their mental health affected by a job that they worked so hard to get, all while being underpaid. 

I never experienced this type of treatment on my unit, and I believe it is why I was able to advance to the place I am at now. I was and continue to be treated with respect. One of the most important things my unit practices is open communication. Feedback is given when reporting back to the nurse after your shift, if need be. Management checks in with new grad nurses weekly. Each new grad has a resource assigned next to them for their first two months of shifts off orientation. The preceptor coordinator also is communicating and checking in with the new grad and preceptor nurse, making sure all needs are being met. 

I'm now into my third year of nursing and I am confidently taking care of our sickest patients. I'm becoming a resource for other younger nurses during our shifts. I still look for help when I need it, knowing that my resources are there and ready for me to help. I also serve as charge nurse from time to time. Eating your young breeds for a toxic environment that leads to worsening staffing issues and lack of safety for our patients. What do you all think?

[JKL33]

Take yourself out of this for one small second, londonflo, and look at it this way:

Entity A: Hospital/Needs workers

Entity B: School/Educates people to make them into workers

Entity A tells Entity B: We will help you facilitate your business by letting you use our premises and our business to provide real-world training to your students, because we need you to keep training workers and encouraging them to come here

Entity B says: Okay, but you want an awful lot of workers, we're gonna need to ramp things up.

Entity A: GREAT! You do that! Pump them out as fast as possible please. K, thx.

Entity B: Hey, we need to use your premises and resources a bit more in order to pump out the workers you want

Entity A: Nope, no can do. Plus don't worry about it, just get us the workers as fast as you can and we'll worry about the rest!!

Entity B: ??‍♀️??‍♀️ Okay, GREAT!

Entity A to New Nurse: Your training sucked and it is going to cost gazillions of dollars to finish training you properly. Because of that we'll have you sign a contract to pay us to finish your training. That is, if you want to work here.

~The End~

Who defends this?

 

 

[londonflo]

10 hours ago, JKL33 said:

Take yourself out of this for one small second, londonflo, and look at it this way:

I have stated my real experiences and encounters (in real seconds, hours, days, months, years) with the world of  nursing education  and the involvement with my local hospitals in my section of a state. nothing 'pretend' I provide reality. 

Again, unless you have been a fulltime nursing educator, you are just giving a supposed opinion with out substantial "been there, done that" experience and no previous immersed role in entry level RN education.

[londonflo]

16 hours ago, JKL33 said:

So someone somewhere feels there is a need for FOUR new programs.

Once again you are showing that you do not know education---and  how educational programs work.  I cannot just sit at home and develop a nursing school (except may be in Florida). New programs have to show "a community/state needs assessment", (no this is not a conspiracy)  that does not impact current programs. The needs assessment takes at least 2 years to complete...looking at student enrollment waiting lists, hospital RN vacancies, home health vacancies, state RN employment needs, difficulty with area graduate students to go on to further education as nursing professors.. The complete documentation (student need, population need) has to go for approval to our state BON. I acutely remember we had to declare our Diploma program closed and for 1 hour I did not have a job until the BON approved the new BSN program. It was a gamble--

Once again you do not know what you do not know. 

 

 

[foxypaws, BSN, MSN, RN]

Something I try to remind myself, that I hope other new nurses make their mantra: "be the change you want to see in the world." Got this. 

[JKL33]

On 12/7/2022 at 4:21 PM, londonflo said:

Once again you do not know what you do not know. 

Your rebuttals amount to circumventing the topic at hand in order to continue discussing irrelevant details that you think only you know about.

I said:

Quote

Okay. So someone somewhere feels there is a need for FOUR new programs. Whoever it is believes there is a need, or at least that it's a concept they can make money from.  They are "willing" to "answer the call" to accept money from students. Why don't you tell me what you think should happen next?

In response to that, you skipped the opportunity to admit that a service should be provided in return for the money and instead chose to pontificate about how it takes 2 years and a need must be shown. Who cares?!

I don't care if they had to go to hell and back to show that there was a need for another nursing school. Whatever difficulty was endured, they chose to endure it because enduring it was considered to be WORTH IT in order to gain the expected return...unless you are next going to try to claim that nursing schools open up due to pure altruism.

I have presented reasonable points of concern. You have not remotely rebutted them but spent all your time reveling in what you assume that I don't comprehend. I wish you would choose to use your experiences to advocate for clearly needed improvements instead of defending a situation that is not helping students, nurses or patients. But that is your choice to make.

 Good day.

[kbrn2002, ADN, RN]

I'm glad for you OP that you were fortunate enough to land your first nursing job in such a supportive environment. Sadly that isn't always the case, maybe not even often the case.

However, it's hard for me to judge too harshly the current floor staff that may not be providing that optimal, supportive experience the new grad needs and deserves. In way too many cases that new grad is set loose with an education and skill set that does not at all prepare them to be an independent practitioner with the expectation that the "experienced" nursing staff essentially finish their education. 

That current experienced staff may or may not be experienced at all, barely on their own long enough to function well in their role and they are then tasked with teaching when they are just getting comfortable themselves.  Or on a floor staffed primarily with travel nurses, the teaching falls to nurses with no investment in or extensive knowledge of the facility much less that floor even if they are experienced nurses. 

Even if that new grad is lucky enough to get hired to a floor that has consistent, experienced staff odds are that staff is working short and truly doesn't have the time to properly care for their own patients much less take on the education of a new nurse which like it or not does take time away from the nurse's normal day to day. That's bound to cause some frustration for the experienced nurse tasked with the job of training a possibly, even likely underprepared new grad. Add to that the likelihood is that the nurse assigned that new grad is not even receiving any additional pay for taking on that duty, or such a small amount that it's more an insult than anything. 

[londonflo]

10 hours ago, JKL33 said:

I have presented reasonable points of concern.

I don't think so. You are just basically complaing about everything.

 

10 hours ago, JKL33 said:

You have not remotely rebutted them but spent all your time reveling in what you assume that I don't comprehend.

 I have given clear details on how nursing education works. You don't want to  understand/comprehend how a a complex educational program works. Go ahead on your merry way with negativity. Do know that RNs will never be considered a profession if their education is not college based? 

I have given  accurate counterpoints to every complaint you have stated. You  continually harp on tuition costs. Okay, let us make every program free! No classrooms, use volunteer faculty , mannikins from the dark ages or none at all, like cathing hotdogs.  Here you go: 

Attend Free Nursing School Online! - University of the People (uopeople.edu)

 

 

 

[londonflo]

poor taste but this is what I feel when talking about the nursing educational process.

 

[londonflo]

 

This is what I feel talking to several people on nursing education. I was a young nurse when this movie came out, knew the writers, they encapsulated what life could be then { AIRPLANE)  and described what I feel talking on AN about nursing education.

 

 

 

 

[Ruby Vee, BSN]

On 12/6/2022 at 8:33 AM, londonflo said:

The hospitals here actively recruit nursing students from as many schools/colleges as they can. We have some colleges that send students from 90 miles away,  2 others 60 miles, as well as 3 local colleges (one a state school that one hospital subsidizes their program). Each college is limited by the Nurse Practice act to 10 students per group. Each college has at least 100 students. We also use Saturday and Sunday.  The education coordinator has plainly said that by exposing this many students to their organization they can get a couple from each college to apply and hire. 

 

 

Active recruiting of nurses is a good thing -- but so is actively retaining more experienced nurses.  I have noticed far more of the former than of the latter.  We cannot have good preceptors without good, experienced nurses and experienced nurses who have learned that we aren't valued as much as the newer (and cheaper) new grads aren't as likely to stick around to BE preceptors.  There's a children's rhyme that goes, "Make new friends, but keep the old.  One is silver and the other gold."  I think that applies to nursing as well.  Hire new grads, but keep the old.  I see one and two year nurses precepting . . . but oftentimes they lack enough experience to know what they don't know.  And then they pass their blind spots on to their orientees.  

Retaining the crusty old bats is the key to having good preceptors to train new grads into good nurses.

[foxypaws, BSN, MSN, RN]

2 minutes ago, Ruby Vee said:

 I see one and two year nurses precepting . . . but oftentimes they lack enough experience to know what they don't know.  And then they pass their blind spots on to their orientees.  

Retaining the crusty old bats is the key to having good preceptors to train new grads into good nurses.

I did run into this in school… one of my preceptors had about a year of experience BUT she was a DEMSN graduate from a top school and was sharp as a tack. Honestly she did a great job, almost as good as another preceptor that had a decade of experience. 

[Rmooney]

On 12/6/2022 at 6:48 PM, JKL33 said:

I don't think it's simple at all.  I am not trying to argue with you but rather point out that there is plenty of jockeying and shenanigans and deal-making that is way above the level of the student nurse and the floor nurse who gets to finish the new grad's training. Nursing schools do have to put up with a lot (from hospital corporations) but they are not complete victims; they are taking students' money after all, it is incumbent upon them to provide a quality service. 

I have NO problem believing this, at all. 

Can you explain more? This reads as if you are saying that staffing is terrible and nurses are frustrated and burnt out because of MNA's activities. Is that what you are saying?

 

You are really downplaying this. You mention "take longer" as if that is no big deal. I know what you mean by (real) emergencies, obviously, and am glad you acknowledged that they exist, but beyond that haven't you noticed that the staff is under pressure over every single little thing--whether it is a real emergency or not? Have you noticed that?

Healthcare corporations have purposely been wreaking havoc on units all over to make sure that we are as "efficient" as humanly possible and at this point there is painfully little slack in the routine--BY DESIGN. Inpatient nurses already feel that they cannot provide adequate care to patients. So it is no small deal when you nonchalantly drop this idea that "yeah, it's gonna take more time...." There IS no more TIME. If time were really an endless resource then YOU would have time to attend all of your students while they pass meds.

It seems like in your post you have blamed the MNA and working nurses for the fact that staffing is, in your words, "terrible."

I think that is worthy of a sincere "come on now..."

 

I think you’re misinterpreting what I’m saying here. I’m not blaming the MNA. My point was that it is unfortunate that the issues have gotten to the point where nurses feel the only option is to strike to get leadership to listen. And I’ve seen how burnt out they are by their reaction to us on the floor.

Also, the nurse that snapped at me about the med pass didn’t even have to give meds with my student. As the instructor, I make every effort to pass meds with my students so the nurses don’t have to. My goal is to take some of the work load off of the nurses while providing a great learning experience for my students. In the past, nurses have recognized that as a benefit of having students on the floor. But recently, I’m seeing and hearing from my students that they don’t feel as welcome. This is an issue because without students, we won’t get more nurses. 

I do know the hospitals are working on solutions to create better staffing for their teams that doesn’t rely on getting new nurses . No one can change the amount of time it takes for someone to complete their program.