Nursing Voices

Friday, August 03, 2007

Why Are Graduate Nurses on Today’s Menu?

I’ve always been able to pick out the new nursing graduates who report for their first day on the job. Look at this young lady. Her uniform is spotless, her cap is impeccable perched on top of her head, her hair is perfectly coiffed, and she made the mistake of wearing high heel shoes to work. Didn’t anyone tell her about Nurse Mates? She’s going to have some really bad blisters by the time her shift is over. The biggest tip off, however, is her demeanor. She has the new graduate glow. Her shoulders are pulled back, she’s standing straight and tall, and her head is held up high. She’s full of confidence and pride.

Now imagine our fair young nurse’s arrival on her unit for her first day at work. Her new coworkers, who are sitting in their faded scrubs and mileage worn work shoes, barely have time to notice her entering the nursing station. The nurses from the previous shift are ignoring the relentless buzzing of call lights in the background as they hurry to get their charting done so they can go home. Their back and legs hurt, and the last thing they want to do is make one more trip down the hallway in order to put another patient on a bedpan. The nurses reporting for work aren’t happy either. They are preparing for another long, difficult shift. In the middle of the chaos stands our perky new nurse, bright eyed and full of zip. The old warhorse nurses take one look at her and the feeding frenzy begins.

(Warning: I’m about to get on my soapbox, so watch out.)

How many times have you seen this happen at work? Experts call it lateral violence in the workplace. Nurses call it eating our young. I’ve seen it a lot. In fact, I was a victim of this phenomenon. One group of nurses that I use to work with refused to talk to me unless it directly involved patient care, and they wrote me up for any little infraction that they could find or invent. A few of them even told me that I was a horrible nurse and that I should leave the profession. I cried a lot, but fortunately I’ve always been obstinate and I told the battleaxes to take a hike. I've never forgotten the pain that they caused me, and since then I’ve vowed to treat all new graduates with respect. If cheerful new nurses irritate you, so be it, but look at the situation logically. Who is going to take care of you when you are old if you keep running the newcomers out of the profession? Graduate nurses deserve our support, even the perky ones who report to their first day of work in high heel shoes. I'm not forgetting the guys. They deserve our support, too.


Anonymous 5 Wester said...

Hi MJ!

I know how you feel. I consider myself a "teenager" when it comes to the profession and I know how it feels like to be on the receiving end of a seasoned nurse's bark (or bite for that matter). It's a tough job and most people don't realize this, and for some reason we are our own worse enemy.

Nurses are an endangered species and unfortunately cannibalism exists. Nevertheless I stand by with you... a little bit of kindness goes a long long way!

6:46 AM  
Anonymous Not Nurse Ratched said...

Thanks for writing this...I dread being the victim of this lateral violence thing. Nurses are so bad about this that I'm glad I'm entering the profession late in life; had I done so as a kid in my 20's, this sort of thing would have driven me to despair and tears (now I will have more of a "take a hike" approach like yours!).

8:26 AM  
Anonymous PDWarrior said...

Nurses do "eat their young." I was lucky when I got my first job. The supervisor warned everyone to treat me with a little respect because "he's going to be your relief when your shift is over. If you don't want to pull a double you need to make sure he comes back."
Her instructions worked, I was pretty much treated like gold (with one exception) To be honest, her words of caution to the other nurses scared me more than anything the other nurses daid or did at the time.

9:33 AM  
Blogger Jean-Luc Picard said...

That nurse probably won't last long; a few weeks of that and she'll be worn out.

10:46 AM  
Blogger Kris said...

I can't recall the number of times I was bullied as a new grad...especially by the CNAs who themselves couldn't make it through nursing school. We have to keep the new nurses from calling all of their friends and telling them to drop out of school, it isn't worth it, etc......we need more of those folks coming in to lend a hand in the already short staffing pool.

6:30 PM  
Blogger Jennifer said...

Thank you for posting this! Beautifully put! I wish this could be posted somewhere for all nurses to see. That is one thing I dread when I graduate - having to face seasoned nurses when I am a newbie just starting out. I've already had to deal with this in clinical - some of the nurses like to make it very clear that they hate students. It makes a very difficult learning experience when no one is willing to answer your "stupid" questions. It's nice to hear there are some nurses out there willing to help us beginners :-)

9:26 PM  
Anonymous Terry at Counting Sheep said...

Good article. Today's new grads are tomorrow's seasoned nurses. Nobody was born a veteran nurse - we all had to move up the ranks. Great words of wisdom - the new grad you diss today will be the same nurse taking care of you tomorrow!

2:46 AM  
Blogger FetchingGal said...

Excellent post, MJ. My unit has some "friendlies" but most who have 15 years or more in are difficult to deal with. Am thinking of putting in a request to transfer to the area of nursing I've wanted since before I started school. Current unit is one of the 3 chronically understaffed. And yes, have called the friends in school to advise them to think carefully about changing majors. ;)

12:37 PM  
Blogger The Nurse said...

It was especially hard for me as I started in ER & was told I was a "softie" and that I needed to get over the "newness" of it all et to toughen up my skin some more.

I think that is why I found my heart in OB (the exitement of ER, but the gentleness that fits me more).

However, I am a bit irritated with some students in clinical, as they follow me around and hang on to my every word... but for the sake of it all, and because I've been in their shoes, I bite my tongue and teach them gently.

10:19 PM  
Blogger may said...

thank you for the reminder.
i make it a point to help the new nurses...we cannot afford to lose them. i must admit though, i have seen new nurses bully the senior nurses too, in a different way.

it's really time we think about teamwork, and forget all the animosity and hostility.

3:00 AM  
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5:08 AM  
Anonymous Anonymous said...

I'll take a perky new nurse in high heels any day of the week.

3:03 PM  
Blogger ~Autumn said...

I've had a few of my classmates graduate already and none have seem to run into this problem, or haven't told me about it. However, most have worked on their units as techs for months before being hired as new nurses on their floor.

I'm hoping that with this option, less new nurses are being bullied.

3:39 PM  
Blogger mielikki said...

In the end, we are ALL in the same boat. Nurses do tend to eat their young, and I hope thats a trend we can all start to eliminate!

5:35 PM  
Blogger Student Nurse Jack said...

***Smooooooooch*** for this post.

I have been fortunate to have supportive nurses on my integration unit asking if I'm going to apply. All of them have been helpful and friendly, but this is not the experience I'm hearing some of my classmates are having. Some of their stories sound like your post. Sans heels, of course.

10:29 PM  
Anonymous kim said...

Were we separated at birth?

(PS - I look like that nurse all the time...LOL)

2:12 PM  
Anonymous Jane said...

It is a strange phenomenon. I am new so I understand this issue. Maybe it has something to do with new nurses asking so many questions all the time and lacking confidence. I certainly do not have the answer. I feel like I am always asking questions and annoying everyone. Maybe the experienced nurses are just trying to beat us down or something so that we will not be so sensitive. While I was a student nurse I had the chance of experiencing an externship or "walking in my shoes" program. It was great. I got paid and experience while still a student. I found my preceptor to be so...."rough". Rough with me, with our patients, with other staff and admin, with the MDs....I was so shocked...After another year of school and being on my own now...I realized that she got the work done in a manner that was ultimately best for the patients and for herself as well.
It was like this "work now cry later" attitude or something.
I am not sure if I am describing this well.
The point is that yes new nurses should be respected...I am a new nurse after all...but there might be an answer (not an excuse) for this treatment.
Maybe they know something and just can not express it.
Or maybe they are just mean and bitchy? Maybe they need to drop the ego. The "I am the best nurse here." attitude. A bit of unity and some more teamwork would be great.
Anyway, I will not forget. When I am no longer the new nurse on the block....I will be kind to the next. I promise.

9:30 AM  
Blogger therapydoc said...

This totally blows my stereotype of nurses being these kind, gentle co-dependent humans, the nicest genre on earth. I'm very upset.

4:19 PM  
Blogger RN Someday said...

Thank you for this post. It came at the right time for me, at the end of my second semester and a particularly rough one dealing with the nurses. This semester I have met some nurses that I hope to never become like them. I have been treated with the ultimate in sarcasm and with a very condescending attitude. Some of the nurses even challenged my clinical instructor and wanted to know why can't so and so do this or that. Just awful. Of course, I suck it up and take a shower with a brillo pad to toughen up my skin. I've resigned myself that there will be these people and I actually feel sorry for them. They must be just miserable and unhappy.

11:03 AM  
Anonymous Anonymous said...

All the competition and abuse creates the environment for these cranky battle-axes to exist. Seems like misplaced anger in many respects. Anger at the loss of innocence and what a veteran nurse frequently has put up with. And this is supposed to be a healing environment? No wonder hospitals freak people out.

4:29 PM  
Blogger Jeff said...

I tend to think, from my experience as a student nurse, and being a bit of a salt in life to boot, that the nurses that give students a hard time are insecure for some reason. I think that they feel a little intimidated by the fact that new nurses, and students, have the latest and greatest knowledge under their belts, and some of the older nurses, deep down, are worried that they will get a question that they won't be able to answer. And in not being able to answer, will feel expendable, with these younger, more knowledgeable nurses coming in.

So how do they avoid that possibility? They try to drive the questioner away. Try to make the questioner feel that whatever the question is, it's stupid, and doesn't deserve an answer. They want to try to make others around them feel that this newbie is under qualified, and doesn't deserve the time of day from others. It gives them an easy way out.

When they were in nursing programs, especially from many years ago, there weren't as stringent of requirements for getting into nursing. You went from high school, straight into nursing if you wanted to. There was a low bar to clear. You showed up at the hospital, and said you wanted to be a nurse. Also, the state of the art at that time was much different than now. So nurses who were trained then may feel inadequate when they hear what subjects are covered now, that they hadn't received in school. Nurses didn't have to know how to read cardiac strips, or analyze ABGs or read labs. They may not feel comfortable doing it today. In fact, they may not have been allowed to see some of those things when they were getting started. Or maybe even today, they fake a lot of things, getting by on instincts.

But the really good nurses, no matter how long they've been nurses, have been conscientious and have continued to learn through all their years on duty. They have fought to know more about the patient's condition from the information available, and pushed for more access to that information. Maybe some of the more insecure nurses are the ones who did not care to learn any more than the bear minimum. That would certainly explain why some nurses wouldn't want to be found out.

I wish I could sit down with those really good older nurses, particularly the ones who are good, but are insecure, and share with them how envious I am of their vast experience. Getting started as a nurse as late as I am in life, I will never have the chance to accumulate the instincts and skills that they have gained, on the job, for 25, 30 or 40 years working with human beings. They have picked up so much knowledge that they, as an asset, are priceless at this point. No matter what the newest treatment is, what the latest research shows, there are timeless things that they know-- in their gut-- to be "the way it works," and the knowledge of how to treat this particular patient in this situation. The research may not catch up to their instincts for another 100 years. THAT is what I want to be exposed to.

I can't take that away from that nurse. I can't replace that nurse. I can only hope to get some insight from them, to help guide me in my experiences, and avoid some mistakes that they may have seen, or made, in their careers.

At the same time, they need to know that even if I am able to teach them something that I learned in school that they didn't yet know, that doesn't mean that because I knew it first, or even if I understood the concept better, that I could apply it in a clinical setting with the expertise that they could, with the foundation that they have. We are new students with the latest tools. But we don't have experience.

Take a carpenter with 30 years experience from a third world country, who has known only a handsaw, hammer and chisel, and give him to me for a year in the U.S. I will show him power tools, and nail guns, and lasers levels, etc. In that time, even though I am not a carpenter, he will master those tools that I've taught him to use, and he will be making buildings that I would never dream to be able to build. But in that same year, I will not gain his 30 years of accumulated knowledge.

One of the best instructors I have ever had-- in nursing or otherwise-- spent the better part of our lunch break one day telling us about her most embarrassing, and educational experiences in her 35+ years as nurse. Do I think less of her for her mistakes? No, I think more highly of her for her confidence in herself and her ability to share for the good of her students' future. She is a nurse's nurse. And they are few and far between.

If you've been a nurse for a while, you can be one of those few and far between, and be honored, respected and sought out for what you've learned and what you can pass on, or you can be selfish and one who "eats their young"--but those are far easier to come by, and infinitely less marketable.

4:41 PM  

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