The *EXPERT* Beginner

[Kelly_the_Great]

Is anybody else sick to death of new nurses acting like they are somehow experts all the sudden because they passed a state board exam?

When I passed mine both times (LVN & RN), I felt like I knew enough to practice safely and now had a license to learn.

The further I continue in my career, the more I feel I am learning. Yet, somehow these folks just got out of school and they are the experts on charting, assessment, etc. but don't know their meds or skills??

[morte, LPN, LVN]

Any of the COB club remember the "Look it up Club" from jr hs? I think that is were I heard/read the "the more you know, the more you know you don't know", and it was visualized with an enlarging circle, inside was what you knew, the outside what you didn't, the ever increasing circumference pointing out the "as yet unknown".

[sjbrk]

This post is interesting to me, as a soon-to-be new grad (May!). I am, generally speaking, a fairly cocky little bugger. I am confident. I am not obnoxious about it, but I have confidence in myself and my knowledge. Or so I thought. Did my preceptorship in January and learned (HOLY SMOKES DID I LEARN) how much I don't actually know. And my preceptor got on me constantly to be more confident, or the nurses and docs "will eat you alive."

That put me in a dilemma, seriously. Be confident when I was not certain of what I was doing? eh? I'm confident when I know what I'm doing, or talking about, etc, but how on earth am I supposed to be confident and still not come off as thinking I know it all, when in reality, I know that I don't know it all?

The best I came up with is to confidently admit when I don't know. To say "You know, I am not sure. I think this ___ but what do you think?" I hope that works, because, really? All I want to do is learn and be the best.

[malestunurse]

nursej22 said:

I saw another new grad put a patient into a critical condition because she started 5 liters of fluid at once in 5 different IV sites that she took great pride in placing. Her comment was that "nurses eat their young".

WOW!, her critical thinking really should have fired off before starting all that fluid though and talked to someone about it first. I hope I don't ever become that complacent that I don't ask my colleagues for advice when things seem a little strange.

[ChristineN, BSN, RN]

I work in the ER and I see this sometimes with the new grads we hire. Since ER is NOTHING like nursing school, the learning curve is steep, and if you are super confident and act like you know everything it can make for a dangerous combination.

[tigerRN2013]

Depends on the new grad- you can't really generalize all of them into being "beginner experts". I know I was scared to death as a new grad when I started working; another new grad who started 6 months later was cautioned by her preceptor for being a know-it-all

[OhioCCRN, MSN, NP]

I've got one:

My preceptee (8 weeks in ) who thought it was great use of critical thinking to run 3 bags of K (60meq) at the same time because the pt had a triple lumen.....

Lets just say i'm glad Im OCD and double check everything.

She didn't even seem ruffled when I asked her what the heck she was thinking.... seemed to think i was being unfair when I said she was unsafe w/ medication.....

[Student Mom to Three]

I am a mere two years in and still often make a list of things I hear throughout the day that are a mystery to me. Then I can be sure and ask someone or do some research on my own. I have also had the opportunity to help mentor a couple of new grads and they were anything but arrogant. They were actually very apologetic about having to ask questions.

Wasn't anybody else told in nursing school to "Fake it until you make it"? I heard that a lot. Maybe that is where some of this perceived arrogance is coming from????

[jjones0812]

I graduated in May 2013 and have yet to find a nursing position. I feel totally lost at this point and look forward to being mentored by experienced nurses in the future. My fear is that I will be treated poorly (if I ever find a job) because I only have clinical experience. I am not one to pretend to know things when I don't. I have heard some great stories of fellow grads feeling totally supported during their training period and I've heard some negative ones. New grads/students that think or pretend to know everything are a danger to patients. I was told to 'fake it til you make it'. That means to fake confidence in your skills but not to the point of arrogance. I say keep an open mind, trust your gut and ask lots of questions.

[SleeepyRN]

Quote

There's a difference between "weakness" and "not knowing everything." If I tell you to not show weakness, I basically mean, don't fall down into a puddle of tears because you get some criticism. Asking questions (reasonable ones that you've put some thought into) is perfectly fine.

I agree there is a difference, but there are others that don't see a difference. I personally will always ask, no matter how stupid it may come across. I'll be asking questions 20 years from now and won't blink an eye if someone else rolls theirs. While I can understand a new grad feeling intimidated and not asking questions, I don't believe they should go on and pretend to know. That's when things get scary. Kind of like I can understand a battered wife shooting her husband, but I find it still wrong. LOL....I watch wayyy too many Dateline shows (murder Media). OK, back to watching Who the Bleep Did I Marry

[SleeepyRN]

\ said:

I graduated in May 2013 and have yet to find a nursing position. I feel totally lost at this point and look forward to being mentored by experienced nurses in the future. My fear is that I will be treated poorly (if I ever find a job) because I only have clinical experience. I am not one to pretend to know things when I don't. I have heard some great stories of fellow grads feeling totally supported during their training period and I've heard some negative ones. New grads/students that think or pretend to know everything are a danger to patients. I was told to 'fake it til you make it'. That means to fake confidence in your skills but not to the point of arrogance. I say keep an open mind trust your gut and ask lots of questions.

I'm only 2 years out of nursing school myself. I have had both great and negative eperiences with coworkers. Some love to teach and take you under their wing. Some just like to be in their own misery and drag everyone down with them. My first nursing job in a SNF, I ended up quitting because of the gossiping about me. My second nursing job, I'll here things like, "can you believe she was still here at 2am?" Now I brush it right off my shoulders. I get along pretty well with everyone, but there are always back stabbers, and we have to realize it is THEIR problem, not ours. While I abhor lateral violence in any way, shape or form, we do not have to take it personally and allow it to affect our emotions about work. When you get that first job, be strong. Gossip may/will happen. Stay away from it. Ask questions, ignore eye rolls. And as you stated, show confidence (in a way thar does not come across as know-it-all) That is challenging for new grads. We have to have a trusting relationship with our patients, so we must act confident. When faced with something new, you can tell a patient, "I've actually never done this before, let me get another nurse to help. That's part of what makes nursing great. Always learning something new." That turns it in to a positive at the end.

[KeepItRealRN, BSN, RN]

Isn't "Expert Beginner" an oxymoron?

[Ruby Vee, BSN]

KeepItRealRN said:

Isn't "Expert Beginner" an oxymoron?

Perhaps, but "Expert" beginner is not.