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LNCtips.com: Orientation or Initiation?


Do you remember your first RN job?  Chances are good are that your employer provided an orientation for you.  However, if you're like me, you received an initiation instead of an orientation.  Let me tell you about my experience and why I think it relates to new legal nurse consultants.

When I was a new RN, I was very excited to get my first job as a staff nurse.  I had worked as a nursing assistant in a hospital and nursing home during high school and college, and I had worked in a doctor's office one summer as a quasi-nurse.  I expected the staff members to be as helpful to me as they had been in my other jobs.  I was in for a surprise.

That first job was at a huge teaching medical center.  Remarkably, there was no formal orientation program except for a ½-hour lesson on how to give medications.  This was before unit dosing and Pyxis systems when pouring individual doses from huge bottles into medicine cups was the way it was done.  The rest of the "orientation" was unit based, with each unit determining what the orientation entailed. Unfortunately, my unit decided that it wasn't worth the effort to orient me or other new graduates. When I asked questions, the staff nurses told me that I was stupid.

"Stupid" seemed to be the favorite term of the staff. There was a lot of eye-rolling and deep sighs whenever I needed help.  Today, the name for this behavior is "bullying". Back then, they termed it "sink or swim." I learned to cope with this type of behavior because I:

* Wanted to become a crackerjack nurse. I was committed to doing whatever it took to attain my goal.

* Realized that I was the only person who had a stake in my success. I was the only one who could ensure that my "orientation" was successful.

* Listened to criticism without getting defensive.  In my mind, some criticism was helpful (There's a better way to do that), and some criticism was not (It's stupid to do it that way").

* Learned to confront nurses who were disrespectful.  (I know that you don't mean anything by your comment, but I don't appreciate the word "stupid." Maybe you could show me a better way to do it.")

* Understood that no matter how it was phrased, some criticism was on target. I wasn't stupid, but there was a lot I didn't know.  Because of that, I spent time in the hospital library after the end of my shift.  (This was before the internet and electronic resources.)  I regularly read every nursing and medical journal available.

Offered to help others.  Whenever there was a skill to be learned or a type of patient condition that I was unfamiliar with, I offered to help with that patient's care. It was a rare person who turned down an offer to help.  And after time passed and new RNs started on the unit, I helped them the way I had wanted to be helped.

Taking responsibility for my own orientation had some unintended consequences.  I was one of the few nurses who frequented the hospital library; the other patrons were residents and attending physicians.  I found out later that I had earned the reputation among the medical staff as being "that smart nurse."   How ironic!

I made it through my "orientation," but I often think of that experience whenever I encounter RNs who are new to legal nurse consulting.   Most new LNCs don't face an initiation to the new role, but they don't get an orientation either.  They're on their own for the first time in their professional lives.

For newcomers, here are a few suggestions to consider when starting out.

* Commit to becoming a successful LNC.  That means devoting the time, energy, and money to achieve your goal.  If you've tried something and it hasn't worked, try something else.  Do whatever it takes to attain success.

* Don't expect others to have as much interest in your success as you do.  Feel free to reach out to others but don't expect them to rescue you.

* Work on your skills. There is more to legal nurse consulting than marketing and reviewing medical records.  If you don't type well, learn.  If you don't write well, learn.  If you don't know how to do internet research, learn.  If you don't know how to create written reports, learn.  The more you know how to do, the more successful you'll become. 

* Listen to others, but use some filters too.  Is the LNC who's giving you advice a successful legal nurse?  Is the LNC currently practicing? Sometimes I cringe at the advice given to others on sites such as LinkedIn because it's evident to me that the person giving the advice has little practical experience in today's LNC environment.

* Offer to help others.  If you're a member of a local chapter of AALNC (and you really should be if you're new), offer to serve on a committee, a project, or the board.  You'll help others while helping yourself too.

Taking responsibility for your own orientation helps you achieve your LNC goals. You can do this!

Want to learn more about LNC skills for legal nurse consultants?  Check out the Archives.

...Katy Jones