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

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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.

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Nicole Lehr

Nicole Lehr is a pediatric nurse. She can be described in three adjectives: content, thankful and fortunate. All credit for the aforementioned description can be given to the love she has for her profession as an RN. She graduated from University of Florida with her Bachelor’s in Nursing and moved to Atlanta to work at the Cardiac Stepdown Unit at Children’s — her dream job.
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6 Responses to How do I deal with the know-it-all orientee?

  1. Kathy

    I am sort of in this situation right now! Except I am the experienced new nurse. As a military spouse and veteran, I have a long resume and move every 4 years. It is very tough for me each time I am new and orienting because i have to prove myself over and over again. I try very hard not to be a “know it all” and i don’t think I come off that way… I hope! I usually take the reins and let my preceptors know what I need from them and show my respect for what experience they do have. I’ve been around enough to know that most facilities have the same standards of care/ policies. But nurses who have worked on the same floor for decades don’t realize that and think their facility is the end all be all of health care and everything started with them! LOL

    I look really young so it is tough to have people automatically assume that I am wet behind the ears. The “know it all” orientee described in this article is probably being treated like a new grad and feels insulted or is acting like a know it all just to proove herself! We have to walk on a new floor amongst cliques and such and it is really annoying to be ignored or shoved asside a difficult pediatric IV stick for example, just because we a new! You never know… Us new orientees might just save your butts! 😉

    • Lauralea RN

      I am a former military nurse who has worked many different fields of nursing. I call myself “Jack of all Trades, and Master of a Few”. I always let the preceptor know what I am good at, and where I have worked. Once. Then I step back and follow their lead. My attitude is there is something to be learned from everybody. If there is a particularly difficult situation, I politely let my preceptor or staff know that I have had success and am willing to try if no one else is successful. Confidence and patience is the key to any situation. I am not offended if they do not want to use my skills, because they will eventually. I am there to work and care for people, and in a new situation, I do anything asked of me efficiently and without complaint. The result is I am always the first choice for overtime or social duties.

  2. NurseDaisy RN

    This is a great article, but what do you do with the new grad (2nd career) who is convinced she knows everything and questions you in front of the patient and their family?
    As a preceptor, this has happened to me. I was her third preceptor because the others before me could not deal with her “I know more than you attitude”. When she questioned my technique during a medication administration, I calmly corrected her idea of what the proper thing to do in that situation was, and then not so gently corrected her behavior once we were out in the hallway (this was not the first time it had happened). Her behaviors continued in spite of my consistent redirection and reminders that she needs to listen. We were not sorry when she resigned from the hospital and went on to work for a big insurance company.

    • Nurse Rene RN

      Fear not for such people always end up getting ‘made’ for the B.S. artists that they truly ARE.
      There is always a Home for them in places like Insurance companies…

  3. Nurse Rene RN

    It is such a RELIEF to find these People who Know Everything because it takes the pressure of trying to know it all off of the rest of us.
    We have all seen such people come and go forever. I have worked with nurses who claimed to have worked everywhere and done everything even though their age and historic timelines prove that there is NO WAY that they have been in all of these places when all of these events went down.
    Someday I will probably meet one who claims to have been the Second Gunman on the Grassy Knoll, in the Witness Protection Program of course…

  4. Lauralea RN

    I am a former military nurse who has worked many different fields of nursing. I call myself “Jack of all Trades, and Master of a Few”. I always let the preceptor know what I am good at, and where I have worked. Once. Then I step back and follow their lead. My attitude is there is something to be learned from everybody. If there is a particularly difficult situation, I politely let my preceptor or staff know that I have had success and am willing to try if no one else is successful. Confidence and patience is the key to any situation. I am not offended if they do not want to use my skills, because they will eventually. I am there to work and care for people, and in a new situation, I do anything asked of me efficiently and without complaint. The result is I am always the first choice for overtime or special duties.

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