Question: Which Two Grads Would You Choose-and Why?

You are the supervisor of a critical care surgical unit. For the past several years, you have been experimenting with placing four newly graduated nurses directly into the unit, two from each spring and fall graduating class. These nurses are from the local BSN program. You consult closely with the nursing faculty and their former employers before making a selection. Overall, this experiment has worked well. Only two new graduates were unable to develop into critical care nurses. Both of these nurses later transferred back into the unit after 2 years in a less intensive medical-surgical area. Because of the new graduates' motivation and enthusiasm, they have complemented your experienced critical care staff nicely. You believe that your success with this program has been due to your well-planned and structured 4-month orientation and education program, careful selection, and appropriate shift placement. This spring, you have narrowed the selection down to four acceptable and well-qualified candidates.

You plan to place one on the 3 PM to 11 PM shift and one on the 11 PM to 7 PM shift. You sit in your office and review the culture of each shift and your notes on the four candidates. You have the following information: 3 PM to 11 PM shift: A very assertive, all-female staff; 85% RNs and 15% LPNs/LVNs. This is your most clinically competent group. They are highly respected by everyone, and although the physicians often have confrontations with them, the physicians also tell you frequently how good they are. The nurses are known as a group that lacks humor and does not welcome newcomers. However, once the new employee earns their trust, they are very supportive. They are intolerant of anyone not living up to their exceptionally high standards. Your two unsuccessful new graduate placements were assigned to this shift. 11 PM to 7 AM shift: A very cohesive and supportive group. Although overall these nurses are competent, this shift has some of your more clinically weak staff. However, it also is the shift that rates the highest with families and patients. They are caring and compassionate. Every new graduate that you have placed on this shift has been successful. Of the nurses on this shift, 30% are men. The group tends to be very close and has a number of outside social activities. Your four applicants consist of the following:

? John: A 30-year-old married man without children. He has had a great deal of emergency department experience as a medical emergency technician. He appears somewhat aloof. His definite career goals are 2 years in critical care, 3 years in emergency department, and then flight crew. Instructors praise his independent judgment but believe that he was somewhat of a loner in school. Former employers have rated him as an independent thinker and very capable.

? Sally: A 22-year-old unmarried woman. She is at the top of her class clinically and academically. She has not had much work experience other than the last 2 years as a summer nursing intern at a medical center, where her performance appraisal was very good. Instructors believe that she lacks some maturity and interpersonal skills but praise her clinical judgment. She does not want to work in a regular medical-surgical unit. She believes that she can adapt to critical care.

? Joan: A mature, divorced 38-year-old woman. She has no children. She has had a great deal of health-related work experience in counseling and has had limited clinical work experience (only nursing school). Former employers praise her attention to detail and her general competence. Instructors praise her interpersonal skills, maturity, and intelligence. She is quite willing to work elsewhere if not selected. She has a long-term commitment to nursing.

? Mary: A dynamic, 28-year-old married mother of two. She was previously an LPN/LVN and returned to school to get her degree. She did not do as well academically due to working and family commitments. Former employers and instructors speak of her energy, organization, and interpersonal skills. She appears to have fewer independent decision-making skills than the others do. She previously worked in a critical care unit.

ASSIGNMENT: Select the two new graduates, and place them on the appropriate shift. Support your decisions with rationale.