New grads have been on my mind lately. Maybe because it’s spring semester and I know classes across the country will be graduating soon. Maybe it’s the staffing shortage, or because I recently gave a lecture to a group of nursing students. Or maybe it’s a weird mixture of all of these things, but regardless, I’ve been thinking alot about new grads in the OR.
As I’ve thought about this, and discussed the necessity of perioperative electives in nursing schools with a couple of friends of mine, I unexpectedly witnessed the perfect example of how we should be treating our new grads – in a hair salon, of all places.
Lessons from a hair salon
I realize it may seem crazy to draw parallels between the operating room and the hair salon, but hear me out. Besides those people who shave their heads and never see a hairdresser, all of us know the fear of getting a bad cut or color. I’ve had several bad haircuts in my lifetime, and it’s always been a miserable experience. We all fear that bad experience, and we always want to make sure that someone who knows what they’re doing is cutting our hair.
That feeling is no different than how we feel about our operating rooms. We all want to work with people who know what they’re doing. Yes, more is at stake than a hair style, but wanting and needing competent people is the same.
And as I sat, waiting for my color to process, I watched my hairdresser working on my daughter’s hair, and this is what I observed:
Meet new grad, Nikki
Our stylist, Amy, has an associate named Nikki. Nikki was hired to work at the salon last August, two months before she graduated in October. When she graduated, she became an associate with the salon, and she’s in the salon, being paid full time, to work alongside an experienced stylist. She works with Amy, either standing close by and observing while Amy explains what she’s doing, or by doing while Amy watches to both prevent mistakes and ensure success. I saw Amy correct Nikki a couple times. Never rudely, never calling her out or embarrassing her in front of the other stylists or the clients, but just to-the-point corrections that ensured Nikki corrected what she was doing and there were no mistakes. Nikki is also given one Saturday a month to work on her own so that she can build up her clientele. But while she’s working on her own clients, she’s never truly alone, and someone is always available if she has a question.
Pictures really can be worth a thousand words
To me, it was the perfect picture of how we should be treating all new grads. Welcoming them into the field, teaching them (not throwing them to the wolves), being patient with them as they learn, and not tearing them down but ensuring their success. Their success means a success for the whole team, and isn’t that what we all want?
We see these types of relationships in most trade jobs, and we even see it with residents and fellowships – although some of the patience is often lacking that new residents really need. But as nurses, I feel like we really miss the mark in this area.
Why aren’t we doing better?
There are a number of reasons I could give as to why: we’re short staffed, we’re too busy or spread too thin to have time to teach anyone else, and we’ve habitually eaten our young. “That’s just the way it’s always been…” Dangerous words, but it’s our culture – as a profession, and as a department.
But it doesn’t have to be this way. We were all new once. Tapping into our own feelings and experiences from our first days as a new nurse ought to give us more than enough empathy for our new grads. We know what it’s like, and we know it sucks, so why wouldn’t we make it better for someone else?
“The way we’ve always done it…”
Historically, the operating room has been a department that has been closed off to new grads. Ideas about needing med-surg experience prior to coming into the department have kept many a new grad from coming into the OR, even if OR nursing is what they really want to do. That’s not the case everywhere, I realize. Larger facilities and academic medical centers typically will have established training and orientation programs for new grads. But every facility doesn’t, and I constantly encounter nurses who are adamant that new grads need to go to the floor first to “build up their skills” or “do their time” or whatever. Which, speaking from personal experience, is bunk. I came into the OR as an “experienced” nurse, but I was as lost as a cow in the ocean. Yes, I had ten years under my belt as a nurse, but none of it related to the OR, so besides being really good at starting foleys, I felt just like a new grad in the department.
Another problem that we have in the operating room is that most nursing schools no longer offer a perioperative option for students who are interested in the OR. Why is that? Perioperative nurses are uniquely trained and highly specialized. Everyone can’t do what we do, but for the ones that want to, why aren’t we allowing them that exposure in nursing school? Exposing them to the OR in nursing school would take away some of that uncertainty as a new employee because they’re already familiar with the environment. It would also help to weed out those nurses who decide the OR isn’t for them. Rather than bringing them into the OR, training them, and then having them hate it and leave, exposing them to the OR in school could help them decide whether or not our department is for them. And if you’re going to be hiring a new grad in the OR, wouldn’t you want to hire someone who was exposed to the OR in nursing school and was already familiar with the basics? Hiring someone who has already shown their commitment and desire for working in the OR by taking a perioperative elective in nursing school seems like a no-brainer to me.
So just like Nikki, who got to start in the salon before she graduated, getting a taste of this career that she believed that she wanted, we should be offering perioperative electives to our nursing students so that the ones who want to come to the OR are given the exposure that they need to either confirm that decision or decide on something else.
As someone who has trained many new nurses, I saw all of the same qualities in Nikki that I would want to see in a new grad. She was attentitive, paying close attention to everything that Amy told her. She jumped at the chance to work, and was never told to go do something, she was already doing it. I never saw her on her cell phone, and I never saw her sitting. If she wasn’t helping with color or with a blow dry, she was cleaning up, or getting the next client, or standing close to Amy, watching what she was doing. She asked questions, and made sure that she understood what she was told so that she would do things right.
Give new grads a chance
New grads are eager to learn. When we’re willing to bring them into the environment, or deparment, that they want to work in, and then we take the time to invest in them, we create that career OR nurse who is confident, secure in their abilities, and able to pass that on to the next generation of new grads.
I’m confident that Nikki will make a great stylist when she’s finally completely on her own. Her own work ethic will be the biggest reason why, but the investment from Amy and from the company, ensuring her success, will be the other. We can do the same with new grads, if we’re willing to put in the work.
There’s no short-cut to success. New grads have to put in the hard work on their end, too. But as a department, we should be pouring the compassion, patience, and education into them that they need to ensure their success.
Until next time,
Melanie