I've noticed alot of threads lately from new nurses who seemed quite stressed out, which I can totally understand, I've been there for sure. So I thought I'd start a thread from the other POV. This shouldn't be an opportunity to be sarcastic or uncharitable, but maybe it can help a new grad to see the other side of the story.
I get nervous by a new nurse who doesn't ask questions. I also will have misgivings about a new nurse who asks a question and then argues with my answer. Also, a new nurse who knows it all makes me nervous.
I get irritated by a cocky new nurse. A little bit of deference and humilty is a good thing. But someone who grovels makes me unsettled. I also get annoyed if a new nurse is too bossy with the pts.
I'm graduating in May and this was really interesting for me to read. I am just the opposite of a know it all. The one thing I'm lacking, according to all my clinical teachers and preceptors, is confidence. I am scared to death(but super excited at the same time) to graduate because I feel as though I don't know enough to do this on my own. I'm glad all of you love answering questions, because I can guarantee I will be the annoying girl that asks 50 million questions for fear of doing something wrong. Nursing is not a job where you can really afford to guess and check and it suprises me that inexperienced new grads are so cocky. ALright, well if around September you're being hounded with questions by a young looking nurse, it will most likely be me :)
Man ... I wished my preceptor was like that. Instead, I was ridiculed for asking questions. I'd always get comments like: didn't they teach you anything in nursing school?
I always do things the way the RN's want it to be done and don't argue. I figure I'll have plenty of time to do things my way when I'm on my own. But ... some of them just want to put you down no matter what.
One time it was an hour before the shift change and I was pretty tired. She had the MAR and I needed to give some morphine. I'd been giving the same dose all day but, I wanted to make sure I was remembering it correctly since I was tired.
Since she had the book ... I casually asked ... this is the dose ... right? Man ... she jumped on me: don't you remember the dose? I said: yeah ... but I'm kinda tired and just want to make sure.
Her response was: You need to develop more stamina!
Ok ... I was just trying to be safe but ... whatever.
After reading many posts here, I have to say that I wasn't pleased with my preceptorship, and now I realize it was even worse than I thought. It was short, inadequate, unorganized (management's fault) and asking questions just brings criticism, rolling eyes, impatient sigh heaving, etc. I am fed up with the place I am working, and I'm outta here just as soon as I get my tuition reimbursement check.
Allot of good answers, however one that I would like to add, which I recall while I was precepting a nurse to our floor (not a new nurse) is to limit your cell phone calls. Nothing worse when you are trying to orient another nurse when she consistently is making calls & receiving calls.
Thanks, to all of you "seasoned" nurses who are telling it like it is. The OP brings up a great thread here - let new nurses know how they are perceived by experienced nurses.
Believe me, (I'm a student), those "know it alls" are just as annoying in clinicals as they are after they start work.
Yes, I totally agree. I don't think they are that common from my own limited experience (never had any no it alls in my clinicals group last semester, and I felt we were all good to ask questions and to be as helpful as possible).
We had one nurse last rotation that came across and stand offish and cranky, but we all had to "just deal." I found every other nurse to be helpful and pleasant, and even "the cranky one" was biddable if you were trying and prepared and gave her a little extra effort. I don't know how common "know it alls" are as students...Now that I think of it, I was assigned to a seasoned tech during a shift, and I wanted to learn of course, but also be useful. She asked me hesitantly if I wanted to empty the trash cans in her hall. I was like, "Yeah, sure, where do the bags go?" and she looked at me and said, "really? You will?" Now thinking back, maybe in her experience she's had people that "were too good" to do that. I might have been blessed with an extremely awesome group.
I've been reading the allnurses.com for a while to know what NOT to do. I don't think I will have a problem.
I'm not new to dialysis (having done it for 5+ years in an outpatient/chronic clinic), but I'm new to a hospital inpatient/acute unit. My preceptor is pretty supportive for the most part, but I don't appreciate it when she corrects me in front of a patient (about something trivial - not an emergency!). I hesitate to even bring this up in private since I don't need an enemy in this setting where everyone has worked for a very long time. So I just try to ignore it (she may not even be aware of it after all).
I just wanted to let you preceptors know to be aware of how - and when - you correct your orientees. Embarrassing them in front of pts or other staff will not help them learn (especially when it's about something that can be correctly done in more than one way, and an orientee who does know something about the specialty )
Here's a solution to the "evil preceptor" problem...
1) Only have people precept who WANT to precept.
2) Train the preceptors.
3) Give them extra $$ for precepting.
4) Give them a bonus for every new nurse who makes it 6 months past orientation.
5) Don't give the preceptor/orientee a ton of patients until they are ready.
Of course, this costs extra money for the hospital, but I would bet that the cost of new nurses quitting after 3 or 4 months would offset the cost of paying the preceptors extra!
Oldiebutgoodie
We do all but #4 where I work. Those are very good ideas.
My manager always asks me if I want an orientee or student, (probably because she knows I'll say yes.) Rencently I precepted a new grad, a student, and a new employee back to back and might have said "no, I need a break and want to work on my own for a few weeks" if there was a 4th one needing orientation. It's always nice to be asked and it's an honor to be chosen to precept someone.
I just want to add my two cents. I myself am a nursing student. I am the type of student that color codes my text books with tabs and high lighters, has alphebetical note cards and I arrange my papers in order. That being said, threads like this really get to me.
I pride myself on knowing whats in the textbooks and being able to recite them verbatum. However that is a BOOK. Real life is very different. It really kills me to see that so many nursing students think that just because they are book savey, also means that they are going to kick ass and take names in the hospital. Yea, some of them might. However, Im sorry to my fellow students but if your instructor says this is how we do it, DO it like they said. Dont argue, dont give them attitude, dont make your constipated face! They are doing it to help TEACH you how its done. You being the STUDENT.
I have had countless times when I was in the hospital and something just wasnt adding up, and I couldnt for the life of me figure it out. Guess who I would go and talk to? My instructor. Its my belief that as much as you know in this field, and in life, you will ALWAYS be a student. Even the instructors are still growing and learning every day. Thats the nature of the "beast." I have no shame and going to ask the other nurses questions because I know they will help me, either through thier own skills and knowledge or finding it out for me by looking it up. The more you ask, the more youll know. And the more youll find yourself not needing to ask so many questions because youll have learned how to do the tasks asked of you.
And yes I have been snapped at. Who cares! I find its best to diffuse a situation with hot coacoa :) People get stressed out very easily some days. If I have 5 minutes where I am all caught up on my work, it never hurt to go out of my way and make someone some hot chocolate or coffee to help them relax for a second and know that someone at least cares. I may be a student and we might be nurses(in trainning) but we are all human beings. Just because someone snaps at you doesn't mean they are going to eat you. 9 times out of 10 that mean comment or hurried phrase is just another way of saying, "Hey I could really use some help." Even small menial things mean alot to people o_O or so I have found.
Oh and for Cookies sake, my fellow students, don't complain about cleaning bed pans and such You're either there to help this patient get better or you're not. I don't know about anyone else but MY nursing program teaches basics of health care first. Bed changing/Bed pans were part of that. Which means its in your scope of practice, so practice
Oh and for Cookies sake, my fellow students, don't complain about cleaning bed pans and such
I don't have problems changing pans - saved me a few items on "patient assessment" check off list [Assess bowel movement, flatus, urine, skin condition]
Here's a solution to the "evil preceptor" problem...
1) Only have people precept who WANT to precept.
2) Train the preceptors.
3) Give them extra $$ for precepting.
4) Give them a bonus for every new nurse who makes it 6 months past orientation.
5) Don't give the preceptor/orientee a ton of patients until they are ready.
Of course, this costs extra money for the hospital, but I would bet that the cost of new nurses quitting after 3 or 4 months would offset the cost of paying the preceptors extra!
Oldiebutgoodie
AWESOME idea! Seriously, this could help with turn over related to bad initial experiences. What do the nurse managers think??
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!
yes, because we all know that any remotely negative feedback is the equivalent of voracious, jaws-like nurse-eating.
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?
Right here is a perfect example:
"My education is newer and evidence-based, as opposed to your outdated, outmoded education. Therefore, I'm just going to go ahead and do what I want to do and ignore you (but I'll be happy to leave you to pick up the pieces if my way doesn't work out after all.")
And actually, there is evidence in favor of using the air-lock method for IM (0.1ml of air--helps to push the med deeply into the IM tissue and also clears the med through the needle). And either injection technique is acceptable.
I'm starting 2nd semester of my first year and while I was fine in the nursing home, I am terrified about starting our med/surg clinicals. I've actually been up all night worrying instead of sleeping and its 3 weeks away!
)
You're either there to help this patient get better or you're not. I don't know about anyone else but MY nursing program teaches basics of health care first. Bed changing/Bed pans were part of that. Which means its in your scope of practice, so practice 
DaBears
3 Posts
I'm graduating in May and this was really interesting for me to read. I am just the opposite of a know it all. The one thing I'm lacking, according to all my clinical teachers and preceptors, is confidence. I am scared to death(but super excited at the same time) to graduate because I feel as though I don't know enough to do this on my own. I'm glad all of you love answering questions, because I can guarantee I will be the annoying girl that asks 50 million questions for fear of doing something wrong. Nursing is not a job where you can really afford to guess and check and it suprises me that inexperienced new grads are so cocky. ALright, well if around September you're being hounded with questions by a young looking nurse, it will most likely be me :)