I’m New. Please Be Kind.

We have all been there. We all know the anxiety. The first day in a new unit. Remember? The uncertainty. The expectations. Will they like me? Can I do the job? You feel like all eyes are on you. And there’s nothing worse than the hostile stare, or worse, the indifferent silence. The Muse RN wrote about the newbie nurse phenomenon on her blog a couple of weeks ago. Her take is that nurse newcomers ought to keep their heads down, bribe the old birds with baked goods, smile a lot, and above all, shut up. “You are here to learn our ways, not the reverse,” she writes.” You were chosen from a handful or more of others to join us – don’t make us doubt our hiring abilities by becoming obnoxious about ‘how you do it.'”

My own perspective is a bit different. It’s obvious that new (to the unit) nurses need to adapt to local norms and mores, and the initial time of employment is inevitably a time of socialization and formal and informal evaluation. But remember, the new nurse on the block is sizing up you. He’s seeing how you and your colleagues are going to treat him, and whether you all live up to the hype. So it’s a two-way street. I would probably go further and say that the onus is with the nurses on the unit to make sure the new hire’s transition is smooth.

I say this for some simple, self-interested, pragmatic reasons. Unit cohesion and teamwork means better patient outcomes, and making a new nurse “pay her dues” is probably not the best way to go about it. What’s more, every unit wants low staff turn-over and a cadre of experienced nurses taking care of patients. The time to ensure new hires are successfully integrated into a unit is in the first few months of employment. A nurse who is treated poorly on arrival by his colleagues — and we have all seen it — will remember the slights and insults for a long time. She will fulfil all your expectations of bad behaviour and bail at the first opportunity. Is that really productive? Do you want to be known as the unit that eats all the new hires live?

I speak here from personal experience, as you might guess. I was thinking of the times I was the new nurse, and I came up with a little list, some thoughts to consider from when I was in the position of being the newest colleague.

Take the time to welcome me. Really. It makes a big difference and doing so (or not) may shape our working relationship for years.

Make a point in including  me in outside-work activities.

Remember I came here because I heard this was a great place to work. Don’t disappoint me.

Whether I am an old nurse with years of experience and perspective behind me, or a new grad with up-to-date knowledge of best practice, I have something to contribute. Don’t dismiss me because “that’s not the way it’s done here.” Consider your opportunity to learn from me is as great as my opportunity to learn from you.

Acknowledge my existence.

Treat me collegially, not like some not-quite-bright child. Don’t talk down to me, and don’t be patronizing or condescending. Remember, I’m an RN, fully qualified and a professional who deserves respect and courtesy, just like you.

Cut me some slack if I don’t have the routines down right away. You’ve been here for years. I’ve been here a few days.

By the same token, don’t roll your eyes at me if I can’t find that special epidural needle the paediatrican prefers.

If I seem to make a lot of suggestions about improving conditions or processes, have the insight to realize I’m still in the honeymoon phase, and still new and enthusiastic. Or better yet, take advantage of that enthusiasm. Get me to sit on a committee, or work on a special project.

Bottom line: be kind and act with empathy and insight. Be nurses. If you don’t remember, being the new nurse on the unit is a lot harder than you dealing with the minor annoyances they create.

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  1. #1 by The Nerdy Nurse on Monday 31 January 2011 - 1312

    Yet another reason why you are one of my favorites.

    We need to abolish the injustice of nurses eating their young and embrace newcomers with open and teaching arms.

    I began my blog because I was bullied and it saddens me to know that there are some nurses, as you mentioned, who think that new graduates have “dues to pay”.

    We are professional adults and although I feel that new graduates should respect the old dogs, the old dogs must not forget that those new-grads have many new tricks that they are eager and willing to share.

    We can learn from each other. We can and will provide excellent healthcare. We have to work as a team so why would anyone want to make it any more difficult on their teammate, and therefor themselves?

    Lives too short to be bitter. Don’t be a bitter old nurse. Embrace newcomers and remember they may very well be taking care of you one day.

  2. #2 by Karen Sugarpants on Tuesday 01 February 2011 - 1828

    I like this approach a lot more. I’m starting nursing school next September, at 37 years of age. So, I’m happy to already feel quite sure of myself as a person. I’m a direct, but kind person. So if the time comes where I find myself in a situation where I’m not being treated fairly as a new employee, I’m going to ask myself, ” Is that really productive?” And if it truly isn’t, I’m going to be the kind of nurse that asks that question out loud. I think that’s a fair way to approach it. Of course, I’m not even in nursing school yet, so maybe I’m wrong! :)

  3. #3 by DOEcomic on Friday 04 February 2011 - 0927

    The rest of my new nurse crew and I thank you. I have been the new kid on the block for 9 weeks now and have been thankful for how the other nurses are treating me. I am lucky in that the “old, crusty my way or the highway” nurses are few and relatively quiet on pushing their values. I always say, “Don’t hate, cooperate.”

  4. #4 by NatashaHM on Thursday 10 February 2011 - 1206

    I teach first and second year nursing students. And while all the ideas and comments are true and valid – in some ways commenting on old v. new and the ‘nurses eat their young’ phenomenon promotes the idea that nursing is a profession that requires a socialization period through a gaunlet to a quality work environment. In ANY first (or new) job, in ANY profession, becoming comfortable with a work culture IS required and IS a two way street. I’m mid-career, and I see just as many ‘new’ nurses bullying as ‘old’ nurses. Things to consider in socializing to nursing cultures are the generational gaps, the ratio of novice to expert nurses on the ward (have you been there only 1 year and are in charge because you’re the most expert nurse?), the turnover rate of staff and patients, and the organizational support for supplies, technology and education. What nurses fail to discuss is that first year communication class and the fabulous helping skills of respect and genuineness. We all learn about being immediate with patients who test us. What about normalizing immediacy with our colleagues (as Karen suggests)? Complementing each other, in the moment, on modeling professionalism.

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