Working with “lifers”

Lately I’ve been thinking a lot about the differences between seasoned nurses, whom we call lifers because they will likely retire on our floor and have been around a long time, and new nurses. This probably has something to do with the fact that, in my new job, I am working with nurses who have been in the profession and specialty for 10+ years—there are not many newbies around. Some of these nurses will retire in a few years having been on the same unit their whole career!
The other night I watched a 25+ year nurse as she calmly took a verbal berating from a doctor only to put him in his place using some evidence-based jargon that had my head reeling!

This is so different in that I am coming from a hospital where new grads moved up the ranks and ran the show at three to four years in, only to burn out and move on. In fact, when I was hired as a new grad, my previous manager told me that the unit had a “burn-out rate” of one year—new grads got their initial experience then moved on.

So, what does my future look like as a seasoned nurse? Here are some common traits I see in nurses with loads of experience:

1. Lifers are calmer in emergencies. Whereas I tend to still freeze up a bit during true emergencies, the experienced nurse moves with a fluidity and assuridity that is remarkable. They don’t seem to question their actions and I can see how refined their critical thinking has become.
2. Communication is more effective. These nurses say what they mean, concisely, clearly and accurately. When they are questioned—by docs, other nurses or patients, they answer without hesitation and seem so sure of themselves.
3. Nurses who have been around know when to admit they are wrong and take responsibilty for their mistakes. They also rely on the nurses around them as sounding boards when things are questionable or difficult.
4. Advocation comes more naturally. Standing up for a patient takes some bravery and some skill—especially when advocating for a patient in front of a doctor (or doctors) who believe the nurse is in the wrong. I am getting better about this, but have noticed that seasoned nurses win more battles for their patients because they are better advocates. They have so much knowledge to draw on!
5. The long-term nurses I know have their education—many of them have master’s degrees—and they have tried out other specialties and other avenues of nursing. Most of these nurses are where they want to be, on the shift they like, and they are going to stick it out. They know what they know, they continue to learn and teach, and they like where they are.
6. In general, they take care of themselves. I am one to skip breaks and meals when I am in a rush, but the nurses I am working with know to take their breaks, to go to the bathroom—they know that “the work will always be there.” They also take care of themselves outside the hospital and make sure they sleep, go to the doctor, work out.
7. Nurses with longevity know how to handle management, the doctors, and the patients. They have become interpersonal experts and can navigate all the drama of the hospital in order to take good care of their patients. I see seasoned nurses at staff meetings, on committees and in charge. They have learned that in order to effect change, they have to take an active part in what’s happening—on and off the unit!

Experienced nurses are an example of how to avoid burn out as they have found ways to cope with and love the profession for the long haul. And yes, I believe that time makes a good nurse even better!  There of course is always an exception to the rule, but for the most part I am in awe of the nurses I am working with and am enjoying watching them in action. As always, I am realizing I have a lot to learn—much of which will take a lot of time. One day I hope to be a “lifer” who is an example of the excellence our profession has to offer.