How do I deal with the know-it-all orientee?

You find yourself in a situation where you’ve been asked to orient a new nurse to the floor. However, this “new” nurse isn’t new to nursing. She’s a veteran nurse of 15 years with a variety of experience at other facilities and hospitals. She has just never worked on a specialized unit like yours. How do you most efficiently and effectively deal with a senior nurse who thinks she knows everything when she really doesn’t?

Be patient. You may need to sit quietly while she tells you about all of the experience she has in nursing. Smile, nod and praise her for her experience. If she continues with self-inflation, just remember that it may stem from her nerves about entering an unknown specialty. Look at her experience as a plus for you: As her preceptor, you’ll be able to skip over all of the generalized nursing details that you might have to emphasize with a new graduate. She should already have mastered time management and basic nursing skills.

Start by asking her what she does and doesn’t know specifically about your patient population. Start the day by detailing what types of procedures and medications you may see on a daily basis on your floor. She says that she already knows all of this? Fine, then give her the most unusually difficult patient you ever had to deal with since working on your unit, and act like it was nothing.

If she continues to act as though she doesn’t need a preceptor, give her exactly that. Cut the reins and let her loose (as long as it’s safe for the patients) because in reality it’s her license at stake. As long as the safety of the patients isn’t compromised, let her fly until she flounders and NEEDS you. She will appreciate your opinion more at that point.

The biggest thing about orienting new yet experienced nurses who think they know it all is letting them control the learning experience. There’s no sense in teaching someone until she is ready to listen.