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.
I have noticed that many seasoned nurses are not up to date with new standards that were taught to us in school.
I'm not sure I understand what makes you think that undergraduate nursing schools are the bastion of "new" standards? Just because it's new to you does not mean it's new in the world of real nursing. New ways to do procedures, new standards of nursing care and the implementation of such START with the bedside nurse, are researched at the bedside by bedside nurses collaborating with upper academia and evaluated by bedside nurses. Then, and only then, does the information percolate down to the nursing schools because it can't be taught until it's proven. So by the time you've learned it, something even newer is likely coming down the pike.
How do you "bridge the gap"? There is no gap to bridge. By remaining open-minded and realizing the fluidity of nursing (great term wondern) you will become a more versatile, knowledgeable nurse and better able to provide the care your patient needs even if it means thinking outside the box.
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.
That's one thing you will always get from All Nurses ... keybord hero's who have their panties in a knot. There is nothing wrong with what your asking and just know that I am a new nurse too and I understand exactly what you're saying. What I plan on doing, finding a balance ... trying to find my own way (of course making sure my patient is safe and according to facility protocol) but also taking advice from experienced nurses. It seems so plain and simple, but as long as you're doing the job correctly, that's all that matters. I think this was an excellent question as a new nurse and for everyone who doesn't agree, it's very simple, if you don't have anything to add, just don't answer. Don't come on the discussion to say "nothing to see here,move on." This crap needs to end ... we are all nurses? We have dedicated our careers to helping and healing, but why can't we treat each other with some type of respect. I have been coming on here less and less because it's so discouraging with all this negativity. Please change my mind.
With regard to OP's ignorance, she started the snarky attitude with the very title of her post then proceeded to follow it up with reference to a more seasoned nurse following a "different protocol that was practiced years ago and not up to date." and this gem "when they had originally started, there was no such thing as an online charting system".
Anyone following this board for any period of time would know that is asking for people to take defensive positions. It's called baiting. As is the annoying practice of using the phrase "nurses eat their young". Which BTW is an extremely dated expression.
Here's a little bit of advice: Don't finish off your post with the question "Any advice?" if your argument to any advice is, I didn't specifically ask that question. As any seasoned nurse will tell you, there is a lot more to communication than the words.
Yeah starting with the "us versus them" title this post was gonna gather some momentum. The problem with momentum is that you don't know what way its gonna go. Also don't ask for advice and get defensive when you get some that you don't like. I have worked in an ER for a long time and the idea of a new nurse showing up and sharing her wisdom because she is "more up to date" is silly and would have horrible results in my opinion. However, its a free country by all means show up and enlighten us on the wonders of academic evidence based practice as preached by a professor from a safe and sanitary classroom & we can do an experiment to see how that educational intervention works out. I personally think its a forgone conclusion but who knows I also thought Trump had no chance
How do you "bridge the gap"? There is no gap to bridge. By remaining open-minded and realizing the fluidity of nursing (great term wondern) you will become a more versatile, knowledgeable nurse and better able to provide the care your patient needs even if it means thinking outside the box.
I misread where you used the words "the fluidity of nursing" as "the futility of nursing!"
Specializes in Peds/outpatient FP,derm,allergy/private duty.
On a related note: please new nurses do not say the seasoned nurse is hopelessly stuck in the past because she learned SOAP charting and not SBAR . You may look that up and you won't see a great deal of difference between the two.
Also, adding several more "rights" to medication administration won't make you safer if you're not already in a patient-safety thinking mode to begin with.
If only nursing school taught and prepared new grads to be proficient and ready to apply comprehensive EBP I would be thrilled. I would welcome a batch of them to come school me and I'd put them right to work at minimal cost to my budget.
I'm a new nurse and going to start orientation soon. My manager told me that I'm going to have a few different preceptors so that I can learn different ways of doing things from the experienced nurses. So my understanding is that it is expected that nurses develop different methods that work for them and I am expected to take these tips and tricks and apply them to my own practice and find my own ways to do things as I gain experience. As far as patient care though, doesn't this stem from hospital protocol and is changing all the time? That would mean everyone working on the unit would be on the same page and there would be no discrepancy between experienced nurses and new nurses because we aren't using what we learned in school (however long ago that was), we are following hospital policy.
I'm a new nurse also so maybe my lack of experience shows, but I couldn't think of a situation in my little experience where there were outdated practices on the floor.
Specializes in Case manager, float pool, and more.
I'm a new nurse and going to start orientation soon. My manager told me that I'm going to have a few different preceptors so that I can learn different ways of doing things from the experienced nurses. So my understanding is that it is expected that nurses develop different methods that work for them and I am expected to take these tips and tricks and apply them to my own practice and find my own ways to do things as I gain experience. As far as patient care though, doesn't this stem from hospital protocol and is changing all the time? That would mean everyone working on the unit would be on the same page and there would be no discrepancy between experienced nurses and new nurses because we aren't using what we learned in school (however long ago that was), we are following hospital policy.
I'm a new nurse also so maybe my lack of experience shows, but I couldn't think of a situation in my little experience where there were outdated practices on the floor.
Yes, things do change indeed. Just adding to what you wrote.Some of us who have been around a bit have seen changes come and go, and some of the time things come back around again. But there are some practices that have stood the test of time too. At my facility, we stay current by attending educational opportunities ( conferences, seminars, and grand rounds ). I also subscribe to nursing magazines, CEU's, and when I get to precept I can sometimes get tips on new trends being taught in schools and hospital skills fairs that at our facility happen annually. I know most of my co-workers do the same. As nurses, we are always learning and growing in one way or another. One of my favorite things is to pass on to others, things I have learned over the years as well.
It is more than just hospital policies though, we need to work within our scope of practice according to our state's BON as well.
Someone mentioned SOAP and SBAR. We use both of those. We still document using the SOAP notes but when we call the physician we use SBAR.
I was going to write a lengthy response full of great advice for a new graduate nurse in your situation, however, no matter how I wrote it, I was pretty condescending.
So I will just say this:
*Be humble.
*2 ears 1 mouth.
*Know your audience: some of those nurses have advanced certifications and have critically looked at the EBP don't believe it to be beneficial to their practice.
I wish you well, being a new grad nurse is a tough row to hoe.
Wuzzie
5,238 Posts
I'm not sure I understand what makes you think that undergraduate nursing schools are the bastion of "new" standards? Just because it's new to you does not mean it's new in the world of real nursing. New ways to do procedures, new standards of nursing care and the implementation of such START with the bedside nurse, are researched at the bedside by bedside nurses collaborating with upper academia and evaluated by bedside nurses. Then, and only then, does the information percolate down to the nursing schools because it can't be taught until it's proven. So by the time you've learned it, something even newer is likely coming down the pike.
How do you "bridge the gap"? There is no gap to bridge. By remaining open-minded and realizing the fluidity of nursing (great term wondern) you will become a more versatile, knowledgeable nurse and better able to provide the care your patient needs even if it means thinking outside the box.