Do “New Nurses” Scare You, Too?

Seems to be an old thread, but I believe a huge part of the new dangerous nurse problem is online schooling. All of my nursing education was completed in person. People can answer all sorts of test questions and participate in discussion boards on line but that should not be acceptable. For nursing education, like learning a new language, a student nurse or new grad should be immersed in the culture. Learning how to keep your wits about you during high stress events is a hands and brain involved learning only that cannot be simulated adequately.
I would drive home when my shift ended examining and rethinking about what happened during a code to reflect upon what could have been done better or faster. In my 15 years of floor nursing I never had a patient die under my care except for “comfort care” patients who were expected to die and that was only once.
I precepted plenty of new nurses and most of them did just fine.
There was at least one who spent 12 weeks orienting with coworkers and was still struggling. By the time that one got me I realized that their head was not in the game and managed to run that one off within 4 hours together. I’m not proud of that outcome, but I would not want that nurse taking care of anyone in my family or anyone else’s family.
I do think at times it should be considered how much technology has changed nursing though. I once told my nurse manager that back in the old pre-EMR days the Physician had to come to the floor to write orders in to the chart.
Now with EMR a physician can be anywhere and add orders for the patient. Is it humanly possible for me to complete all of those orders and do all of the expected things—bathing, tolieting, linen changes, passing meds, drawing lab, transporting to appointments with MRI, Echo, ultrasound and so on? Likely no..but it is what it is.

As an RN for over 45 years and still active I thought only us dinosaurs felt this way, thought it was a sign of aging. Yes, they scare the beejebus out of me, not just in nursing. I find the current crop of new professionals are of the mind that everything they need to know they already do and their mission is to bring the rest of us up to par. No longer are they told, as I was, here’s your degree and your license you have met the MINIMAL standards for practice go and learn all you can and never stop learning.

I’ve been a critical care nurse for almost 31 years and I remember how appreciative I was when the more experienced nurses would teach me things I didn’t know. I think critical thinking skills come with time and education. I have seen some things that new nurses have done that made me nervous and if I have the opportunity I try and educate them on the correct or preferable way to do things. It doesn’t serve any purpose to degrade someone on something they did in error. I also believe that there are a lot of people going into the profession that are just doing it for the money and have no idea what they’re getting themselves into.

I love this post. I believe however, sometimes experienced nurses are intimidated by newer ones and it should not be this way. I think Dawn sums it up when she says one day those younger ones will be caring for the older nurses so may I suggest we embrace and teach and if we see something being done wrong correct, retrain should be the first approach not throw them under the bus and gossip about their lack of competency.

I am a nurse with 10 years experience. I went straight from nursing school into the ED. As a new grad , my manager hired me and 2 other new grads into a new program called the “Versant residency program ” ( suppose to be a 4 month orientation/ training). We were all placed with specifically an old nurse with 10 years plus and also a newer nurse with 3-5 years experience as our preceptors. I had the privilege of good preceptors and breezed through my training. I ( because I have always been a crap magnet) was then trained to crash/ trauma after 2 months off orientation. My manager asked me the best question ever before being trained to trauma and it was “do you think your ready?” That question stopped me in my tracks , I thought about it and then replied “yes.”
Looking back, I had the confidence to move along at an excellerated rate only because I worked with an incredible team who were supportive in my asking questions/ desire to learn. My teammates challenged me and told me a very important concept ” you are not alone and always ask no matter how silly the question is.”
Today as finally a nurse veteran, I teach by example. I teach why I do things and relay all the stories of what made me do things this way as well as some of the horror story encounters. I am notorious for shoving a piece of paper in my students hand and tell them they are going to chart for the code / critical event taking place. I tell them, don’t worry I’m here and will tell you what to write. I love the confident ones, just make sure to remind them to Chanel their confidence in the right way. Remind them to check themselves, the old ” measure twice ,cut once ” concept should be applied to all meds and procedures.
It’s a balance. You want nurses confident but also comfortable enough to ask questions. Always remember we are teaching those that will care for us one day and no one was born a nurse. If a new nurse is performing dangerously, correct them and provide teaching.
-Dawn

I’ve been a nurse for 30 yrs. 19 of those as an Advanced Practice RN. For the last 7 years I have taught in an associate degree program. Yes, I’ve had some stellar students. But I have had more mediocre students than I care to count. One thing I try to teach them is that all important “putting things together” piece of critical thinking. WHY is the patient getting that med? WHY did the MD order that test? Assessment can start by just taking to the patient. Are they SOB just sitting there? How’s their color? What about skin temp? What IV meds are running?
I’m strict on dress code and appearance, too. If we want to be treated as professionals, shouldn’t we look the part? If I catch them playing on their phones (Facebook etc) I take the phone till the end of shift! I remind them that they need to imagine their own mothers in the bed, and how would you like them treated. I remind them “No, you won’t get Mon -Fri day shift” right out of school. So,yes. There is more and more a sense of entitlement among the young nurses. But once hired, experienced RNs need to mentor effectively. Explain everything. Ask THEM those “why” questions. Teach them those subtle cues that only come with experience. Teach them to round every hour. Remember why you became a nurse and pass that on!

I’m a new nurse, only four years of experience under my belt, and i had the privilege of attending an excellent nursing program. in those 4 short years, I’ve seen a deterioration in new nurses. even when i graduated, there were too many nurses that had obviously gone into the career because of the great career prospects and decent income. the nurses that I’ve seen coming into the industry within the last year scare me the most, the majority (it’s never all of them, there are exceptions to every rule) have this arrogant air about them, that they know everything already, and there is nothing they could possibly learn from other nurses or doctors. I’ve taken some aside to talk about certain situations that occurred, but alas, it falls on deaf ears. how do i know? well, the glazed look is a give away, but the biggest ‘tell’ is that the same situation occurred with the same nurse either within that shift, or the next shift.
my first floor was a stroke/neurological surgical step down unit. i had nurses working with me that had 15ys+ experience. it was great. until they left. then ALL of the nurses that came in to replace them were new grads. by the time i left that floor (after a measly 2years) i was the most senior nurse on the floor, which was too scary for me to contemplate staying there. now i work mostly with nurses that have 15+ years experience again. i breathe a sigh of relief everytime i think of my first unit.

I am a physician of over 25 years practicing ER medicine. When I started, ER nurses where the cream of the crop, they had a minimum of 2 years ICU experience and prior to getting to the ICU would have several years of floor nursing. So, they were experienced with sick patients. Today, the average years of being a nurse in my ER is under 2 years. Again, when I began this business, a nurse with 2 years experience might get the opportunity to go to the ICU where she can be trained with another highly experienced nurse and get the comfort of dealing with only 2 or 3 patients for the shift. They exhibited ownership of that patient’s well being. It seemed that nurses of old had a true desire to learn about their patient’s disease, meds, prior treatments, prior surgeries, ect… They would inform the physician of the things necessary for great care to be given. Rarely did I hear of a nurse giving a wrong med, or more likely, the doctor ordering a med without an update about the patient condition or improvement thereof and the nurse giving it when it was not needed. What was great, was the nurse would communicate that to me. Today, I order a med, it takes way to long to get it to the patient and then I never hear if it worked. The nurses of old had a maternal desire to truly care for the patient. Nurture the patient. And most importantly, they were the physician safety net. The nurses were fully informed and understood the patient condition and would help the physician with medical decision making. I miss the old days when a nurse would say to me, “the patient in room 2 needs your attention”, I would go into the room and most of the necessary orders were already in motion, the meds required for this patient were also already order or infusing. The nurse was confident and knowledgeable about the disease state of this patient. Most of all, I miss nurses being nurses. Today they are no more then glorified data entry specialist and medication delivery system. By the way, my experience is they pull the drug and give it to the patient without given a first thought of what it was for. NOT AN EXAGGERATION. I will ask after I know the nurse has given the med ordered, say for high BP, I will ask what was the BP before you gave the med…….. silence. They did not take it prior to given the med. Now I could understand if this occurred in isolation, but it happens routinely. Not just where I work but all over the US. How do I know, I am an ER doc, I have friends all over the nation and we vent to each other about the same poor quality nursing. I never experienced this prior to 5 years ago. Over the past 5 years there have been at least a 5 fold increase in med errors and just basic failures of nursing that I have never experienced previously. No longer are nurse doing the job for all the right reasons. It is a good pay check, thats all. I will not hear that the patient in room 2 really needs me to see them now, the meds and labs required are not ordered. And, when that rare instance occurs when they do recognize a sick patient they have not done any assessment themselves. Not even simple things like listen to the lungs. No longer can I trust a nurse. Now I know those reading this will think many bad things about me, and of course there are exceptions, but the poor state of the nursing corp today this is the rule not the exception. It is no longer ok for me to get upset when a nurse messes up. Even if this puts the patient’s life in danger. In the old days, I could make a stern point to the offending nurse, and guess what, she did not make that mistake again. Today, the nurse’s feeling get hurt if I point out that she screwed up, instead of thinking, “my goodness I could have hurt the patient”, they run to administration of say how mean the doc was and how her feeling were hurt or better yet, the work environment is hostile. I agree, the work place is hostile……. for the patient because of the poor state of the nursing profession. There is not a physician today with at least 10 years experience that does not have the same feeling and experiences with nurses I have just laid out. Nursing today is dangerous. Now, I can also go on about medical education for physicians as well, they too have an thin skinned entitled mentality like the new nursing corp and between the 2, God help us all in 20 years.

Yes new nurses are scary however so are some nurses that have been in the profession for years. I head the nursing department in a LTC facility and its scary. They don’t sign off their medications given, no follow through on issues and attitude ! I am not sure this facility can survive theses nurses but they don’t care, it’s frustrating and scary.
I have been in the profession for 40 plus years and 30 of that managing nurses but it’s seem social media takes precedent over everything. Heaven help us in the future.

At some point each commenter has been the “scary” new generation to the staff nurse/preceptor. I look back 36 years and see myself as the barely prepared nurse that made mistakes, took direction from those that taught, and shied from those caustic, been there/done that, how can you be so stupid, bitches happy to let you fail. IF your concern is their assigned patients or any future patient–help them. Younger generations are more technologically driven, less likely to go on a scavenger hunt to the lab to fetch fallopian tubes or listen to stories about standing up to give the MD their seat at the desk. COME ON, nursing education changes, but not at the speed of change in medical care delivery. It is our duty to find ways to pass along our knowledge and prepare our successors.

I am a nurse practitioner with 20 years experience and 20 years before that as an RN. Needless to say I have seen many generations of new nurses and nurse practitioners. While I was completing my education I taught in an ADN program where the students wore shirts with ” 73 equals RN ” when I asked what they meant they would laugh and say that was the lowest grade they could receive and pass. I was appauled how could they be so cavalier to think they would have the tools to succeed if they barely Passed. I began to tell them in clinic that I wanted to feel, if I were the patient looking up from the bed at my nurse, I would know she/he was well prepared and understood how much I was depending on their knowledge.

So yes I worry about new nurses but now there is a bigger fear as nurse practitioner are allowed to go from their BSN directly into their NP program. Nursing is just like life you learn something from every experiences, every patient every illness we our selves suffer. How I ask, can these young nurses Be In charge of a patients healthcare. When my now elderly husband goes to see the doctor he see’s a nurse practitioner. Part of me is proud how far we have come but then when questions that should be asked regarding His chief complaint are not asked or test results are not completely explained I worry. I try to step back and let them practice but it is difficult. We all need to grow and continue to learn and never and I do mean never stop learning. All of us “older nurses and NP’s” must mentor the new nurse. By gently guiding their continuing education by demonstration, patiences and understanding that they too will be the “older” nurse one day.

I work private duty home care and have for about 20 of my 25 years of nursing. I have found an interesting mix in the new nurses and often it truly is us who are the problem. I like to take someone fresh out of school and break the bad habits they were taught right from the outset. I was rather surprised to find that home care is being taught as the “lowest form of nursing” where’s I find it to be one of the more challenging since you truly have little back-up in the home. I have no tolerance for what we call “paycheck nurses.” I have little tolerance for those who think that just because our patient can’t speak or see that that means he has no value. My approach though is to teach and share and try to get past that mostly false bravado of the new nurse who really just wants to be taught the things suddenly facing them. Ours is a daunting career and very complicated. The psycho-social aspects of treating not just your patient but, instead, remembering the rest of the frightened family and managing their issues as well is a huge part of nursing and it is just not taught anymore. If that means we have to teach, then let’s teach. If they refuse to learn they rarely stay with the position anyway. I like to show them resources for continuing to learn. I like to explain that I had the same performance anxiety (often hidden behind that veneer of bravado) when both teaching and learning. The new groups didn’t learn the same values we may have when breaking into the profession, but that doesn’t mean we can’t teach them. Regardless, yes, the new nurses can be scary, but the rest of us also gave the skills to either make them or break them. I prefer to work and try to produce a more polished and compassionate nurse and one willing to keep up with the rapidly changing field. I will not, however, ever retain a paycheck nurse once it becomes clear that nursing is clearly not their calling. Let them explain to the next employer why they can’t keep a job more than a month or two. In the long run, though, I find most of them are just covering up anxieties about the responsibilities or trying to impress. Let them know you see that, understand and you will do your best to make them into a better nurse, if that is what they really want to be. Try it. You might find an appreciative person on the other end.

Just an FYI- A new nurse may not ask questions because they are not comfortable with who is training them, or simply just do not know the questions to ask. As a new nurse myself, I know for a fact I don’t know everything, however I find it very difficult to ask questions at times because when I have I get rude comments or looked at like I’m stupid. Its not always the “new nurses” fault. Preceptors these days are rude and inconsiderate. Through nursing school and training I have had only one preceptor that actually gave a crap about what they were doing. I had to quit only after a month. I could not learn in an environment that frowned upon new nurses. Everyone was new at some point in their career. I have the utmost respect for experienced nurses. It is a difficult job. But if you do not want to train someone new, SPEAK UP!

I have been a cardiac nurse for 17 years. I continue to work in a clinical management position. The lack of knowledge of the new nurses regarding medications and their lack of compassion is disturbing. It seems as if they call physicians just to document that they have called. They have not checked on the pt; only calling per a monitor tech’s report or CNA VS information from 2 hours ago. It is sad. Nursing is such a rewarding profession.

I have been a critical care nurse for 19 years. I also have found this recent group of new nurses scary. In the past I have trained and enjoyed educating new nurses. Recently , however, they know too much to ask questions. Any nurse can learn something new. Any one that says they know everything is dangerous.

I’m in total agreement with you. I’ve been at this profession for 40 years now and am still learning new things. It is scary to see some of the new nurses coming out thinking they have a handle on everything.

As a patient, too often, I am scared of them. I always try not to say I am a nurse. But seriously their long hair touching me, and probably Mr so and so next door, bothers me. I was recently on the pulmonary floor with broken ribs, collarbone, and a pneumothorax, my first nurse and my last nurse (over 3 days there) actually listened to the breath sounds, the others barely touched my chest, moved too quickly to next area, and no way assessed at all, let alone to the extent I should have had. I try so hard to be patient but some times, yes the new ones scare me!

My answer is a definite yes!!!Too many new nurses are out there only for a paycheck.They have no time for patient care…they are too interested in who is on facebook or who is texting them at that moment.They go down the hall with their music blasting.Maybe this is the dawn of a new day ???How about spending time with the patients?You may think you know everything but you DO NOT!!I have been a nurse for 30 years and at this point I am ready to hang it up.Yes there are a few really great new nurses…who really do care and who come to work to work.But the rest….go somewhere else!!!

Having been a critical care nurse for 24 years I have been very cautious around nurses straight out of school, keeping a keen eye on their actions and reactions. I have been told on many occasions that nurse’s eat their young and frankly I am sick of hearing that expression. If that be the case, so be it! I am a patient advocate first and a nurse that is continuing to learn each and every day, I am also preceptor with an ever evolving and continuous learning curve. New nurses tend to be mechanical and task oriented and cannot encompass the patient’s situation as a whole. Critical thinking will hopefully come later as the new nurse is able to quantify or add the components of patient care together as to the why things are occurring and the how and what to apply to achieve excellent patient outcomes. I had a great nursing preceptor that wasn’t shy to stop me in my tracks and let me know that I didn’t have a grasp of the situation. I can tell you countless stories of letting go of what I thought I knew right out of school to learn what I really needed to know thanks to a nurse with the gumption to speak her mind. I am still humble when it comes to new ideas because health care changes on a daily basis. What you learn today may be old news tomorrow.