Sink or Swim/Eat Their Own

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Recall your first year(s) of nursing. Did you feel as if you went through a hazing or cruel initiation? Or--was it a supportive and caring experience with veteran nurses providing encouragement and mentoring?

[K8RN]

Yikes. I'm the only one so far to have a good supportive experience?? No complaints outta this girl for the floor I work on. Us new grads are welcomed with open arms and given awesome support from junior and senior staff alike. Im staying put for awhile. :)

[zambezi, BSN, RN]

K8RN...no you are not the only one. I feel sooo lucky when I read about the negative experiences expressed on this board for all of the good experiences that I have had. I had a great time! My orientation was not always easy, nor always good, but I made it fun and I was always learning. I oriented on my current floor as a student for six months, then did a month on days and two months on nights. Of course, there were some preceptors that I liked better than others, but I think that it was more of a personality thing that an "eat their own" type of thing. As a nurse for about a year, those that I didn't really click with then it is the same now. We are professional and nice to one another but just have different ideas in our heads about attitudes, how we want to do things. Unfortunealty, there really are mean people out there, people that are grumpy, burned out, don't want to be preceptors and are "forced" to...this is not an enviornment that one should be learning in. Find a preceptor and environment that works for you. Someone that will teach you what you need to learn, be a good resource, be nice, and offer constructive criticism. As newer nurses, students, new grads, we need to be able to take constructive "criticism" (RESPECTFULLY given with the intent of the preceptee learning not being knocked down) when our preceptor offers new ways of thinking and doing. Make the experience something that you can take knowledge away from. Even if you wouldn't do it that way...as long as the information you are getting is accurate and per policy and procedure. Sometimes the only thing you might take away is that "I don't want to be like that" ( however if this is how you feel, I would seriously look into a different preceptor because you are not learning what you need to). Advocate for yourself- it is your learning experience. Jump in a do things. If you feel that you are being "eaten" talk with your preceptor first, mabye you are not on the same page. Talk with you nurse manager, see if you can precept with another person. We do not always get along...but everyone has the right to be respected, to feel valued, and to learn. Just my two cents. :kiss

[EricTAMUCC-BSN, BSN, RN]

Found this while surfing the AACN web site.

Viewpoint: Apply Your Expertise as a Tour Guide for Novice Nurses

Fontaine

Hanson

Critical care has typically attracted young nurses in the past. However, with only 10% of all nurses today younger than 30, the specialty is being disproportionately affected. How novice nurses are nurtured can make a difference.

AACN is committed to creating environments where novice ICU nurses feel safe, can learn and still make their optimal contributions. Partnering with educational institutions to produce more qualified new graduates is an important collaboration that must take place. As AACN members and experienced critical care nurses, we individually and collectively have great potential. Together, we can help to change the stereotype where critical care nurses "eat their young" into one in which critical care nurses nurture and support their newest colleagues.

We asked board members M. Dave Hanson, RN, BSN, CCRN, EMT-P, and Dorrie Fontaine, RN, DNSc, FAAN, to discuss this issue from their unique perspectives. Hanson is a nurse educator for the Surgical, Trauma, Neurology & Transplant Services at Baylor University Medical Center, Dallas, Texas, and Fontaine is associate dean of the School of Nursing at the University of California-San Francisco.

Patti's story

While attending nursing school, Patti worked part time as a nurse technician in the 12-bed medical-surgical ICU. After graduating with a bachelor of science in nursing, she knew she wanted to be a critical care nurse. However, she lacked the formal education and training required by many of the ICUs. So, she found a hospital that provided an internship program for critical care nurses, which would help to prepare her for this new and challenging role. During the internship program, Patti was matched with a unit-based clinical preceptor who helped to teach, nurture and support what was being taught in the classroom. Patti successfully completed the 10-week internship program and was assigned to the night shift, where she connected with a special person who would continue the coaching and mentoring process. Now, 12 years later, Patti still enjoys her work as a staff nurse in the ICU.

Patti's story represents the successful journey of an ICU nurse from novice to experienced practitioner. It is an example of what can happen when experienced nurses create opportunities for novice nurses to succeed in the critical care setting. However, it is equally important to remember that, without the appropriate support systems, being a novice ICU nurse can potentially lead to feelings of inadequacy, helplessness and frustration.

Clinical perspective

Hanson: As a nurse educator at Baylor University Medical Center, Dallas, Texas, I help to educate novice ICU nurses and provide them with the tools they will need to move along the continuum to expert status. I've seen the results when experienced nurses commit to helping novice nurses transition into the critical care setting. Unfortunately, I've also witnessed as novice nurses with excellent ICU potential have simply left because there was no support system. Following are just a few of the ways that experienced ICU practitioners can help novice nurses to succeed.

* ICU nurse internship programs are valuable because they provide the educational experience to help link clinical and classroom instruction. Clinical experts who support the development of competent and proficient practitioners generally guide the internship content. It is important to recognize that "on-the-job training" is not considered an internship program.

* Preceptors should possess sound clinical experience and a strong desire to share their knowledge. The preceptor plays a vital role because he or she helps the novice nurse to integrate the acquired knowledge and skills. The relationship between novice nurse and preceptor should ideally be a one-to-one arrangement. The preceptor can have a positive influence by being a teacher, resource person and role model.

* The mentor--a different role from the preceptor--challenges and supports the novice ICU nurse to achieve higher levels of performance. The focus of the mentoring process is to promote professional and personal growth of the novice nurse. However, it is important to acknowledge that there are only three letters between mentor and tormentor. Patti described her mentor as that "person who helped in the process of professional socialization and who first encouraged her to network in the local AACN chapter."

* An emotionally intelligent critical care setting allows the novice nurse to feel proud of his or her accomplishments. It is also a place where novice nurses do not feel inadequate, frustrated and unappreciated. Whether novice or expert, each of us has something of value to bring to patient care. The next time you begin to hear your peers talk about perceived deficiencies of a novice nurse, we encourage you to "to take the high road," use your bold voices and begin helping to build realistic expectations among the staff.

There are many obstacles today that novice nurses must face. Whether we started out in the ICU as a new graduate or first sought some medical-surgical experience prior to coming to the critical care unit, we succeeded because there was something or someone (internship, preceptor or mentor) helping to make the journey easier. I'm sure that each of us can remember what it was like, as a novice ICU nurse, to feel overwhelmed and inadequate. However, just because some of us had to "learn the hard way" does not mean that the novice nurse of today must face that same difficult experience.

Our challenge as experienced critical care nurses is to identify the best in ourselves and commit to sharing it with novice nurses. While some of us might be better teachers, educators or preceptors, others are better suited for the informal yet highly important mentoring relationship. In the words of Leo Buscaglia in his book Born for Love:

The majority of us lead quiet, unheralded lives as we pass through this world. There will most likely be no ticker-tape parades for us, no monuments created in our honor. But that does not lessen our impact upon the world, for there are scores of people waiting for someone just like us to come along; people who will appreciate our compassion, our encouragement, who will need our unique talents. Someone who will live a happier life merely because we took the time to share what we had to give. Too often we underestimate the power of a touch, a smile, a kind word, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.

Academic perspective

Fontaine: As a nursing educator in a baccalaureate program, I have watched with pride as an increasing number of new graduates choose critical care as their first position after graduation. Although some may be influenced by growing up with the television show "ER," I believe their choice also comes from the 15-week clinical practicum experience in their senior year, when they spend 16 hours per week in a precepted clinical of their choice at schools like Georgetown University in Washington, D.C. The students receive both classroom and clinical instruction, with a focus on critical care knowledge and skills. Students are expected to join AACN during their senior year, when the curriculum content is patients with complex problems. The journals they receive with their membership--Critical Care Nurse and the American Journal of Critical Care--assist them in writing papers and care plans, as well as passing exams and studying for NCLEX.

The critical care units of today need our new graduates, and we owe it to the hospitals to produce students who are ready, willing and able to hit the ground running. Increasing numbers of BSN programs are adding critical care electives for this reason. The future will include ideas like pre-CCRN certification courses for undergraduates so that, once the new nurse has the requisite year of experience, the journey of studying and passing the CCRN exam is a reality. AACN has the resources and tools to assist faculty and students with teaching and learning critical care content.

http://www.aacn.org/AACN/aacnnews.nsf/GetArticle/ArticleThree196?OpenDocument#view

[nyapa, RN]

the senior staff member and the staff attracted to the ward. An orthopaedic ward I worked on definitely "ate its own staff" apart from a few shining examples. The current medical ward I am on consist of the opposite combination...a huge majority of supportive staff. Any who love to "rip into ppl" seem not to survive.

[Agnus]

I only stayed

[BRANDY LPN]

How funny, At my first job I was supposed to have 6 weeks of initiation and 3 days in the DON said to me well theres noone here to work with you today so I guess you will "sink or swim" her ecact words lol. stayed 3 months.

[nursebedlam]

was like sink or swim, l swam

[tmoorelpn]

It seems like my hazing came with doing clinicals in school at the hospital. That was horrible experience and not very conducive to learning. We were treated like we were the scum of the earth and time was NEVER taken to explain anything to us or to show us anything useful. We were made to feel like we were in the way, that we weren't worthy of their time since we were LPN students. I was told on more than one occassion, "well, since you're just a LPN.....".

When I started my first job at a LTC facility, I was scared to death that I would run into the same attitude but I didn't. I was welcomed with open arms, I feel free to ask questions, I'm included in conversations and nurses actually associate with me. The RNs aren't embarrassed to be speaking with a LPN, it's just completely different. They ask for my opinion on things and it's just been a very pleasant experience.

Recall your first year(s) of nursing. Did you feel as if you went through a hazing or cruel initiation? Or--was it a supportive and caring experience with veteran nurses providing encouragement and mentoring?

[kimmicoobug]

I think it is a mixture of both. There are definitely some nurses that I avoid at all costs just because of how they treated me when I was first hired. I have also learned who to go to when I have questions.

[PedsNurse1981]

Why do some nurses have to be so darn mean??? Granted, I've only been out of school for a little over a year and a half so I haven't seen much, but I've seen enough to know some of my coworkers are down right spiteful! Geez! I've been around a new nurse or two that had no brain and made stupid mistakes like hanging blood 10 hours after it was ordered, FFP on a kid in DIC 6 hours late, no ordered antibiotics on a septic kid, etc, but it takes a real idiot to do those things! I try to show everyone the same respect I wish to be shown. What are those of us who are newer supposed to do, stand up and yell, "Hey b***h, I'm not going to take your s**t anymore. Get over yourself, there's nothing wrong with the way I'm doing this. Just because I do it different than you do doesn't mean it's wrong." Sometimes I hate my job because of the people I work with.

[SCRN1]

When I was a new nurse and began working as an RN, I had only good experiences from the other nurses. After taking a couple of years off work to do things with my family, then going back to work on a different type floor and at another hospital (where I still am), again, I was given a lot of support from the other nurses. While in nursing school & doing clinicals at different hospitals, I felt a lot of support from nurses there also. But, there were some who gave the impression that they felt we were in the way.

Because of my experiences as a new nurse or new to a floor, I have vowed to always try to show as much support and friendliness to all new nurses or students.