All Entries Tagged With: "new graduate nurses"
Kathleen Bartholomew, RN, MN, answers questions about ending nurse-to-nurse hostility
Kathleen Bartholomew, RN, MN, dared to ask the question, how can a profession that is based on caring include such uncaring behaviors? Her powerful research exposes the toxic relationships and bullying behavior that causes nurse burnout and threatens patient safety. Here’s a question and answer session where she offers practical advice to real-life problems.
Q: It’s often easy to point out the shortcomings in others. What do you do for people to help recognize and overcome their own bad behaviors?
A: Peer evaluations are effective, but a critical conversation is the most powerful tool both peers and managers have. I ask, “What do you do well?” “What would you like to do better and how can I help?”
Q: What is the most important thing we as nurses can do to turn around toxic work environments that are deeply rooted in bullying and disrespectful behaviors?
A: SAY WHAT YOU SEE. Your voice is your power. These behaviors will be NORMAL until someone stands up and says, “Hey, this is impacting the patients and morale. This needs to stop.”
Q: Any suggestions on how to handle shift-to-shift complaining and bullying?
A: I know this one is hard. When I was a manager, no amount of teaching or counseling could change the shift-to-shift so I asked the nurses to switch shifts for a week. Then I never heard another word. The “walk in their shoes” experiment also worked for nurses complaining some floors were easier. Next, I worked closely with the charge nurses and gave them the knowledge, skills, and confidence to stop these behaviors when they saw them (that took almost two years).
Q: Have you actually seen the “turnaround” of a bully in the workplace work other than dismissal of that employee? Isn’t the bully in a person part of their personality trait?
A: Great question. Personally, it’s been 50/50 in my experience. And if you are a leader/manager and start drawing the line, there is a high chance of the bully going on FMLA/being injured etc. It takes a lot of people skills to turn them around because if they are not going to be the bully, then who are they? How do you create an alternative role for this nurse in the unit? Also, don’t think of a bully as an individual problem. It’s the unit’s problem because many nurses have tolerated the behavior for years (even decades).
How to get started with a nurse residency program
Want to build a nurse residency program for new graduates but not sure where to start? Kendra Varner, MSN, RN, nurse residency program coordinator for the Kettering Health Network in Dayton, OH, and contributing author to Nurse Residency Program Builder: Tools for a Successful New Graduate Program, offers the following steps to get your started.
What’s the first step?
The first step is support. You need support from above if you want to start a successful program, so make sure you have someone who understands the return on investment who can champion the cause.
Organizational culture is also important. The culture has to support nursing, education, etc. A culture that features low morale, quality, and job dissatisfaction are significant challenges as they tend to perpetuate themselves from one generation to the next (e.g., preceptors demonstrating poor attitudes and low quality care will result in new graduate nurses with the same behaviors). These issues must be addressed by nursing leadership.
If your organization struggles with low patient satisfaction and high nurse vacancy rates, then employee morale may be poor. It’s important to have a positive culture. A good clinical working environment and a nurse residency program will make employment at your organization highly desirable among new graduate nurses in the area. It takes a village to raise a child. The residency program belongs to the entire organization and its success or failure cannot lie with the program leader alone. [more]
Helping new graduate nurses over transition shock: Part 2: The “being” stage
Kendra Varner, MSN, RN, nurse residency program coordinator for the Kettering Health Network in Dayton, OH, wrote in the book Nurse Residency Program Builder, that new nurses go through many experiences as they transition to become competent nurses. In the second part of a three part series, Varner describes the second stage.
Judy Duchscher elaborated on the concept of new graduate nurse shock by describing the transition process as a nonlinear “Process of Becoming” a nurse (Duchscher, 2008). This process has three stages: doing, being, and knowing.
During the “being” or transition crisis phase, the real work of role transition occurs, beginning around the fourth month. During this stage, new nurses have consistent and rapid knowledge, skill, and critical thinking acquisition, but at the same time begin to experience a paradoxical loss of confidence resulting in uncertainty, confusion, and even depression. Consciously aware of competency level and significantly doubting their own abilities, new nurses seek validation of decisions from more experienced coworkers, which may be met with mixed reactions. While examining inconsistencies and inadequacies within the healthcare setting, graduate nurses struggle to reconcile their previously held view of self and the world with current reality, or they cognitively adapt to the change. Described by Bridges (2009) as a psychological wilderness state between identities and realities, this stage is profoundly frustrating, as well as irritating for nurses, impacting both personal and professional lives.
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What’s the best way to welcome new graduate nurses to the unit?
This week on StrategiesForNurseManagers.com, we asked what’s the best way to welcome new graduate nurses to your unit?
Fifty-two percent of respondents say the best way to welcome new graduate nurses is for them to have lunch with their new colleagues. This gives new nurses a chance to get to know their colleagues in a more personal way and helps them start to feel part of the team.
Twenty-nine percent said they like to hold a staff meeting and introduce everyone by name, 10% like to take new graduates off the unit for a one-on-one lunch with their manager, and 10% post information on the unit’s bulletin boards about the new staff nurse’s likes and dislikes, family, and other personal tidbits so everyone can get to know him or her.
Helping new graduate nurses over transition shock: Part 1: The “doing” stage
It’s the time of year when hospitals are welcoming new graduate nurses to their units and nurse managers are preparing to help these new nurses make the difficult transition from nursing school to nursing practice.
Kendra Varner, MSN, RN, nurse residency program coordinator for the Kettering Health Network in Dayton, OH, wrote in the book Nurse Residency Program Builder, that new nurses go through many experiences as they transition to become competent nurses. In the first part of a three part series, Varner describes the first stage.
Judy Duchscher elaborated on the concept of new graduate nurse shock by describing the transition process as a nonlinear “Process of Becoming” a nurse (Duchscher, 2008). This process has three stages: doing, being, and knowing. Graduate nurses’ transition begins with the “doing” stage and orientation to the role.
In this stage, graduate nurses can experience a wide range of emotions, including an initial elation over passing the licensure exam and acquiring a staff position, as well as an unexpected grief due to losses associated with changes, such as loss of contact with school friends, as well as familiar routines, and faculty support. Discovering the new practice environment as well as nursing culture to be different from what was experienced at school results in “transition shock,” prompting graduate nurses to learn new skills and engage in behavior adaptation by “acting like a nurse,” focusing upon nursing skill acquisition, such as successful task performance and time management.
NCLEX passing standard raised due to sicker patients with longer life spans
The amount of care required by hospitalized patients seems to grow every year, and many nurses in the field question whether recently-graduated nurses are sufficiently prepared to take on the demanding task.
This is the issue considered by the National Council of State Boards of Nursing, (NCSBN), which recently raised the passing standard on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to ensure new nurses are sufficiently ready to take on the growing needs of sicker patients. [more]
Sim Man 3G becoming more common in nursing education
Many facilities across the nation are investing in state-of-the art technology that allows students and staff members to gain real life experience without the fear of killing a patient.
The high-tech mannequin, Sim Man 3G, costs roughly $27,000, but can cost up to $60,000 with additional accessories and programs available for download onto the mannequin. Even though many facilities have been forced to cut back on their programs and spending, the price of Sim Man 3G has not deterred facilities from purchasing the state-of-the are technology. [more]
Keeping new graduate nurses happy and on the job
Within the first two years of becoming a nurse, more than 60% of nurses end up leaving their first job. In this economy, nurse managers have to find ways to keep morale up and nurses in their positions. To make the transition between the classroom and hospital setting easier, many facilities are turning to residency programs.
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Poll taps into time frames for new grad orientation
Orientation is a critical, and often stressful, period for new graduate nurses. Adapting to a new facility, trying to remember everything from nursing school, and applying the knowledge learned in nursing school at the bedside are all tall tasks in themselves. But a supportive work environment, and some time, can ease the transition for new grads. [more]
Grasp your new grad nurses
Transitioning from nursing school to the bedside can be difficult for new nurses. And literature reveals a hefty amount of new nurse graduates depart from their first position within two years of hire. So, why are they leaving? Like many of us, new nurses want to feel valued, be rewarded, have strong relationships with their managers, and enjoy a work-life balance.
Managers work so hard to get nurses in the door that it makes sense to work hard to retain them. It’s important to let new nurse graduates know they are welcome on the unit and will be a valued part of the team. Here are some ways you can do this:
- Create welcome flyers. Make welcome flyers and post them around your facility-not only in nursing areas, but also in places physicians will see them.
- Get to know them. It can useful to get to know new graduates before assigning them a preceptor or a mentor, because that way you have a better idea of their personality and can make a suitable placement. To accomplish this, consider spending the first two weeks of new nurses’ orientation with them as much as possible.
- Check in weekly. Most new nurse graduates are beginning their first-ever full-time job. The reality of this can be overwhelming, so check in weekly to make sure they are not overwhelmed.
- Recognize the new nurse at staff meetings. Before you begin the weekly staff meeting, take the time to introduce everyone to the new nurse. This is a great way for the new nurse to remember faces and feel a part of the team.
How do you make your new grad nurses feel appreciated?
Editor’s note: This excerpt was taken from the book, Nurse Retention Toolkit: Everyday Ways to Recognize and Reward Nurses. For more retention tips, look out for its release in early September.
