Nurses work in different hospital areas. These nurses work with different types of people, along with differently-aged professionals, with varying level of skills and theoretical knowledge. Often, in an area, there are these nurse who are termed “seniors”, and there are also the so-called “juniors”. The basis for the terms varies from hospital to hospital. Sometimes the sequence of hiring is the accepted standard: first in, first senior, but more often than not, seniority depends on the years of experience nurses have and it also depends if they were assigned previously at special areas.
It is the prerogative of the hospital’s Nursing Service Department if it would implement the concept of seniority. However, there are certain pros and cons to its implementation. Pros would include: a chance for juniors to inquire about certain procedures they have not done before from seniors, seniors can guide juniors on policies and procedures and seniors can assist juniors should problems arise. Cons include: an intimidating work environment where juniors would feel belittled by seniors. In some circumstances, seniors will abuse juniors with the client assignments, assigning them the most “toxic” patients given their limited skills. Juniors sometimes get apprehended and are slave-upon by the seniors. It is really a weighing of the pros and cons and success will depend on the traits and values of the nurses involved. For juniors, however, who feel intimidated, I have here a list of the things we (yes, I am still a junior too) can do to address these issues:
You must know yourself, your level of knowledge, and your level of skill. You know yourself and you know your strengths and weaknesses. Always keep in mind that you are a professionally-educated nurse. Admit to yourself and accept your own flaws.
Be confident, but not over-confident
Be confident enough to perform nursing procedures that you know. You were trained and educated to be a generalist nurse by your school and the PRC has provided you with a license and has conferred to you rights to perform all the duties and responsibilities of the Nursing profession. Be confident in doing the things you know. On the contrary, do not be over-confident, admit to yourself that you still have much to learn. Ask seniors if you have no idea on what you will do. It is better to look like a newbie to your colleague than risk a client’s safety.
Know hospital policies and protocols
Different hospitals have protocols and standards used in performing procedures and in documentation. Always keep the manual in your mind. If you do forget one thing, open the manual located at the Nurse’s station and read it again.
Do your job and learn
As a junior, you are expected to be enthusiastic in learning new things from experience. If you are to do procedures for the first time, ask for guidance from a senior and do them properly and with precision. Do your job well and learn from all the tings you do. Be wise enough to learn and not just do and forget.
Never accept everything a senior says
Seniors are people too. They are not perfect. Although they have been in the profession for a lot of years, they may refuse new procedural instructions and they may do things traditionally. Always update yourself with the Nursing Standards of Practice and use your critical thinking to judge whether the instructions you receive from a senior are current, are safe, and are correct. Do not just take everything in like a spoon-fed baby.
Our seniors were educated with standards during their era. Sometimes, conflicts will arise between the juniors and the seniors. Should this happen, respect your colleague. Explain your side and listen to theirs; and then use your critical thinking and the principles of beneficence and non-maleficence to do your bidding. Always keep in mind client safety.
Keep quiet or use your voice
If all else fails and a senior seems to abuse his seniority over you, it will either be you voice out your concern or you keep quiet. You must weigh the situation prior to taking any action. If you will use your voice, make sure that you have correct and fair points. You may talk to your chief nurse, or supervisor regarding the issue. Remember, he is your senior but he is still a staff nurse in the same position as you on the organizational chart. Keeping quiet may seem the right thing to do, but if you do not use your voice, you risk yourself for more pressure and ridicule.
Seniority is a concept in Nursing that uses a skills and knowledge-based system to determine the hierarchy of nurses. This has long been practiced at different medical institutions and the success rate would determine on the attitudes of the nurses themselves. There are seniors who would apprehend juniors, and there would be stubborn juniors who would think they are better than the seniors. Nurses are colleagues and we are all members of a team. We must work together and ensure the well-being of our clients. Nursing is not about seniority, or position, it is about caring for our clients. We must be able to set aside differences so we can render the best care possible. Shake hands, all the juniors and the seniors. There is no competition.