The recent experiences of two friends who are newly-minted nursing school graduates underscores the notion that the needs of new nurses are not being met when they hit the ground running. In the hospital setting, especially, new nurses need gentle and constant nurturing and preceptorship in the first stages of their career. Taking into consideration that nurses in the hospital are dealing with acutely ill patients, often pre- or post-op, with a plethora of comorbidities and high risk of complications, new nurses cannot be expected to jump on that wagon alone for some time. It is disconcerting that some new grads seem to be getting the short end of the preceptor stick, as it were.
Having completely eschewed the whole hospital experience post-graduation (something I was told was professional suicide), I have not personally been responsible for six or more patients at a time on a Med-Surg floor, but in my current capacity as a Nurse Care Manager, caring for more than 80 chronically ill patients on an out-patient basis does give me some traction vis-a-vis the vicissitudes of detail management and multitasking.
I'm saddened that new nurses are invited into the intense environment of the hospital, given cursory orientations, left in the charge of preceptors who are themselves too stressed and overworked to do their junior colleagues justice, and then thrown to the wolves, often drowning amidst the acuity of their multiple patients and the resultingly overwhelming paperwork.
How many new nurses have been frightened away from their newly chosen career based on a devastating first work experience? How many new nurses have been proferred less-than-adequate guidance as they entered the fray?
Taking into consideration the overall nursing shortage, the simultaneous nursing faculty shortage, and the fact that nursing schools are turning away record numbers of qualified applicants due to that lack of faculty, it is even more imperative that new nurses be given the highest quality introduction to their new career as possible. If we lose them to other industries due to our lack of leadership and empowering mentorship, then it is not only us, but also the hospitalized and ill public, who will suffer in the end. Nursing shortages can translate into overworked staff, increased errors, increased nosocomial (hospital-born) infections, decreased satisfaction for both staff and patients, and overall poorer outcomes in both surgical and non-surgical patients.
It has been said for decades that nurses eat their young. You would think that after so much time, after so much experience garnered by so many, that this industry-wide practice by jaded and overworked nurses would come to an end. Apparently, it is still a nurse-eat-nurse world out there, and many a new grad is suffering because of such a widely tolerated atmosphere of poor management and lack of empathy for the new nurses in our midst.
If nurses wish to truly be the purveyors of health that they claim to be, then the nurturing must start with the self, extend to coworkers (and neophytes especially), colleagues, and then to the public at large in the form of our patients. If we do not care for ourselves and each other, we are truly only continuing outmoded practices propagated by the patriarchal paradigm. (Alliteration unintended but nonetheless entertaining.)
In a female-dominated industry, traditionally male managerial models of subjugation, humiliation, and trial by fire must be altered, or the unhealthy and overwhelming hell of being a new nurse may only be prolonged for decades to come. For all those who do indeed nurture the neophytes, thank you---your service will benefit more than you may ever know or experience. For those of you who are guilty of letting the struggling swimmers drown, it's time to embrace a new way of being and welcome those who join our ranks with open arms and willing hearts.
9 comments:
Here! Here!
I echo your sentiments. After 31 years, I can say it hasn't changed. What makes us think that it is acceptable to make the new nurses go through what we did... we survived, but was it right? Did it help? How many have left our profession because of a lack of support and encouragement? We face enough challenges in the course of a day's work. It is often the confirmation of a job well done that keeps me wanting to go back the next day. Thanks for your opinion!
Amen! What you said!
You should submit this to the next Change of Shift.
Keith,
Thank you for shedding light on the problem. Its a vicous cycle and the preceptors don't seem to realize how huge of an impact their mentorship has on a "neophyte."
As a student, I have encountered many a jaded nurse that is clearly bugged by the fact she has to have a student for the day.
If I ever have the chance to be a preceptor someday, I will remember your admonishon.
..."unhealthy and overwhelming hell of being a new nurse..."
Truer words have never been spoken! I got lucky--I had a good preceptor who guided me well and was honest about the unit and it's failings but always made sure to highlight the strengths (she was also bat-poop crazy, but she was clear and direct and knew her stuff). We have only two good nurses on the day shift who take on new hires, which is a shame because although they are good at it, they are burnt out on it. They have had a steady strean of newbies for over three years.
But if they didn't take them on, we'd be losing new hires in droves because of bad teaching experiences with preceptors who were less than welcoming.
As a nursing student currently do clinicals, I really appreciate this post.
We started a new hospital recently and it was readily apparent as soon as we walked onto the floor that we were not welcome. Many of the nurses and those behind the desk did alot of eyerolling and huffing and puffing when we asked them questions. I personally don't know any other way to learn than to ask.
At my last rotation, my nurse was nice enough but she used me solely in the capacity of bedpans and bathing. I don't mind doing these things and I realize that it's a part of being a nurse but at this point I KNOW HOW TO DO A BEDBATH AND HELP A PT USE A BEDPAN (sorry about that)
I would like to actually do some type of real learning amid the bedpans and baths./rant
Thanks!!
Dawn
Great post.
I'm 10 months out of nursing school, and I have to say that I had wonderful preceptors. My trouble with being a freshly-minted RN wasn't that anyone was cruel to me, but their overconfidence in me.
I'm 34, and I've had a career before and have the confidence that a mid-career person does. My preceptors and my boss assumed, then, that it was okay that I take charge for a night before I was off orientation. I rolled with it fine, my patients were fine. But more and more, I take on responsibilities that terrify me. Wednesday and Thursday of this week I was the only nurse on our rehab floor for 7 patients, with an agency CNA. By morning, everyone had a pulse and was breathing.
Which, I guess makes it okay for me to come back to the same thing Friday night.
No, it's not 50 patients. I wasn't the nurse who had 11 patients by herself in chest pain center. But I had heart arrhythmias, brittle diabetics whose sugars were dipping, dipping, dipping overnight...confusion secondary to brain mets...
I don't let on that I can't handle it because I'm not that kind of person. I somehow, over my previous career, learned to ooze confidence. That doesn't mean I'm not a new grad and a big fat faker.
We do eat our young. Sometimes in more subtle ways than the blatant cruelty and hazing that I've seen happen. Thanks for your thoughts. I'm glad you sent this to Change of Shift so that others can read it.
/jo, rn, bsn
Time and time again, my mother told me she didn't want me to become one of those crusty, mean, old nurses. She was a medical social worker and was exposed to such creatures. I swore that I would never be like that. Well, I have been an RN for seven years and I am starting to feel a little crusty around the edges. That makes me sad.
I work in the OR and have heard MANY stories about how mean people used to be and how much harder they had it. I look around and think to myself about this. There aren't very many nasties in our department but there are a few. In my experience, those tend to be the ones that are saying how bad it used to be.
At first, I was given students (interns) because I could relate to how they felt being new and all. Now it is because there isn't anyone else. I have had 2 summer interns, I get my second transition student next week, and I have oriented 2 nurses(that is six months in my department). It is hard. It is hard to teach someone new. Some personalities don't mesh well. I am a doer, I have a hard time standing back and seeing tasks that haven't been done yet. I am constantly being pressured by boss to hurry - time is money. How are you supposed to teach then?? I get frustrated when I explain how we do something, why we do such thing, and when only to be completely ignored. I watch others just push their young out there to fend for themselves and it kills me. Not only are they not helping a new person but they are not providing the patient with the best care.
Thank you all for such thoughtful comments. I guess I hit a nerve....
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