"When nurses eat their young"... I think I've been eaten...

[phoenixfire]

Ok, so I'm super excited... I just got my first job at an ICU, a place I LOVE TO BE. There is so much going on, so much to learn, and so many ways in which we can make a difference. I asked some of the seasoned nurses that I work with now (I'm a part time tech in an ICU unit) what I can do to be successfull in my new job. Some of the replies I got were a little.... disturbing. I was told not to voice my opinion (ever) because since I'm a new grad, I haven't earned the right to have one (apparently, you can only voice an opinion if you are an experienced nurse). I'm not supposed to ask certain questions because that is questioning the judgement of the nurse, and not the procedure (no matter how the question is phrased).

I'm at a total loss. I've worked my tail off to get this far, and I found a place where I really want to be, but feel like I'm being chewed up and spit out by the same people that are supposed to teach me so that when they retire or leave the unit, that knowledge won't get lost. I've gotten to a point where I'm questioning myself as to whether or not I even want to be a nurse anymore. I know that I don't have the knowledge or expeirence to walk into an ICU and take care of a critical patient... but I'm willing to learn, and I don't know how I'm supposed to do that if I can't ask questions or have an opinion. I've been told that I'm not a team player, and that people in general do not like me because I'm aggressive and independant, too focused on the details, and have 'an authoratative tone' when discussing concepts. I know that I shouldn't let one instructor review, or even one or two other nurses opinions stop me, but if I'm getting this from multiple places it really makes me wonder if I'm cut out for this... I'm struggling to figure out how to fix this so that it doesn't become a problem in my new job.. I just don't understand. If I'm caught up with my patients, I ask the other nurses if there is anything I can do to help... If the doctor comes in for an update on a patient that I've been with all day, do I let my preceptor answer him, or do I speak up? If another student asks me a question, and I know the answer, I tell them (and if not, we look for it together). If I don't understand why we are doing something, do I question it, or do I accept the judgement of more experienced nurses?

So I guess my question is: How can I be successful in my new job? What can I do to NOT be perceived as a...witch...? Any guidance would be great...

[sunnycalifRN]

Lot's of great replies here already. But, I'll add a few more centavos.

1) ask questions during relatively quiet times . . . when things are really hectic, no one has time to teach

2) as others have said, it's best to approach in a passive, rather than aggressive way . . . e.g., "I don't understand this or that . . . could you help clarify it for me?" Don't go, "I read a study in NEJM today that says, blah,blah,blah"

3) or, "I've noticed that you always are monitoring this or that . . . is that because . . . then, state your best understanding of it, then most nurses will add their two cents or just say, "yep", if your understanding is correct

4) have a notebook and write down all your questions and you can go to the ICU textbooks, policy and procedure manual, or internet, later to check it out. This is because sometimes when I'd ask a question, the reply was, " that's a really good question, why don't you look up the answer."

[inshallamiami]

Regardless of your/their level of experience, I don't know why we all can't be nice or kind to each other. It's amazing how many NASTY nurses are out there, whether they're stressed or burnt out or nervously new or eating their young or young being eaten, or whatever, there is NO REASON we cant be nice to each other.

[oldiebutgoodie, RN]

I actually think you are a good candidate for the position you seek. I will tell you how I was told to ask questions......without it sounding so bad. Apparently, I had a preceptor that complained to my NM because I asked "why", and believe me, I wasn't trying to pretend I knew more.

NEVER ask a nurse "Why?" This word is perceived as questioning the nurses judgement. I was told by my NM to use the word "Rationale." So when you need to ask a question, say "What is the rationale behind doing so and so, thank you for educating me on this topic."

I'm sorry, I think it's just total BS that you have to tiptoe around these so called "special" ICU nurses when asking a question, God forbid you actually open your mouth! I think that the whole ICU culture is warped, I spent a year there, and decided that I didn't need to prove myself to a bunch of nasty people who seemed to delight in reporting us new nurses for anything they could, rather than teaching us.

And now I am a specialty nurse who they consult and (sometimes) suck up to. Isn't that interesting. Once I put the white coat on, I wasn't such an incompetent boob.

And from my conversations with other collegues from other ICUs, it's pretty much the same in other places. One of my friends was told that her nursing skills were questionable, and that her nursing school must be mediocre (named one of the best in US News, etc.). My friend is now in CRNA school. Yeah, that's questionable, all right.

So, come on, ICU nurses, get off your pedestals, HELP your new grads, ANSWER their questions, and they will be a bigger help to you. Otherwise, you will lose 50% of your new grads who don't feel like taking this nonsense.

Oldiebutgoodie

[shoegalRN, RN]

I'm sorry, I think it's just total BS that you have to tiptoe around these so called "special" ICU nurses when asking a question, God forbid you actually open your mouth! I think that the whole ICU culture is warped, I spent a year there, and decided that I didn't need to prove myself to a bunch of nasty people who seemed to delight in reporting us new nurses for anything they could, rather than teaching us.

And now I am a specialty nurse who they consult and (sometimes) suck up to. Isn't that interesting. Once I put the white coat on, I wasn't such an incompetent boob.

And from my conversations with other collegues from other ICUs, it's pretty much the same in other places. One of my friends was told that her nursing skills were questionable, and that her nursing school must be mediocre (named one of the best in US News, etc.). My friend is now in CRNA school. Yeah, that's questionable, all right.

So, come on, ICU nurses, get off your pedestals, HELP your new grads, ANSWER their questions, and they will be a bigger help to you. Otherwise, you will lose 50% of your new grads who don't feel like taking this nonsense.

Oldiebutgoodie

I can certainly see where you are coming from. I'm a new grad in the MICU, and I precepted on the SICU and I heard the nurses over there gossip about everyone's nursing abilities they felt were "questionable". These are nurses who have only been a nurse for less than 2 years or so, and God forbid if someone else knew more than them. I see how they point out every little mistake someone makes and run and report them so they can feel better about themselves or try to make themselves look like the "super nurse". Alot of passive aggressiveness going on. Instead of helping new grads, they tried to "eat" them and run them off. And they claim the ER nurses are bad. I spent a month in the ER in my new grad residency program and I never felt so welcomed by a better group of nurses. I also noticed the ICU nurses are clicky (at least over the SICU, and this doesnt apply to ALL ICU nurses, only relevant to MY experience), and if you are not in the "click", they have it out of you. A few nurses I know of can't wait to get off the unit because they feel that they don't "fit in".

I don't see what the big deal is. Why the "holier than thou" attitude? Everyone was once new, no matter how long ago that was. Lucky for me I got a really good and supportive preceptor NOW that I can ask questions and not be made to feel like an idiot. I've already decided I'm doing one year and I'm out of there. I will go to the ER and maybe do dialaysis nursing on the side.

[nyforlove]

I can certainly see where you are coming from. I'm a new grad in the MICU, and I precepted on the SICU and I heard the nurses over there gossip about everyone's nursing abilities they felt were "questionable". These are nurses who have only been a nurse for less than 2 years or so, and God forbid if someone else knew more than them. I see how they point out every little mistake someone makes and run and report them so they can feel better about themselves or try to make themselves look like the "super nurse". Alot of passive aggressiveness going on. Instead of helping new grads, they tried to "eat" them and run them off......

You have described it PERFECTLY. And here is what I consider the PERFECT explanation that was posted in another thread on allnurses.com:

"Nursing is a very stressful profession and nurses bear maximum responsibility for patients' wellbeing, yet have very little power to influence the medical care they receive or the hospital policies that dictate how care is delivered. Finger-pointing, blaming, nit-picking and judging others on the unit is a great way to divert negative attention away from oneself. Much like a playground bully, the meanness is almost always rooted in self-loathing and insecurity."

Now, I believe the above quote is a perfect EXPLANATION, but NOT an excuse---because there is no excuse for such behavior--it's just the result of insecurity and worsens when a spineless manager permits it to go on. DON'T ALLOW THE BAD ONES to discourage you. I was fortunate in that my first 2 years in an ICU were with wonderful, eager nurses willing to teach. I later got married and moved so I went to a new hospital, where I experienced the rude "welcome wagon" you describe (more about that later)--I see that it can be very difficult for new nurses, particularly young ones right out of school....I'm not sure I know the best way to handle it, but I have read good comments on allnurses about being receptive to learning and not trying to show everything you know right away....Also read a great comment here that said, "Hate to admit it, but you really should kind of treat the older nurses with a bit of finesse and respect,"... just like any new crusty, old employer--after all, they forged the path for us over the past 20---30 years when salaries were nowhere near what they are today and took a lot of crap from doctors before hospitals finally started reigning in the screaming physicians...so, yeah, step out of the older nurses' way and let them go to lunch first, and don't complain if she takes a clean pillowcase from your bed instead of walking to the linen closet to get her own ....but what I deem intolerable is the "nonsensical" screaming-for-the-sake-of screaming that some nurses like to shower on new nurses. Again, I was fortunate in that my first 2 years in an ICU were with wonderful nurses, so not sure what to recommend...If it helps, though, I can assure you that it does not last after the initial "boot camp" period; interesting was how I stopped some of the "bad apples" at my new job when I first arrived there after moving. Apparently, one thought I was a new grad and screamed at me because I called to get the full sharps container replaced. She screamed at me in front of others, "You called to replace the sharps container when you don't have the key to remove the old one?!!!" I screamed right back in front of the others, "YEAH, I called to get an empty sharps container and am taping over the full one until maintenance brings the key on Monday so no one gets stuck." I then ignored her every morning in the break room when I ate breakfast, made no effort to chat, and just spoke with her as needed on the floor. Significantly, I warned new nurses about her "nonsense." That's how I deal with it as an experienced nurse---and as a confirmation of what a poster wrote on another thread: Yes, that screaming nurse was pretty miserable----a husband at home bedridden on 2 wound vacs and herself stuck as the sole breadwinner...Sad for her, but no excuse for her to verbally abuse new nurses, and I have no regrets for the way I responded to her abuse.