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.
Yeah. Like I said before, the bridge you have to cross as a new nurse is very long. The gap between where schools leave off and where hospitals want you to be as a new hire is large to say the least.
It takes a good preceptor and preceptee to bridge that gap. Any time one side or the other falls short, the whole thing comes tumbleing down.
I guess that my view that the way to deal with this is to change the way we precept stems from the belief that vet. nurses have more capacity to change things than new grads. As a new nurse, I was so overwhelmed with......well, everything......I couldnt see the big picture.......with my patients or my career or how what I did affected nursing as a whole. I think a lot of people would agree they felt the same as a new nurse. Now, with a little experience under my belt, I see more of the picture.
Vet. nurses on the other hand, can, with confindence, insist on being 100% sure that if there is a person who does not cross the bridge, it will not be because the proper precepting process was not in place. Then, those who truly deserve to make it will, and those who dont wont. I am still of the belief that our process lets GNs who could very well become outstanding nurses fail. To top it off, not only do some people with potential fail, but some who are very smart but not interested in their work get through somehow. Its.........discourageing.
I agree with your main points here. New nurses do indeed have a steep learning curve. There are some progressive health systems which hire new grad nurses for 6-month to 1-year residencies and this is, IMO, an idea whose time has definitely come. It simply takes longer than 8 weeks to "become" a nurse. A fairly typical 6- to 8-week precepted orientation for a brand new nurse in an acute care environment, even under the best circumstances with a supportive culture, an experienced preceptor who has a talent for teaching, and a capable, motivated new nurse is barely adequate. Factor in the typical limitations -- the preceptor-of-the-day, scheduling discrepancies, and patient volume & staff shortages that do not allow the preceptor/preceptee team to take a reduced patient load to allow time for actual learning to take place -- and you have a set up for mediocrity and potential disaster.
The last part of your post actually supports what OP Ruby has said. There are some qualities necessary for success that are impossible to quantify and may be difficult to even identify until the potential new hire is actually working on the unit. These include the ability to take direction, commitment to increasing one's knowledge base, and the emotional maturity to handle different situations.
I love this idea too. Thanks for the input Altra. Love to see people debate and get different views out there.
I cant make the same connection you are though. I dont see it. The one about Ruby and I agreeing.
Way I see it, I am for reforming the preceptor process. Ruby may be more for.......changing where schools leave students off so the gap is not so large. Maybe more than 2 yrs. for a degree or something to that effect. IDK, I dont for a second think I can speak for her, thats how I take it though. I just am not connecting the dots the same way as you I guess.
Vet. nurses on the other hand, can, with confindence, insist on being 100% sure that if there is a person who does not cross the bridge, it will not be because the proper precepting process was not in place. Then, those who truly deserve to make it will, and those who dont wont. I am still of the belief that our process lets GNs who could very well become outstanding nurses fail.
I agree. But I think what Ruby's post was about ... and what some of us veteran nurses get very frustrated about ... is that every time we try to have a conversation about the new grads who shouldn't be simply "passed along" indefinitely, we get accused of being uncaring b****** who eat our young. We can't discuss it without having the thread hijacked by students and new nurses who can't see the other side of the fence and who jump quickly to the assumption that every new grad failure was the preceptor's fault.
We all acknowledge that there are bad preceptors in the world as well as some really bad work environments who don't properly support new grads. However, we need to be able to have a conversation about the opposite problem -- new grads not doing their part, etc. -- without having the thread hijacked and/or being accused of being horrible people.
We need to have a safe place to discuss these things ... now tough decisions have to made ... how we (the veteran nurses) are usually criticized vehemently by the students and newer nurses every time we try to enforce some standards and protect our patients and profession. We need that safe place to discuss our tough job -- and don't always find it here on allnurses.com.
I love this idea too. Thanks for the input Altra. Love to see people debate and get different views out there.
I cant make the same connection you are though. I dont see it. The one about Ruby and I agreeing.
Way I see it, I am for reforming the preceptor process. Ruby may be more for.......changing where schools leave students off so the gap is not so large. Maybe more than 2 yrs. for a degree or something to that effect. IDK, I dont for a second think I can speak for her, thats how I take it though. I just am not connecting the dots the same way as you I guess.
Both sides have to change -- the hospitals and the schools.
1. You can't make a nurse in a 15-month "accelerated" program. Even 2 years is pushing it. That needs to be acknowledged. Rushing students through their nursing education only makes the challenges of entering the profession much more difficult.
2. Hospitals must provide thorough, structured orientation programs (internships or residencies, etc.) that are longer than 8-10 weeks. These programs need to be designed and run by people with expertise in nursing staff development -- not just any nurse on staff. Hospitals need to stop cutting these programs (and these experts) from their budgets.
3. Everyone needs to realize that such in-depth orientations are expensive. Therefore, new grads are going to have to be willing to either sign enforcable contracts -- or be willing to accept a signifcant decrease in pay for the time they are receiving the education (in the residency, etc.). It's not reasonable to expect the same pay when you are not doing the same job as the nurse who is working on her own without a preceptor. The financial burden of running those big orientation programs needs to be addressed -- and the new grads who want/need them need to be part of the solution to those financial burdens. The patients and 3rd party payors are not going to pick up the entire tab.
The whole system needs reconceptualized ... but I'm not holding my breath.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
i love this idea too. thanks for the input altra. love to see people debate and get different views out there.
i cant make the same connection you are though. i dont see it. the one about ruby and i agreeing.
way i see it, i am for reforming the preceptor process. ruby may be more for.......changing where schools leave students off so the gap is not so large. maybe more than 2 yrs. for a degree or something to that effect. idk, i dont for a second think i can speak for her, thats how i take it though. i just am not connecting the dots the same way as you i guess.
i think the preceptor process in my unit is working just fine. i'm not sure about the process where you come from. i'm glad you don't think for a second you can speak for me -- i hope that means you weren't actually speaking for me, although that's exactly how it looked!
as far as the schools go, i have no input into what does or does not go on there. i can only work with the finished product, the brand new nurse i am given. most of the new nurses i've precepted over the years have become wonderful nurses. even the few nurses i've had to "flunk" have become fabulous nurses -- after a stint on the step-down unit or a med-surg floor. but there are new grads out there who just don't get it, won't get it because they won't work at it, fail, and then blame the failure on everyone and everything other than themselves. i've seen that from a distance before, but sal was probably the most blatant example of that phoenomenon i've ever seen up close. sal's failure doesn't mean the process has failed. it simply means that sal failed, and she has only herself to blame because the rest of us were sure knocking ourselves out trying to help her. unfortunately, sal doesn't get that, either.
if i've made a few "sals" stop and think for a moment that perhaps the fault lies at the feet of the one person who can change their behavior -- themselves -- they could turn things around before it's too late and actually succeed. then i will have helped a few sals when i couldn't help the one i really wanted to.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
i agree. but i think what ruby's post was about ... and what some of us veteran nurses get very frustrated about ... is that every time we try to have a conversation about the new grads who shouldn't be simply "passed along" indefinitely, we get accused of being uncaring b****** who eat our young. we can't discuss it without having the thread hijacked by students and new nurses who can't see the other side of the fence and who jump quickly to the assumption that every new grad failure was the preceptor's fault.
we all acknowledge that there are bad preceptors in the world as well as some really bad work environments who don't properly support new grads. however, we need to be able to have a conversation about the opposite problem -- new grads not doing their part, etc. -- without having the thread hijacked and/or being accused of being horrible people.
we need to have a safe place to discuss these things ... now tough decisions have to made ... how we (the veteran nurses) are usually criticized vehemently by the students and newer nurses every time we try to enforce some standards and protect our patients and profession. we need that safe place to discuss our tough job -- and don't always find it here on allnurses.com.
you have that so right, llg. we don't often find a safe place to discuss the tough job of being the veteran nurse among hordes of newer nurses without getting attacked and criticized. in fact, i cannot recall even one thread where the students and newbies just listened rather than jumped in to tell us how wrong we were to feel that way. this thread has been better than most in that regard. a couple of years ago, several newbies told me i should not only not be a preceptor but that i was too nasty and mean to even be a nurse. (i hope, with a couple of years of experience under their belts they've re-thought that situation, and maybe they'll pop back on those threads to tell me so.)
You know I think it's just a matter from where you stand, or for that matter how far removed you are from being a student, a newbie, a novice (which I am still considered having less than 5 years nursing experience) or doing something forever and being very good at it.
I see desperate messages for help from students trying to understand very simple concepts and sometimes I think why are they posting that? Then I remember how desperate I was on occasion to understand, get some kind of validation, or when I just didn't get it.
Other postings by brand new nurses seem childish sometimes, yet I remember when I dreaded working with some preceptors (even though I was over 40) because I just could not deal with their crappy attitudes....and yet, now that I know them well I think, were they really crappy or was I insecure in my knowledge?
And as I read ideas to educate fully at reduced pay I agree that it is a good idea, but I can guarentee I would've thought you were out of your mind 3 years ago!
So back to the beginning, sometimes it's really how you view the picture and what seat you are in that influences responses. I think I am a good preceptor that is honest from the get go, but with solutions to the problems. I am sure as time goes on my ideas will continue to evolve as will all of the newbies who think preceptors aren't as nice as they can be.
]I agree. But I think what Ruby's post was about ... and what some of us veteran nurses get very frustrated about ... is that every time we try to have a conversation about the new grads who shouldn't be simply "passed along" indefinitely we get accused of being uncaring b****** who eat our young. We can't discuss it without having the thread hijacked by students and new nurses who can't see the other side of the fence and who jump quickly to the assumption that every new grad failure was the preceptor's fault.[/b']
We all acknowledge that there are bad preceptors in the world as well as some really bad work environments who don't properly support new grads. However, we need to be able to have a conversation about the opposite problem -- new grads not doing their part, etc. -- without having the thread hijacked and/or being accused of being horrible people.
We need to have a safe place to discuss these things ... now tough decisions have to made ... how we (the veteran nurses) are usually criticized vehemently by the students and newer nurses every time we try to enforce some standards and protect our patients and profession. We need that safe place to discuss our tough job -- and don't always find it here on allnurses.com.
I understand. I really do.
The preceptor system we use is just a pet peeve of mine. Maybe didnt really apply here. I could have started my own thread, and probably would have had the support of a lot of those who oppose me in this thread.
Yeah, this thread got me thinking of a few people who didnt make it, and when they proclaimed they were going back to school for something else I was........happy for the profession of nursing. So, its not like I completely dismiss that people like Sal exist.
I think the difference is, I get more upset about the poor working conditions and lacking orientation processes than about people like Sal. This is why:
When the orientation process fails someone who otherwise would have been a very good nurse, it means an entire group of people have fallen short, including us as nurses. Now, when someone like Sal comes along and fails, it just means someone like Sal failed.
i think the preceptor process in my unit is working just fine. i'm not sure about the process where you come from. i'm glad you don't think for a second you can speak for me -- i hope that means you weren't actually speaking for me, although that's exactly how it looked!
as far as the schools go, i have no input into what does or does not go on there. i can only work with the finished product, the brand new nurse i am given. most of the new nurses i've precepted over the years have become wonderful nurses. even the few nurses i've had to "flunk" have become fabulous nurses -- after a stint on the step-down unit or a med-surg floor. but there are new grads out there who just don't get it, won't get it because they won't work at it, fail, and then blame the failure on everyone and everything other than themselves. i've seen that from a distance before, but sal was probably the most blatant example of that phoenomenon i've ever seen up close. sal's failure doesn't mean the process has failed. it simply means that sal failed, and she has only herself to blame because the rest of us were sure knocking ourselves out trying to help her. unfortunately, sal doesn't get that, either.
if i've made a few "sals" stop and think for a moment that perhaps the fault lies at the feet of the one person who can change their behavior -- themselves -- they could turn things around before it's too late and actually succeed. then i will have helped a few sals when i couldn't help the one i really wanted to.
no, just a bad attempt at pointing out how we are coming from different directions but towards the same goal (i believe anyway). i just couldnt connect the dots the same way the person i was respondeing to did.
i come from a background of having been lucky enough to find a "first experience" that was ideal, for myself and any new grad. i needed a lot of direction and redirection, a lot. but, said redirection happened in a way that promoted growth. i never felt "passed" or "failed", i just had what needed changed pointed out to me and did my best to do so.
i guess thats the real difference between myself and sal then. like you said, you've made people stop and think for a moment. sal didnt do that, i did. i'm glad i did.
besides, i'm too fat to say i'm being picked on because i am prettier than my preceptor.
I will never forget that when I was a brand new GN, my then-manager told me that they didn't have "time or resources" tp precept me. I was 22, working on a very small, specialized unit, and had no idea what was standard practice. He told me "don't worry; Joan will help you".
Joan was 62 year old nurse, the only other nurse on night shift. Her age wasn't the problem. But her health was. She was a brittle diabetic who played games with insulin all night - eat a pound of chocolate, take 20 units insulin. I found her dazed and diaophoretic more than once, having to stick her finger along with the patients. She was ZERO help to me. The nursing super was ZERO help to me - she was a retired LTC nurse who knew nothing about the acute care I was asking questions about. I ended up calling the doctor frequently, because I really didn't have any other resources. I am smart, I can "think critically", but I was green as June. I needed someone to guide me.
Anyway, this nasty dayshift nurse, who hated anyone with a BSN, (how she found out I had one, I don't know, I sure never announced it!) went around telling all the staff how "scary" I was because I called the doctor for guidance about things I should know.
It hurt me so terribly at that point in time. I cried, and cried, and was sure I was going to lose my job. But, I didn't. And at the end of a year, I was a pretty strong nurse, because I had survived basically on my own (and I had also witnessed/identified/sought help for my coworker's AMI right beside me after she played her game one too many times).
Years later, after being known as a good nurse with strong skills, I said to that dayshift coworker, "You know what I think is 'scary'? I think it's 'scary' as **** that someone who calls themselves a nurse enjoys watching a young girl get no guidance and drown. Instead of helping her, she essentially pokes her with a stick to enjoys the show. That's what's scary, the personality disorder that causes someone to behave like that".
Her face turned white, and she had no idea what to say. She got up and left the room.
I don't know why I shared that particular story here, lol. I just felt like it.
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RN1982
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