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 really become quite nervous around new grads who will NOT ask for help until a situation escalates into an emergency. I spend a lot of time watching certain grads because they have way too much confidence in themselves and not enough knowledge to back up their actions. I also have no patience with tears and tantrums. One of our new grads got 2 weeks off because she was stressed out. She pitched a fit at the DON and got that time off because " we don't want the grads to leave because they are stressed"...well alrighty then. Does that apply to any of the more seasoned nurses who have become stressed because the grads told them " you had better watch yourself, I was told I could write you up if I don't like your attitude "...my days of precepting are over...I have always tried to teach the new nurses what they need,with patience, kindness and understanding that we are not born with the knowledge or skills necessary to be a nurse. This latest crowd has cremated whatever iota of excitement to teach them I ever had. Patence and a sincere desire to help them learn is not enough anymore...I will not pucker to anyone's behind. I shall continue to be helpful to anyone but I WILL NOT PUCKER UP TO THE NEW RUMPS IN TOWN !!!
I think most new grads know they are clueless, anyway, the ones I know think that way. I am distressed over the negativity toward new people in nursing in general, and in this thread.
From another perspective (that of nursing clinical instructor) it has been my experience that nurses have unrealistic expectations of students at times. The program I teach with is always struggling to find enough clinical spots and what has happened is the students are often getting only 1 12 hour day a week for their clinical rotations rather than 2 6 hour ones. We all know that that greatly cuts down on the stuff they are exposed to. In acute medicine our students only get a total of 10 shifts. Some of them have to do 5 of these in a pediatric setting. Could you imagine having a 5 shift exposure to adult internal medicine and then ONE YEAR LATER (after going through palliative and psych rotations) you show up to start your senior practicum? Of course they will be weak.
I think the reason they often have what we call "grad-itis" and that know-it-all attitude is they are on the defensive and they often have more current knowledge and have just reviewed procedures manuals while nurses are doing things by memory from years gone by and may actually be doing something that is not technically correct. It is very tempting when you have always felt like you know nothing to jump all over another person's error to make yourself feel bigger. I give a speech to all my groups about this type of behaviour. Team player..If you are not part of the solution you are part of the problem..yada yada yada. I discourage this attitude but have seen other instructors encourage it by also criticizing the practice of nurses on various units as substandard, etc. So if you have a student that came out of this climate I would not be surprised by a continued critical attitude toward senior staff.
We all have to take personal responsibility for the way we act. Student, instructor and nurse alike.
I myself am a fairly new nurse (grad last May). I could not imagine acting as if I knew what I was doing. I sometimes feel bad at how many questions I ask or I feel like I am annoying some of the other nurses as I know we are all busy. But at the same time, I would rather ask and possibly "annoy" someone, then make a mistake or overlook something I am unsure of. I sometimes feel like I am not cut out for the hospital because I feel like I will never be sure of myself. But I have had more experienced nurses say the same as most of you, they would be much more worried if you didn't ask questions. Quite frankly I wish I could get more constructive criticism, but when you are off orientation, it is hard for anyone to be watching me to tell me if there are things I could improve on. Nursing is for sure like no other job I have ever had!
I would agree that a new nurse who asks a question and then argues with you would become hard to take. When someone does this to me when I'm teaching them something about riding a horse, I shut down and let the wheels fall off, until they come back with some humility, unfortunately that can't always happen with nurses because it will cause harm or risk the patient somehow.
That being said, I think sometimes a preceptor needs to recognize the reason why a student/preceptee might not ask questions is that they are so overwhelmed that they don't know what to ask. Or, perhaps that isn't their learning style, maybe they learn by observation and repetitive doing of whatever task it is that you are trying to teach them. Not everyone is an auditory learner, and not everyone learns by reading a book/looking it up. Some of us just have to learn by repetitive practical application of the knowledge and/or skill. I think that preceptors need to learn to teach, as some who take it on really shouldn't, due to their own lack of confidence, nervousness and self esteem issues. If the student isn't "up to snuff" they somehow think it reflects on them.
I had a preceptor in the OR who screamed at me (literally) because she felt that I hadn't prepared enough for a TAH (hysterectomy). I was so overwhelmed during the procedure it was all I could do to focus on the surgeon, meanwhile she was whispering to me what to do differently and that was just breaking my focus. The surgeon told her to be quiet, and after the procedure was over chastised her for putting me in that position and not taking over when things proved to be more difficult than anticipated. She started crying, and then after our 1400 lunch break, she took me aside and stripped me down telling me it was my fault for not preparing (I had). She started crying again and then stated "how do you think it made me feel being yelled at by the surgeon, when I was clinician for 10 years in gyney?", which tells me the whole thing had WAY too much to do with her ego and very little to do with my education.
I tried to explain my learning style, kinesthetic, and tried to help her by telling her what I needed in order to learn better. She was just a nut bar, and never did try to see things from my angle.
I've also worked with a few nurses who were calm, confident and kind who gave me time to understand and practice and made sure I had ample opportunity to repeat a task over and over until I got it. They were few and far between however. Most were either teachers who got out of active care for the same reason that I am considering it, or nurses who didn't join the status quo and hate all newbies.
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.
I can identify with your comment. I had such a bad experience as a new RN three years ago, that I left hospital nursing permanently. I would never treat anyone as badly as I was treated, I was literally harassed and the only solution that I was given by the CEO was to transfer to another floor or return to the harassment. Nothing was done to the manager(s) and the group creating the problem. And this was at a magnet hospital. Thank goodness there is a variety in nursing fields.
When I was a new grad, I had good support from my co-workers. But I did have one problem: it took a few months to realize that I wasn't a student any more, and there wasn't always time to take a pt to a proceedure/exam and then stay and see what they were doing to "learn" about it. If finally dawned on me that I needed to get the work done first!
A nurse once told me while I was still in school, "when you graduate you will find out how much you don't know". He was so right. Don't be afraid to ask questions. The know-it-alls are the most scarey! I especially see this in the ER with students. They don't need to start another IV because they started one yesterday. Guess what!!! Each start is different and you learn every day. When you think you know it all look out!!!
Ah, yes, I DO remember! :) The preceptor I had was so good - she praised me for doing the smallest things properly - she was a very laid back, very knowledgeable person, and I still remember how dumb I must have been about some things. When I first went to school, we didn't have IV pumps, so mastering them seemed SO difficult - now I couldn't count a drip to save my life.
As an orientee almost 2 years ago, looking back I am so grateful for the patience, long suffering, and kindness shown to me by my preceptors...wow, they really were great!
I was such a poor new nurse that my department head decided it would be best to extend my tour of duty under the tutelage of an awsome nurse who to this day remains one of my heroes on my unit.
I have learned from my kind treatment as an orientee to treat students, aspiring nurse aides with kindness and consider them for little teaching moments...this is one way I show others what a super job my hospital did orienting me :+):paw: :paw: :paw:
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
quite frankly i wish i could get more constructive criticism, but when you are off orientation, it is hard for anyone to be watching me to tell me if there are things i could improve on. nursing is for sure like no other job i have ever had!
quite frankly, many of us have been put off giving constructive criticism by the attitude of those we are trying to help. when you try to help someone with a gap you've noticed in their knowlege base or an area in their skills that is weak and they lash out at you for trying to help, you think twice about trying to help again. i pointed out an error in the way a new grad was totally her i & o's a few years ago, and she went off on me. i thought i was being calm, reasonable and focused on the is & os, not on her mistake. she told me that she was off orientation now, and i needed to butt out. the next day, the head nurse called me into her office to discuss "why you made wendy cry."
another time, i was trying to help a new grad figure out why his pumps kept beeping. turns out, he had heparin and lasix trips infusing through the same line, and they'd precipitated, clogging the line. i explained why they can't go together and helped him change the tubings. later, i overheard him on the phone telling his so that "this old witch just won't leave me alone. she jumped all over my case because my pumps were beeping. why can't she just worry about her own assignment and let me figure my own out!" when this sort of thing happens over and over, you get out of the habit of wanting to help!
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greysage
8 Posts
I really become quite nervous around new grads who will NOT ask for help until a situation escalates into an emergency. I spend a lot of time watching certain grads because they have way too much confidence in themselves and not enough knowledge to back up their actions. I also have no patience with tears and tantrums. One of our new grads got 2 weeks off because she was stressed out. She pitched a fit at the DON and got that time off because " we don't want the grads to leave because they are stressed"...well alrighty then. Does that apply to any of the more seasoned nurses who have become stressed because the grads told them " you had better watch yourself, I was told I could write you up if I don't like your attitude "...my days of precepting are over...I have always tried to teach the new nurses what they need,with patience, kindness and understanding that we are not born with the knowledge or skills necessary to be a nurse. This latest crowd has cremated whatever iota of excitement to teach them I ever had. Patence and a sincere desire to help them learn is not enough anymore...I will not pucker to anyone's behind. I shall continue to be helpful to anyone but I WILL NOT PUCKER UP TO THE NEW RUMPS IN TOWN !!!