Nurses FEEDING their young- the inevitable end to Nurse Cannibals

This article is the fourth part of a series about the impact of YOU- and the end of cannibal behaviours in health settings. This was originally a four-part series but as a part of this journey we have had a lot of feedback that nurse cannibal behaviours are not limited to the new nurses joining our work units. Nurses at all levels have experienced horizontal violence and even targeting from other levels of nurses- be it below, same or above their current level. So, we will have one more part in this series which will explore the relationship and experiences of nurse to nurse cannibalism (regardless of level).

 

Part one discussed the culture of ‘eating our young’, Part two discussed ‘helping each other out of the cannibal’s pot’, part three discussed ‘protecting others from the cannibal’s pot, and in this article we will talk about ‘nurses feeding their young’. The future of nursing is bright, and even from the feedback we have seen in response to our articles, we can see a tidal wave of nurses committed to being the change they want to see. Big culture changes occur due to small actions made over and over.

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Tracy- Getting old is a privilege not all of us will experience, however we will all require healthcare at some point in our lives. The reason why I am so passionate about supporting new and developing nurses, is because I know the importance of the work they do- the value of the care they give - and I know I will need their help in the future. Great people stay in great workplaces. But what makes a workplace great is the people within it. When the people within a team support, develop and encourage each other we all benefit and patient care is better, and our patients have better outcomes. The new nurse entering great workplaces benefits because they grow and learn faster and can contribute more. They are not afraid of being ‘eaten’ and they can focus on giving great care and learning instead of worrying about their psychological safety. The experienced nurses in great workplaces feel respected and rewarded because of the contributions they make. Patients benefit from more advanced and compassionate care, and managers benefit because we can spend our time on adding value to the team (instead of trying to find replacement staff).

Emma- The reasons I am passionate about great workplaces are probably more selfish than Tracy’s – they are better to work in for me. I am more productive, I have better ideas, I can share my experiences without fear of judgement or shame. I know what it is like to work in a workplace that is challenging and doesn’t feel psychologically safe, and I know the shame of being renowned for having an unhealthy culture. Pride in a workplace translates to pride in practice and the care we deliver so it is vitally important. I am committed to supporting and developing new nurses because we will reap what we sow. I want the leaders of the future to be greater, better and more visionary than I am. I can only imagine what impact they will be able to have on the healthcare system and patient care in their lives. The thing is that a sustainable healthcare system NEEDS these future nurses to WANT to stay in nursing, to WANT to dedicate their lives to making the system the best it can be, and in order for them to WANT to do these things they are going to need to feel safe, welcome and supported.

We are both passionate about FEEDING new nurses from the early development years and beyond. For us, this means:

·      feeding the minds (giving helpful information and coaching for development),

·      feeding the hearts (being emotionally supportive and providing care) and

·      feeding the spirit (encouraging and praising them for great work). 

Emma has created an on-boarding program which has provided an incredible change in the support and connection our new hires have with the team (stay tuned for this article!) and is a proactive mentor to many nurses. Tracy likes to link in early with nurses while they are still studying. Meeting them in person and encouraging them to provide feedback on our team (both positive and constructive) has seen them more empowered when starting a placement. It is important that they know unkind behaviours are not acceptable in our workplaces. In part three we talked about how you can intervene in a cannibal kitchen moment, and now we would like to share with you some positive ways you can connect with new and developing nurses.

1.      Get to know them

When any of us start in a new job, it can be daunting. Not knowing who to sit with at lunch, learning the culture and learning a new job are challenges for all of us. It can be made so much nicer, by even one person reaching out. “Hey, I’m Tracy. You can sit here if you want. How’s your day going?” As a friendless newbie, I would have LOVED to hear those words. Humans are wired for connection; it also protects us against stress. We can offer this support to our new nurses, at no personal cost to ourselves.

2.      Offer support

As experienced nurses, we can see when someone is struggling. It could be an unfamiliar task, it could be trying to find equipment or it could just be struggling with a heavy workload. “Hey, I’m up to date with my work- what can I do for you?” Can provide a lot of relief to a drowning colleague. Be careful with your words. Ask what can I do? instead of is there something I can do? This assumes there are ways in which you can help, and it is less overwhelming for the nurse to reach out. A nurse can easily think of just one thing when their brains are trying to keep up with the other parts of the job. Support does not have to be doing physical tasks. It could be emotional support too. “You look as though today has been rough. Want to talk about it?” Even if they don’t want to talk, knowing someone cared can make a huge difference.

3.      Provide feedback/ coaching

When we see a new nurse doing something which appears incorrect, it is easy to keep walking. Committing to help our new and developing nurses means stepping in to help if necessary. If there is a task that needs to be done differently, it should be discussed in a private space away from eyes and ears of others (unless it is a risk to patient safety). The approach we take can make all the difference here. Compare these sentences:

·      Augh! You’re doing it wrong. Here, I’ll do it myself.

·      Can I show you something that might make this easier for you?

·      Let’s take this into the medication room together and see what is going on.

Please don’t use the first option. The second one is good, and the last one (which leads to coaching- letting them do it as you talk them through it) is best. When providing feedback, we want the nurse to know we are on their team, not a threat. Collaboration, not conflict is what we are striving for. Remember there are many different “right” ways to do something, so try not to pull someone up over something that is just your personal preference, also worth remembering is that just because we do things certain ways – doesn’t mean this is current best practice. New graduates are filled with contemporary and up to date knowledge which may just be better than our own. Be curious, be open to learning and be kind when giving feedback.

4.      Encourage

As a new nurse, when we do something well- we may not notice. There are so many things we are trying to learn that we rarely stop and take a moment to feel proud of our achievements. Experienced nurses can see these moments and give a word of praise or a pat on the back to highlight the progress the new nurse has made. “You did well to cannulate that patient, I saw his veins and they looked tricky”. Encouragement can also look like showing faith in the new nurse to do something. “Would you like to do this advanced dressing? We can go over it first before we get into the room, so you are refreshed about how to follow the procedure.” Encouragement only takes a moment, but the impacts can last for days or weeks. Tracy and Emma both had senior nurses encourage them in the graduate years and they still both remember the effect this had on them.

5.      Mentor

Mentoring does not have to be a formal relationship, although there are preceptors, graduate buddies and graduate clinical facilitators in organisations today. A mentor is an experienced person who can share stories of what has happened in a way that can teach the new or developing nurse and provide guidance and suggestions for their progress. A mentoring relationship can start in a couple of different ways, try to be open to different approaches.No alt text provided for this image

1.      You as an experienced nurse see potential and talent in one of your colleagues, you reach out and invite them to have a conversation. From here you could say we should do this again would you like to make this a regular catch up? I see a lot of potential in you and I would like to help – this approach can be really helpful as many people are afraid to ‘bother’ someone more senior for fear that they are too busy or might say ‘no’ it is a vulnerable position to be in to ask someone to invest in you.

2.      If someone approaches you for career or development advice or help with dealing with something they are facing - be open to the invitation, it might be a request for mentorship in disguise (see the points in number 1).

3.      Someone might come right out and ask you. In my experience this is the approach least often used (see the points in number 1).

Mentoring is such an important part of the future of our nursing culture. When we leave fresh nurses to sink or swim, only the strong survive, but often they are wounded by the sink or swim approach. The danger in this is that we need all types of nurses to care for all types of people. The old ‘matron battle-axe’ is not the only type of nurse we want caring for us and our families when we need care, whilst we do need strong nurses, we don’t need nasty nurses. When we feel vulnerable, we need someone who can connect with us. That type of nurse may not survive the cannibals pot unless we all make a committed decision to support each other.

There are several ways in which you can feed and nurture the nurses who come after you (or even the ones who came before – we all need nurturing to reach our potential). We have given you a few things to consider in this article – how will YOU make an impact? What big culture change will you start by making a small behavioural change over and over?

Tune in for article 5 in this series which we will discuss nurse-nurse cannibalism.

 

Authors

Tracy Churchill, Nurse Manager
Emma Versluis, Assistant Director of Nursing: Practice Innovation

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