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Professional Pointers

Memories from the Trenches

About 6 weeks ago I had dinner with a dear friend I've known since my first job in nursing. I hadn't seen Lynn and her family since they moved to Minnesota about 15 years ago.

I knew there was so much to catch up on - besides nursing, believe it or not.

So before we left for the restaurant, I slipped Lynn a few copies of ADVANCE to read in her spare time. It's my show-and-tell - an easy way to let my friends know what I'm doing these days.

Last week, I received a letter from Lynn telling me she had read the magazines, particularly my columns. Her response was, "You really do promote nursing in your writing." She went on to tell me about her 21-year-old daughter, now a student at the University of Chicago. Her daughter had never considered nursing as a career choice, but then, Lynn added, she never encouraged her daughter to pursue it either.

Staffing Sours Nurse's Spunk
What I found interesting about Lynn's letter was her rationale for not wanting her daughter to follow her career path.

"I guess I was turned off to nursing at XXX [the hospital where we first worked]. We never had enough staff and on the rare days that we did, they always floated the extra person to another floor."

Her frame of reference was 37 years ago. As Lynn said, we were understaffed in the trenches in those days - but it was nothing like it is today. Lynn left hospital nursing, received her BSN at the University of Pennsylvania, and found her niche in public health nursing. She continues to practice enthusiastically in this specialty today.

As I digested Lynn's letter, I thought her message showed a dichotomy.

Obviously, she has had a satisfying career, but she wouldn't want it for her daughter. What was I missing? The more I thought about it though, the more I understood Lynn's reasoning. She had found a specialty that allowed her some independence. It's a role that suits her personality, skills and talents.

Unfortunately, her memories and perceptions of a system and its politics that were not nurse friendly created an impression that hasn't changed over the years. In fact, her recollections were so terrible that she doesn't want her daughter to experience the same chaos and treatment. She also knows health care hasn't gotten any friendlier to nurses in the past 3 decades.

Nightmare on Nurse Street
This past week I received a heartfelt letter from a nurse who also has vivid memories of her first 6 months of employment. Here is the essence of her message:

"I need to inject some realism into the topic of the nursing shortage in hospitals. I graduated from nursing school in 1998 at age 36. There was not a shortage yet. I had to do some begging for a nursing position and ended up taking a job on an infectious disease unit, 11p-7a.

"Three months into my new job, including 2 months of orientation with a wonderful, understanding mentor, I couldn't take the shift any more. I felt like the living dead. They [the unit staff] did not want me to leave. (I must have been a decent nurse or they were desperate). They offered to waive the mandatory 6 month requirement and let me transfer to a med/ surg floor, 3-11p. The nurses that I interacted with on this floor were not so, let's say, touchy-feely. After 3 more months, I left my position rather abruptly and went to work for a physician."

Three years later, this nurse still remembers what did her in. Read on!

"Let me detail the reasons that I felt that I needed to leave the hospital. There was a nurse who I had to give report to in the a.m. who lived to make my amateur-nursing life a nightmare. I was dancing as fast as I could, but nothing would please her or answer her questions ... Then there was a nurse on the med/surg floor who also lived to torment me when I gave report. She made sure that she asked me enough questions that eventually I was stumped ... Then another nurse voiced her opinion that I whined when I told the head nurse that I couldn't handle a new admission at 10:45 p.m. Bottom line - they expected more from me than I could give after 6 months of employment."

Time for Reflection
What impressed me about this nurse's letter wasn't the horrific experiences she endured as a new grad. But, rather it was her ability to accept some responsibility for these experiences. After some time away from the situation, she was able to let go of her defenses, reflect and do some self-analysis. It sounds like she grew from the experience.

"Now that I look back, I was whining too much. I had so much adjusting to do; I was overloaded and emotional about the whole experience. Maybe I expected too much from the other nurses," she admitted in her letter.

Cleaning up the Trenches
The nurse's last paragraph summed up what I'm sure other new graduate nurses would like to share with nurse recruiters and hospital/nurse administrators: "All the money and scholarships do not replace the dignity and self confidence that is often stripped from a new nurse on a hospital floor. I hope I have provided you and recruiters with some insight into this dilemma," the nurse concluded.

We all know that most nurses leave nursing in their first year or 2. We need to clean up the trenches if we're ever going to make any progress in nurse retention.

Kay Bensing is senior staff nurse consultant at ADVANCE.

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