Thursday, March 03, 2016

God, I love nursing students. And new nurses. And newbies, in general.

The best shifts I have come when I get to precept nursing students or new nurses. It doesn't happen very often, probably because I have a bad, bad reputation with Manglement when it comes to new RNs. I say things like "Don't let that doctor talk down to you!" and then call the doc in question out when he's been an asshole. That does not make me popular with people whose job it is to make sure the fruit plate in the doctors' lounge is fresh and full of papaya.

Still. . . .when I get to precept a new nurse, or a student, it's such a freakin' high. People who don't know a lot, or anything, about a discipline ask the best questions. I'll be talking to a newbie about the diagnosis for Mister X, and say something like "and, of course, he's very disinhibited because he had this right-sided stroke" and the newbie will be all "Wait, what?" and then I'll have to explain it in plain English. Which is exciting, because of the whole translation aspect, and also because I have to dig deep into this brain that's been doing this for a long time and come up with answers to the questions that'll certainly follow.

So, Newbies of every stripe, pay attention:

1. Really and truly, no question is a dumb question. 

No, seriously. If you ask me a question that is extremely basic, I will not get mad at you. Often the most basic points of a problem are obscured by language or the cool stuff that isn't so basic. Ask away.

2. If you meet an instructor who says "Nurses eat their young" or "All nurses are codependent," look at them only through slitted eyes.

Most nursing instructors these days are, thank God, decent nurses. Still, you'll occasionally run into one who couldn't hack basic nursing, either because of a lack of brains or a lack of spine. Those are the ones who will tell you horror stories about nurses. Ignore them. Most of us--especially the younger ones--are without bullshit and without an agenda. We want you to succeed, we want to see you on the floor with us, and we're ready and willing to help you out.

3. Likewise, be aware of the Cunt Nurse.

The very first day I was on my own after orientation, back in the Jurassic period, I was present for a conversation between two Old Nurses. They were talking about a neurosurgery resident, a woman, who was both extremely bright and more than usually attractive. The gist of their discussion was that she must've slept with the chair of the department to have gotten as far as she did.

I remember sitting quietly, sorting my charts out, and thinking "Jesus, that nurse is a fucking cunt." I was right. She *is* a fucking cunt, and I still work with her, and I've not seen anything in the past fifteen years to convince me differently. (The other nurse she was talking with was a manager, and was fired shortly thereafter.)

The point here is that if somebody badmouths a colleague without reason, or fakes a kidney stone to get out of precepting you, or generally makes you think "that person is a cunt," you are probably right. And cunts never change. Avoid them.

4. Please have the basics down.

And by that, I mean the absolute basics. Know how to tell the upper back from the lower back. Know where the brain is (hint: it's on top). Be aware of how to take a pulse. (Note that I don't require anybody to be able to take a manual blood pressure; it's surprisingly tricky and needs lots of practice.) Know how many legs your average human should have, and whether or not your patient has a uterus. I don't require more than that, honestly. Unless you cop an attitude, and then I will make you sweat.

5. As for making you sweat, we won't do it in a mean way.

Unless you cop an attitude. As I did when I was a new nurse, and boy, did I ever have to answer for it. We may ask you tricky questions and wait, as you shift from foot to foot and glance at your fellow newbies for help, until we give you the answer or you come up with something that we'd never thought of before. We won't pimp you the way doctors do, don't worry.

Mostly, honestly, we ask you questions not because we want to know if you have the textbook answer, but because we want to see you work out a plausible answer on your own. Hell, I'll take a flamingly wrong answer that's well-conceived over a boring, flat textbook answer, simply because the wrong one was more interesting and gave more scope for teaching.

Don't be scared. Unless you're an asshole. Then, be scared.


Now Am Found! said...

you've been missed

bobbie said...

I used to love precepting students and new hires, and I gave the same words you did, about 'no dumb questions'.

Enid Mueller said...

Inspiring for student nurses!

Anonymous said...

I am getting way too old to precept or even be among the newbies. They are far too jittery and nervous. One of the little squats called a code on my patient who was de-satting. I mean the fellow was 85% for christ sake - we bagged, suctioned and he was 98% in seconds. They freak - they are nervous - they give my hairdresser lots of grey to freshen up.

Anonymous said...

I wish you could come be my preceptor but I'm all the way up in PA
I hope I am with someone as kind and knowledgeable

caitlin said...

Yay! Welcome back! I run Nurse Residency for our newbies and I frequently share with them your OTHER amazing post for new grads from a few years back. They are so fresh and excited and scared shitless which is how they learn. And then midway through the year they all want to quit and run away, then a month or two later they are like seriously 6 inches taller and look like Real Fucking Nurses. It's the BEST.

SisterLilly said...

God this post resonated with me so much. I'm a new grad nurse myself, but I've facilitated student nurses before in my previous assistance nurse position, and I so totally love it, because I get to explain stuff to them! It's such a little pleasure, but I love seeing their brain working when they understand something! Yeaaaaahman!

Comradde PhysioProffe said...

Late on the uptake, but this is fucken brilliant!

Kim said...

I found this blog in about 2011 (and read back to post one) before I started my nurse training and while I was still trying to get the qualifications together to go to university. It kept me going when I lost my mum and number one cheerleader a day before I started an access to university course and doubted everything, through the two years I had to work in finance when my first interview went badly and I got a place but it was too far away from home. I kept reading through my second interview, this time with lecturers who asked me about actual patient care and wanted to know that I would advocate for my patients and fight their corner. And through the second year midway dip where everything seemed endless and essays seemed to be all I spent my time doing. I noticed you'd gone away in November but placement got more intense and I got super busy until this evening, when I found this post. Which is now completely relevant because I qualified as a paediatric nurse last week! The comments section is probably the wrong place to write War and Peace, but in a roundabout way I just wanted to say thank you so much for keeping me going and reminding me there was a purpose and people out there who still love what they do, despite the politics. And I'm glad you're back! Kim x

autumnfaerie said...

I just found this blog and you are fabulous! I found it because I'm a first year nursing student that was looking for a simple explanation of decorticate and decerebrate posturing (thanks, btw). I say you're fabulous because you are one of the few nurses I've seen that seem to actually like having nursing students. Thank you for that. It gives me hope.