So, since I was so rough on my fellow nurses and griped about it for two pages, here are some things that need to happen to stop this internal problem.

First, would you want to be treated how you are treating that person?  Before you start the line, “well I was treated this way,” answer whether you liked it.  If you did well, you are a little maso and phone a friend because the general lot of us does not like it. The excuse of it being, “how I was trained,” doesn’t cut it.  How you are trained prepared a nurse just like you are.  I am not saying you are not skill competent or unable to provide patient care. I am assuming you are not a team player.  If you bully someone on your team or treat them as some sub-nurse, then you are not a team player. So, you have no excuse, check your behavior and make those adjustments.

New nurses or nurses that are new to the unit that are being precepted are not servants they need to be mentored. I heard a nurse say one morning (when I was forced to work days…ugh I have never wanted scream more) Oh good I have a newbie I should have a nice relaxed day.  Whoa there chief, when I have a newbie or student, I am exhausted by the end of the day because I spend it asking them questions, watching them work, and showing them ways to do something (and more importantly watching how they do something). Learning is always a two-way street, and we should not only impart our knowledge and wisdom on a new or new to us nurse, but we should also be able to learn from them. If you have been in nursing for over ten years, you will know medicine has changed, and best practices have changed.  Maybe you have no clue what those are, and you shouldn’t discount someone with new information (especially folks who just graduated who had to know it by rote) just because your dinosaur butt hasn’t “ever done it that way before.”

Now I know that good mentoring requires time, and often they slam someone who has a student or newbie because “you have help.” You don’t have help, you have someone that you need to work with, coach, correct, and follow all shift long. Some folks do well and require less coaching and correcting but some do, and authentic teaching requires this.  This is a management issue that needs to be addressed, and regardless of anything, it is a cost that you have to endure.  Nurses are not a disposable commodity, and well-trained acculturated nurses are a valuable member of the team. Acculturated here does not mean, “used to the bullying or hazing.” Since I know management won’t step up or is reluctant to, these are things nurses should fight to obtain.  I think in one position I had a whopping two-week orientation and pretty much was left to fend for myself because they needed me to be fully functioning right out of the chute.

Here is a contrast.  As an NP I was taken through the processes used in the clinic, followed a clinician and no clinical responsibility other than observation and then eased into charting and patient exam requirements. I was given constructive feedback as well as tips on how to make the mountains of charting and order writing easier. The difference?  First, NPs are expensive and recruiting and keeping one is difficult at times.  Second, we are billable.  All of the CPT (Current Procedural Terminology…Yeah I didn’t know that one either but anything for you my dear reader) codes I use are specific to my care.  General nursing codes do not exist.  Meaning that as a registered nurse your services bill to an overall bed charge, meaning you are billed with laundry, housekeeping, and food service.  It isn’t saying those services, and yours aren’t essential, but you have to see that you are not viewed as necessary to the hospital. I had an instructor tell me one time that “no one will take nurses seriously until their services are a line item on a billing statement, “and she is correct. As Registered Nurses, we are a long way from that reality, especially when we behave on the level of a junior high gym class (yeah that even includes wedgies).

Many NPs, Nursie poo included, are shocked when we move to the land of being billable.  It means we exist and that we are treated as professionals.  We also have organizations that truly fight for our professional lives.  While nurses have the ANA and some state associations (some are better than others) they do not put the level of emphasis on practice and professionalism that NP associations do.  Both provide a valuable source of CE, best practices, evidence-based updates, they are different. As a nurse, you should be politically involved, and you should have a place at the table.  I will tell you it was odd for me to watch legislators asking questions in committee and watching my colleagues testify as to why moving NPs towards full practice authority in our state is important (remember billable).

When you take the time to mentor a newbie, you take the time to develop your team.  People that have your back; people that when the fertilizer hits the spinning ventilator are right there instead of having to drag them in there. It may still turn to a shit storm, but at least you will be covered in it together.

Please for the love of dog, just because you gossiped in Junior high doesn’t mean its right on a nursing unit, or off of the unit socially.  It’s ok to be friends with your co-workers just don’t rely only on those friendships.  Someone you don’t know as well may know more.

Well, time to give the hellhounds a pet and get ready to teach prevention and managing disruptive behavior…oh will I be sore tonight.