Seasoned Nurses VS Newbie Nurses

[Alexx_xox]

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?

[SpankedInPittsburgh, DNP, RN]

Babychickens, Brandon and the 36 nurses that supported his post gave you a glimpse of the realities of working on a hospital unit. It wasn't rude it was informative. No blood so no foul. On the other hand take the whole "seasoned nurses versus newbie nurses" on to a unit and you will have rudeness defined if you are lucky. If you have a seasoned nurse that has some empathy for you she might take you aside and tell you to your face that orientation is a really good time to shut your mouth unless it pertains to an issue at hand, learn as much as you can, work hard and try to fit in so skip the newbie advice and nursing school stories. If you are unlucky a nurse will say nothing to you but rather she will go to her friends and talk about the newbie nurse who has all kinds of spiffy advice from her nursing professor. Of course all these nurses will smile to your face but they will begin planning your demise. So if you think your advice about priming IV pumps or whatever is all that important & lifesaving by all means pipe up as soon as you get to where you are going. If you see something that is gonna cause an adverse outcome to a patient in reality please do speak up but for the rest of the stuff wait till you build some relationships with a little mutual respect behind them

[YUKONrn]

True story. 95% of what you need to know to be a good nurse you don't learn in school. You can read something 1,000 times over in a book, or be told about it, but until you experience it IRL, you won't know what's going on. Hell I worked ER/ICU for so long I can tell by the color of somebody's skin if they are having a STEMI while c/o chest pain. 12 lead? Please!

[YUKONrn]

About a month ago a postop pt c/o cp and I was like "He's having a legit stemi." EMS arrived on scene and sure enough he had 0.5 mm of elevation in 2, 3, and AVF. Off to the cath lab he went. Then I finished taking care of my other 39 residents.

[YUKONrn]

If anything advances in medicine have made nursing easier. You have smart pumps that calculate mcg/kg/min for you, we used to have to do it with a calculator. You have balloon pumps that set their own timing, you used to have to use slide bars to set the inflation and deflation based on their cardiac rhythm. Nursing is no longer a challenge to veteran nurses.

[YUKONrn]

All I can say is, be prepared to meet nurses who are smarter than most doctors. Because they have been at the bedside for 12 hours a day, 4 days a week, for 10+ years. My best advice to you is to play stupid. The replies that you're seeing do happen IRL if you think you're hot s**t straight out of nursing school.

[tnbutterfly - Mary, BSN]

Several off-topic and divisive posts removed.

[Alexx_xox]

Well, thank goodness you're there to show all the experienced nurses what they're doing wrong.

... That was so rude. and the fact that 36 people liked your rude comment shows how this field is. OP was being earnest in their search for advice. They even mentioned respect for older nurses. Geez!!! Surely you all felt the same way when you started about some system. Why is it that a new way of doing things is inherently an attack on your practice? Do you remember nursing school?? The professors are drilling these things into our heads; best practice this, QSEN that. It's absolutely maddening. Sometimes I think they are trying to scare us into what modern nursing looks like- how not to get sued. Ok, I'm being dramatic...but some days that's what it feels like, so as new nurses or nursing students we go on the floor and all we see are things our professors practically smacked our hands for when we did them. How dare we prime the IVPB tubing into the trash and not backprime, etc?! I mean, really!! Now there's my rant. :)

Thank you for chiming in and sticking up for me, everyone got super defensive very quickly. I

Luckily, I have thick skin; however, I feel bad for the others that they treat this way who can't handle the negative comments and snarky responses of their colleagues. Honestly it's so sad.

[Ruby Vee, BSN]

To enlighten you a little, I am often very well liked by my peers. I am super respectful, honest and go out of my way for others. I didn't say I had plans on "pointing out" how out of date a nurse may be, that was never my plan. I asked for ADVICE regarding the differences in generations and the care thats provided. I also stated in the post that I absolutely love learning from seasoned nurses and that their experience and knowledge is invaluable. Read the post next time before you come up with a snarky comment, thanks.

You're not going to be well-liked by your new nursing colleagues with that attitude. Please follow your own advice about the snarky comments.

[Ruby Vee, BSN]

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 think you may have overlooked the snarkiness in some of Alexx's posts. Please don't slam "nasty attitudes" unless you're including the snark of the original poster.

[Ruby Vee, BSN]

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.

The OP started the thread with a snarky attitude and entitled it with a very divisive header. Then she was quick to jump on all the posters who didn't tell her exactly what she wanted to hear and snarkily admonished them for their snarkiness. Rather than thanking anyone who took the time and made the effort to respond to her posts, she gushed praise at those who agreed with her and snarked at those who didn't. And now you're wondering why "we can't treat each other with some kind of respect." I suspect that the tone of the thread was set from the start and the poster you ought to be admonishing for failing to respect others is the OP.

But go ahead -- accuse the seasoned nurses of negativity, eating their young, failing to respect a poster who disrespects them and being out of date. We're used to it.

[Ruby Vee, BSN]

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.

Hear, hear!

[Lunah, MSN, RN]

I take that back. One new thing I have seen is these, I don't know what to call them other than an "antibiotic ball". It's actually pretty cool because it's pressurized and doesn't require a pump. You just hook it up to the IV or central line and unclamp it, and it infuses at whatever rate is ordered by the doc. You know when it's done because the ball flattens out.

They're called elastomeric pumps, and they are absolutely brilliant! If anyone reading this has no idea what we're talking about, stop now and Google. This is a great way to get around the eternal pump shortage in every ED I have ever worked in, haha. :)