Newer nurses with TOO much confidence?

[kidnurse98]

I have been a nurse for 12 years with critical care and tele/med surg experience who changed career paths a couple of years ago and started working at a prestigious children's hospital in 08. Lately, things have been getting really annoying with one nurse in particular. She is a new grad (I say new grad meaning less than a year experience as an RN and this is her first job).

Anyhow, this girl is always signing up to be a super user of some sort, brown nosing, etc. etc....we have ALL worked with those types of nurses and generally I tend to ignore them, then laugh to myself when they eventually "lose" it.

The last couple of weeks I have noticed her following me into my patient rooms, like watching me perform care and attempting to "correct me". The thing is, I'm not doing anything that she should be correcting me on in the first place. I am a great nurse with excellent skills, I earned the right to say that by breaking my back since 1996!

This got out of hand the other day when she "took over" suctioning my patient d/t his sats being low, then cautioning me on what meds to give him. I almost bit my tongue in half from keeping my mouth shut on the matter. BTW the meds were discussed with the NP and MD....I just mentioned that if he did not calm down after what I was giving him what the plan was.

Apparently, I am not the only one who is noticing this behavior change she is exhibiting....people have started talking and we all know how that goes.

Any advice on how to handle this?? I really want to pull her aside and say something to her, but I don't know exactly what to say. She may think she's "super nurse" right now, but dang when her assignment gets tough she gets frustrated and says she's gonna quit. I think she is a smart girl with decent skills for a new nurse-and I do care enough to not have her get a rep for being a know it all brwon noser type-although she seems to be getting there on her own.

Any advice would be appreciated :)

[roser13, ASN, RN]

I wonder if someone so b***sy as to follow you into your own patient's room and attempt to take over care would even listen if you tried to speak with her about her actions/attitudes. I don't think I would have been as nice as you in that situation - I don't think I could have held my tongue.

I think if she tried to correct me again, I would be tempted to give her a blank stare and say something to the effect of "I'm sorry.....did I give you the impression that I needed help? Because I'm actually fine and I'll call for help if I need it." Enough of those exchanges and I'm guessing she might get the message.

But of course, no matter how you handle the issue, you will be Eating Your Young.

S.I.G.H.

[Katie5]

I wouldn't say anything at all. Some of us have to live and learn for ourselves. If other healthcare providers are talking, laughing, and carrying on about her, I am sure she would get the ideal sooner or most likely later. I have worked with nurses like this and believe me they finally realize what is really going on in the world, by learning the hard way. Healthcare providers suppose to work as a team not against each other.

Then not telling her is going contrary to your kind suggestion here.

[dtrmnd2sccd]

I'm heading into my first acute care position in two weeks, and I REALLY hope that if I do something offensive or rude that someone will take me aside and explain it to me.

In my clinicals, we student RNs were always jumping in and helping each other with patient care--it was part of the "teamwork" that my clinical instructors encouraged. If we had down time we'd tag along with another classmate to see what was going on with their patients and see what we could learn. We were always bouncing ideas off of each other, too.

I wonder if maybe this new grad is still in "clinical mode" and doesn't understand the boundaries she needs to keep now that she is an RN? Her eagerness and enthusiasm to sign up for new things are probably what got her high grades in school (and possibly the job on your unit). She may have no clue how the way she's acting is being perceived now that she is in the real nursing world, and would be very greatful for the advice of a more experienced nurse.

[BluegrassRN]

I've had to deal with know-it-all new grads. But I think it isn't so much to do with being a new nurse, but personality issues. Some people are just know-it-alls. I remember one of my nurse friends told me when I first started that she felt I was too confident because she never heard me complain about something being too hard to handle and I never seemed intimidated. I just told her that I ask for help when needed....would never attempt to tackle something I'm inexperienced with and I tend to not let others intimidate me. *wine

Yup.

It's a personality thing, not a new nurse thing. Be direct, but not unkind.

Another point...I think it's hard as newer nurses when you see the experienced people go to one another for assistance. Of course they do that; but I think maybe the newer nurses get left out of that equation too often sometimes. It won't kill us old fogies to ask some of the newer people to give a second opinion on an iffy IV or a change in condition, or bounce some ideas off of them every once in a while.

She might be trying to be a helpful, competent team play. Take her aside and kindly but firmly let her know she's overstepping her bounds. Thank her for her enthusiasm and her desire to help, and assure her that you will call on her if you need assistance. Issue addressed.

[nursel56]

I'm heading into my first acute care position in two weeks, and I REALLY hope that if I do something offensive or rude that someone will take me aside and explain it to me.

In my clinicals, we student RNs were always jumping in and helping each other with patient care--it was part of the "teamwork" that my clinical instructors encouraged. If we had down time we'd tag along with another classmate to see what was going on with their patients and see what we could learn. We were always bouncing ideas off of each other, too.

I wonder if maybe this new grad is still in "clinical mode" and doesn't understand the boundaries she needs to keep now that she is an RN? Her eagerness and enthusiasm to sign up for new things are probably what got her high grades in school (and possibly the job on your unit). She may have no clue how the way she's acting is being perceived now that she is in the real nursing world, and would be very greatful for the advice of a more experienced nurse.

Didn't see any mention of high grades and people can and do act like know-it-alls with mediocre grades. I don't think this person is a brand new grad, but -- did your nursing school classmates "correct" you "caution" you and barge in to take care of your patients when you didn't ask them to? I don't think the two things are comparable at all. If she is smart, after having been there for as little as 4 weeks she would notice that "clinical mode" is not what is surrounding her there on the unit. It's important to adapt to a changed environment like that.

Hopefully, the OP or someone else there will tell her about the perception she is creating. I agree with you 100% on that one. There have been too many posts here "thought I was doing good then I got fired :crying2:" - I'm always really sad to read those - it's so unfair to the new nurse.

[linearthinker, DNP, RN]

Could she be on drugs? This does not sound like the behavior of a rational person.

Anyway, I'd tell her point blank to stay out of my patient rooms unless I invite her to assist.

[elle_RN]

When she follows you into a room, I would turn around and say "I'm fine in here, thank you". Just shut it down. Eventually her over-confidence is going to result in an error and you don't want to be associated with that, especially if it's YOUR patient. As a new grad, I can understand the excitement that comes with feeling like you know what you're doing, but good grief.

In nursing school there was a know-it-all guy...and he really did think he was hot sh!%. He worked as a PCA and would tell doctors what to do and the nurses HATED him. His GPA was terrible because he felt he didn't need to study...he knew the "important stuff". Anyway...I would rather have someone like you're describing than someone like him, but either way it's annoying and you'd be doing her a favor by (nicely) putting her in check. This guy couldn't take the hint and can't find a job as an RN now.

[Orange Tree]

Great! I love co-workers with lots of time! Send her to the pharmacy to pick up those meds you've been waiting for....or maybe she can clean up that patient who's been vomiting and has diarrhea.

[lkwashington]

Then not telling her is going contrary to your kind suggestion here.

You have a good point. Treating people with kindness is the way to go with me. I know how I am and not too many nurses going to come in my room and show me how to do my job. Believe me if I have any problems and/or questions I will ask someone. I am not going to put my patients in harms way. I am figuring, maybe someone filled her head up with something. Who knows?

[silentRN]

She'll probably end up being the CL or Manager one day

[mazy]

If she's taking care of your patients who's taking care of her patients?

[Up2nogood RN, RN]

I work with a newer nurse than I and she's always looking for fault in others.

Well anyway she comes to inform me that my patient in room such and such is in V-tach!

Hmm, well I asked her how she figured this out since she's not even on tele?

Oh she said "her pulse ox was alarming and I read the wave and I saw it was V- tach" :smackingf