Nurses Eating Their Young- A Different Perspective

[llg, PhD, RN]

The military way of life is not for everyone. But just because a person isn't cut out for military life doesn't mean that they can't be a productive member of society. That style of training is not for everyone -- and just because it is not right for a specific new nurse doesn't mean that orientee can't become a great nurse.

The BEST teachers/mentors/preceptors/colleagues/etc. can adapt their style to suit the needs of the learner and the situation. Education is not "one size fits all."

I opened this thread hoping to find a good explanation about why nursing education, orientation, etc. sometimes seems harsh and why we have to uphold high standards -- even if that means some unpleasantness at times. I don't believe in over-coddling our young, either. Some new nurses do need to toughen up a bit.

But I definitely believe in kindness and compassion ... courtesy and inter-personal respect ... etc. should prevail in the way we treat each other. We should not be "speaking bad" about one another: we should not be committing violence upon one another. Metaphors such as "skinning you alive" should not accurately express how we treat each other. We can and should do better.

[martymoose, BSN, RN]

Interesting perspective.

[amzyRN]

Different strokes for different folks. Though I do think some people do respond to this type of training and my even excel, not everyone does and it will cut out members of the profession that might have made great nurses had they had a "softer" approach. By softer approach, I mean basic human respect. This doesn't mean that we have to all smile at each other and be best friends and laugh at each others jokes and never utter criticism or never be in a bad mood.

To intentionally degrade another persons character or competency (especially in front of an audience) is uncalled for unless from the beginning it was expected. I have a tremendous amount of respect for members of the military, knowing that not everyone can do that kind of work. If I'm working in a civilian hospital, I would like to be treated with basic human respect because I treat others that way. If I see a mistake, I will call someone on it or even write it up. I can correct a new nurse without making them feel incompetent and I have found it often works. I never try to humiliate someone in front of an audience and will always take them to the side so no one hears.

I make mistakes too and wouldn't want to be publicly humiliated either. I've had tough preceptors that weren't "nice" but were always respectful and for me personally, that is how I grew professionally by having mentors that weren't afraid to call something out but also helped build my confidence with respect. I have learned to not take things so personally by being around different people with varying degrees of antagonistic behavior, recognizing that not everyone has bad intentions. Nevertheless, in my progressing adulthood have less and less tolerance for this. I don't want to work in a culture of fear and hostility and thankfully there are enough options out there to work elsewhere.

So for all you new grads out there, I encourage you to be able to tolerate criticism and know that people may have had a bad day and are stressed, so try to have perspective. You will know the difference between bullying and grouchy/rude. Grouchy/rude people are everywhere. Fear, intimidation, work place hostility shouldn't be tolerated unless you signed up for it. And before you leave nursing and think it's like that everywhere, know that it's not. There need to be more studies showing that more nurturing environments might even produce a greater number of competent nurses (because less people leave). It would be interesting to know if it makes a big difference or not.

[SoldierNurse22, BSN, RN]

As an active duty Army officer and in my experience in both civilian and military medicine, this is absolutely incorrect and total overkill.

In medicine, the goal is to be forthright while being professional, polite, concise and accurate. Even in the military, this is the case with little exception. There are still pieces of military culture mixed into military medicine to be certain, but no one benefits from having someone jump down their throat in an attempt to "teach" them something important, especially in a field like nursing where being able to ask questions and approach one's preceptor is absolutely paramount.

No matter what it may feel like, nursing isn't war. Not even close. To draw such tight parallels to training like an infantryman who will eventually have to perform under fire is ridiculous. I work on a ward where the military leadership treat each other and their civilian counterparts like they were training for a literal battle--the backbiting, bickering, and lateral violence is unbelievable and extremely unhealthy for both the staff and the patients who came under our care. I would NEVER condone a "battle mindset" as appropriate conditions for which to teach new nurses, much less to work as an experienced RN. I cannot say enough on this matter--even in the military, lateral violence is not only ineffective as a teaching tool, but it is unacceptable.

I wish I had time to write more. This very topic is one I've been dealing with for some time, and I have quite an opinion on it. I just don't want anyone to think that abuse and mistreatment--whether that be mental, emotional, physical, etc--are ever acceptable teaching methods in nursing.

That's why the AMEDD has a markedly different culture from the rest of the Army.

[PICCRN2]

Interesting perspective is right. But I'm sorry but this is not acceptable behavior. One of the other responders is right, this may be how the military does it but that does not mean that the real world has to condone such lateral violence. And that is exactly what you are describing. I've been a nurse long enough to have been brought in this way. It was humiliating and degrading and almost ran me out of the profession. There as no support and no permission to ask questions or acceptance that it was ok to ask questions. My second unit was completely different, day one I was told that questions were normal, there was no such thing as a stupid question and that I didn't have to know all the answers but where to find them. Guess which unit made me a better nurse?

If the behavior you described was happening in my facility I would make sure that each of the nurses acting this way were put on disciplinary action. This is just wrong.

I do think we need to hold new grads to a higher standard but we do not have to completely leave them to sink or swim on their own. Providing security to allow them ask questions before they make a mistake because they were afraid they would look stupid or be humiliated in front of the entire department is tantamount!

So Kyrshamarks, either you are part of the problem or part of the solution. I think you are part of the problem.

[buckgirl80]

I still consider myself a newer nurse, after almost two years of being on my unit. I feel like this is a perfect example of how things were when I initially started out as a new nurse. Did I like it? No, and reflecting back there were many times I made my trip home washed in tears, wanting to give up or quit. Does it have to be this way, probably not, but for some people, just getting the bigger picture can be so difficult.

The times when I made a mistake and nobody noticed or pointed them out in an obvious way; they do not stick out, and I can't remember exactly what went wrong. The mornings I left work crying, I can remember what I did wrong and I vowed each time that I would not make the same mistake twice! These were the times when I had a drill Sargent to give report to. My initial reaction was to be prepared for giving report to THIS nurse. I would look ahead to see who my patient was being assigned to. I would make an extra effort if they were going to one nurse or another. After a while, I thought to myself why couldn't I just be just as prepared when I give report to all nurses like they are this nurse. It really helped me see the bigger picture to prepare myself because I did not want to disappoint myself or anybody else.

In the little bit of time I have had to experience nursing, I can honestly look back on these moments and feel like this was what worked for me. I didn't like it, but I did not feel adequately prepared when I graduated. Perhaps some of that is my fault. I definitely feel like the alternative of accidentally costing a life is much more haunting.

In another perspective, on some nights, I would not have wanted anybody by my side other than those drill Sargent nurses. They were the ones who came and helped out during an urgent or emergent situation. They were the ones who chimed in additional information because they had been charge nurse and were more familiar with the situation. Did I fear these nurses? No, I respected them. Much the same way a solder respects any rank above him. These nights made me realize that the attitude I got was not personal, it was merely a way of helping me sink or swim.

[amzyRN]

These nights made me realize that the attitude I got was not personal, it was merely a way of helping me sink or swim.

While I admire your ability to "survive" the training you received and respect the fact that you respect your mentors, I think the notion of "sinking or swimming" should not be occurring. If someone is sinking, then as a member of my unit, I'm gonna throw you a life vest because I don't want you risking lives of patients on the unit. If I see someone floundering I see no purpose in allowing this to continue. If I make a mistake or don't know how to do something, being relatively new myself (2.5 years) yet competent, I would much rather have someone point it out in a direct and respectful way. I don't need to be coddled or have my ego stroked, but clear communication and help by a team member is what I expect (if one of my patients is crashing and I need help, I expect it right away). I may have a different attitude being further on in my adulthood however. For people in their 20s, maybe they might have more tolerance for it, I don't know. But I just don't. If my care is near flawless (my patients are safe, pertinent info is reported, important things done when they should be done, and pertinent info is passed on) if I get a big fat attitude all the time please do expect that attitude to be checked. For all of you who dish it out, just make sure you can take it because you might be in for a surprise.

[MeiLana]

I had to work with 2 nurses who fit this style. One always ALWAYS reacted with anger in everything (AngryNurse) and the other had only ONE style of teaching which went against everything that worked for me. I never learned anything from her other than how to avoid her -- she was the my-way-or-the-highway (MWOTH) nurse.

ANGRYNURSE and I started out as friends, but after a while, her constant negativity, constant criticism that no one was _ever_ up to her standards, nothing was EVER good enough, everything was always a cluster&^%$ was too much. Frankly, throwing your emotional payload around like that does rank as emotional abuse and her disregard for anyone else's feelings even when it didn't directly benefit her to be compassionate or not... it drove people away. When in leadership roles, she only cared about her clique and even then, it was still anger-saturated. She didn't mind eating people up and felt that unless they were up to her standards, they were asking for it. What they were was her buffet of targets.

MWOTH nurse only had one style of teaching. I approached her to ask if she could walk me through something verbally before standing there and ordering me through how to do it step-by-step. I explained that I need to understand the overall picture instead of just seeing it as a task. No dice. She felt that if you couldn't handle what she was dishing out, you weren't good enough. I heard her tell someone they should seek another profession.

I believe this is a tough profession -- and people need to be weeded out. Those who remain need to be made stronger. However, "Eating of young" is a catch phrase for people who see every problem as a nail, for which they have only one tool -- a hammer. It is also a useful excuse to cover a world of slights, faults and problems when no other solution can be found.

It is, to make a comparison, the nursing world's "to spank or not to spank" debate. Resorting to thinking it has to be this way is frequently because of frustration and an inability to control one's self along with having no other ideas about how to approach problems. But it's such a comfortable habit for people who have been brought up in it or have "strong nurses" as good examples of how it worked. Never mind the missing ones who washed out of that methodology or otherwise now abuse others.

[buckgirl80]

I like your point amzyRN, but in regards to sinking or swimming, I mean either being a better nurse or looking for another career. I have not been put in situations where people were not willing to help or answer questions. I have gotten that look like "Did you really ask that question?" and a time or two I have actually gotten that comment.

I do have a certain respect for those who have more experience than myself, that is just how I was raised. I am not in my twenties and began pursuing my career in nursing at an older age than most because I spent 10 years as a stay at home mom. I see some of the younger nurses more tolerant in some ways but less tolerant in others.

When I started out in nursing, there were times I didn't get the bigger picture, and other nurses would ask me about one situation or another, and I felt guilty for not having to have looked for the answers before being prompted. I was called out on it on several occasions-in a very direct and respectful way, and this at times was the tough love or "attitude" I would get at the end of a shift. These nurses were not ruthless or disrespectful, but often it was a harsh reality of what I did wrong. Reading some of the other posts, I guess I had it pretty easy....

[nifty_n]

I agree. There's no need to act this way. You don't need to go out of your way to make things more difficult than they already are.

[amzyRN]

I hear ya buckgirl80. I think some people aren't meant for acute care or maybe even nursing in general. There does need to be a filtering process. I had a coworker on a previous unit that was unsafe and management was very supportive of him, gave him extra orientation etc. People on my old unit were very considerate and helpful too. It was very obvious that he needed to be in a different area. I think by being supportive of floundering employees will weed out the ones who should be in a different specialty. By supportive, I mean encouraging questions, facilitating learning, encouraging new orientees to keep an notebook to write things down, showing them where to find things and answers and how to use equipment. Just basic respect, simple straight forward expectations.

I do think nursing is a tough field, but I think that once someone gets some experience and confidence, it's really not that bad at all. Some new nurses can't thrive if their confidence is stripped away. There may be people that have different experiences in life, maybe abuse or what ever that make them a little more fragile. There's got to be a way to integrate different kinds of people into the profession. I too have a lot of respect for more seasoned nurses and am never disrespectful of their experience, both in the profession and life experience too. If they have an insight, I always listen. In performing my duties, I really don't ask for much, just a little basic human respect. I don't think this is too much to ask.

I have had to learn to stick up for myself, had a very rough child hood with bullies that I had to be able to physically defend myself from. They were physically dangerous. I developed a bit of a mean streak because of this and it comes out when I feel threatened and personally disrespected. I do think there's a difference between being tough and being straight up mean and cruel. I just hate to have those old feelings come up in my adult life.