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.
I was given six preceptors in two weeks. And then given poop when I couldn't find my butt in the dark with a map and a flashlight.
There are three sides to every story: yours, mine, and the truth.
Do you mean that due to some factor not relating to yourself you were assigned 6 preceptors? I've seen 2 or 3 due to staffing. 6 can really screw up a NG's head!
Maybe she just was not cut out to be a nurse , some people just DON'T get it all people have an issue with this at some point in there life. Unfortunately it was too late for her to realize that about herself. Maybe it took her to be fired for her to get awake up call if she even did but it sounds like she still doesn't understand.
The actual sad truth is that we will never know about this particular person. What I do know is capriciousness, lack of continuity and objective instruction and evaluation along with consistency is a huge problem and Magnet or not, many hospitals do not see to care about it. I've seen things get distorted. Sure maybe what you are saying about this nurse is true, but I've seen more bad and inconsistent treatment, and a general lack of true support in nursing be a bigger, more ubiquitous problem
Nursing and administrations just refuse to deal with this. Personality and likeability is what rules. If you got that going for you, people can spin a nurse's mistakes in a more understanding way--amazing how likeability aids the tolerance factor. If on the other than one does not have enough personality and likeability factor, the least little thing can be spun in a hugely bad way. I had a nurse tell me about this with her. I said look, if it truly is as they are making it out, then they would need to notify the state board of nursing. Now when they are making mountains out of molehills in order to eliiminate someone, they aren't going to go through the trouble or the potential law suit of defamation, etc.
So I am wondering if the supposed errors, which could be a true as presented, I really don't known, were presented to the Board of Nursing for investigation. ????
Nursing over the last 3 or so decades has become more of a dog-eat-dog, cut throat field. While we have been exposed to more reasons for greater overall support of each other, we really have simply decided to stick with cliques and factions and have no idea what truly open collaboration and building coalitions is all about. And because of this sad reality, nursing continues to have trouble being valued and empowered to be a true profession. People say "nursing profession," but it is really often half-hearted.
Unification, respect for each other openly, resisting cliques, personal or spot-group agendas, resisting factions and then learning and implementing coalitions--these are the only way nursing will ever truly hold legitimate standing as a profession. It is not the amount of doctorates and graduate degrees nurses get either--though there is nothing wrong with that. What WILL make the difference is in learning how to do the former things I stated above--forget agendas, games, every nurse for him/herself, and cliques, and learn how to form openness coalitions.
I like many aspects of primary care nursing, but I remember my mom as a nurse back in the 70's. Many places were still using the team nursing approach. There was often more unity then. It was more like an effective platoon. Any cut throat behaviors were eliminated--dealt with immediately. Generally there was more support for new nurses and those from the outside coming in--not means to try to eliminate them--dispose of them--and go try out the next nurse victim (new grad or new to the institution).
And that's what is essentially unhealthy today so often in nursing. The need to victimize or step on someone out of feeling threatened, or stepping on them to make themselves look better--or trying to form the perfect mold for the perfect "team" member. It's utter rubbish, and it's unhealthy, unprofessional, costly, and destructive.
But it goes on all the time. It won't stop until nurses start getting that the must protect and support their fellow nurses and the nursing as a whole. It means nurses have to put their own agendas aside for the greater good.
My orientation consisted of taking up to 7 patients a day while the preceptor played computer games, sucked up, and humiliated me in front of everyone else when I had questions. There was never an evaluation or even a "go over" of how I did. I got up the nerve to ask her one day how she thought I was doing, and the answer was: Great!! Wonderful!! Fantastic!!
So how constructive is that?
A person must definitely swim or he/she will sink.
We use a combination of team and primary nursing - patients are allocated geographically, with two nurses carring for eight patients between them. They both listen to hand over and create a shift plan, but take responsibility for half the patients (depending on acuity) - do obs, give meds, liaise with other members of the team, write notes etc, while acting as a support and resource for the other team member.
The grads share a preceptor - for the first six weeks they all work the same shifts, with the preceptor a supernumerary member of the team. In addition to the preceptor they have a clinical support nurse (one per ward) and a grad coordinator/educator (one per two-ward floor), and study days.
Despite this integrated, consistent approach, we still have nurses who just don't get it, who focus on the tasks and don't recognise the underlying stuff exists (let alone know any of it), who don't understand that they need to check the blood work before calling for an IV flask or warfarin order, do obs before giving meds etc, and who won't be told. Nurses who believe that any kind of individualised goal setting, criticism, concern or reprimand is personal rather than professional, an example of being picked on (fortunately the phrase "nurses eat their young" doesn't have a firm foothold in Australia).
Which brings me to the point of the OP - sometimes it is because there isn't enough suypport, but sometimes nurses who believe they were fired for NO reason are plain incompetent and unteachable.
We use a combination of team and primary nursing - patients are allocated geographically, with two nurses carring for eight patients between them. They both listen to hand over and create a shift plan, but take responsibility for half the patients (depending on acuity) - do obs, give meds, liaise with other members of the team, write notes etc, while acting as a support and resource for the other team member.
The grads share a preceptor - for the first six weeks they all work the same shifts, with the preceptor a supernumerary member of the team. In addition to the preceptor they have a clinical support nurse (one per ward) and a grad coordinator/educator (one per two-ward floor), and study days.
Despite this integrated, consistent approach, we still have nurses who just don't get it, who focus on the tasks and don't recognise the underlying stuff exists (let alone know any of it), who don't understand that they need to check the blood work before calling for an IV flask or warfarin order, do obs before giving meds etc, and who won't be told. Nurses who believe that any kind of individualised goal setting, criticism, concern or reprimand is personal rather than professional, an example of being picked on (fortunately the phrase "nurses eat their young" doesn't have a firm foothold in Australia).
Which brings me to the point of the OP - sometimes it is because there isn't enough suypport, but sometimes nurses who believe they were fired for NO reason are plain incompetent and unteachable.
Emphasis sometimes. What I have observed is there are a lot of nurses who want to do well, yet the games never end--and those that run them have bought into them--regardless of how the particular culture refers to nurses eating nurses or cut throat. I'll say it again. Nurses don't eat their young; they eat each other. The form cliques and factions. Again very POOR team formation, and it ultimately will be problematic. The idea of forming coalitions totally escapes certain folks in nursing, b/c what they really care about are their own little agendas--NOT THE BIG PICTURE. Hence the many problems in the field.
I have taken people that could barely multiply, taught them things, they grew in confidence, and then they were able to do greater things. The investment in the nurses, whether new grads or experienced nurses that are new to the unit or the institution MUST BE THEIR. OFTEN IT JUST REALLLY ISN'T. Agendas, games, evaluating nurses by way of the Stepford Wife approach gets in the way.
Sure there are some people that may be unteachable. But they are rarer than rare. The reality is many aren't trained and supported well enough, there is templating of an approach, little to no understanding in how to educate and direct adult learners, and just a general lack of respect to many that are new--whether experienced nurses or new grads. Invest yourself in those that are to be "precepted." Truly learn what the word precept means, and the learn about effective coaching. As they may need to take their ego out of their new learning situation, you also may need to take yours out. Don't be so quick to get your backs up or take offense over every little thing. Some people just have straightforward personalities. So what? My preceptor got wiggy siimply b/c I stated, "Fine. We'll do it your way." He miscommunicated/interpreted something I said about someone waiting for pending orders--telling the NM I intentionally made that person wait just to show her a thing or two. That was utter nonsense, and bearing false witness. I believe God deals with such things. If the NM mistook what he shared, he should have jumped in and clarified it--and should have shown more commitment to his orientee. But its all about personality and personal agendas, and frankly it's quite sad.
I have no idea what goes on in Australia, but I have worked long and hard enough as a nurse to know what goes on in places here in the US. Nurses eat other nurses---sure, they may smile when they put the knife in and pull it out, but the results are the same. I am continuing my education, I hope to change this problem with more effective precepting and orienting of nurses after I complete my masters. I might not be able to change it everywhere; but I can try to effect change and bloom where I am planted.
In the meantime I feel sorry for these institutions that allow things to look Magnet status quo, but at the end of the day, underneath the fascade, the antics are the same. You have no idea how many nurses this institution has hired, "precepted," and let go over the past several years in their critical care units. And you can blame it all on episodes of things from three years ago. The institution isn't really looking at what they are doing, or there is some way they can hire nurses, use them in orientation for 90 days, re-hire new nurses, and then let others go when the 90 days are done. I haven't figured it out yet, but even with orientation expenses, somehow they are making out on this deal. Bottom line, they want their new hires to make a commitment and act in due diligence, but they don't really believe that they should reciprocate. I won't disrespect the place to to others, b/c I believe all sides of a story should be represented before we try to influence folks. But now I understand the negative feedback I got from fellow nurses when they heard I accepted a position at this place. It really is a shame. Letting someone move through the 90 days and then eliminating them b/c some don't like the personality or style of someone is just ridiculous, and it really isn't doing due diligence in the process of orientation, precepting, and making the same kind of commitment that they ask of the new hire. That's also part of the problem in America--the capricious use of At-Will-Employment. See the employers see it totally from a one-sided perspective, and all the benefits of the doctrine tend to work in their favor. That's one of the reasons nurses have pushed more in the last 15-20 years for unionization. Many of us had mixed feelings over it. And in some ways I still have mixed feelings over it. But I have seen too many imbalanced, unfair antics over the last two decades. Nurses need proper representation--primarily b/c the employers often enough don't feel a sense of commitment to due diligence and truly fair play. The only folks that get any extra protection outside a decent union are those that have a strong EEOC case. For everyone else, come on board, but bring your K-Y. Not every place I've worked for was like that thank God. But many are.
Meanwhile my automechanic makes >$70/hour and doesn't have to have an extended academic education or put up with 1/8 of the nonsense most nurses do.
We had a new grad on one of our tele floors quit recently "Before this place makes me lose my license." Okay, there are some places that are that bad. But our facility is not one of them.
In ONE WEEK, she managed to:
Give meds to the wrong patient on at least three different ocassions
Leave blood transfusing as the patient spiked a temp from 97.8 to 102.2
Attempt to start an IV into a dialysis fistula (and then insist that "once they don't work anymore, they need to take them out somehow so we can use those veins")
Not recognize sustained V-tach; then, when it was pointed out to her, had no idea what to do about it, didn't even go to check on the patient
Left a femoral sheath open so that the patient bled all over the freaking place
Draw a PTT on a pt on a heparin gtt from the IV access that the heparin was infusing into, thus destroying the access on an impossible stick and getting a PTT result of >200, so she shut off the gtt (this was on a patient with new positive Troponin I's)
Push undiluted Lopressor over about five seconds on the above patient, without checking the BP/HR first, resulting in a drastic and sudden bradycardia into the 20's
Sure, it's our facility's fault that you got your license out of a Cracker Jack box. Seriously, I have little patience for nurses who fall into this category...she knew it all, and would yell at you if you tried to help her, then disappear as you fixed the screw ups she caused.
So I know exactly what Ruby is talking about. There are many sad points to this... One, she should have been let go. I'm sorry, I may get flamed for this, but the learning curve in nursing is steep for a reason; people's lives are in our hands. If you can't hack it after a reasonable amount of time, you should be out. Two, her lack of skills and knowledge placed an unfair burden on the rest of us. Three, she'll probably never figure out just why she didn't succeed, since nothing is ever her fault, and she'll be dealing with traipsing from job to job until she does lose her license...that can't be a fun life. And most importantly, how many people will she seriously harm or even kill before it gets to that point?
I can look back and see some pretty stupid stuff that I've done over the years, but never anything of that caliber.
It is hard when you're faced with criticism, I'll allow that. I had a HORRIBLE yearly eval a few years ago. Prior to that one, I had always gotten "exceeds expectations". That year, I barely scored high enough to get my raise. I went home, fumed, cursed, cried, and yelled about it. The next shift I worked, I pulled a few of the people whose opinions I trust aside, told them that I had some questions that I wanted honest answers to, and showed them my eval. Mostly, the response that I got was "What did you do to tick her off so much?". But there were a few areas that I thought I was doing fine in that my co-workers told me I was doing adequately, but could do better. At first I was a little hurt, but after a few days of reflection I realized that maybe I could improve. It took a level of maturity that I don't think I had when I was 22 and a new grad.
To those who would say that this poster's former co-worker needs "better preceptorship/instruction/nurturing/supervision/guidance/remediation" or whatever- I say "you can't make a silk purse out of a sow's ear."
To those who would say that this poster's former co-worker needs "better preceptorship/instruction/nurturing/supervision/guidance/remediation" or whatever- I say "you can't make a silk purse out of a sow's ear."
Amen. I'm getting sick of hearing "Oh, they need better supervision,remediation"...If someone needs to be remediated THREE TIMES for giving meds to the wrong patient THREE TIMES, sorry, no more remediation, it's time to go..After they kill someone, are people gonna keep making excuses for these peoples' incompetence? Honestly, how many times do you have to say STOP GIVING MEDS TO THE WRONG PATIENT.:banghead::banghead::banghead:
Gees, its basic nursing 101, when you give meds to the patient, you make sure before giving the meds, you go through the five rights. Is it really that hard?
Amen. I'm getting sick of hearing "Oh, they need better supervision,remediation"...If someone needs to be remediated THREE TIMES for giving meds to the wrong patient THREE TIMES, sorry, no more remediation, it's time to go..After they kill someone, are people gonna keep making excuses for these peoples' incompetence? Honestly, how many times do you have to say STOP GIVING MEDS TO THE WRONG PATIENT.:banghead::banghead::banghead:
Gees, its basic nursing 101, when you give meds to the patient, you make sure before giving the meds, you go through the five rights. Is it really that hard?
OK, but in total reality--that is forgoing all hyperbole, how many nurses are actually screwing up meds three times in a row--and what exactly were the kinds of "screw ups???" Most nurses, even new nurses, are not so inclined to be idiotic like that. (By the way, they've introduced more than five rights now--like other patient identifiers and even metabolic reactions in pts.)
The teaching approach and environment and type of "precepting" needs to be intensely evaluated if you really want to show commitment to fellow nurses and due diligence on orientation.
Furthermore, certain people should not orient or "precept," and generally those that have had no comprehensive study in teaching adult learners should be liimited in their "precepting."
People are very different. They are often highly nervous and intimidated on orientation, even when they know they have what it takes. It is stressful for the person that "precepts," but it is three times more stressful for the person being "precepted."
I have seen way too many impatient, highly hypercritical nurses functioning as "preceptors." I say stop blaming the people before you analyze the process. It's too easy to just relegate people as idiots. Another function of modern nursing. sigh.
And this only emphasis my points about consistency and sytematic, more objective and well-documented progress on a weekly basis through the process. The trouble is, often no one, including NMs or nurse educators want to make the necessary investment in time. It's a huge mistake.
What happens is that people just get "tossed" without anything really objective in terms of evaluation over time. If they make mistakes, there is no evaluation for remediation. I guarantee you would never tell your kid, "Tough crap. You missed this type of question three times on your Algebra exam. You're an idiot. Live with the poor grade and not understanding what you are doing wrong--as well as what you are doing right."
Listen, if you just don't have the patience and commitment to guiding, teaching, and coaching other nurses, you should not be
1. a preceptor
2. a nurse educator, and/or
3. a nurse manager for that matter.
It's time hospitals lookclosely at their systems of education for new hires and objectively look through cause analyses.
Yes, some folks should not be nurses--or perhaps at the least should not work in certain areas. Competence wise, these folks are very few and far between. It doesn't take Einstein genuis to function effectively as a nurse--or a physician for that matter.
It's more an issue of personality many times and a total lack of understanding--and the fact that institutions do not want to grow and evaluate their nursing orientation programs--on a larger and also individual nurse scale. It's too time consuming. They'd just as soon kick newcomers to the curb, and like disposable diapers, put on a "new" one." Another very sad function of modern nursing.
:banghead:
johnst10
122 Posts
Do you mean that due to some factor not relating to yourself you were assigned 6 preceptors? I've seen 2 or 3 due to staffing. 6 can really screw up a NG's head!