When Eating your Young is HEALTHY
Posted on: August 10th, 2009
When “Eating Your Young” is Healthy?
We’ve all heard the expression, “Nurses eat their young”. But what does it really mean?
Eating young as a phenomenon has existed for far longer than I have been around healthcare (20+ years). From what I remember of it from my early days, it began as a technique intentionally crafted to help nurses “drive off” new grads and transfers who consciously refused (or who were completely incapable) of providing the type of care required to keep patients safe. In many cases it accomplished good things . . . specifically for this group of American workers who had yet to find their voice in matters of leadership and management. Eating your young was quite often the healthy choice for protecting patients from sub-standard care and dangerous people.
Unfortunately, in intervening years, dining on new hires began spreading to where it was applied not just to poor performers but also to people who didn’t “fit the team” or to those with “different educational backgrounds”. And I believe it is in that radical expansion of focus that it finally gained its reputation as a “bad thing”.
Now I’m not saying that even “back in the day” it wasn’t sometimes abused by staff who were protecting turf or the status quo. What I am postulating is that the trick of driving off a poor performer through ritualistic hazing and verbal snubs worked very efficiently for those who dared deploy it – often to the benefit of the hospital and its patients. You must remember, this technique was created before regulatory scrutiny, formalized performance management systems and the creation of good models of vertical communication began providing healthier options to nurses.
“Back in the day”, Human Resources was “Personnel” and complaints were not welcomed. Nurses 20 years ago worked really short at times and administration’s view was that any set of “extra hands” was better than nothing. And to top it off there was the onset of additional nursing work burden created by the adoption of new clinical technology. And strangely enough, some of “those nurses” were actually better at using it (and why not, they weren’t wired to provide the type of “hands-on” healing care as everyone else)!
Hey, wait a minute . . . that all sounds familiar . . .
Could it be that 20 years has brought us full cycle?
Wouldn’t it be funny (in a sad sort of way) if it was discovered that the recent resurgence of snacking on GN’s was actually coming from the same place in the hearts of nurses? Would it be wrong if it was being used to protect patients and peers from a generation of new nurses who just aren’t “getting it done”?
Consider this: Is it possible that the role of nursing in some institutions has become so granular (with duties being so tightly defined and measured) that it has now become possible to be proficient without actually needing to care? Have any of you ever met a nurse who was better with technology and treatment than with people? How about the ones who wouldn’t work an extra minute in a crisis unless/until they had been assured that extra money was forthcoming?
So where are they all coming from, this new breed of nurses . . .
In recent years, high school guidance counselors have begun distributing a list to graduating seniors of the jobs with the highest first year income for college graduates. Want to guess what hovers near the top of the list for the last 7 years? You got it . . . nursing. An entire generation of high school students is being told that, “getting an RN license” is one of the fastest tracks to a $40,000/yr income. It is not only true, it has created some interesting subsets within the nursing spectrum:
- The “Accountants in Scrubs”
- The “Technophiles”
- The “Work/Life” quality kids
- The “I Can’t Stand People” squad
This is quite a list when compared to the “are they safe” or “are they not” of 20 years ago. Not that there weren’t each of these groups “back in the day” but it sure seems that their numbers have increased in recent times.
This brings us full cycle to our opening question, “When, if ever, is it OK to eat them”?
There is no short answer to the question. Some details have to be determined first:
· Does your annual performance process allow for peer feedback – does your probationary/mentoring period?
o If yes, then it is more appropriate to handle things that way (assuming the input is listened to and used in making decisions).
· Does HR accept feedback and concerns with good grace (and then act on them)?
o If so, then that could be a healthier route.
· Does the unit manager listen to the advice of senior staff and take action based on it (knowing they have the best interest of the unit and its patients at heart)?
o If he/she does, then certainly that would be preferable to chewing up a new hire.
But there are some other questions that matter in this time of shortage:
- Would this nurse be a great nurse if they worked in another area?
- How about if they received more training?
- What about an extended mentoring/precepting period – could that help?
- Do they even know how they are supposed to behave and act? Can we be sure they have ever been taught?
If none of the above yield an affirmative answer, then it may be time to consider the answers to some framing questions:
- 15 years from now if you were in this hospital, would you want to be cared for by this nurse?
- Would you want a family member to be?
- What happens if they are the only option?
- Have we ever considered that we may have no choice? That for every 3 of us there is only 1 of them?
- What happens in that magical 10-15 year period when we all retire and our need for healthcare services radically expands and what’s left are the very nurses we snub now . . . . . . .
Build them ‘cause YOU will need them . . .
Might we be at a crossroads where it is time to re-establish the unit based “pot luck”, the after work bowling league and the home-based Tupperware party? If “they” (these nurses not like us) are going to be a good portion of the nurses left when we retire, shouldn’t our purpose be to begin establishing first a connection with them, then eventually through camaraderie and example, begin instilling in them an enhanced understanding of what great nursing is . . . you know . . . “our” understanding? Don’t we have an obligation to remake them in our own image to ensure the legacy of amazing care that is ours, remains after we are gone?
It’s a heck of a thing to consider that they might just HAVE TO BECOME LIKE US for not only our own benefit, but for the benefit of generations to come.
Those narrow shoulders are quite likely going to be required to carry our generation’s extremely heavy load and they will be our legacy to healthcare.
Are they prepared . . . are we . . . ?
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