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.
Thank you so much for writing this. I did not get fired, but I am a new grad and of course I need to get better at time management. I work really hard at home, going over notes, rereading my patho and medsurg books. I have found that coming out of a BSN program, with not enough skill practice, and no prior hospital experience, I had to learn everything! Today, I came home wondering if I was ever going to "get the whole picture" or even have time to sit and think about the whole picture! Thankfully, I don't give up that easy, and your story made me realize I can and will do this. Thanks.
A co-worker of mine who recently got off orientation told me that at the last hospital he worked at gave him zero orientation when he was a new grad. They told him that they do not have the budget to have him and his preceptor work, they just put him on the floor with no guidance. He worked on a cardiac/tele unit. He said there were 36 patients and the other nurses would leave him and another nurse to watch all the patients while they went to walk the stairs. He complained many times. I don't know why he stayed there for two years but he stuck it out hoping it would change and it didn't. I told him that I would have left the minute they told me no orientation.
When I was "precepted", I was actually precepted by an older nurse, that made alot of biased comments, and about 6 monthes into my stint, got axed for using restraints in an abusive manner.
As a traveler, I was rarely but occasionally placed in the position of precepting. I have been in my current nontravel position for barely over a year. My facility of course lauds their new nurse residency program and howone does not precept until you have been specially chosen and trained.
So guess who walks in, to find a packet for precepting in my mailbox at work. No warning, no preceptor class, no "would you be comfortable with?". And I get only two days notice. Why????? you ask. Because the floor is short, and we need to get the new nurses up and running, as soon as possible.
Now if there is ANY time, in which new grads need MORE time to precept and BETTER precepting, it is when you are dropping them into an already problematic situation, with high census and lower staffing.
They certainly do not need LESS orientation....which is what usually what occurs.
I am doing the best that I can to precept. But I was not given the "proper" tools to do this job - no information, no guidelines, nada. And frequently, I am having to teach my orientee how to manage things that I find unmanageable, as an experienced nurse.
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.)
ah yes ruby.. i've had the nursing and pre-nursing students on these forums who have told me that i shouldn't be a nurse either! ha~
A co-worker of mine who recently got off orientation told me that at the last hospital he worked at gave him zero orientation when he was a new grad. They told him that they do not have the budget to have him and his preceptor work, they just put him on the floor with no guidance. He worked on a cardiac/tele unit. He said there were 36 patients and the other nurses would leave him and another nurse to watch all the patients while they went to walk the stairs. He complained many times. I don't know why he stayed there for two years but he stuck it out hoping it would change and it didn't. I told him that I would have left the minute they told me no orientation.
Then there are the places that tell you that a superb orientation program has been planned. The person who was supposed to give it, took another job in the organization, left me high and dry, a week into the job. That's happened to me a few times, and I hit the ground running, saw that the crisis was an opportunity to shape the job (Infection Control) the way I wanted to do it. It took a lot of library hours (no computers then.....), a lot of 1:1 with ICNs at other hospitals (it had been a couple of decades since I'd done IC before). Through the generosity of others, I got myself oriented - but then I didn't have the patients' needs to meet immediately and had an office to go back to, and call others and/or figure out what to do.
It seems to me that requirements for hospitals, LTC and nursing homes should have enforced orientation to retain certification. That may/may not have the check lists that get automatically checked, without verification..... To retain staff and standards of care, individualized orientation should be in place.
If the only person who can do the orientation leaves, she/he should be made to write a manual to take the place of information that would have been given, along with names and extensions/email addresses of people who have answers to situations that can come up. It should be up to date, and reviewed before the last evaluation is given her/him.
lamazeteacher you are so right! This is a trend everywhere. In one of my two current jobs (school nurse) I had one day with someone and access to them for 1/2 of the second day for my orientation. At another job- QI - I had a 1/2 day with a supervisor for my orientation. At a nursing home PRN casual job I had 1 day with someone for my orientation. None of these were jobs that I had previous experience in- except for my clinical experience and a little subbing as a school nurse. No one seems to want to spend the money to orient their employees these days.
I have plenty of nursing experience, but learning a new job on your own is just plain tough. It is not fair to anyone and contributes to turnover.
May I say, I identify with both sides of the story....I don't believe all "old" nurses are 'mean, nasty, smelly, and whatever else it was"....and I don't believe all 'new" nurses are incompetent and unwilling to "get it"....
As someone with just over 6 months experience, a 6 week preceptorship in which I was given 7 pts a day while the preceptor played computer games, sucked up to the bosses and drs, meanwhile humiliating me in front of families, drs, and bosses, I am not very sympathetic to the "sink or swim" module which seems to be the modus operandi these days. I've worked hard to get where I am, but I don't feel that it's good enough. After 6 months, I feel "okay" at work. Some days are good days, a lot are bad days. I feel like there is no time to ask any questions or critically think, because I can't get it all done in an 8 hour day, and then my boss yells at me for having 15 min- 1 hour overtime. I feel like the "wow, how cool is that" learning phase is over and the slave phase has begun. I feel like I am not an autonomous, thinking human being, but a robot who does tasks all day. All that said, I do think I'm as good as a nurse can be after an awful preceptor and the expectation to be 100% at 6 weeks and one day. I haven't made any med errors. I haven't killed anybody. I think I've even done some people some good- caught things that should've been done, taken time to listen to people, notified drs when necessary. But I sure don't feel like the Florence Nightengale that school promised it to be.
lilly blue, wow, it speaks tomes. If we could read the minds of some significant number of nurses--those that precept and those that not, and perhaps some managers and "nurse educators" as well, that is exactly the kind of thing we would here.
That is reality and also the sick power of "weeding." If someone truly doesn't care about patients and families and is truly incompetent, yes I can see the need to weed them out. But personality issues, issues of conflict and differences, issues where there is a lack of understanding that team or unit integration is a two way street that takes a lot of time--often well past the probationary people--or those poor new grads that simply are NOT given the consistency and supportive guidance that they need--or others that need constructive yet supportive feedback through orientation--these weedings are not simply wrong they are UNETHICAL AND A DISGRACE TO THE WHOLE NURSING PROFESSION. Yet they are somehow allowed to go on and on.
This makes people see the need to avoid going into nursing or avoid staying in nursing. And the institutions, teams, and ultimatelyl the patients and families suffer for it. When will nurses and administrators and managers ever get it???
"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".
Yep, lilly that is the scariest thing of all as it pertains to what is happening to nursing--and what is stopping if from truly being a PROFESSION.
Specializes in pediatrics, palliative, pain management.
I have found this thread great to read! It reminded me of my initial preceptorship experience.
When I was first preceptoring as a new grad onto a peds unit, I was paired with an older, very experienced nurse. She refused to answer any of my questions! AND SHE WAS FABULOUS. She wouldn't answer my questions, but went about showing me how to find the answers I needed. How to look things up in the policy and procedure manual, in text books, in journals (all pre internet access) and how to phone pharmacy or get the resources I needed. Whenever I asked a question, she would send me in the direction of the answer, and take the time to look things up with me. I remember thinking how generous she was with her time, and how valuable these lessons were. It would have taken her way less time to just answer my questions, but I learned so much more through her teaching.
What was really interesting was a nurse who had preceptored onto the unit about 6 months prior to me with the same nurse and described the nurse preceptor as unhelpful and not knowing anything! This other new grad nurse's interpretation of the acts of "making her" look things up and phoning pharmacy etc was a sign that the preceptor didn't know her stuff.
Interesting isn't how we see things! By the way, this preceptor "knew" her stuff, and her lessons of looking things up for myself and verifying information are things i have used through out my nursing career.
she/he should be made to write a manual to take the place of information that would have been given, along with names and extensions/email addresses of people who have answers to situations that can come up. It should be up to date, and reviewed before the last evaluation is given her/him. 
eriksoln, BSN, RN
2,636 Posts
Oh my Lilly. Thats just, ah......scary. Having to check your co-workers BS and all. Gee, I would have been crazy.