Tuesday, June 2, 2015

why we eat our young

Someone recently told me something that disturbed me deeply. It was something I had heard before, but I chewed on it this time for a while and have been pondering about it since. It involves human nature, and behavior. This was the story:

"A young woman recently graduated from nursing school, and went to work in one of the larger hospitals in one of the largest cities in the state.  She was hired in as a new grad nurse in the NICU (Neonatal Intensive Care Unit) and was excited and enthusiastic about being a nurse.

Her joy was short lived however.  The staff treated her so poorly, and were so rude and unhelpful, that eventually she quit, and now works as a nurse in a non-nursing position, away from the bedside nursing she had dreamed of doing."

Two things disturbed me about this. The obvious thing was her maltreatment from her peers. It isn't the first time I have seen this happen. Over the years I have watched nurses who are rude to the nurses they are training, who don't have patience to take the time to give them the guidance and support they need to become excellent nurses. They often do this because they feel they don't have the time to spend training and mentoring due to their own workload (this is another issue I will talk about at a later time), or they just don't have the skill to teach. Not every nurse is cut out to be a teacher/mentor.

The other aspect that disturbed me is the administrator who hires a new nurse and puts her in a high stress area to work, where extensive, expert skills are needed to keep a patient alive, straight out of nursing school. A nurse does not begin to even understand her job for the first six months, and functions at a very basic level. The book that brought this home to me and taught me a lot about the stages of experience for a nurse was a little book written by Dr. Patricia Benner, From Novice to Expert: Excellence and Practice in Clinical Nursing Practice.  In simple terms, it takes 2 to 3 years to reach the third, or competent, level of nursing doing the same or similar type of work.

To gain experience in an ICU, you have to work in one. This is where it is important to choose the proper preceptor for a new nurse hiring in, give her a workload she can handle with the added responsibility of training a new nurse, and monitor the relationship to make sure that it is the right fit for both nurses. I have to say that in 20+ years of being a nurse in many different areas, I have never seen this happen. EVER.

As I heard the story of the young nurse's disillusionment and resignation from her job, I was saddened, and thought of the saying "nurses eat their young". Simply put, it meant we don't take care of the new nurses coming into the profession, but instead throw them in on their own, with little or no support from the experienced nurses. The meaning hit me full force, and I felt anger and frustration. Anger at the nurses who didn't bring this new nurse on board, and support her as she tried to gain her footing in a highly technical, stressful job. Nurses too burned out, too overworked, too whatever...to see this nurse as the future for all of us, not only nurses, but also patients. Someday those nurses will be patients in a hospital, and facing the same kinds of attitudes they displayed. I wish it wasn't so, but I fear it will be.

The ultimate responsibility though, goes to hospital administrators who don't encourage a different culture of training and mentoring for new nurses. Who think of nurses as a disposable commodity, with access to a never ending supply. As long as nurses are thought of this way, this type of behavior and treatment will go on.

It doesn't happen everywhere, on every unit. But to lose even one new nurse, full of enthusiasm and desire to care for people, is a tragedy. One we will all pay the price for, ultimately.

Let's stop eating our young.

...life is good. ~cath
i am @jonesbabie on twitter

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