Hey everyone! I graduated in may and landed my dream job in a busy ED. Our orientation is 8 weeks and I should be off of orientation this week but they don't feel that I am ready. I just had a meeting with my educator(who is also our manager) and he informed me that I will have another two weeks of orientation and that I will be switching preceptors.
This is has me very worried for my job security as well as it makes me feel like I'm not cut out for this while nursing thing at all.
My preceptor is a fantastic nurse however I just don't feel that he is the greatest preceptor for me. I have learned a lot from him but there are times where I feel like I'm being set up for failure. There are days when I am able to handle 4-5 patients and not need help, and then there are days where I am just drowning and it seems like I can't do anything right. Sometimes I feel like I'm truly being set up to fail.
For instance a few weeks ago I got an ambulance and was triaging them, hooking them up to tele, starting a line and drawing labs (which he told me to do and then to come back out and report to him when I was finished)...I was in that room not even 10 minutes when he comes flying in and telling me that I need to move faster bc I also got another ambulance (which no one told me until then) and the ems was waiting to give report.
Another example was was last week when he told me to go into my patients room and start a line on them, draw the 10 labs, and give them the 4 iv meds that were ordered. We had just settled another patient who was very critical and he assured me that now would be a good time to go do the tasks for this other pt. It took me awhile to get the line going in that room and even longer to medicated and get the labs into the computer since we don't have a scanner in all of our rooms so I had to individually click off each lab and each med which takes forever. Meanwhile when I was in with that pt our critical pt took a turn and I didn't know it. When I came out I got chewed out for not being around for our critical pt. Which I asked him what he would have done and he said well not what you did. Which confuses and upsets me bc I even asked him if he was sure that I was ok to go do all of that bc I didn't feel comfortable being too far from our other pt.
Its just stuff tiff like this happens all the time. I don't know what to do about it. there was a week where i was with other people when my preceptor was on vacation and they all said that I was doing great.
im just really concerned. My preceptor is good friends with our educator/manager, and the new preceptor that I'm being given seems to be good friends with them as well. I feel like I have no one to talk to about what's going on. We supposedly have a nurse residency program for us new grads but NOTHING has been said to any of us, we have yet to have a meeting, and we have no idea is supposed to be running it. That also makes me mad because I decided to come to this hospital because I did my clinical here, it's supposed to be a great teaching hospital and I wanted to start in a place with a nurse resisdency program and we were told that we would have one.
i just don't know what to do or who to talk to. I will be devastated if I loose this job
8 weeks is a short orientation for the ER. I had 10 with the option of extending and I had 4 years experience as a nurse and it was tough to be done at 10 weeks. You should have had very clear guidelines of what was expected of you and also of how your thinking process needed to be in order to pass orientation.
In order to pass, you must be able to prioritize critical tasks and patients appropriately and know why you are doing things. On top of all that the flow of the ED (the time factor and patient movement through the ED) is always considered as well. It sounds like your preceptor may have problems with that, your critical thinking skills and lack of consideration of time and how to get things done.
There is no way you will have the speed of a nurse that has been doing this for a while, but what you must master in your orientation is your priority setting and ability to find help and delegate to get your tasks done in a timely fashion. One of your techs should be helping put your patient on the monitor and getting the vitals and EKG.
You've got to ask for help. Tell your preceptor that you'd like to use them as your tech, while you do all the nursing stuff. That's what my preceptor did for me. During my orientation, my preceptor made sure we were on the same page with what things should go first, what things can wait, and what patients needed more attention. If my priorities weren't in line with hers we discussed this, she also helped me with "flow" expediting disposition and time management-clustering care and delegation.
I'd have a talk with your preceptor if I were you and ask for their honest feedback and what they want to see you do so that you get off orientation. I think it's usually bad to change preceptors and I have seen more bad outcomes than good ones. Good luck and don't be shy about taking control of your orientation.
Last edit by amzyRN on Sep 27