To the Experienced Nurse

rn/writer, RN · Mar 11, 2010

The Real World nursing class would teach students how to talk to patients and family members. This is a skill that requires some finesse and having a few tricks up your sleeve. Definitely good to learn this before you need it.

Are any of you old enough to remember the Goofus and Gallant cartoons from the Highlights for Children magazine. I used to read the magazine in doctors' waiting rooms. Anyway, they were the "before and after" boys, with Goofus being totally self-centered and doing everything wrong while Gallant was the poster child for good manners and considerate behavior. We could have nurse versions of these boys where Nurse MeeMee hides in the linen closet, is always texting, makes med errors and wears a hot pink bra under her low cut scrub top. And Nurse Pleasant is just the opposite (too boring to write out, but not at all a drag when you need a good right hand).

Any other ideas?

nursemike, ASN, RN · Mar 11, 2010

Beautiful analogy! Up until the point where you asked, do you make yourself scarier. You make yourself scarier to an already floundering new-grad and they go every which-away, except the path you actually want them going.

I'm generally not bothered by the give-and-take on these boards, and my personal tolerance for rudeness and bad language is probably a bit more tolerant than our terms of service (although I do agree a line has to be drawn somewhere, and that being the case, the TOS is probably as good a place as any. )

I do get a bit bugged when someone gets on to vent, and if anyone dares to disagree, they're some kind of heartless ogre. As an example of that sort of thing, this thread is actually pretty mild, but there has been a little of it. Personally, I didn't find the post that started this thread hideously offensive, or even entirely wrong, but I am inclined to concur with those who say you'll see it differently in five years. And, if you think about that, you'd have to be kind of dim not to see things differently in five years, and I haven't seen anything in your posts to suggest you're dim.

As far as the deer-in-headlights analogy, ideally, it should never get to that point. If you throw a puppy into the pond, most puppies will learn to swim, but a significant proportion will drown. If you gradually introduce a puppy to the water and let them get used to it, nearly all will instinctively swim. The same rationale can apply to new nurses, and should. But, to extend that analogy, we're all walking on slippery banks, and sometimes we fall in without being thrown.

Eh, so, enough with the furry critters, although I do regret not having had the chance to work cats into it. The point of the "being scarrier than the headlights," is not that that should be a first resort, or second, or third. I'm just saying I have seen people in the position where they really, really, really need to do something NOW, or they're going down the tubes, and how do you get them to see that?

I'm not talking mainly about situations where a patient is crashing and their newbie nurse is paralyzed. I've been in that position, too, and about the only thing an experienced nurse can do is shove the newbie aside and save the patient. There will be time for bebriefing, later. But I've also been in the position where a problem with my practice was threatening my future, and massive anxiety was keeping me from seeing what to do about it. The instance that comes to mind was in nursing school clinicals, and the first step toward recovery was a kick in the pants by my clinical instructor. I did not enjoy it, and that CI and I have not become bestest buddies, but I do recognize that she was doing her job, and while I give myself a fair amount of credit for figuring out how to solve my problem, if she hadn't gotten me out of my fugue state, I would probably have flunked out. Even if my first step was toward the headlights, at least I was moving, and that's a start.

Discussions like this have a way of getting stuck on extremes: newbies who truly are feckless, old hags who really do eat their young, even my deer-in-headlights. But I do think at least 80% of the time, it isn't that extreme. A lot of times, it's how to persuade someone that they really do need to label a new IV with the placement date and document it in the chart. And that kind of thing can seem pretty picky when you're still celebrating a successful stick, but it needs to be learned, and some of us take more convincing than others.

allnurses Guide · Mar 11, 2010

They do- it's called "Leadership". I have no idea what it is called in other schools

Most schools do have classes that teach those things, they're presented in orientation programs and mandatory "workshops". Most of the time they just can't fix tactless, egocentric, whiny, sarcastic, overbearing people.

But on a related note, I think it is "leadership" that can affect change most in a unit. A good manager in a unit really does set a tone for acceptable behavior. I've had managers or preceptors that sounded brusque to other people, but in reality they had our backs when the going got tough, and that blunt five word directive teaching something you must know will be recalled far more easily than a long talk full of "I messages" thought out ahead of time in an effort to avoid hurting somebody's feelings.

ok2bme · Mar 11, 2010

i'm really sorry for you that you keep encountering all these mean, nasty people. i can't imagine how you've managed to run into so many awful people, because i just don't see them out there. but perhaps you're just so perfect they're all jealous of you. it couldn't possibly be that you're seeing mean people because you're just a tad bit negative.

maybe you rarely see mean, nasty people in nursing because..like you said..mean is relative. perhaps you are one of those nurses so to you such behavior appears normal and neutral. stating that the op will likely be "embarrassed" reading her post in a few years epitomizes the catty, nasty, "nurses eat their young" culture. better you than me. *wine

ok2bme · Mar 11, 2010

Very interesting posts, gives me a little insight and feel for the experiences to come. I respect you all for your work. Our son is fighting AML (cancer), and I get to see what you great nurses are doing for him. You really do make a world of difference, and just like the nurses currently taking care of him now, I thank you.
I am looking forward in learning from you

Sending positive thoughts and best wishes to you and your son. Posts like these remind me that amongst all the drama..us nurses young and old share a common goal. :nurse:

trudlebug · Mar 13, 2010

:uhoh3:

It's at this point that I invariably ask the person who brings it up to define "compassion" without looking it up first. I'm always interested in knowing what people think compassion is and what compassionate action should entail, and then I want to know how they think it should manifest in a nurse's behavior.
Most people really don't have any idea of what compassion is and how it operates in the realm of functional human interaction. The image of compassion that most have is actually outrageously dysfunctional, and the picture of compassionate nursing behavior leads right back to the traditional silent, servile handmaiden. People also make this mistake with the definition of empathy, as though it should mean the listener should have no conflicting opinions of his or her own or advice to share. Often, it is for these people that interactions are the most skewed, for whom "compassion" seems only to apply to how he or she is being treated immediately by a particular person at a particular moment. For them, compassion happens when we tell them they are right about everything no matter how wrong it looks. When we fail to do that, we are cold, unfeeling hags who "don't remember what it's like..." blah blah blah.

com-pas-sion

/kəmˈpæʃən/ Show Spelled[kuhm-pash-uhn] Show IPA

–noun 1. a feeling of deep sympathy and sorrow for another who is stricken by misfortune, accompanied by a strong desire to alleviate the suffering.

em-pa-thy

/ˈɛmpəθi/ Show Spelled[em-puh-thee] Show IPA

–noun 1. the intellectual identification with or vicarious experiencing of the feelings, thoughts, or attitudes of another.

as an individual:

While I agree, compassion is a good quality, instead of compassion from my nurse, I would rather my nurse have the SKILLS to "alleviate the suffering" more than just the desire......I really don't care if they FEEL sympathy or sorrow as long as I am cared for with dignity and respect.

as a nurse:

I want to be the one who can alleviate the suffering, while presenting respectful, helpful and friendly support for each patient I have. (golden rule applies here)

in reality:

"We all try to be peaches, the problem is, not everyone likes peaches" - quote from a boss I had while working retail....

trudlebug · Mar 13, 2010

. What some new grads fail to realize is you don't know what you don't know.

italics are mine....

I remember saying the same thing when I started my new job. I told my manager exactly "I don't know what I don't know"!

Then comes the Ahhh...moment: now I "know" what I don't know....that's when the learning really starts

FlyingScot, RN · Mar 13, 2010

:uhoh3:in reality:
"We all try to be peaches, the problem is, not everyone likes peaches" - quote from a boss I had while working retail....

Love it!!!!!

angel_bear_4670 · Mar 22, 2010

There are some nurses out there who are awesome in their knowledge and love to share and help the students grow. They can't do enough to help their students, and encourage them to learn more and become the best nurse they could possibly be.

Some students suck up the knowledge, wanting more and more. Some students need some reminding, others need a lot of reminding, some shouldn't have chosen nursing in the beginning.

Some trained nurses shouldn't be preceptors, and sadly, some should go look at another profession because nursing clearly isn't in their's or their patients best interests.

It goes both ways (is what I'm trying to get at) I know good and bad, both in RN's, EEN's and students. We're all individuals therefore our approach is always slightly different.

But seriously .. having seen an RN screaming at a brand new 2nd year ... well now c'mon .. in this day and age .. it's just simply unprofessional and unacceptable.