Saturday, October 15, 2011

Interesting question via the comments.

I got this the other day in the comments and decided to repost it for everybody to take a swing at:

Dear head nurse,
I am currently interning at a heart institute in Texas .
All (except one )the RNs here treat me like trash and also are slave drivers , Not exaggerating here.They get paid for the crap i am doing for them .
I would truly love to hear your thoughts on this.
And heres the best thing , they dont let me learn anything , or watch procedure s , as their filing and copying is of utmost importance to them more than my learning phase. What do you think?

First things first: If you're in a situation where you're supposed to be watching procedures and helping care for patients and you're not able to do that because you're getting saddled with copying, filing, whatever--it's time to talk to the person in charge of overseeing your internship. The primary purpose of a nursing intern- or externship is to learn the theory and skills you'd use in the unit where you're placed.

When you approach your internship coordinator, take in a list of times when you've not been present for procedures because you've been tasked with something clerical. If you've been assigned a job that's not patient-care-related and told that because of that task, you can't practice a particular skill you're meant to master, take that (or those) specific examples in with you as well. You don't have to name the people who've assigned you those jobs, but *make sure you have documented times when it's happened.* Be specific and timed and all that stuff.

("Specific, timed, and measurable" works for more than care plans. Who knew?)

Second things second: When you say the RNs treat you "like trash," what exactly do you mean? Is there a fundamental lack of respect, trash-talking, or lateral bullying? If so, again provide concrete examples--and in this case, you might be asked to name names--to your coordinator. It will help if you can keep a written list of times Person X has said something belittling or bullying to you. This is standard practice in situations when somebody feels discriminated against or harrassed, and it's a *good* standard practice: building a list of incidents helps you build a case.

While you're doing those things, do two more: take a look at your expectations for the internship versus the facility's expectations for the internship. If there's a basic disconnect--in other words, if you wanted nursing experience and they put you into a position where you're learning to be a unit secretary--you'll need to talk to the coordinator about that as well.

Examine the culture of the place where you're interning, too. There are some places that are great, some that suck, and a whole bunch stuck in the middle. If you're in a place that just outright sucks--where there's a lot of what they call "lateral violence," like bullying or back-stabbing--you might need to go somewhere else. If you're in a place that's great but just isn't a good fit for you, again, you might need to find a different position somewhere that's a better match. If you're in one of those facilities that's in the middle, you can work with the people who treat you well in order to carve out a better learning experience.

Can you talk to the RN you mentioned and ask him or her to act as your advocate? That RN might have some insight as to what's happened with previous interns. She or he could tell you if the way you're being treated is something that's habitual, or if there's a better place within the facility to get the experience you want.

When you present all this stuff to the person in charge, be as unemotional as possible. Avoid the terms "slave-drivers" and "crap" at all costs. There's a certain amount of drudgery and general-factotum-ness in every job, and some of that's going to spill over into an unpaid position. (By the way, yeah, those RNs are getting paid for what you're doing. . .but that's kinda the nature of the beast.) Focus on how the stated goals of the internship aren't getting met, and be sure to present possible solutions. You can't just go in with a list of problems; you'll get a much better reception if you can come up with ideas for fixing them.

And good luck. This is a tricky spot to be in.


RehabRN said...


I wholeheartedly agree.

It is to your benefit to be as unemotional as possible. And to hold them to the standards of whatever program you're in, and say, "You want me to do x, y, and z and Saint Whatever Hospital nurses don't want me to. How can we resolve this?"

Chain of command is always nice and professional. Holding people to standards also is necessary to making your point as unemotional as possible. The main thing is that you need that experience to a) be a good nurse, and b) be capable to do the job wherever you go. Jobs are just too hard to find these days.

If you can, get a hold of Stuart Diamond's Getting More book. It talks a lot about negotiation. It is probably the best practically oriented book I've ever read. (and no, I don't get a commission or anything.)

Just my $0.02 from years of work experience...

danielle said...

The only thing I would add is to closely examine your own behavior. Have you just rolled over and let the RNs think you really are not interested in learning? Have you been a know-it-all and antagonized those RNs? If yes to either - is it too late to change your behavior? If no to both, make sure you communicate that to your coordinator.

messymimi said...

Excellent advice for even non nurses who are experiencing this sort of difficulty. Oh, and i loved what you said in the Reader's Digest.

Anonymous said...

Dear Internist,
You know what? You have presumably chosen to become a Nurse, and whether you realise it or not, the most important characteristic that a nurse needs to develop is mental toughness. Because, long after Dr has gone home, it is you that is going to have to deal with the blood, the pus, the shit, the untreatable pain, the anger of patients forced to face their mortality, the ignorant and rude family members. You are going to do all this while remaining cool, competent and professional. Now if you can't handle a bit of paperwork and some offhandedness from your supervisors I suggest you STFU and change your major to interior design.

Penny Mitchell said...

Okay, I'll say it. Am I the only one appalled by the grammar, spelling and use of punctuation in the quote?


Anonymous said...

I would first advise this person to look at their job description. Many times a person in nursing school is told that if they take a job as an intern or extern it will be a great learning opportunity. This may be true, but the institutions that hire these students are usually paying them to act in the capacity of a nurse's aid, meaning their primary responsibility is to AID THE NURSE! That doesn't mean that learning opportunities will not arise, but the job comes before their education. I can't imagine that in today's world a hospital is going to pay someone to come into their facility just to "learn".

gigi wolf said...

You are paying for your education, no one else is. Therefore, you are your own customer, and need to give yourself the best service possible. I interned once with the same results of filing every single day, and learning no front office procedures. I went to the person at my school responsible for placement,(these placements are getting a steady stream of free labor, but not necessarily hiring the interns)who was extremely snotty about it. I then went to the dean. At that point, the school was not standing behind their paying customers. I then was given permission to talk to other places and choose where I would like to intern, assuming they wanted me. gigi wolf, author of A Woman's Guide To Everything on

Rosanna said...

'Probably at least a couple-hundred dollars' worth of really, REALLY good, professional, "workable" advice here, (i.e., that you gave the intern), Jo!!

Not, of course, that any of us actually expect to receive any monetary compensation for giving advice to interns; proctoring nursing students; or mentoring new graduate nurses, because it's honestly just "Part OF Being A Nurse." (Wonderfully-*generous*-with-blog-advice!) you know what I mean............

However, 'sure do hope the intern has (and/or will)............ at least acknowledge, and thank you kindly FOR, your very wise Nursing Advice, though!

Anonymous said...

Dear Head Nurse ,
I am totally grateful to you for your advice , Thanks a ton for taking the time and the patience to guide and type it , in your busy schedule , Very few people do that,
I am not a nursing intern , I am a graduate intern in Kinesiology,
Like you mentioned all the paperwork did affect my opportunities to watch procedures .

Thanks again for your valuable advice
Bless you


Doogiesmom said...

Yes, we do tend to eat our young, but be careful. The nurse who gets paid for doing all the crap he/she dumps on you probably doesn't get paid for precepting you. So give him/her a break. And like Danielle said - examine your own attitude. We all started with the crap jobs. Get over it.