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.
Specializes in med/surg/tele/neuro/rehab/corrections.
Hehe As a student I did a 4 week rotation in a peds clinic so even as I was writing that I took pause. :) I thought about it and was too lazy to go back and change it and I hadn't even saved it yet But it also generates good discussion as to where this kind of nurse could work. And is she really unteachable? Isn't everyone teachable on some level? Or do we really have to throw in the towel on her completely? Maybe she just needs an extra long orientation on her next job.
I am curious to know where this nurse ended up, what kind of job did she find. And I wonder what kind of advice was given to her when she got the boot, such as ICU really isn't for you. Perhaps you would be better in such-and-such.
Whoa there Faerie...I work in a clinic. Does that make me a dingbat? Check my profile! Just saying...
At any rate a person who is unteachable is going to be unteachable no matter what setting they are in. Med/Surg and clinic work may not be glamorous but sometimes it can be downright scary and you have to be able to apply what you have learned in those situations. This sounds like a person who cannot do this and unfortunately that is not something easily learned. Just because a person can pass a standardized test does not necessarily mean they can function in the real world.
I think too we are so quick to jump on people about not knowing better.
Take the INR and coumadin incident for one. I wonder if anyone pulled her aside to see if it wasnt a problem with how she looked up the info, if she had attempted to do things right and something else happened other than just assumeing she was stupid and didnt know it was not proper to give the med.
Let me explain a med. error that I've seen that shows what I mean:
At my first hospital, we were computerized. You could pull up all your pt. into onto the screen. Vitals, labs, history, allergys, pending orders, new orders.........everything.
More than once, someone new to the hospital system would come in and make an error that was becoming much too common.
See, the info. always posted with newest info. on the left........older info trailing off to the right. Except for vitals info...........it went the other direction. So, on a couple occasions, a nurse would make decisons based on very old data because they were in a hurry and looked at the left most info. A couple times doctors got called about abnormal BPs or HRs and then the error was pointed out to the nurse. No big deal, just learn to look at the date of the data is all they had to learn. Then, a student nurse with a fill in clinical instructor (the usuall instructor on the floor didnt make it in due to weather I believe) gave a BP med. to someone with a BP of.....oh, something like 101/60. Problem was, they read the info. on the left as being most recent, and thought the BP was high. After that, the hospital fixed the problem.
The error with the coumadin was so...........just.........not acceptable, I find it hard to believe she didnt know better. My first impression is that something happened. Something that didnt come out. Maybe even, after being called into the office and told "YOU SUCK" by everyone, she was rushing to keep up and didnt even look. Thats a whole other problem, refer to my first post in this thread for my reaction to that.
I guess I cant wrap my brain around that. I am not afraid to say it out in the open........when I was a GN coming right out of school.........I was convinced I was.......ah, remedial. Not bad for "showing up late, not helping, leaving the unit" type reasons, but not the smartest out of my class by a long shot. And, for lack of a better way to put it........even I would not have done that.
So, I just rack my brain for other reasons that it happened............like the one I described above.
IDK. Coming out of school I saw people going str8 into ICU and such. My instructors who were looking out for me told me to go into a small hospital M/S setting and build up confidence and skills. I'm glad I did that. Maybe Sal needs it too.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
as the op stated, the coumadin/inr thing was just one incident among many for this nurse.
in my experience, these type of nurses go into mgmt.
you're absolutely right! and in a few years, when she's in management, she's going to counsel some poor nurse for making the exact mistakes (the inr incident was only one of the many) she made! it's a frightening thought, isn't it?!
I don't think it's any more fair to stereotype managers than it is it stereotype new grads. Those who can do cannot necessarily teach; those who teach often can do as well, and do so very well. I've been fortunate to work for and learn from excellent managers who could in fact do the jobs of many who worked for them -- and do it better, at that.
Remembering all the times here that I have been absolutely pummeled, kicked, and beaten for saying that not everyone is cut out to be a nurse.
It is nice to finally have someone agree!
Where do you draw the line between "cant do" and "can".
Dont tell me you think the process of training a nurse, from school to our first experience..........is accurate and efficient. I dont think so. Like I said before, the gap between where school leaves off (they are only concerned with you passing boards first time) and where hospital administration expects you to be on your first job is HUGE.
It is vital to have preceptors who can help bridge the gap. Simply pass/failing people just wont get the job done.
I agree, not everyone is made for nursing. I've known people in it who are very intelligent and fast workers, but they have a temper or are short with everyone. They dont make it. Then there are the ones who just are not at all motivated. You see the posts about people doing homework while on the clock, taking long breaks and expecting their pt's to be looked after (usually at the expense of other people getting no break at all). The nurse who just doesnt understand its no good being extra nice to pt. A and fetching that sprite while pt. B is having a stroke wont make it either. I get that.
The part I dont get is, it seems there is almost a hurry to see people fail so we who have made it can say "See, cant do it, I told you so." Whats that all about?
Another thought has occured to me too. I dont want to come off as a "see all know all". I'm relatively new too. I've been nursing for 3 years and........was always told you had to be in the field 5 years before you would really start to see yourself as "a nurse".
I've never precepted. So, maybe I'm being like the people with no kids who think they know whats best for raiseing kids.
So, experienced nurses.........go ahead. Educate me a little.
Is it that bad really? Are the GNs coming out of school really that difficult to move along? Is Sal the exception, or the rule?
Because she was not being trained right. Hospitals are all about making money. They want to start milking the cow before she is ready. If this girl had gaps in her learning they should have been filled. That is what preceptorship should be all about "experience."
The new nurse should have been explained the process of preceptorship from day one, and given support in transitioning into a functioning nurse. I guess we wanted her to start earning her keep from the 7th, 8th, 12th week onward. She did what she could. Was on time. She did not do what she could not. Use experience.
It is not enough to tell someone they don't have critical thinking skills. We should know those skills don't come in 6/8 weeks. But we are in a hurry to make money.
Err.. this new nurse did go to nursing school, right? We should not have to teach a new nurse what coumadin is, what an INR is and what those two things have to do with each other. New nurses MUST come prepared with SOME basic knowledge.
And to work in an ICU means HOME STUDY! I'm, quite frankly, over new grads thinking that they don't have to study at home!
The error with the coumadin was so...........just.........not acceptable, I find it hard to believe she didnt know better. My first impression is that something happened. Something that didnt come out.
My guess is that she didn't even "think" to look up what the INR was (in the ICU she should "know" it) prior to her administration of the med.
That's the whole problem. Some people are: looking at the MAR--> Coumadin due at 1600, get coumadin, pass coumadin, mark off the MAR...
But, they didn't stop to think....
What's the INR?
Why is the INR elevated?
What's going on with this person's liver, is something else going on here?
What is the side effect of this med?
etc, etc
I teach newbies and students all the time, "look at each med and question why we are giving it, is it indicated, is it appropriate for the pts condiditon, etc.'"
Soooo many people are just interested in marking the med off the MAR.
Specializes in Clinical Research, Outpt Women's Health.
Hi Erik,
To clarify I mean that there are people (not less intelligent at all) who are simply unable to think critically. It just does not work for them. This makes it very hard for them to ever be a good nurse. Also, there are some people whose personality is simply unsuited to nursing.
I am not a hospital nurse because although I think critically just fine I absolutely hate being around sick people and blood and guts! :lol_hitti
Seriously, I have meant some student nurses and some experienced nurses who simply are not cut out for the unique blend of skills and qualities that are required to be a good nurse. I think no one does them any favors by not telling them that. There are some things that cannot be learned no matter how hard you amy try and wish to do something. That applies to many fields, but in nursing or medicine it can be life or death.
Faeriewand, ASN, RN
1,800 Posts
Hehe As a student I did a 4 week rotation in a peds clinic so even as I was writing that I took pause. :) I thought about it and was too lazy to go back and change it and I hadn't even saved it yet
But it also generates good discussion as to where this kind of nurse could work. And is she really unteachable? Isn't everyone teachable on some level? Or do we really have to throw in the towel on her completely? Maybe she just needs an extra long orientation on her next job.
I am curious to know where this nurse ended up, what kind of job did she find. And I wonder what kind of advice was given to her when she got the boot, such as ICU really isn't for you. Perhaps you would be better in such-and-such.