I've been a nurse for almost a year now. I research and study at home because I want to know the whys of what I do and know the best practices. I have my own binder of P&Ps that I have printed off the work intranet. I don't know everything (who does?), but I work at knowing as much as I can.
We sometimes have agency nurses where I work, and they usually just need help with knowing where things are, unit-specific processes, and occasionally asking about a P&P. They have been great to work with, and they have definitely taught me a few things, too.
Actions speak louder than words.
One night, we had an agency nurse that I've never worked with before. She started out by proclaiming, "I'm a team player," and for some reason that would be proven throughout the shift, my bull**** meter went into the red.
1) During night downtime, she spent the shift with her head buried deep into Facebook and texts on her phone.
2) She never answered the unit phone.
3) As is my habit, I tidy the nurse's station and restock meds carts and make a reorder list during some of my night shift downtime. As I was doing this, the nurse was again busy with her phone, and I had to ask her for assistance.
4) As end-of-shift neared, we had to move one of my patients to make way for a dayshift admission that needed to be close to the station. As the charge was giving me the new room assignment, I mentioned that I would like help for the move because the patient had equipment and supplies and a lot of personal belongings that needed to be moved. The agency nurse looked at me, then went back to texting. Again, a deliberate request for help to her specifically had to be given to get the assistance from her. As we went into the room, she just stood there, unsure of what to do. "All of this has to go," I said, thinking that would be enough. Nope; no movement. "Please roll the suction machine and the IV pole to room 426." Ok, that was enough to get her moving. When I got to room 426, I found the suction and the IV pole outside the door of the room, and the nurse was nowhere to be found.
Researching and initiative is important.
It is assumed that agency nurses have a broad knowledge base and are adaptable to different units, and that they would refuse an assignment that was out of their skill set.
With the first question about a very common cardiac med, I answered it and asked her how long she had been a nurse. She claimed four years, but only one as agency. "I'm a med surg nurse--not a telemetry nurse--but they keep putting me in telemetry." "How long have you been assigned to telemetry?" I asked. "All the time for the past year," she replied. She went on to say, "I've asked for telemetry classes, but it hasn't been arranged yet." I gave her the name of the book I bought off Amazon when I first got my job and explained the the EKG basics class during my orientation didn't cover any more than the book did.
Somehow I doubt that she'll even Google the name of the book.
During report, I overheard her say more than once, "I'm not a telemetry nurse," when asked what rhythm her patients were in overnight. Not once did she ask any of the permanent nurses to help her read the monitor.
I got the distinct feeling she lacked confidence in her skills, but I also knew that she took no initiative to gain the knowledge that would increase her confidence.
I've put this in the first-year forum for one reason: To give you a tale of what to do and what not to do. After the first year, there is an expectation of moderate competence in your specialty. The first few months of my career was spent just becoming acclimated to what nursing really is, the P&Ps and unit-specific processes, increasing time management skills, and learning who to call and when to call. Researching and studying on my own helped accelerate my learning. Being able to pick up on what other nurses are doing was also very important. You don't have to stop everything and deliberately observe; just keep one eye and one ear open to what is going on around you. It all increases your own confidence. Being a team player requires confidence to get in there and get your hands dirty, rather than waiting for someone else to tell you what to do.
Your own initiative can make or break your career and your reputation among co-workers. If you aren't invested in your own learning, how can they be? Learning never, ever stops. Every shift, I come across something that I need to take a couple minutes to research at that moment or when I get home. It has built my confidence in my practice. It has also kept me grounded to recognize what I don't know and ask for help when I need it.
