nursiee

Thank you! I did already have my interview, and a lot of those questions were asked!

I have an interview next week for a clinical instructor. Does anyone have any tips? Common questions asked? I know a question about how to deal with difficult students will definitely be asked. TIA!

Peds nurses just play with kids all day!

28 years old, been a nurse for 4 years.

I agree with what a lot of the others said with regards to doing something non-bedside. Bedside nursing is not for everyone, and that's okay! Nurses are needed in many areas, not only at the bedside. Do what works for you, Ashley!

Coworkers giving you the silent treatment - would that be considered passive-aggressive? Let's say another nurse gives you report before going on break and asks you to a complete a task (which is not high priority, but has to be done at some point during the day). You're not able to do this task because you get caught up handling a situation with one of your other patients. You make this nurse aware of what happened, and she doesn't look pleased, and gives you the silent treatment for a while after that.

I've heard a bit about it, but I haven't done in-depth research on the subject.

Excellent points, everyone! Thanks for your responses. I like hearing different perspectives.

Do you think that most nursing schools use a lot of fear tactics? In the particular nursing school I went to there seemed to have been particular instructors who, while teaching skills in lab, would always say things like, "This nurse put the wrong thing in the wrong lumen and the patient died." "Oh, this and this happened and the patient died and the nurse didn't continue with their career." One year, my peers and I did a presentation on suicide and nurses. We talked about a nurse who made a fatal med error and ended up taking her own life as a result. There is a lot of rhetoric on protecting your license. "Don't do this, you need to protect your license." Isn't protecting your patient more important? What about the value of human life? It can make you afraid to make a mistake. When you do make a mistake, it can make you afraid to tell anyone. A lot of times, you don't know if you'll be supported when you make a mistake. Don't get me wrong at all! I know that we as nurses have to be super meticulous and careful, because we are caring for human lives. I get it. However, I don't think it should be motivated by fear of losing your license. I'd be interested to hear what your thoughts are on this issue!

Aren't nurses considered the eyes and ears of the physician? Still pretty important. And, don't you mean learn how to help & assist him or her?

Whoa!

To be honest, I'm not completely sure if they ask or not. It goes both ways - when you see another nurse very busy on the floor, the polite thing to do would be to ask if he/she needs help and to help them. However, no one is a mind reader. So, if there is a super busy nurse who needs help, he/she should be forthcoming and just ask for it. If a nurse asks, and they refuse to help, then welp, that's a problem.

They're float pool nurses. I do hear the same complaints as well; it seems to be a common trend in a lot of places.

To be more specific, the unit I'm referring to is a pediatric oncology unit. Some of the float nurses have a few years of experience on other pediatric units, but are new to this unit. Some are new grads who previously worked in adults who've since switched to pediatrics and have had orientation shifts on this unit.

Thanks for all your replies! I'm getting the sense that the way things work in the hospital I work at is different from everyone else's. I apologize for not being clear. To clarify, these newer float nurses were doing orientation/buddy shifts. For those three weeks or so of orientation shifts, they are paired with a preceptor during each shift and share the same patient load. The preceptor is required to orientate that nurse, and obviously by the end of these buddy shifts, the preceptee should demonstrate some competence. This unit has a very specialized patient population, and they do things a lot differently than the general units do. There are many medications given on that unit that aren't given on other units. They handle IV infusions differently. When a patient has a fever, an antipyretic is not routinely given right away like it is on other units; the source of infection needs to be determined before going forward. They only administer one type of narcotic on that unit. They also only administer one type of anti-emetic. Hence, there is a bit of a learning curve. What these nurses are used to doing on other units (e.g., the way in which an IV infusion is set up, preparing a medication), doesn't fly on this particular unit. At our hospital, float staff are included in the baseline staffing numbers, they're not only needed when the unit is short-staffed.

There is a very specialized unit in which some of the nurse friends I work with also float to, let's call it "Unit X." This unit has the reputation of being unwelcoming towards float nurses, especially the newer float nurses. Many of these nurses dread going to that unit. Here is a common scenario I often hear happening on this unit: New Nurse makes a mistake during an orientation shift. Unit X Nurse sees this mistake, and instead of going to New Nurse to tell him/her about it and provide a good teaching moment, he/she will correct the mistake themselves and go talk behind New Nurse's back to the other Unit X nurses. It is not even a med error where a patient has been directly affected. It's more things like a med not being constituted the right way (but has not been administered to the patient yet) or an IV line not being primed properly. Other, perhaps more trivial things have also occurred on the unit: the Unit X nurses chat amongst each other without including the floats. They all decide to order food and don't include the floats (not the most polite thing to do, but definitely not the end of the world, IMO). Or, when a new float nurse is running around the unit, very busy with their patient load, the other nurses will just sit there and whisper about them instead of offering to help. Nurses from other units have suggested to them that they should get in touch with the manager of the float pool and let he/she know what is going on. However, a lot of them do not want to tell the manager; one nurse in particular said she didn't want to because she doesn't like confrontation. I then told her that there are other nurses who seem to be unhappy on that unit, so if they joined forces and all went to tell the manager, she wouldn't have to do it alone. The float nurses seem very eager to learn, but don't feel they are being supported in their learning on this unit. I'm just curious to know the right way for this situation to be handled. Would it be better for the newer float nurses to politely confront the nurses on Unit X when the negative behavior occurs? If so, how should they go about doing it? Would going straight to the float pool manager also be a good idea? I currently don't float to that particular unit, but I guess it would also be helpful for me to know how to handle it in case I end up working there in the future.

For sure, it wasn't that bad at all. I'm not "scarred" by it or anything I didn't intend for it to come across that way. I have searched on Google here and there for assertiveness strategies, but I will definitely spend more time searching!

Thanks for your response! I agree with you that it would be helpful for me to go back to them, but this meeting happened over a year ago, and both of them are no longer in management positions. They still, however, work in the same hospital. Would it be awkward for me to still ask them? Or should I just go to my current manager and ask for strategies instead?

I'm including these past situations to highlight a pattern here - I'm often told that I'm too nice, passive, laidback, things like that - with regards to being treated poorly by other people, but not saying anything about it. · When I worked in long-term care when I was a student, another staff there asked me if I liked the job. I told her I didn't really like it because of some negative experiences that I had. She then replied with something along the lines of, "You don't talk, that's the problem. As for me, they know they can't mess with me." · During a psych rotation, I was placed on a young adult unit. On the first day, I met a patient who was extremely inappropriate with me - hitting on me, asking for my Facebook, trying to give me a hug, those kinds of things. I was very shocked and speechless, so I just declined and laughed uncomfortably. I had never had a patient behave that way with me, so I didn't know how to react at the time. Another student, let's call her Martha, gave me some tips on how to deal with those situations. At the end of the day, we had post-conference. Each of us talked about how our day went. Martha, who was right there with me when this patient was being inappropriate, told the instructor and the other students that she gave me some tips on how to be assertive because she felt that I was being passive. · During my first orientation shift on a certain unit, a nurse introduced herself to me, and we made small talk, trying to get to know each other a bit. She then told me about the unit and said that some of the nurses were very mean. She also told me that I look like someone with a very quiet and gentle personality, but if I show them that I can stand up for myself and not put up with their behaviour, they won't mess with me. · Management sat down with me one day and said that they were doing an investigation on bullying and that when talking to other staff members about it, my name often came up as someone who was being bullied. There was one nurse in particular who they heard was "bullying" me. I thought that the nurse was quite unpleasant with me, but I didn't think he/she was bullying me. I may be wrong, but I feel like the true meaning of bullying has been lost. Anyway, I told them that I am more on the sensitive side (which I am working on), so when people are rude or whatever, I always try and think, "Hey, maybe I'm just taking it too seriously, so let me try and forget about it." For this particular situation, I tried to tell myself that this nurse behaves that way to a lot of people, so it's nothing personal. The managers then said, "The fact that they do it to everyone doesn't make it okay." They said they would be able to provide me with strategies on how to deal with negative behaviour. I didn't ask them for strategies because I didn't really think it was a big deal. In hindsight, I think I should have anyway, because it would've been helpful for any encounters with "bullying." I always get mixed advice about this, anything from, "Don't worry about it, just be kind back" to, "Well, you shouldn't put up with people's crap." I'm trying very hard to let things roll off my back. I know that in this field, you have to have a thick skin and not react to every little thing you hear. Correct me if I'm wrong, but I think developing assertiveness is more important for patient advocacy rather than standing up to someone who is always rude or talks down to people. Being assertive and advocating for a patient who I assess to be in distress to a doctor who thinks they are just fine, would take priority. I honestly don't know what to do. Truthfully, though, there have been times when I felt like I should've said something to someone who was downright nasty to me. I do think I need to be more assertive, but I sometimes don't know when to say something, or when to just let it go. Not being assertive in the right context can be a hindrance. Can anyone provide some insight on this? How do I go about being more assertive?

Thanks so much for your input, dontbetachy90. I really appreciate your advice! I agree with you that being quiet is not a bad thing, but being quiet and being shy are two different things. Not all quiet people are shy, and not all shy people are quiet. Not all introverts are shy either. Some people are introverted simply because they do not feel like talking all the time, not because they'd like to talk but feel too shy to do so. Being quiet is fine, but being shy can be problematic. Most of the time, my quiet nature at work has to do with me being shy. If I wasn't shy, I would be one of the most outgoing people there. I can be very extroverted when I am comfortable. The problem is that I lack confidence in certain areas - carrying conversations, approaching patients and families, doing new skills, etc. I would like to talk more sometimes, but being shy hinders me in that I feel uncomfortable to do so. I am still very nervous when going in to assess a patient, or check in on them throughout the shift. I sometimes wish I could be part of the group chit-chats and all that, but then I wonder if it is really worth it. I'm quite ambivalent about it because I know mixing work life and personal life can lead to issues. I know I shouldn't worry about being liked at work, because work is work. I still think I need to get along with my peers, though, to have a good team environment. Anyway, like many other "quiet" people, in nursing school, I was often told by instructors to talk more. I wish I would've talked more, but I was often too shy and uncomfortable. There was always this stigma against quiet people. I guess the reason why instructors worry about quiet folks is because they wonder if we'll be able to be assertive in our nursing careers; quiet is often seen as weak. I remember during one of my clinical rotations, after doing a systems assessment on a patient, my instructor would ask, "What makes you nervous about doing an assessment? Your patient will be able to pick up on it." I was also told that nursing would be a tough profession if I'm not able to communicate well, which I do agree with. That is why I'm trying very hard to improve myself.

Thanks, JKL33. Much appreciated!

A little over two years!

I struggle with shyness. People who don't know me well/aren't close to me, will say that I am a quiet person who doesn't like talking. However, when I am with people I'm comfortable with and close to (usually outside of work), I can be very extroverted and bubbly. I am quite introverted at work, and it's not really by choice. My introverted nature at work has more do with being shy. If I wasn't shy, I would be just as chatty as most of the other nurses. I do enjoy getting to know people, finding out what their story is, and connecting with them on a deeper level. However, my shyness sometimes hinders me. I often lack confidence on the floor. I've been a nurse for a little over two years now. I am able to advocate for my patients, ask questions, bring concerns forward, etc. I just need more confidence when doing these things. Some people are better at hiding their nerves than others. I guess I need to be able to "fake it till I make it." Small talk doesn't really come naturally to me and I'm not that "good" at it. Some people enjoy small talk, but I'm not one of those people. I DO know that small talk is a necessity, especially working in a field like nursing. It's important to make a good first impression. Patients and families don't care whether or not I'm a more talkative or more open person outside of work, or that I take a bit more time to warm up to people, they want to know that I am able to build rapport with them right then and there. I'm working at it though; I ask patients how their day went, what their favorite subject is in school (I work in peds), whether they live in the city or not, etc. I've read some threads on here that small talk with patients can really help with nursing care (e.g., if you ask a patient how their day went, and they say they had a bad day due to their pain, you can talk to the physician and come up with a better plan to manage their pain). I do think that some patients and families don't care whether a nurse is chatty or not, they just want someone to listen. I think it's important to gauge each situation and know what is best for the patient at a particular time. I've had patients and families tell me that they appreciate the care I'm giving them, so I know I'm doing something right! Some have also told me that they appreciate my calm nature. You can be a quiet nurse and still be confident. I just need to gain more confidence. In addition, the staff on the unit I work on are quite tightknit and I find it difficult to break in and feel a part of the team. They spend more time talking to the colleagues they hang out with outside of work and just make minimal polite small talk with anyone who is not in that group. How can I interact better with my colleagues? I do find that showing an interest in them will in turn help them show an interest in me. I do try to do that, although I may need to do a better job. Is it better to only try to maintain good working relationships with them and not have too much of a personal relationship? Can you offer me any suggestions to get over shyness with patients, families, and coworkers? And any tips on becoming more confident? I would really appreciate any advice!

I personally do not think that 4 shifts is enough. When I worked in adult med/surg as a new grad, I only had 5 orientation shifts. I didn't think it was enough, but I still thought I would be okay working on my own. I worked on my own after that, and the shift was a gong show to say the least. One of the nurses I worked with on that shift encouraged me to advocate for myself and ask for more orientation shifts. I then asked for 2 more buddy shifts, and I still didn't feel ready after that, but I just didn't want to keep having to ask for more shifts. I just sucked it up and worked on my own. It was still quite overwhelming. Some staff were helpful, some staff were not so helpful, but meh. They don't usually give many orientation shifts for med/surg because it's not a specialty area. I don't think it's fair. If you don't feel comfortable after 4 shifts, then you can try asking your manager for more shifts again. I also agree with what NurseBeth said: you can find out where you need to be at in order to come off orientation. It may also be helpful for you to find a really supportive nurse on your unit who would be willing to mentor you when you work on your own.

Thanks, JKL33, for the very helpful advice!