Over Confident GN's

[nlhnurse1982]

I have only been precepting for a few months and I love it. I do however need some advice for one of my orientees. This person has no fear or messing up what so ever and feels she knows everything already (very scary) and the ironic thing is the orientees that are about pooping their pants with fear of making a mistake are doing really well; this one I can not even trust to draw up medications because I have watched her reconstitute things incorrectly after I have talked her through what she needs to do, calculate rates for IV medications incorrectly and try to hang meds without checking the compatability. She also does not do a name and date of birth check before meds I have to remind her, I found a pill on the floor and she insisted it was not from her med pass when the patient told me he dropped it after she gave it to him and walked out, thankfully it was tylenol. The list goes on and on. Besides this she used to be an aide and asked the other aides how it feels to have her in charge now and she will shirk responsibilities that she feels are not "RN" specific. I would never treat any of my aides like this they work with me not for me and I tried to explain this to my GN. I am trying very hard to correct her in a positive manner and role model with the aides so she stops this.... it is not working. How can I approach her in a constructive manner without being abrasive. I don't want to make her orientation a negative experience and be looked at as one of those nurses who eats their young. Any advice from seasoned preceptors who have dealt with this type of new nurse before would be so appreciated.

[RN1982]

I have only been precepting for a few months and I love it. I do however need some advice for one of my orientees. This person has no fear or messing up what so ever and feels she knows everything already (very scary) and the ironic thing is the orientees that are about pooping their pants with fear of making a mistake are doing really well; this one I can not even trust to draw up medications because I have watched her reconstitute things incorrectly after I have talked her through what she needs to do, calculate rates for IV medications incorrectly and try to hang meds without checking the compatability. She also does not do a name and date of birth check before meds I have to remind her, I found a pill on the floor and she insisted it was not from her med pass when the patient told me he dropped it after she gave it to him and walked out, thankfully it was tylenol. The list goes on and on. Besides this she used to be an aide and asked the other aides how it feels to have her in charge now and she will shirk responsibilities that she feels are not "RN" specific. I would never treat any of my aides like this they work with me not for me and I tried to explain this to my GN. I am trying very hard to correct her in a positive manner and role model with the aides so she stops this.... it is not working. How can I approach her in a constructive manner without being abrasive. I don't want to make her orientation a negative experience and be looked at as one of those nurses who eats their young. Any advice from seasoned preceptors who have dealt with this type of new nurse before would be so appreciated.

Its time to sit down with your manager and evaluate your orientee's progress. Bring a list of the problems that are occuring with the orientee and explain that you have directed the orientee in the proper technique/form and that despite the education, she continues to make errors.

[Blackheartednurse]

Well it was her reaction to these mistakes that really sent up the red flags. I was a GN just 2 years ago myself so I know how hard it is, However when I made a mistake I was always very upset and terrified of doing it again. She will question me like I am wrong and then be very nonchalant like oh well I'll just do it your way to make you happy. When I asked about compatability I said okay, so before we hang this is it compatibile with the patients fluids and she said yeah I think and goes to walk in the room! That is when I stopped her and asked did you look it up and I was told no:banghead:. Now I knew that they would work together but she did not. So I had her look it up. Anyway I am going to talk with her tomorrow morning and use some of your advice about all of this and see how it goes. Hopefully she will become more mindful of what she is doing. If not maybe I'll tell my manager that the GN should precept me since I dont know everything yet and she seems to know it all :chuckle. Thank you all for your great advice!

Thank you...I'm just trying to prove "Nurses eat their young theory" wrong!!! Haha:))

[SpringerCab]

I had a similar experience but with an LVN who had 20 years of experience but not in the hospital. She had three different preceptors. Two of us had the same amount of experience she did and the other one had about 10 years. We wrote down where she needed help, what she was doing wrong, and how we felt she was a danger to the patients. She left the floor at one point when I was precepting her because she was angry that I had told her that she had an order to removal staples and she told me she didn't know how. I told her that I didn't believe her that in 2 months she hadn't been shown how to remove them. She clocked out and went to talk to someone in administration. She had not charted on any of her patients for the day, but she was allowed to come back and chart and then leave. I was then responsible for the patients the rest of the day. I had made my assessments and knew what was going on so it was easy to take over. She was on orientation for 3 months, never learned how to take care of hospital patients, and was only fired for calling in sick. The reason she was fired for calling in sick according to the nurse manager is because you don't collect unemployment for that if it is well documentated that you have been talked to about it.

One thing to think about if your nurse manager does nothing consider peer review if your facility has one.