nikkole318

OMG my heart goes out to you. I had a similar experience as a new nurse. I started off with a preceptor who clearly was not interested in helping me learn. As a brand new nurse, she told me to go discharge a patient without showing me how to print learning materials for the patient, what steps to take in the EHR, or anything else. She simply handed me a checklist and said “go do this discharge - it is self-explanatory. She would become visibly annoyed if I asked about something more than once even though trying to learn everything as a new nurse is like trying to drink out of a fire hydrant. I asked our educational director if I could precept with other nurses for a more broad experience and she said no with her explanation being “she was a teacher at a school so she’s the best nursing preceptor.” This educational director also told me that I wasn’t talented enough to work there because I hadn’t passed my arrhythmia test on the first try. Mind you, other people in my class failed as well so I wasn’t the only one. No remediation, no help, just “If you don’t pass this next time, you should look elsewhere for a job.” The most ridiculous thing about that was she had no power over hiring or firing, and we were union. As a brand new nurse, I was crying, thinking my livelihood was at risk. Looking back, she literally just said it to bully me. Another awesome thing that happened was that I had asked way in advance to have off one Friday because I was a bridesmaid in a wedding that was taking place that day. The education director snapped at me, saying “okay but let’s not make this a habit.” When I started all new graduates were hired into the critical care float pool. I was paired up with a nurse who had no idea she was supposed to have a preceptee that day and literally had a tantrum when I showed up. I ended up precepting with her anyway. I made a couple mistakes (mind you I had been a nurse for all of 3 weeks) such as documenting certain things too often, I.e. every hour when they were supposed to be every 4, and running a 4 hour IV antibiotic as piggyback instead of concurrent with the maintenance fluid. I overheard her telling another nurse who precepted me that I “didn’t know what I was doing” and that she should give me a poor review. When I returned to my regular floor, my original preceptor came up to me and said “This Nurse was talking about you, telling other people that you have no idea what you’re doing.” Even after this, I was paired with her. The straw that broke the camel’s back was when at the end of the day I was trying to give report to the next nurse, she interrupted me, and told me I was doing it wrong and just started speaking over me. I was about to start crying, so I ran into the locker room because I was embarrassed to cry in front of everyone. Adding insult to injury, the next day, the learning director approached me and said “your maturity level has got to improve. I was told you walked away during report.” I was so overwhelmed and upset that I didn’t know what to even say and started crying again! I ended up sticking it out for a little more than a year, then moved on to a much better job. I still get upset thinking about my experience as a new grad, but it has taught me that there are good people out there and there’s no rule saying that you have to spend years in a toxic work environment. Just get your feet wet, and if things don’t get better, move on.

I disagree with your first sentence. I think that when people are in the hospital, there are very much out of their element and the stress of being there along with being ill or injured makes them more likely them to act out in ways they would NEVER act out in other situations. For lack of a better word, they "forget" that the people helping them are humans and that, especially if they are competent, they are to be held accountable for their actions. I think a "reminder" that assaulting healthcare workers is illegal would help.

Great advice

Omg, I'm SO sorry that happened to you. Yes, just drop the potato and walk away.

"I'll have an order of COPD, make that a value chronic illness. Hold the steroids, extra breathing treatments.". Illness forces them there, they want the illness to stop but in the grand scheme of things, they don't want to be there at all. This is an excellent thing to remember!

I would NEVER advocate pressing charges against a dementia patient who thinks we are invading his house and sticking him! I'm talking about policies and procedures for those who are either completely competent and assault healthcare workers.

Maybe you can help, point me to some good resources.

Yeah, I guess it is. I work for a for-profit hospital and they really have done nothing as far as education.

I've actually seen those commercials and they are great. I think that our hospital should have a policy regarding violence, such as incident reports, or at least a guideline that employees can refer to when it happens. At my hospital, management does absolutely NOTHING about violence against healthcare workers. A nurse in our ER got severely assaulted by a completely competent man who just walked into the ER and apparently wanted to find a woman to beat up. She was so badly injured that she was out of work for months. We don't even have real security. We are a for-profit hospital, so they "save money" by hiring 1 rent-a-cop per shift who gets paid $10/hour.

Yes, I have taken care of too many ETOH patients to count and I've been lucky enough to not get assaulted (yet). I realize that it is part of our job to take care of patients, but it is not our job to take physical abuse. I've witnessed abuse happening from patients who are 100% with it too, which is even more intolerable. Thank you for the article. I would like hospitals to take measures to prevent abuse from occurring in the first place. Is their medication being managed properly? Have there been any studies to show that ETOH patients should be managed a certain way? Should competent patients sign a waiver to acknowledge the fact that hitting healthcare workers is against the law (I think people forget). What studies have been done to try to determine what prevents violence? This is such a huge topic, and a controversial one, so I don't even know where to start! I was going to find books to read about addiction, because these patients tend to be the ones who are most likely to be violent. That way I can bring more understanding to the situation.

That is so messed up. What is wrong with people?!?! That last part you said is an excellent point.

WOW! Yeah, that is rude. It seems like people forget that nurses are people too, with their own struggles. What did you say?

I agree that there are some patients who just need to vent. Sometimes just asking them what's wrong goes a long way. Other times, patients are mad at you for providing care. Haha.

People are always saying not to take your work home with you, but I think you def cannot help it at times, the good and the bad.

Hi Everyone! I've been SO exhausted lately! There are times where I know that I was meant to be a nurse, there's nothing I would rather be, and I feel that my job is SO rewarding!!! .....and then there is this week. There seems to be a very large influx of patients and family members that are extremely rude and demanding! I'm looking for help before I get burned out! There are a lot of things that patients sometimes say, such as "hurry up, you people aren't helping me (when you've been running around all night, cleaning them up every hour), etc..." I TOTALLY understand that these patients are probably having the worst day of their lives and I would never in a million years trade places with them, but I can't help but to take it personally sometimes. Can you give me some advice on how to diffuse or deflect these types of comments? Maybe some good ways of handling some of the more rude comments that you've been handed? They don't have to be the ones I mentioned above, because I'm sure whatever you've heard, I have heard or will hear too.

Recent discussions with coworkers about some unfortunate events inspired me to write this post. At the hospital where I currently work, there was a patient who was going through Alcohol DT's who punched one nurse in the chest and a nursing assistant in the face. He barely grazed the nursing assistant's face, but he did knock her glasses off of her face, breaking them. This was a fairly large male patient, first punching an older woman and than punching a small 110 pound girl. I get really upset when I hear about violence against nurses and would like to do something about it. First, neither nurse pressed charges against this patient. I think both of them were a little bit afraid to, because it "just isn't something you do." I just cannot grasp how healthcare workers are intimidated into not pressing charges. If a man showed up in any other establishment, he would immediately be arrested, alcoholic or not. How can I help to change this culture? Second, I would like to bring awareness to this situation. Hospitals should be required to hold assault perpetrators accountable for their actions. By letting people get away with hurting healthcare workers, it sends the message that this behavior is acceptable. Third, I would like to work with legislators to help make laws that will actually make changes. Can someone point me to some resources?

Don't even think about giving up nursing yet! You will find something you love in due time, trust me. You have been a nurse for 9 months, which probably seems like an eternity when you dislike your job. In 3 months, it will have been a year, so it will be time to start applying for other jobs. Try telemetry if you can't get a job in women's health. Keep your options open and keep applying!

Definitely don't let your age be a factor! Nursing was a second career for me, so I understand how you feel, but think of how long you will be working before you can retire. You might as well be happy during those years. I agree that sometimes a specialty will find you. When I was in nursing school, I thought it would be cool to work in an ER. Well, I floated to the ER and I found out that I HATE it there! I actually ended up in ICU, where I never thought I would work. I definitely recommend floating and just learning as much as you can. Acute in-patient rehab is very similar to Med-Surg, so I would go to the Ob-Gyn conference. As far as ortho...I have worked in 2 heathcare systems and both have eliminated their ortho floors. People have their surgeries done as outpatients and hospital stays are shorter and shorter. With the current health care environment, I just don't see many opportunities in ortho in the future. In both the systems where I have worked, the ortho patients are kind of mixed in with the Tele and Med-Surg patients.

Is there a reason she is putting in her assessments late? Many times, new graduates aren't aware of the protocols and unwritten rules for entering things into the computer. She may be under the impression that it is okay to enter the information into the computer late, just as long as she actually completed the assessment and has it written down on her paper. Some of my issues during orientation stemmed from receiving conflicting information from different preceptors regarding the way I should be doing my job. For example, some of the preceptors enter everything into the computer as they are doing it and some just write the info down and enter it later.

Most of the nurses that I am encountered have been very nice as well, but just like graduates, the bad apple preceptors stick out more than the shiny red ones. The limitations to what students can do probably vary by state and by institution.

That is too bad that you aren't being paid enough to precept, but is it really the orientee's fault? If nurses have a problem with their pay, they should bring it up with management instead of taking it out on new graduates. If you have any issues with how the colleges are educating the students, you should bring it up with the instructor or someone who works for the school. Treating new graduates like garbage doesn't accomplish anything. Also, when I was a preceptee, I am sure I was annoying, asking a million questions, but overall, I think it evened out considering that by my second or third week I was doing all the assessments and passing most of the morning medications.

These types of comments are the exact reason I wrote this post to begin with. I am not disagreeing with you that nurses used to get a more comprehensive and hands on education nor am I denying that nurses are not paid enough to precept. But I would like to point out that it isn't the new nurse's fault that their education was different from your education nor is it their fault that nurses don't get paid enough to precept. Thinking back, do you think it was safe for you to "sink or swim" after 5 nights of orientation?

I found out that one of my preceptors stated behind my back, "She has no idea what she is doing." I was a brand new nurse, just graduated, on my 3rd day orienting in the ICU.

These types of comments are the exact reason I wrote this post to begin with. I am not disagreeing with you that nurses used to get a more comprehensive and hands on education nor am I denying that nurses are not paid enough to precept. But I would like to point out that it isn't the new nurse's fault that their education was different from your education nor is it their fault that nurses don't get paid enough to precept. Thinking back, do you think it was safe for you to "sink or swim" after 5 nights of orientation?

I found out that one of my preceptors stated behind my back, "She has no idea what she is doing." I was a brand new nurse, just graduated, on my 3rd day orienting in the ICU.