What makes you nervous about or irritated with a new grad or orientee?

clemmm78, RN · Jan 2, 2007

"I know, I know." Nurses who know everything are, IMO, very dangerous.

We had a RNA like that here for a while. We'd find something she'd done wrong and try (gently!) to explain it to her but she knew, so she said. We'd have a new thing or an unusual situation but she knew what to do, even if she'd never encountered it before.

I've been a nurse for 25 years and there are still things that I don't know. I am the first to say "I don't understand," or "I've never done that before," rather than "I know!"

Ruby Vee, BSN · Jan 2, 2007

i agree with both of you. a new nurse who doesn't ask questions or believe he/she knows everything is downright scarey!

however, i'm wondering how long it will be before you're accused of being hostile to newbies or "eating your young." seems like that's what always happens to threads of this nature!

GardenDove · Jan 2, 2007

Really Ruby? I haven't been here at all nurses long enough to know that. I'm definately not the mean type of nurse, I'm usually quite appreciated by new nurses as being nice and supportive. I really try hard to set people at ease because I know how nervous I am in new environments.

KellNY, RN · Jan 2, 2007

Yep, know-it-all new nurses bug me. When I try to show them something (ie: "They're going to extubate Mr. Smith-why don't you go assist?" or "Mrs. Jenkins is going to have a c/s and btl, why not scrub in and assist or observe?") I get back "No, I saw one last week." or "We did that in clinicals."

WTH? Take each opportunity you can to learn. No one expects you to know everything. Nurses are never done learning. I can say with honesty that I've never seen two identical deliveries. Even now, I still learn something with almost every patient, be it better positioning for comfort...better technique for procedures...different emotional reactions...more words or phrases in Spanish...side effects to meds, etc.

KellNY, RN · Jan 2, 2007

I'd just like to add that as a relatively new nurse, I def. think that there are nurses who eat their young. Why, I'm not sure, but I've never confused them with a nurse who genuinely wanted to teach me.

jasmine4494 · Jan 2, 2007

Give me a new grad who does not suffer from an excess of self esteem. Uncertainty paves the way for teachability. There's a term for cautiousness in the absence of experience; it's called "prudence." With experience comes the ability to discern and to intervene appropriately. Some, through careless, will also learn by experience, much to the detriment of the patients under their care.

How about motivation? Could I also have someone who understands from the beginning that hospital nursing is not a desk job? I know it's important to be able to delegate some tasks, but someone should explain to these prospective nurses (before graduation--so we don't have to) that it will not likely go over well when they attempt to delegate all their most unpleasant tasks for the purpose of spending more time warming a chair.

Conversely, it is incredibly rewarding to share knowledge and experience with new grads who are motivated to learn and to expand their understanding, incorporating what they have learned into their own practice. In my experience, deficits in knowledge, experience or organizational skills are much more easily corrected than disinterest and/ or lack of motivation.

chenoaspirit, ASN, RN · Jan 2, 2007

The ones who are afraid to ask questions for fear it will make them look stupid, then do a procedure even though they dont know how. I would rather be asked a TON of questions rather than have them do it guessing. I dont mind a bit to answer any question. No question is stupid.

UM Review RN, ASN, RN · Jan 2, 2007

New nurses playing with pumps scare me.

I precepted one that was notorious for turning off a beeping pump because she didn't know how to stop it from beeping, then she'd forget to tell me she did it.

This happened with stuff like TPN and Vanco.

New grads often have to realize that we also have a different staffing grid for preceptor/preceptees. Where I'd usually get up to 9 patients with a tech, when I'm precepting, I'll get no tech, just you and me and 12 patients.

I have to check all those charts and double back on any questionable assessments or challenges that any patient may present. I have to do the IVs, the admission assessments, and chart checks for all of them. Then I have to check your charting and in some cases, co-sign.

It's a lot more work, a lot more responsibility, and a heavier patient load, which scares even the best, most helpful preceptor. I've had 3 patients crash simultaneously on this type of plan, and it was pretty horrible, even with help from the other staffers.

So please be aware that if we look extra-stressed, that would be why.

UM Review RN, ASN, RN · Jan 2, 2007

Also....

My personality really clashes with argumentative types. I'll just shut up and let you be wrong rather than argue with you. So if I say, No, that's incorrect, and you start haranguing me and pleading your case, you're apt to get no response.

Please understand this:

That doesn't mean you've persuaded me. It doesn't mean you win. It means that I'm right, you're wrong, and I refuse to argue about it.

atwtrn · Jan 2, 2007

I had something happen in clinicals and I wasn't sure how to handle it. The Nurse had a great deal of experience, but she interfered with my IM injection. First she yelled at me for using the scoop and sweep technique after I drew up the medication. She claimed the needle wouldn’t be sterile? Then she told me to draw back an extra CC of air to “keep the medication in”. Finally she tried to move my hand and make me aspirate with the other (we were taught to use the thumb). I didn’t argue with her. After all, she was signing her name to the chart. I’m just a student.

But, when I talked to my instructor, she told me to ignore the nurse’s “suggestions” and go with the techniques we learned. After all, we were being taught the most up to date ways to perform procedures and the procedures are evidence based.

I'm just wondering how to handle this in future clinicals. What do ya’ll think about that? Any ideas?

navynurse06 · Jan 2, 2007

Even though I’m a relatively new nurse (I’ve been a nurse for a yr), I’ve already had several students and new orientees that I have precepted. However, I have a vast background of clinical experience from working while in nursing school, so I like to educate and pass on the skills and knowledge that I have gain in my short career. Also, in the Navy you are bumped up to “seasoned” nurse on the floor very quickly due to so many people coming and going on the floor. Almost immediately after coming out of orientation we start orientating new corpsman and nurses to our floor (I’m not saying this is a good thing, its just the nature of the beast).

Sorry I got off on a tangent….to address the question….I agree with the OP that I find it very annoying when someone I’m precepting argues with me about the answers to their questions. I’m just like why ask me when you are just going to argue with me! We have one nurse in particular that several staff members have had problems with that does this. I’m not saying that I know all the answers but…stuff that I do day in and day out please don’t argue with me about them!

This being said I love precepting new staff members. I love educating new nurses, because I remember those really good preceptors that I have had. So some day I hope someone can say the same about me.

The day you stop learning in nursing is the day you become dangerous