To recommend or not to recommend?

[CNL2B]

Recently was told in confidence by a co-worker that my NM refused to write a brand new (less than 2 months off orientation) ICU nurse in our unit a recommendation for a CRNA program and she was HOPPING MAD, making statements like "My b#$%^ of a nurse manager", etc. etc. This particular nurse is 24 years old and in no way has mastered ICU practice in her two months (from my humble observation, and everyone elses.) I think it makes sense that she didn't write her a recommendation -- how do you do that when you know this person is a novice ICU RN? FYI my NM is not a b@#%(. She is one of the best and fairest bosses I have ever had.

Said nurse is very book smart, but she has a bad work ethic from what I've seen. She wants the sickest patients -- not unusual from a new nurse wanting to jump right into ICU, but she really expects us all to back her up (and basically do 75% of her work while she observes and charts) -- and we do, for the patient's sake. In her two months, she has been out sick for an extended period of time (2 weeks) once already (a shoulder injury outside of work -- couldn't lift), and she has expected us (her coworkers) to accommodate her when she has had to go to urgent care TWICE at the end of her shift in the last 6 weeks for non-work related health problems (once, a bad rash, the other time, to get an epi pen because she was going out of town the following week. So really, we are supposed to cover your leaving 45 minutes early when you could do that on your next day off?) We all know that s#$% happens, but this is getting ridiculous.

I got a feeling we have a bad egg here. Anybody else know someone like this they work with? What did you do?

[leslie :-D]

did she ask you to write a letter of recommendation?

if so, is the crna program looking for experienced icu nurses?

(i'm wondering what specific criteria they want to know about candidates.)

my initial reaction is to not write this letter.

her work ethic is questionable, as is her attendance.

she certainly does not have experience, and the dept has invested big $$ to train her.

it sounds like she may have an entitled attitude, and as far as i'm concerned, no one owes her a darned thing.

after further thought, no way would i write this letter.

just try and decline in a sensitive but firm manner.

much luck to you.:)

leslie

[CNL2B]

No, she didn't ask me -- she asked my boss, but I'm sure that this is going to get around to my coworkers (not from me....I didn't spill the beans in the first place.)

All CRNA programs that I have seen want 1 year of recent ICU experience. She may have that by the time she got into one, depending on how far the application date was from the program start date, but I get the reservations with wanting to recommend when you have only observed someone for two months.

She is very entitled. I was going to mention that in my first post but I was afraid someone was just going to tell me I'm an old bat that has it in for the new girl. It seems like more and more of the younger nurses we hire (read, 25 or less) are like this --know it all, I'm too good for this job type. (Now I really AM going to get flamed from the 25 and under set.) I don't know if this is just at my job or if there are some generational differences here I just don't get. I was always one of those people that had to work my patootie off for every single thing I had -- I didn't grow up underprivileged, but my family was working class to the bone, and couldn't help me at all when I got out on my own. It seems like this new crop of grads we have always have had everything paid for and they just expect it.

Maybe that's the core of my post ... just misunderstanding of where this girl comes from. IDK.

[netglow, ASN, RN]

A fair amount of nurses who go into ICU these days view ICU time as "doing time" just for entry to CRNA programs. She is just trying to "phone it in" till she gets into some program. Unfortunately it really isn't her fault. The people who made up the prereqs for CRNA are to blame. What a huge mistake, huh.

Your manager should let it get out there that your unit is not a springboard to CRNA.

[P_RN, ADN, RN]

Don't most CRNA programs require AT LEAST 2 years of critical care experience?

[Divergirl]

You must have at least one year of ICU experience in order to be admitted to CRNA school. Kudos to your manager for not writing her a letter of recommendation. I've interviewed candidates for CRNA school and its nice to see a manager who doesn't just pass someone through.

[Divergirl]

A fair amount of nurses who go into ICU these days view ICU time as "doing time" just for entry to CRNA programs. She is just trying to "phone it in" till she gets into some program. Unfortunately it really isn't her fault. The people who made up the prereqs for CRNA are to blame. What a huge mistake, huh.

Your manager should let it get out there that your unit is not a springboard to CRNA.

What's wrong with someone who wants to go on to CRNA school?? ICU is the best place to gain the experience someone needs to become a good CRNA. I've noticed, when someone makes it known they want to go on and obtain further education, their co-workers become hostile.

[Jules A, MSN]

What's wrong with someone who wants to go on to CRNA school?? ICU is the best place to gain the experience someone needs to become a good CRNA. I've noticed, when someone makes it known they want to go on and obtain further education, their co-workers become hostile.

It sounds more to me as if it is this particular nurse's lack of insight rather than the fact that she is a new nurse with goals for further education. FWIW my unit, although not ICU, is very supportive of people who are continuing with their studies.

[twois]

I get so tired of hearing that kind of talk from people. I had one fantastic professor in my NS prereqs who was extremely selective in who she wrote letters for and gained the ire of several students who hadn't put much effort into her class but expected a glowing letter for their B- efforts.

It's a letter of recommendation, not a confirmation of attendance. Receiving one from someone should be an honor, not a right.

[netglow, ASN, RN]

I personally know of 3 who actually told me they have no interest in nursing and just want to get "the necessary evils" done so they can get to that money. I have told them that they have decided on a dangerous path IMHO. They freely admit to seekin NG ICU only for that reason and have no intention of giving ICU the attention it needs. This is scary.

[llg, PhD, RN]

I get so tired of hearing that kind of talk from people. I had one fantastic professor in my NS prereqs who was extremely selective in who she wrote letters for and gained the ire of several students who hadn't put much effort into her class but expected a glowing letter for their B- efforts.

It's a letter of recommendation, not a confirmation of attendance. Receiving one from someone should be an honor, not a right.

Exactly. I was recently asked by a former student to write a letter of recomendation for her. She was in the bottom third of the class as far as her performance was concerned. I declined and tried to explain to her that she should ask someone who had taught a course that she had done well in. She didn't seem to get it.

[TigerGalLE, BSN, RN]

I can imagine that ICU managers really struggle with this issue. Turn over rates are high in our ICUs because of this very reason. This is bad for the budget. Fortunately, most of the nurse I know that are in ICU with plans to go on to CRNA school are good nurses. I think the sense of entitlement issue depends on how you were raised. I'm 25 but I've been working since I was 15. My parents were not poor by any means, but they grew up poor. So they taught me to work for what I wanted, just like they did. My parents worked hard to get where they are. They passed on those same ethics to me.

Our ICUs are hesitant to hire new grads that just want to get the pre-reqs to CRNA school.

I don't blame the manager one bit.