New Nurse; How do I earn respect from PCA/CNA?

Jedrnurse, BSN, RN · Jun 27, 2017

How long are you working with a preceptor? Honestly, you may not be able to change this in a short time. When you're the primary nurse (solo), they'd have to report things on your patients to you.

What if your preceptor just refers them back to you when they try to report off to him/her?

roser13, ASN, RN · Jun 27, 2017

This is a common problem when new grads return to their old floor with a new designation. Whether out of jealousy or habit, the peers from the former (CNA) role do not usually respond well to the new role. I think Jedrnurse has a good idea - your preceptor can refer them back to you. The 2 of you will have to collaborate to ensure that the critical results truly do make it to you and don't get "lost" along the way.

JKL33 · Jun 27, 2017

I think you are taking this too personally and making too much of it. There are very practical factors that are likely influencing this right now - namely the fact that your preceptor is in charge of those patients right now. That's not to say that things shouldn't be reported to you, just that the techs are busy and they know who is ultimately responsible for those patients and that's their go-to person. Secondly, since at this stage your preceptor likely gives you some independence, there are undoubtedly times when s/he is available and you're in a room. It's also not uncommon for techs to see bits of what's going on with the orientation and go to the preceptor as a way to not overwhelm the new nurse who is trying to juggle lots of other things.

As the PP notes, this is fairly simple. Talk with your preceptor and let him/her know that you'd like to receive these messages so you can learn to incorporate that aspect of managing your patients. Ask if s/he would be willing to refer the techs to you when they have an update/message.

It almost sounds like you may be thinking that the co-workers you "left behind" in the tech role when you became and RN are going to your preceptor to purposely slight you; implying that they may be jealous. I hope that's not the case because that would be kind of a "big-headed" way of looking at this. My advice is just don't go there with your thoughts. Treat them with respect and earn theirs.

HaleyRoseRN · Jun 27, 2017

It is very possible that I'm taking this too personally. I tend to take things personally, even when trying not to.

I am in no way implying that the techs are jealous of me, nor do I see myself as "better" than they are, since I was tech myself for 2 years. I appreciate them and respect them a lot. I guess all I'm saying is I want to be taken seriously as a nurse. I'll have to discuss with my preceptor. Thanks for your input!

caliotter3 · Jun 27, 2017

Get your preceptor to cooperate by referring them back to you.

Cvepo · Jun 27, 2017

Get your preceptor to cooperate by referring them back to you.

This. When I precept, I tell them "tell the orient, not me."

Apples&Oranges · Jun 27, 2017

I have had the same problem when I was orienting. I don't think it has as much to do with you being a new nurse as it does with you being on orientation. I have had to beg unit secretaries to put MY name on the e-board, not my preceptor's. I have had to beg preceptors to please, please give me the full responsibility of provider questions, calls from pharmacy, radiology, ect...that's the only way to really get to know the intensity of the workflow on a unit, even when I had more nursing experience than my mentor.

This is why when I am precepting, or even have a student nurse for the day, I make sure THEIR name, not mine, is on the board. Including the white board in the room. If a doc needs to be called, I have the new nurse or student do it. Same with calls coming in. Same with radiology, MRI, OR, monitor techs, anyone who wants to bargain for the nurse's time.

You need to be clear with your preceptor that you NEED to be the primary and only contact from here on out, in order to learn how to manage your time, and learn to prioritize and delegate.

THAT SAID: I just re-read that you are only 3 weeks in...take your time. Take primary on x patients this week, x+1 next week, full assignment for at least a week prior to being cut loose. She is probably trying to do you a favor and keep you from drowning before you are ready to swim.

You will drown. You will. Try to do it in small increments, rather than all at once.

JKL33 · Jun 28, 2017

It is very possible that I'm taking this too personally. I tend to take things personally, even when trying not to.
I am in no way implying that the techs are jealous of me, nor do I see myself as "better" than they are, since I was tech myself for 2 years. I appreciate them and respect them a lot. I guess all I'm saying is I want to be taken seriously as a nurse. I'll have to discuss with my preceptor. Thanks for your input!

I just mentioned it because it's something that crops up...possibly even more when someone changes roles and is now delegating to your peers whose role you used to share. I do think I wrote that a bit harshly - I actually meant it as just something to be aware of (from their point of view as well as yours).

You'll do fine; just make sure you straighten it out with your preceptor so you're managing everything for the latter part of your orientation. Best wishes!

MasterNursinator · Jun 28, 2017

I never got this at my first job. I think they all saw me as being incompetent simply because I was new. I changed jobs 6 months later and had no trouble from then on. I do not recommend changing after 6 months, though. Wherever you go, stay at least a year. Trust me. Years later I STILL get asked why I left that job so quickly. It's incredibly frustrating to have to go through that discussion every time I interview for a job. GL!

Apples&Oranges · Jun 28, 2017

Sorry, I just realized I didn't really answer your question. Respect from PCTs should not have to be earned (where is NOADLS when you need him?) but in reality, it is. From the perspective of a long time PCT, let me tell you how RNs got it from me:

-Ask for me help, don't ever TELL me to do something.

-Thank me for helping you with YOUR patient.

-Please don't call me from another task to do something that you could have done while you were right there in the room. Unless you are in a critical time crunch, this is not cool. If you do, be prepared to justify it.

- Similar to the last: If I am in a room, and need the NA to clean a pt, toilet, whatever, I always have a good reason, and share it: "Hey, Lucy, could you help Mr J to the bathroom while I get his meds together and call medicine for this critical lab? I have to hang blood next door, but when I'm done with that, I can help you get him in a chair."

I don't "use" unlicensed assistants when I don't want to do something, I ask for and appreciate their help when I have stuff to do that is timed or they can't do. I think/hope most of them realize that. Maybe I'm delusional, and they all think I'm a lazy cow.

-Don't ever, ever, ever ask ANYONE to do ANYTHING if you have been on your phone in the past 2 hours. Or if you just went out to smoke. Or if you took a 45 minute lunch and I haven't peed in 9 hours. I'm a pretty nice person, but you will NOT like my response.

hateschool · Jun 28, 2017

talk to preceptor!!