Orientation for Experienced Nurses - page 2

So you're an experienced nurse, and suddenly you find yourself, once again, in orientation. Maybe you've lived in Seattle and you want to live somewhere with more than 65 days a year of sunshine;... Read More

  1. by   starlane
    Quote from VANurse2010
    There are some relevant points here. However, sometimes people have to change jobs not by choice, but by circumstances, and sometimes things really can be done in a better way. Respect an outsider's perspective.
    That is true, however if you are newly hired you do have to show some respect to the people working there and even if this job is not ideal, the person should be thankful they HAVE a job.
  2. by   VANurse2010
    Of course, but a little bit of understanding on the existing unit employees' part goes a long way.
  3. by   Ruby Vee
    Quote from Bridgid Joseph
    That is a great technique! It is one of the best things you can do is to encourage new orientees, or really any surly staff, that have a lot of negative input is to offer them to be a part of the committee or workgroup that has created a policy. It allows them to be a part of change, if they choose, and if they choose not to, (at least in my eyes) it takes away their right to complain!
    I think it's a good idea to encourage the complainers to be a part of the solution, but I'm thinking it's probably better to wait until they're off orientation and have been around long enough to have a good idea what's going on on the unit.
  4. by   Ruby Vee
    Quote from VANurse2010
    Of course, but a little bit of understanding on the existing unit employees' part goes a long way.
    There's a little bit of understanding on the existing unit employees part, and then there's putting up with a nasty new employee who constantly belittles and puts down her new unit and new colleagues. I'm saddled with the latter.
  5. by   Bridgid Joseph
    firstinfamily, it is interesting that you refer to the "high school mentality" of established staff, it has become something that is now termed "lateral violence" and I know a lot of hospitals are trying to stop it altogether, but it is a tough one to end; it is a cultural shift. It's true some of the different personalities you walk into on various units sometimes, but there are always a few welcoming people, so good luck an I am sure you will wow them
  6. by   Bridgid Joseph
    Ruby, of course, you are correct. I was thinking as my role as CNS, if I saw or heard about that behavior from an orientee, I would encourage them to be a part of the solution to the problems once they were off orientation and in the groove a bit. It's one of the techniques I use with all my staff, to be honest with you.
  7. by   bagladyrn
    Being a traveler I am the perpetual newbie. You make good points, some of which I emphasize when talking to new travelers - especially the part about shutting up about "where I came from".
    I'd like to pass along a couple of things from the other side of the equation and get your take on them:
    Since I am an experienced nurse in my specialty you can assume I know how to do the basic tasks - for example I do not need you checking after me on a vaginal exam. I'm not going to participate in putting the patient through that and increasing her risk of infection. However if you want to stand and watch me perform basic care you are welcome.
    I will only get 1-2 shifts at most of "orientation" so it would be helpful if you ask me "What do you need to know?".
    If I ask you to review a procedure or go over a piece of equipment with me do not exclaim "I can't believe you don't know that!". Realize that you (the generic you) have been working at your one facility since graduation and the rest of the world may do things differently or use different equipment. That being said I will do things any way your facility wants it done as long as it is not potentially harmful.
    If you want to know what my background or level of experience is just ask. I have no problem with that. I won't bring it up myself though because I don't want it to be taken as putting down the young nurse orienting me or trying to boost myself.
    Any feedback on this?
  8. by   dudette10
    Quote from bagladyrn
    If I ask you to review a procedure or go over a piece of equipment with me do not exclaim "I can't believe you don't know that!". Realize that you (the generic you) have been working at your one facility since graduation and the rest of the world may do things differently or use different equipment. That being said I will do things any way your facility wants it done as long as it is not potentially harmful.
    I'd like to ask you a question on this because I want to know the best way to approach education of an experienced nurse. Would it be helpful to ask you how you did it before so that I have a frame of reference from which to explain a procedure or piece of equipment? For example, I could say, "Ok, we do everything you've done except the X step. The reason why we do that part differently is Y."

    Would that be the most helpful approach to it? Or is there a different way that you prefer?
  9. by   bagladyrn
    I'm pretty proactive in saying "I haven't used this model (of whatever equipment) before" and in looking over the policy for various procedures when new on a contract.
    The best way I think to approach this is to ask - "Have you used this model before?" or "This is how they like us to do this - is this what you are used to?" and show the traveler where the p&p manuals and instructions for use of equipment are kept.
    My biggest problem area is quickly learning new computer systems at each place. I find myself inadvertantly trying to use commands from the previous one that are still stuck in my head. Be patient when the new person asks "How do I enter this again?" especially those of us that didn't grow up on computers - it isn't instinctive the way it is for youngsters - we have to learn it each time!
    The main point is not to "put down" someone who hasn't done it your way. (Again, the generic you)
  10. by   Ruby Vee
    Quote from bagladyrn
    Being a traveler I am the perpetual newbie. You make good points, some of which I emphasize when talking to new travelers - especially the part about shutting up about "where I came from".
    I'd like to pass along a couple of things from the other side of the equation and get your take on them:
    Since I am an experienced nurse in my specialty you can assume I know how to do the basic tasks - for example I do not need you checking after me on a vaginal exam. I'm not going to participate in putting the patient through that and increasing her risk of infection. However if you want to stand and watch me perform basic care you are welcome.
    I will only get 1-2 shifts at most of "orientation" so it would be helpful if you ask me "What do you need to know?".
    If I ask you to review a procedure or go over a piece of equipment with me do not exclaim "I can't believe you don't know that!". Realize that you (the generic you) have been working at your one facility since graduation and the rest of the world may do things differently or use different equipment. That being said I will do things any way your facility wants it done as long as it is not potentially harmful.
    If you want to know what my background or level of experience is just ask. I have no problem with that. I won't bring it up myself though because I don't want it to be taken as putting down the young nurse orienting me or trying to boost myself.
    Any feedback on this?
    We've had a run of travelers lately, and some of them, despite their claims to have had years of experience in our specialty, aren't safe when it comes to some of the more specialty-specific care. We have to ensure that they're safe before we allow them off orientation and give them free rein with our patients. Some of the more experienced (and proficient) travelers are insulted that we need to watch them perform nursing care tasks, yet half of the most recent batch of travelers were NOT proficient, despite their claims, in our specialty. It's not a matter of not doing things our way -- and you're right, many preceptors have been in the same job since graduation and do not understand that there are other ways of doing the same thing -- it's a matter of not being safe.

    Because of our acute staffing needs, we've let some travelers off orientation with a note to the charge nurses to assign them only to patients who are stable and perhaps close to transfer and then to watch them carefully. That puts a lot of burden on the charge nurse.

    Traveling is a specialty of it's own, and most experienced travelers (the ones who have traveled for a while and aren't just fresh from "my hospital") are very astute at getting the information they need in a short amount of time from even the greenest preceptor. I've been having more problems later with the new hires who have years of experience at the same job, and have been used to doing things a different way. They seem to have a lot of difficulty understanding that there are different ways to do things and that they need to change their thinking a bit to fit into their new job.
  11. by   Ruby Vee
    Quote from bagladyrn
    I'm pretty proactive in saying "I haven't used this model (of whatever equipment) before" and in looking over the policy for various procedures when new on a contract.
    The best way I think to approach this is to ask - "Have you used this model before?" or "This is how they like us to do this - is this what you are used to?" and show the traveler where the p&p manuals and instructions for use of equipment are kept.
    My biggest problem area is quickly learning new computer systems at each place. I find myself inadvertantly trying to use commands from the previous one that are still stuck in my head. Be patient when the new person asks "How do I enter this again?" especially those of us that didn't grow up on computers - it isn't instinctive the way it is for youngsters - we have to learn it each time!
    The main point is not to "put down" someone who hasn't done it your way. (Again, the generic you)
    I feel you on the computer systems! In the nearly ten years I've been at my current job, we've changed computer systems four times and are about to make a fifth change!

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