we often see threads with the title "fired for no reason," or "new grad harassed and fired" or something to that effect. and i always feel at least a little sympathy for the individual involved, if only because i can clearly see by reading between the lines of their self-justifying post that there was a reason for their termination, even if they just don't get it. (there are always a few posts every year from a new grad who is convinced that the reason she's not getting along with her co-workers is that she's just so beautiful they're all jealous, that crowds of mean people are following her around, that she's so wonderful she's going to rock the er or icu or nicu or or and no one sees her wonderfulness clearly, or that some mean, tired, old nurse who ought to retire and get out of the way is targeting her for no good reason.)
i worked with a new grad who was recently terminated for, as she puts it, totally bogus reasons. evidently seeing mine as a sympathetic ear, she went on and on and on about how unfair it was that management expected her to get her act together and actually understand what was going on with her patients. "i've got the time management thing down pat," she said. "i don't know what else they want. they're just picking on me for no good reason." i liked sal, i really did. she was interesting and entertaining and really, really nice. she was also smart, hard-working (when she was at work) and well-educated. but she didn't study outside of work, and really didn't understand what was going on with her patients. i participated in several meetings with her in which it was pointed out that it's not enough to do the tasks, you have to understand why you're doing them. it's not enough to draw the labs. you have to understand what the results mean and then address them. for instance, if the inr is 9, it might explain the nosebleed, the cherry red urine and the fact that the hemoglobin is now 6. giving the coumadin at 6pm as scheduled is not a good thing, even if you gave it right on time and were able to explain to the patient that "it's a blood thinner." i could go on and on.
i got a call from sal today, complaining that she knows she's blackballed for no good reason because she just can't get another job. she wanted me to give her a reference. did she just not get it?
all you new grads out there who are convinced that you're being picked on for no reason, that your more experienced colleagues are just out to get you, and that you're being unfairly targeting, harassed, or picked on, hear this: it may be something you're doing (or not doing) and all those "mean people" are trying to explain it to you so you catch on, learn your job and succeed. we all tried over and over with sal, and she still doesn't get it. are you guilty of the same thing? if your preceptor says you lack critical thinking skills, do you take it to heart, think about it and learn from it? or are you convinced that the entire issue is that she's jealous of your extreme good looks? if your charge nurse charges you with a deficit in your time management skills do you spend time figuring out where you could speed things up a bit? or do you dismiss her as a tired old dog who can't learn a new trick and ought to retire anyway? are you taking to heart and benefitting from any negative feedback you're getting, however poorly given it is? or are you obsessing about how "mean" that nurse was to you and totally overlooking the message?
i wish sal would have "gotten it." she would have been delightful to work with if she had. but right now she's focused on badmouthing her preceptors and the charge nurse, and she still doesn't understand what she did wrong. don't make the same mistakes.
It is in the chart. The chart is there to use as a tool to guide your NDx's, Tx's and EDx's for the client. If you don't use the tools provided, and have to be told everything, well, eventually, a little less than everything will be told to you one day, and you have a good chance of killing your client like "Sal" almost did. Sal had the tools in front of her to use, requiring only curiosity and perserverance on her part, NOT just a bookful of knowlege. But she did not use the tools, instead, went and administered the medication, and nearly killed someone in her quest to put a checkmark next to her list of mindless tasks to accomplish during her day asa nurse.
Thank you for that small bit of insight. I bolded out the part that really summed it up for me. The nurse who "doesn't get it" is the nurse who looks at is as "her day"- the nurse who gets it knows it is, in reality, other folks' lives that we are concerned with. To hell with "my day" because I can always stay late and tidy up the mess if there is one; how about preserving life and doing no harm?
This is one of those 'funny but not' stories. I remember when I first started on the tele floor, I was taking my time filling out the paper assessment when I noticed the block for "positive pedal pulses" was checked all the way across the page by nurses every 4 to 8 hours. He was a double amputee. So we can all fall into ruts (experienced and not-so), trying to get stuff done. I still use that story to prove a point from time to time.
Specializes in CVICU, Burns, Trauma, BMT, Infection control.
I've definitely seen the nurses who "don't get it" and it's not for a lack of other folks trying to teach them in many ways. I don't think they want to sometimes.
I find it very sad that the new nurses here are working hard and not feeling supported,and not getting feedback when it is clearly needed and then getting fired? That really sucks. When I was precepting new grads all I asked for was a willing learner,someone who asked questions whenever they needed to,no matter how silly they might be. Of course I gave a few of those looks when I was tired and got a question that surprised me. One very intelligent and capable new nurse said my look made her feel like she hadn't gone to nursing school. Oops. We laughed.
As long as the new nurse had the basics and a willingness to learn and study we got along fine.
The good thing is that some of the new nurses that want to 'get it' are posting their thank you's and requesting clarification on this site so they can start to 'get it'. I am very impressed by the humility. Its up to the rest of us to be supportive
This thread kinda scares me. I feel like my critical thinking skills are sorely lacking. I've been on my own for four months and have been a RN for almost six months..I work on a tele unit and feel like I have a very formulaic type of nursing. New onset chest pain=nitro, EKG and call to Dr., INR 9=hold coumadin, potassium 5.5=hold K, things along that line. But I live in mortal fear one of my pts will go bad and I won't know what to do. Any advice???
Dont drink the opinions from this thread, its a dangerous/poinsonous kool-aid for newer/student nurses. There should be a filter on this thread that locks out anyone with 3 or less years in the field.
This thread is a bit like abortion. The topic of abortion tends to be polarizing. People for it point out the most extreme cases of why it should be allowed (dumpster babies etc). People against it also do the same thing (people who have had 8 abortions etc).
In this topic, those who think people like Sal are lacking and will forever be the same, sometimes, in a hurry to make a point, I think accidentally take on a tone that is not deliberate. They aquire a tone that new grads are inferior and the majority wont get it. I dont think thats what they mean, although I've received more than a few PMs due to this thread asking me "is there any hope for a new nurse these days, how do I avoid people like the ones in that thread?".
Me on the other hand, also in a rush to make a point, point out the shortcomings of our preceptorship system and give the impression that the whole "nurses eating their young" thing is still going on to the point where there is no hope for new grads.
The truth lies somewhere in the middle. Not all preceptorship opportunities are simple "pass/fail" approaches with no support for those who need a little more than that. On the other hand, not all GNs are motivated to learn and grow from their experiences during preceptorship, and these people would fail even in a well balanced/planned preceptor program.
Ruby Vee's viewpoint comes from someone (unlike me) who has precepted a lot and has become very tired of certain GNs who dont seem up to snuff. Mine comes from someone who has never precepted, but as a new nurse, I reaped the benefits of a preceptorship program that was well thought out and designed to retain ALL nurses who went through it. There were new nurses who didnt make it on my unit, but their shortcomings had nothing to do with "critical thinking" skills or "having good looks". They had habbits/attitudes that would have been an issue in any field of work (coming in late, expecting too many accomadations on the schedule, lack of desire to do OT or be a part of the team when it required sacrifice from them to do so). If you dont have any of these types of issues, you have nothing to fear as long as you are carefull about where you get your first experience.
I dont mind being in the minority opinion wise when I say our preceptorship ways in the nursing field are failing us. I think a great many nurses nowhere near as bad as Sal dont make it because they needed more support than what a "pass/fail" approach gives. I think experienced nurses would benefit from insisting something better than this be offered on their units. I have seen experienced/veteran nurses willing to lay it on the line to managers/administration who rush GNs through the quickest/easiest routes of preceptorship. The vet. nurses stand up and demand more time, better learning experiences before cutting the nurse lose on their own. Thats the kind of thing I am trying to get across in here.
I guess the point of it all is, yes, the task at hand for GNs is intimidating to say the least. But there is a remedy to the problem of bridgeing the gap between where schools leave off and where hospitals must pick up. Posting threads that GNs need to "shape up" and "stop thinking your being picked on cause you are beautiful" wont do it. Your attacking the victim in more cases than not with that approach. I say, stand up to the administration that doesnt allow the time and care for the GNs that is necessary. If GNs and vet. nurses stand together (now there is a pipe dream) we can make things better for our profession, for everyone in our profession, GN and veteran alike.
Many of the comments have been positive and not so one sided if you read thru them. I think that old and new can benefit from this thread and be open to learning from the experiences of others. Many have stated their orientation was a good one. And therefore, the system must be working in some hospitals. One of the NICU's I oriented to improved tremendously after I went through my orientation there. So even managers respond to feedback when the numbers warrant it.
Many of the comments have been positive and not so one sided if you read thru them. I think that old and new can benefit from this thread and be open to learning from the experiences of others. Many have stated their orientation was a good one. And therefore, the system must be working in some hospitals. One of the NICU's I oriented to improved tremendously after I went through my orientation there. So even managers respond to feedback when the numbers warrant it.
As you said it though........after.............hence, there was a problem.......before.
Your managers changed things, but most dont. Its too easy to just pick whoever for precepting. Between meetings about dead end interventions like hourly rounding charts and being beat over the head about budgets, most managers dont have the time or patience to consider better precetorship processes. And, as your unit shows, there are a great number of units that are in need of a new way.
I've been reading this for a while, without commenting. It made me go back and think about my own experience.
With 6 months experience in med/surg, I wanted to go on to critical care. I was hired at a rural ER. The manager gave me 90 days to orient and learn everything there is to learn about the ER. (ha ha, like you can learn that in a rural er in 90 days) But, I was naive and thought that I could do it, and I wanted to get into critical care sooo badly.
Anyway, I worked ONE dayshift and then was put on nights with a TRAVEL NURSE and an LVN. The travel nurse was responsible for orienting me. Now, while I understand that during those 90 days, there was really no way for me to learn very much, and I certainly could not be turned loose to charge on nights. I don't know what in the world this manager was thinking putting me in that situation.
When the 90 days was up, she let me go. But I couldn't help but wonder why in the heck she thought a new grad could orientate on NIGHT SHIFT with a TRAVEL NURSE who wanted to renew her contract. Even IF I had done well, this travel nurse knew her job was over if I succeeded.
At the time, I was heartbroken. But, a day or so later the ICU manager from a sister hospital hired me on by transferring me. I was grateful that I wasn't fired and had the wonderful experience of a GREAT ICU ORIENTATION. I was much better able to take care of my ICU patients after this orientation.
It all worked out for the best. I am really glad that I didn't stay in that ER, and I know now that ER is NOT for me!~! lol
I guess where I"m making my point is,,,, they never really gave me a chance, and looking back 6 years later, I can say that they set me up to fail. Come on, night shift at a rural ER, orientation by a travel nurse who doesn't want her contract to end,,, ... there is more, but I won't get into it here...
I KNOW this thread is for those new nurses who "just don't get it", but I just couldn't get it because no one helped me at all.. but like I said, it all turned out for the best and the experience is one that has helped me. I can see how an orientee can be put in a bad situation.
Yes, exactly. Sometimes the problem is being clueless. But other times the problem is being too green to realize your were thrown into shark infested water. As a person gets a little experience under their belt, they know what to demand before ending up in a dangerous situation.
But seriously, I was put in a sink or swim situation, and I swam. Sometimes I had to grab hold of a life preserver or two, and if not for them, I would have sunk for sure.
But that is not what this thread is about. I've seen a few come and go that were scary in their cluelessness, not because they were clueless, but because they blamed everyone but themselves for any mistake or oversight on their part.
I made my first med error in nursing school. It was a PO med, and I did all of the checks. I gave the med, and back then I saved all the wrappers and went through them as I charted the meds that had been given. I came across the wrapper for one med, and noticed that the dose was different from the dose that had been ordered. I could not for the life of me understand how that had gotten past me the first time I checked the meds prior to giving them, but there it was. I was so scared, worried about what might happen to the patient (he was fine), and that I might be kicked out of nursing school. When I went to my clinical instructor, after checking on the patient and filling out the incident report, she said to me "You could have easily tried to cover up this mistake, but you didn't. You did the ethical thing by coming forward with it, and we need ethical nurses.". Since graduating, I've made a mistake here and there, but I always harken back to that experience and those words.
Virgo, That reminds me of when one day the nurse who was taking care of my mom, called me. By that time my mom had been in a nursing home a few years. She said she called to tell me that she made a med error, and accidentally gave her an Ativan. I said: "Well she'll probably get a good nights sleep. And thank you for being the nurse I now trust the most. It looks like the first med error in all this time, and we know that's not true." She was not new and evidently kept her values.
Sorry, I got off the subject again, cuz I'm one the old, fat, ugly, jealous, mean, smelly (well I don't do smelly, but somebody threw that one in back there somewhere...lol), seasoned nurses.
So we can all fall into ruts (experienced and not-so), trying to get stuff done. I still use that story to prove a point from time to time.
J/K.
Indy, LPN, LVN
1,444 Posts
Thank you for that small bit of insight. I bolded out the part that really summed it up for me. The nurse who "doesn't get it" is the nurse who looks at is as "her day"- the nurse who gets it knows it is, in reality, other folks' lives that we are concerned with. To hell with "my day" because I can always stay late and tidy up the mess if there is one; how about preserving life and doing no harm?