Generation Gaps

I recently took a course with nurses of varied years of experience and ages, but it was primarily made up of fairly new graduate nurses within the last year or two. During one lecture the facilitator was speaking about the future of nursing and how we need to address the current issues and challenges that exist in the nursing profession today, and asked the class to outline a few. Issues such as the global nursing shortage, heavier workloads, lack of education support, feelings of little public appreciation and individual unit situations were brought up. One nurse felt that on his unit there was a large divide between the older senior nurses and the new junior staff. This perked up my ears. He felt that the senior nurses were threatened by the amount of theory and knowledge that he and his fellow junior colleagues had and insinuated the senior nurses felt the juniors were going to take their jobs or roles on their unit. He continued to say that the generational and differing nursing requirement (degree vs. diploma) issues existing on his unit put a huge divide between the younger and older staff. (*disclaimer* While yes, I have written about how nurses can eat their young, I disagreed with the standpoint he took.) It’s terrible to think this is happening, and despite what I have written (that is only a handful of nurses FYI, by no means the picture of the entire Acme Regional ED senior staff in the least) I personally find that there is a great blend of ages and levels of experience within my unit personally.  He stated that perhaps the junior nurses should be on their own line with the senior nurses on another. I cringed at the thought of that. For any unit to run effectively and safely it is in my opinion, which I am almost positive would be shared with most, that there needs to be senior staff at all times. A line of strictly junior staff would be unsafe and potentially detrimental to patient care not to mention the amount of issues, disagreements and incidents that could and would arise. I think of inconsistencies in care and the potential for a patient’s change in condition to be overlooked simply due to inexperience until too late.  I have found that the novice and senior staff continue to learn from each other as each are on different ends of their careers with different types of knowledge to share.  This nurse went on to say that maybe the senior staff needs to go in for remedial courses to be brought up to the “standard” of the new grad degree nurses. *insert shocked look on face*. I nearly fell off my chair. If the experienced diploma nurse does not want to go for their degree how and why could one be forced to take theoretical courses that in my mind, often have little to no benefit to the patient at the bedside. I relayed my personal opinion that the diploma nurses he is suggesting should go for remedial courses to be “brought up to speed” in fact had far more clinical time as students than any of us degree nurses and as a result were far better prepared going to the bedside when they graduated as opposed to us. I reminded him of the amount of papers and classroom time we spent talking more about nursing than actually doing it. I could write a 10 page paper on how to properly sew an emblem on a jacket with 4-5 APA references if I was asked to (please no one ask me) as a result of the amount of theory referencing involved in the degree program. This nurse’s sentiments about how degree nurses are far more qualified to be at the bedside than the diploma nurses and generation gaps exist out of jealousy or by being ill prepared made me question what sort of nonsense he was spoon-fed upon his obviously very successful graduation from a degree program. I am the product of the degree program but I do not endorse the structure of degree nursing program, at least not the one I was in. I think I should have been at the bedside far more than I was. I had yet to give an IM injection to a real patient until I was consolidating in my final 4th year placement. I had however written an excellent 25 page paper on nursing leadership and how to effectively determine who should get Christmas vacation with examples of different leadership skills, roles and suggestions on effective management.. *insert vomit sound*. I suppose however it can depend on what one wishes to do with their career and the direction they want to take it.

Ultimately what I am trying to get at is while I am sure generation gaps exist on units, I do not believe it is entirely as a result of degree vs diploma more than it might be just personality related. Differing maturity levels, different interests, and people at different points in their lives not to mention the obvious that we are all individuals.  I enjoy working with the tough take no nonsense 15 year nurse as much as I like working with the 35 year veteran nurse who still gives every patient a bed bath and the novice 2 year nurse who wants to learn about every patient condition possible. A few of my closest coworkers have nearly 10+ years on me with a couple who could even be my parent.

Gaps exist only if we let them and really, we are not here to make friends. When we do that’s great, however, we have a job to do. If that 25 year nurse doesn’t like me, she at least knows I can get an IV on a 5 day old on the first poke and that’s all that matters. We often forget how our “issues” can affect the patients.

So i ask this, do generation gaps exist on your units? If so, are they related to degree vs diploma nurses or more just due to differing personalities and individuals at different points in their lives? Do you find yourself getting along with the nurses of the “opposite” generation?

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  1. #1 by Ali on Saturday 16 June 2012 - 0941

    I can see where this guy is coming from. Where I did my preceptorship, there were diploma nurses, and degree nurses were just being phased in. There was a lot of push back about how degree nurses don’t know as much, and I was often told how degree nurses are all idiots.
    I have seen great degree nurses, and great diploma nurses, I think you get what you out into the program. I suppose I was lucky, when I graduated I had done most basic nursing skills. I also had a chance to go to Alberta and be an employed student nurse, which I think had a huge effect on my practice. It gave me tons more confidence and exposure to the hospital.
    I agree with you, I cringed when I read about the junior and senior lines. I think that everyone has something to learn, and if you think you are done learning,then you are done with nursing

    • #2 by jeanhill on Saturday 16 June 2012 - 1138

      I suppose I had thought the whole degree vs diploma issue was old news as the degree program has been around for more than 10 years now, but one should not assume.
      I think a large contributing factor to my feelings of illpreparedness had to do with the fact that that I was part of a College/University’s first class of degree nurses and there were A LOT of quirks to work out.

  2. #3 by shrtstormtrooper on Sunday 17 June 2012 - 1729

    Experience is the single most valuable thing to an ER nurse, in my opinion. All the theory in the world won’t prepare you on what to do when you take care of your first truly sick or decompensating patient, but that ER nurse with 15, 20, 30 years of experience can calmly walk in and know what to do – and how to do it quickly.

    Experience means knowing how to set up an autotransfusion in the midst of a crazy trauma. It means knowing how to identify that priority 3 patient with the sort of “off” look and know that they are actually really sick. It means being able to look at an EKG for 1.5 seconds and see what’s wrong – and how to fix it. It means knowing how to set up transvenous pacing when then cardiologist is yelling at you to hurry up because the patients’ HR is 27. It means just knowing how to mix the right amount of levophed into the right amount of fluid and start it at the right rate, and then knowing what to look for after it’s been started.

    Theory is important and a necessity now, but to discount all those diploma nurses who learned at the bedside 30 years ago just because they don’t write papers with APA format? I hope those new theory grads are remembering just how much diploma nurses *aren’t* needed when they’re drowning in that really sick patient.

    I’m a degree nurse with less than five years experience. I still feel like I don’t know anything, and I breathe a sigh of relief when the other three nurses in the station with me are diploma nurses with 20-30 years of experience.

    • #4 by jeanhill on Monday 18 June 2012 - 1755

      I couldn’t agree more. I imagine you know more than you think but when surrounded by all that knowledge and experience it’s easy to feel that way ;)

  3. #5 by torontoemerg on Monday 18 June 2012 - 0853

    A couple of points: I think the “clinical practice gap” is smaller than people realize, and their reflections on this are tainted by nostalgia and “common wisdom.” Contrary to popular belief, diploma nurses were not instant Nightingales the moment they earned the RN after their names. They needed mentoring and skill development too. So my message to all those diploma nurses who bemoan the lack of clinical skills of new BScNs: Get over yourselves. You weren’t that great either. But you became great, because other nurses took the time to mentor you.

    That being said, I do think that diploma RNs had the advantage as new grads — over the short term. I firmly believe, on the other hand, that baccalaureate nurses will over the long haul be better nurses, precisely because they have that theoretical background.

    I also think your instructor was a little but nuts. But that’s just me.

  4. #6 by Darlene on Monday 18 June 2012 - 1555

    As a 20 year diploma nurse working on my degree, I do have a few things to say…I agree with both sides to a point. As I work on degree courses, I can appreciate that there are some things I just don’t know. For example, Community planning, and all the stuff that goes along with that. My 3 year diploma course just didn’t teach that.
    On the other hand, I am spending WAY too much time on APA (crap) that I truly feel has nothing to do with what I do, and who I am as a nurse.
    I work with mostly degree nurses in my practice today. There are some great new grads, and some not-so great.
    #4’s post sums it up I think.
    “Contrary to popular belief, diploma nurses were not instant Nightingales the moment they earned the RN after their names. They needed mentoring and skill development too.” As I recall, as a new grad, I was scared to death that my head nurse would figure out that I didn’t know anything, and fire me when she found out.
    Its a new world, and we as nurses need to get used to it, get over ourselves and support one another.

    • #7 by jeanhill on Monday 18 June 2012 - 1802

      We all have to start somewhere. I just dislike the thought of any New Grad coming out thinking they know more than someone else because they have a few extra letters behind their name and have written x many papers. As J mentioned in post #4, the diploma nurses required mentoring just as the degree nurses have and do and as you mentioned at the end of the day, we as nurses need to support one another, whatever educational background we derived from.

  5. #8 by Keith Carlson on Wednesday 20 June 2012 - 1013

    Great conversation and very relevant points all around. In our field, there simply must be room for everyone, and I have also met degree nurses and diploma nurses who were both very sharp, and….well…..not so sharp.

    Unless the powers that be declare once and for all that we all nurses must have a degree, then it’s imperative that we learn to work together and respect one another while also learning from one another.

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  1. Nurse Blog Notes: Generation Gaps, Hypothermia, Informatics, Nurses Writing « Off the Charts

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