Seasoned Nurses VS Newbie Nurses

Nurses General Nursing

Published

As I've stated in multiple other posts, I am a new grad in the ER. As a new grad, I do not possess the EXPERIENCE that a seasoned nurse has; however, I have noticed that many seasoned nurses are not up to date with new standards that were taught to us in school.

How can one bridge the gap between old knowledge vs newer knowledge?

Here is a perfect example. We were doing ACLS and all the new grads were very knowledgeable regarding the new ACLS protocol; however, a more seasoned nurse was there as well and was following a different protocol that was practiced years ago and not up to date.

With preceptorship coming soon, how do I as a new grad decide what to follow as far as their experience and advice, versus what was taught to me in school?

I am not talking about ACLS protocol here; OBVIOUSLY I am going to follow what the AHA recommends, but I am talking other things here for instance:

-skills

-assessments

-charting

etc.

I have noticed seasoned nurses also don't chart the same as newer nurses, especially because when they had originally started, there was no such thing as an online charting system.

I respect all seasoned nurses and love learning from them and their knowledge is absolutely invaluable, but I have noticed a lot of discrepancies between what we learn and what they do.

Any advice?

Specializes in LTC.

Ooooh what a post!

Newbie here, well kind of. I've been doing this for only 2 years and faced a lot of challenges. But I 100% believe that I am a better nurse now than I was when I first graduated with all the material "fresh in my mind". Experience trumps education ALWAYS.

In a perfect world, during my med pass, I would like to have to do my 3 checks. I would love to have time to do a full through assessment. But in nursing school, you don't have the hustle and bustle of 10+ patients, angry doctors, concerned family members, etc. Nursing school is set in Hospital Utopia where all of the situations are ideal.

Your methods may be new but experience nurses know what works and what doesn't. Sometimes old is gold! But no matter if you're a newbie or a seasoned nurse, you're always learning so really no one should be using obsolete methods.

You pose an excellent question. I have been a RN for 17 years, and I recognize that much has changed. On a med-surg floor, I would have much to refresh on. But, in my speciality (very small and unorthodox, will not mention it as it will be too easy to identify me), I am an certified "expert" and aware of almost every change and update to practice. I am very confident that I am using current knowledge (they don't even teach my speciality in school). So, to answer your question, I bridge the gap between knownledge and experience by narrowing my focus, and devoting my proffesional life to it. I am sure new grads could run circles around me when it comes to say, fetal monitoring, but within my little world, I have both academic knowledge and the wisdom that comes from caring for the same population for a decade.

I don't usually post here, but I had to speak up after reading some of these comments.

The nasty attitudes on this post are the reason I'm starting to feel disappointed in the nursing profession. I'm about to be a new grad RN in a brand new job, and instead of being passionate and excited to learn, all I can think about is trying to find a job where the nurses aren't nasty to each other.

Alex is bringing up something that is pounded to our head in nursing school- using evidence based practice. An amazing example of seasoned nurses transforming seamlessly into newer, safer practices: our nursing school instructors! They're adapting to the latest research in order to teach us the most current evidence based nursing practices.

I can see, from my clinical experience, how this concept is quickly forgotten in the real world. I can also see that seasoned nurses have an incredible amount of real world experience that, hey, if it's worked for 20 years with good patient outcomes... keep doing it!!!! My mother is a very seasoned critical care nurse, and I trust her judgement in a profound way... she is sage in the world of nursing - and I am sure to ask her advice as often as I can. However, if a newer, safer practice exists, it's worth bringing awareness to!

New or seasoned, patient safety will always remain paramount, and I think that is what Alex was trying to get at in this discussion post. I wish that nurses, as a community, could spend more time lifting each other up and helping one another learn (new practice, and seasoned, very valuable practice!) instead of throwing egos around the halls of our facilities and creating ugly environments for us new nurses to try to learn in.

Xo

Isabel

Honestly, this is EXACTLY my thoughts. Talk about nurses eating their young here. WOW, just trying to get some advice and input I'm not say one is better than the other by ANY MEANS. In fact, I stated that their knowledge is invaluable and they're soooo very lucky to have it. It is quite sad to see how other nurses treat their colleagues.

Sometimes facility policy will deviate from what you learned in school. As long as it's not unsafe or blatant bad nursing, follow the FACILITY policy. To put an even finer point on it, sometimes policies differ from ED/floor/stepdown/ICU.

I think most of us understand what you were trying to say. Perhaps the heading got some fired up. Seasoned Nurses VS Newbie Nurses makes it sound like a heavyweight title boxing match :)

Specializes in Critical care.

Well sonny, when you've been a nurse as long as those "other" old people, you realize ACLS guidelines change and even though the flavor of this revision says to use or not use a certain drug these old dogs have been through 10-12 revisions with those same drugs either on or off the list, and have seen them work in real codes, not in class. Don't get me wrong, I agree nursing is changing so fast, and so often, it is hard to keep current, but maybe next time ask why ....

Cheers

1 Votes
Specializes in Family Nurse Practitioner.

My suggestion is learn as much as you can from everyone you can. There is something to learn from every person from the environmental services folks through management. Take what you learned in school and intermix what you learn on the job. Create your way of providing safe, efficient, and timely care. Most importantly, make friends with the CNAs and ER techs. They can make or break a shift. Always ask questions when you aren't sure.

Specializes in Psychiatric and emergency nursing.
I don't usually post here, but I had to speak up after reading some of these comments.

The nasty attitudes on this post are the reason I'm starting to feel disappointed in the nursing profession. I'm about to be a new grad RN in a brand new job, and instead of being passionate and excited to learn, all I can think about is trying to find a job where the nurses aren't nasty to each other.

Alex is bringing up something that is pounded to our head in nursing school- using evidence based practice. An amazing example of seasoned nurses transforming seamlessly into newer, safer practices: our nursing school instructors! They're adapting to the latest research in order to teach us the most current evidence based nursing practices.

I can see, from my clinical experience, how this concept is quickly forgotten in the real world. I can also see that seasoned nurses have an incredible amount of real world experience that, hey, if it's worked for 20 years with good patient outcomes... keep doing it!!!! My mother is a very seasoned critical care nurse, and I trust her judgement in a profound way... she is sage in the world of nursing - and I am sure to ask her advice as often as I can. However, if a newer, safer practice exists, it's worth bringing awareness to!

New or seasoned, patient safety will always remain paramount, and I think that is what Alex was trying to get at in this discussion post. I wish that nurses, as a community, could spend more time lifting each other up and helping one another learn (new practice, and seasoned, very valuable practice!) instead of throwing egos around the halls of our facilities and creating ugly environments for us new nurses to try to learn in.

Xo

Isabel

I don't think anyone was "trying to throw an ego around." All the seasoned nurses here are saying is that real nursing practice is often nothing like what you're going to read about in a textbook, and that having a new nurse fresh out of school (or still in school) telling them that their practices are incorrect and outdated is... aggravating. This is especially true when the seasoned nurse has years of positive patient outcomes, and does not have the time to go "by the book."

As far as evidence-based practice goes, yay EBP! The only thing about EBP is that, even after the research has been done, it takes a while to disseminate the findings, and even longer to put them into practice. If the OP is truly concerned with EBP and better patient outcomes, she should find a specific focus, do some research, then present this to the unit manager/director, or ask to present it at the next unit meeting. However, until the change is implemented, I would caution the OP about practicing with EBP if it does not follow current hospital policy and protocol. Even with more recent EBP, if there happened to be poor patient while following the EBP, the OP would not be covered, and could be fired, sued, or worse.

Specializes in Psych, Corrections, Med-Surg, Ambulatory.
Think about this... 5 years from now when you are a preceptor and a new nurse is following you around they will be saying the same thing about you.

And accusing you of snark and NETY when it rubs you the wrong way.

Honestly, this is EXACTLY my thoughts. Talk about nurses eating their young here.

Disagreeing with you is in no way eating you, it is not treating you badly and FTR it is not bullying you.

Your title was inflammatory and you made a gross generalization of seasoned nurses based on your experiences and yours alone. Not only that but you cannot be sure that just because you learned it in school it is the latest and greatest. You wouldn't believe the nonsense I've had to correct in my years as a preceptor and yes I keep up with EBP.

As for ACLS. It is upated every two years. It changes every year. Sometimes it changes back to the way it was done in a previous iteration. Usually it rolls out in a somewhat confusing way. Until you've had your ACLS for more than one cycle that may be difficult for you to understand. Sometimes you run into someone who is at the end of their cycle and will be updated at their next re-cert. When you learn a rote skill and a major change is made, for example, you've had "ABC" not "CAB" beaten into your head for over three decades it can be difficult to remember that change in the heat of the moment. Cut your colleagues some slack just like I'm sure they are doing for you.

1 Votes
You'll find older nurses chart less, the young ones usually over chart because that is what they are taught and they are worried about making a mistake or being sued!

... This brings to mind the micromanagement another ER nurse mentioned in the article here Knaves, fools, and the pitfalls of micromanagement and how new nurses were documenting to a T, but in the process patient's safety and real life needs were being put on the back burner...

Sadly while the protocols are meant for best practice and some spurred on by medicare demands and reimbursement, they are not always realistic due to the time constraints, number of patients and the need to keep everyone safe. All you can do is do your best to follow the protocols while keeping patients safe.

Thank you for your insight about documentation and protocols! This gave me a new perspective, and it's very helpful!

Specializes in Emergency Nursing.

As someone who has seen both sides of the coin, here's my little bit of advice:

Follow the golden rule before anything else: Keep them breathing, keep them safe. If your preceptor does something that puts either of these into question, then you have the right to speak up and speak up quickly.

For the rest of the time, pay attention to your preceptors assessments. Most seasoned nurses (especially ER nurses) have the ability to quickly whittle away useless information/physical findings and hone in on what is pertinent. This will be difficult at first for you but will be a huge time saver as you develop this ability.

I would also encourage you to pay attention to their procedural skills and get all of the education/tips and tricks related to these procedures that they will give you. We can all read the procedure of how to place an NG tube, but what separates the experienced nurse and you is experience from having done these procedures over and over again. They will have knowledge that the book simply can't provide.

Another thing that I encourage new grads to do is ask why. Some people find this annoying, but there are so many things that experienced nurses do that are like second nature, that they don't even think about or realize they are doing. However, asking them why will give them the opportunity to explain to you, which will help you understand why they are doing what they are doing, which will in turn help you to understand your job better.

Go with the flow and follow what your preceptor teaches you and like previous posters have said, unless it is going to cause harm to the patient or directly goes against your hospitals policy and procedure, just pay attention and change your practice as you see fit when you are on your own.

Good luck with your new nursing job!

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