Nurse Bully, please protect your young: "Don't eat them"
Nurses are divided in two groups. The first is tough skin, and strong willed. The second is sweet, angelical, compassionate and don’t have a mean bone in their body. When group number one gets frustrated they take their grievances to the young and docile. Please don’t do it Mr. bully. Have some guts and face your boss and his rules, the ones you really have a problem with.
I believe nurses are very special individuals. Think about it. They are professionals who take care of others in their dire moments. They patiently heal the putrid wounds of some; calm the fear and hopelessness of others; tolerate ingratitude and hostility daily; endure day after day of toiling around the sick and dying. Is only natural you'll find compassionate and warm hearted beings among nurses. I have been in other professions and the contrast is clear to me.
But because nursing is a tough job; some of us develop a thick skin. In a way, is a protection mechanism some develop to survive - you either get tough or you die. Although there is nothing wrong with being tough, some nurses can become quite aggressive and hostile to other nurses. We all have met them at some point, I surely did. But even being aggressive and assertive, nurses cannot match the aggressiveness of some bosses. Oh yes, let's talk about them bosses.
But bosses are people too. Yes, there are reasons why nurse bosses are sometimes so bossy. But bosses also have their though fights to fight. They too must develop an even tougher skin to survive the trials and tribulations of health care. Sometimes bosses are just nurses who left the floor because they simply couldn't take it anymore. Then to find even more stress in management.
Nurses are usually between a rock and a hard place. They have lots of responsibility, but lack the power to make decisions on their own. Doctors have much more say so in regards to their professional lay out. They call the shots, they can fire patients and are respected by most. Nurses on the other hand need to make decisions but always filtered by a set of rules created by others. Nurses must endure whatever BS is thrown at them. If you have an abusive patient, all you can do is to write a note and hope for the best. Most nurses can't simply fire a patient or they'll get fired.
Nurses run the show but are told how things should run. Often by someone who is deciding for them from an office chair; people who never worked on a floor or have not worked in years and can't remember anything. So, nurses are in a pressure cooker situation. Pressure from all sides and not an outlet in sight.
Well actually there is: and that is to relief the pressure on the least dangerous and inconsequential outlet - the young and vulnerable ones. The perplexed and scared nurslings are the recipient of a lot of pent-up anger. But why older nurses engage in this predatory and coward behavior?
It must be their inability to change the system and claim their power. Their extreme frustration lead them to eat their young. The ones they should be nourishing, protecting and grooming to take nursing to the next level just got eaten for lunch. Just like scared animals - they step on their own eggs. This is unfortunate.
If young nurses were well groomed and nurtured they would be the ones able to take nursing to the next level. Instead nurses create a culture of perpetuating the errors inflicted in them by transferring it to the young.
Protecting the young
Again, if you want to bully someone bully the oppressor and not the oppressed. Bully your problems and not the people who are here to learn. The bully energy is good energy but wasted and pointed in the wrong direction.
The alternative to bullying is to preserve and protect the young: because teaching the young the right ways is the only viable way to change nursing culture. It changes things because the young always will change the world. But instead we teach them the culture of bullying. We create perfect students in the art of bullying others. Nothing changes.
So, Mr. Bully next time you decide to torture the young, think of why you went into nursing back in the day. Bullying the young will only perpetuate the culture of abusiveness you were ounce, and continues to be a victim of.
Last time I worked I was give 2 students to follow me. I was so busy trying to show them the eMAR, how I organized my time, and so forth that I got completely distracted and missed a bunch of am meds for one of my pts. Luckily, no harm came to the pt but it really upset me.
having students is a lot of extra work for nurses.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Lateral violence is a topic I discuss with my junior nursing students before they set foot in the clinical setting; however, nothing I can say prepares them for the incivility and sometimes, down-right hostility, many of them experience from a staff nurse. The behavior ranges from statements such as "I don't have time to teach today" to ignoring the student's presence completely. What many nurses do not realize is that the student models his or her behavior on what they see in the clinical setting and the cycle of incivility will not end until we change the way we treat each other. As nurses, each of us are educators, and it is part of our role to educate students and set an example for them to follow. We do not tell patients and families that we "do not have time to teach" them post-op care or medication information because it is part of our role as a nurse.
Our profession should be above such behavior. We are professionals and should behave as such, through our words and our actions. Before you tell me that I do not have a clue about the "real" world of nursing because I am in academia, and that my thoughts are both idealistic and unrealistic, please know this is only my second year as a professor...after practicing in the real world of nursing (ED, ICU, surgery, and rehab) for 30 years.
And how are you discussing lateral violence? Are you one of those faculty who is warning/frightening students that there are bullies everywhere and they have to beware of being "eaten"?
I think most nurses realize that students model the behavior on what they see in the clinical setting, and if they don't feel up to modeling perfect behavior perhaps they should be excused from teaching that day. After all, the students follow us into the break room, the med room and sometimes attempt to follow us into the bathroom. Unlike patients and their families, we cannot really get away from the students. A nurse who is having a truly bad day or month or year ought to be allowed to say "I don't have time to teach today" or even "I don't want to teach today." As their instructor, it is YOUR job to teach them; not mine. Teaching my patients and their families is my job; teaching your students is not.
Perhaps you have been in the "real world of nursing" for 30 years, but you still don't seem to have a clue about it.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Perhaps I have oversimplied it, yet I was not aware that our jobs were broken down as such so that we are paid per task. In most nursing job descriptions, there is a line "and all other duties assigned". One could argue that training and precepting fall under this clause. I was certainly never paid specifically to empty the trash, clean up a spilled drink, or help a family member connect to the wireless internet in the hospital room, yet I have done this and more as "all other duties assigned".
Our school of nursing has an affiliation with an area hospital, so it is expected from the nurses by administration that they participate in the training and precepting of students. Just an FYI...there are systems in place that provide training...as well as a stipend to nurses who are preceptors. Perhaps these places are more to the liking of those who feel training students and new nurses is a burden.
I think my issue is that we were ALL novices at some point. How were you treated by the nurses as a student, new graduate, or simply a nurse in a new environment?
Maybe money is a motivator to some nurses. I have always looked at it as an opportunity to better my profession. For me, I am satisfied in knowing that I had a hand in the training of a nurse who may be caring for me or one of my loved ones, or who may be my supervisor some day. Think about it before you refuse to precept. You never know when it might be YOU in the bed, or this young, aspiring, and movitaved nurse may end up as your nurse manager. Everything comes back around to us. I believe it is referred to as Karma....
Precepting cannot be compared to emptying the trash or cleaning up spills. Yes, trash and spills can take up some time, but precepting quadruples the workload -- assuming your planning to actually teach something, of course.
I've never run into one of those places that provides a stipend to nurses who are preceptors to students. For training new staff, yes. The $.075 per hour came in really handy at Christmas time. (Not.)
I've always loved teaching, and was usually happy to precept new staff or new students. But I think staff need to be given a chance to say no to the "opportunity" to precept students. A staff nurse who has had no break from precepting a constant turnover of new staff for the next couple of years should be allowed to say "no" from time to time. But saying "no orientee this time, please" only means they get saddled with students. I know that I was not at my best in precepting the orientee that came through when my father was dying, my mother needed to be placed in a nursing home because he couldn't take care of her anymore and I had just taken FMLA to fly back to the midwest to deal with that situation for a month and new I'd be going back when my father actually died. The orientee was gracious. The nursing instructor who would not take no for an answer was not.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Lol, trust me, YOU are not doing the job I am being paid to do; however, if you are a nurse, I have done the job you are doing and I did it for 30 years full-time. You have one student following you around to see how you organize your care, assess patients, pass meds, use SBAR, and document. I have 77 students in the classroom setting, from all different generations, who learn in all different ways, who must be "edutained" in order to engage. I am trying to help them make the connection between didactic and clinical... all the while trying to teach them the right way of caring for patients. I teach in both the classroom and the clinical setting, I pass meds with all my clinical students, and I do a complete head-to-toe assessment (not a listen-to-one spot-to-see-if-the-heart-is-beating and-two-anterior-spots-to-see-if there-is-air-moving). All the while trying to explain why nurses aren't "scrubbing the hub" and washing their hands...
While I am not saying this is true of your particular practice, my students see nurses taking dangerous short cuts during their clinical experiences. I have to remind them that they decide every day what kind of nurse they are going to be. Perhaps some nurses don't want students because they are threatening and know what is proper practice vs. dangerous practice.
Many of them have concluded on their own that the nurses who do not want students, do not want them because they are going to be held accountable for the care they provide or the mistakes made by the student. We carry nursing liability on our students.
Sorry, I'm still chuckling over your comment. After all the hours I put in, as much aggrevation as I experience (including text messages, calls, and emails during off school hours), for the small amount of pay I receive, I figure I am paying someone to work, BUT I love what I do and I am not bitter over a career choice that has become my life's passion.
You may have been employed full time as a nurse for 30 years, but you're still not getting it.
Precepting is difficult. There are times when nurses don't have the energy to teach on top of their full assignment. They should be allowed to say no. We don't get paid for teaching the students. That is what YOU get paid for. Your job may be difficult and your pay low, but YOU signed up to teach the students. The staff nurse who finds out at 6:59 that she's going to have a student dogging her every footstep is not getting paid and ought to have the option of not having the student. Maybe if nurses weren't being forced to teach your students, they wouldn't be "incivil" about being saddled with them.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I truly am sorry if this is your experience with local nursing schools. I DO have the full responsibility of my clinical students. We really try to be a blessing to the nursing staff by answering call lights, ambulating patients, giving meds, and directing questions about practice to ME, not the staff nurse. I never leave the floor (I teach junior students) because I can not trust them not to make an error. I watch them like a hawk. I only want them to observe the nurse. I want to be the one to help them draw blood, put in a foley, pass meds, etc. Maybe my program is the exception, but we are shoulder-to-shoulder with our students until they have their capstone experience in the last semester. Very little of our clinical time is done through simulation (less than 10%). My ratio of instructors to students varies from 1:3 (Fundamentals clinicals and Med-surg I) to 1:5 (Maternal Newborn). We are old-school strict and tough, but we turn out good nurses that health care facilities covet.
For those nurses who share their time, knowledge, and expertise with my students---I am forever grateful to them for helping me develop competent students with critical thinking skills. For those who don't want students with them, thank you for letting me know because I am protective of what is mine. We need nurses (and have since I graduated in 1987) and I don't want them scared off because of the negative comments or actions of a staff nurse.
I am sure that you are the perfect nursing instructor and none of us will ever have reason to see you or your students as anything other than the blessing that you are. However you are condescending, patronizing and totally unreceptive to hearing a point of view other than your own.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
As stated, I do provide the clinical education to my students. Do not think otherwise until you work with me and my students on your floor. Please understand that all programs and nursing school cultures/philosophies are different.
As for converts, I'm not here to win anyone over to my side or my way of thinking, nor am I here to take the abuse and incivility for all of the nursing schools/instructors you have dealt with in the past. I am happy with my career choices, happy with nursing, and would not ever have chosen anything else. My point of view is what it is--it is mine and I own it. I thought the purpose of a discussion board was to present different points of views, but apparently on here it is not. I'm sorry, I didn't realize I had to stand with the majority and stay silent, all the while reading how nurses don't eat their young. I mistakenly thought I had free speech but didn't realize I would have to dodge stones while expressing it. So sorry I didn't just read and lurk for any longer than I did, but I'm even more remorseful that I wasted my time trying to defend a profession that I love, advocate for students and new graduates, and a career that I am so passionately ready to defend.
Please don't bother to respond. I refuse to be the target of your bitter one-liners. I'm out...
And the internet flounce . . . . after having the last word, of course.
Perhaps I have oversimplied it, yet I was not aware that our jobs were broken down as such so that we are paid per task. In most nursing job descriptions, there is a line "and all other duties assigned". One could argue that training and precepting fall under this clause. I was certainly never paid specifically to empty the trash, clean up a spilled drink, or help a family member connect to the wireless internet in the hospital room, yet I have done this and more as "all other duties assigned".
Based on your several posts following this, it sounds your program may be the exception to the rule in that the instructor really does stay available and take responsibility for the teaching. If so, thats great.
However, I find the portion of your post that I have bolded to be problematic. Lets say that teaching students DOES fall under "and other duties as assigned". So if my workload is already at 110%, and then you/the hospital/the boss wants to add 10% more workload for teaching a nursing student.....do you think that 10% of my other work will be removed so that I am still only expected to do 110%? No, now I am expected to do 120% of the work, in the same amount of time, for the same pay. It is exhausting. And even more that that, while some students are wonderful, other students are unappreciative and unpleasant. That can be draining. You must understand that, what with your experience in education.
And I love teaching. I've been known to borrow other nurses students to show them something interesting. But yeah...I am also motivated by money. No shame in my game.
Last time I worked I was give 2 students to follow me. I was so busy trying to show them the eMAR, how I organized my time, and so forth that I got completely distracted and missed a bunch of am meds for one of my pts. Luckily, no harm came to the pt but it really upset me.
having students is a lot of extra work for nurses.
It seems to me as though there may be a new model for student clinical experience. When many of us were students our role was hands on; we were assigned patient/s by our clinical instructor and we provided total care for them; bathing, toileting, feeding, transferring, assessing patients, plus whatever skills we had been checked off on in skills lab. We were responsible for carrying out the plan of care to the extent that we had been taught/had our competencies validated in skills lab, under our clinical instructor's supervision. We were taught to use the Nursing Process, and we were expected to use it when we provided care. We co-ordinated our care with the nurse assigned to the patient and reported any important information to them, such as changes of condition, and asked necessary questions, but we didn't follow the nurse around with them explaining how they organize their care etc; we were expected to learn that by ourselves by doing the care.
It appears that (some) students are in a much more passive role today in clinicals; observing how nurses practice seems to take the place of actually doing much of the actual hands on care. It seems very unfair to me to take the nurse away from their patients to provide explanations to the students about everything they are doing, for both the nurse and the patients. Patients need their nurses' full concentration; they are usually very sick with multiple medical problems and complicated treatment plans, and nurses need to be able to concentrate on providing safe patient care in a timely manner with their full attention.
So, I will try to weigh in briefly. I attended a school with a different education model, as I have shared before. I won't harp on it now. But the bottom line was, the faculty *were* very involved, and then gradually became less involved as the student progressed and approached graduation.
The key here was that the staff nurses volunteered, in advance, quarterly and were compensated with a stipend from the University in the way of a cash lump sum payment and some other benefits like CEs, as well as by the hospital with preceptor pay (not much, couple bucks an hour). Assignments were adjusted somewhat to lighten the load and provide certain experiences, if possible. The students did not get assignments ahead of time - they were expected to be proficient enough with SBAR and charting *before* entering the hospital environment and attended report on time, in uniform, and got their assignments with everyone else.
While the preceptors who worked with this program certainly weren't making boatloads of extra cash, I feel that the planning and communication involved ahead of time, as well as at least *some* compensation for the extra workload, helped to ensure smoother experiences for everyone. We had people doing clinical on all shifts based on who was interested in precepting.
I personally feel that I had a smooth transition after graduation - at least in comparison to what I read on AN. I was challenged as any new grad is, but I don't feel that it was some incredibly stressful nightmare. Some people are difficult - they are in any profession - communicate, try to give them what they need (within reason) and do your job. Learn, be accountable. Use your resources. Shake it off if someone has a grumpy moment - and find the nugget of truth in the feedback they're trying to give.
That said, this is only one out of three of our regional nursing programs. The hospital does still provide preceptor pay, but other programs use different models which definitely results in many of the problems enumerated here. I know that my shifts with a student who has an absent clinical instructor, especially if they're a junior student, can be an absolute nightmare. I tend to be the one who gives a couple of chances for the student to demonstrate entry level competence and if they don't rise to the occasion, I grab the reins, pump the brakes and they end up shadowing while not touching my patients (unless the faculty is right there). Certainly not an optimized experience for everyone involved.
Luckily we we have a pretty supportive management team who defers to the nurses judgement when it comes to student performing hands-on care, and if we say "no" to a student that day, management tries to accomodate. Not always possible - but at least they try. My unit may be in the minority even within our organization.
It seems to me as though there may be a new model for student clinical experience. When many of us were students our role was hands on; we were assigned patient/s by our clinical instructor and we provided total care for them; bathing, toileting, feeding, transferring, assessing patients, plus whatever skills we had been checked off on in skills lab. We were responsible for carrying out the plan of care to the extent that we had been taught/had our competencies validated in skills lab, under our clinical instructor's supervision. We were taught to use the Nursing Process, and we were expected to use it when we provided care. We co-ordinated our care with the nurse assigned to the patient and reported any important information to them, such as changes of condition, and asked necessary questions, but we didn't follow the nurse around with them explaining how they organize their care etc; we were expected to learn that by ourselves by doing the care.
It appears that (some) students are in a much more passive role today in clinicals; observing how nurses practice seems to take the place of actually doing much of the actual hands on care. It seems very unfair to me to take the nurse away from their patients to provide explanations to the students about everything they are doing, for both the nurse and the patients. Patients need their nurses' full concentration; they are usually very sick with multiple medical problems and complicated treatment plans, and nurses need to be able to concentrate on providing safe patient care in a timely manner with their full attention.
Exactly. Your first paragraph was my experience as a nursing student, also, and the model I have used as a clinical instructor. The students work alongside the staff nurses, under the supervision of their instructor, but there is ZERO expectation that the staff nurses will spend any time or effort instructing or supervising the students.
I enjoy teaching and have worked as a full-time and adjunct faculty member in ADN and BSN programs over the years, but I have absolutely no interest, when I'm working in a clinical role, in having students dumped on me suddenly and being told that it's my job to provide them with a suitable and productive clinical experience for the day.
Horseshoe, BSN, RN
5,879 Posts
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