Orientation Nightmare!

Pepper The Cat, BSN, RN · Mar 29, 2011

Interesting. The OP makes mistakes but that's OK because she is a new grad. She can make mistakes and learn from them to be a better nurse.

This is her precptor's first time precepting - but she is not allowed to make mistakes and learn how to be a better precptor.

ninaricci · Mar 29, 2011

Even if there is a window in which a med can be administered it is important to check to see when the last dose was given. For instance, if a med is scheduled for 12 and 4 but was given at 1 you wouldn't want to give it at 3.

I understand your frustrations. It is hard to get past a bad start, just as a bad first impression is hard to overcome (guess they may be one and the same in many ways). I would try, as hard as it is, to not internalize it too much or to become discouraged as this will further undermine your confidence. Remember it is not meant to tear you down but the process is meant to ensure patient safety and promote good patient care. Instead, I would meet with your preceptor and/or manager, reiterate that you value this time for learning and that you want to be the best nurse you can be. Make sure you are on the same page with them in regard to your goals. If they have a critical comments on an area, empower yourself by researching the topic. Everyone grows in different ways and at a different pace, try not to compare yourself to your peers. By giving you additional precepting time they are not giving you a slap in the face but rather are supporting you in teaching you. If they put you on your own before you are ready you risk error that could not only harm patients but cost you your license and the opportunity to have a career as a nurse. The first year in nursing is very hard but you will get through it!

sasha2lady · Mar 29, 2011

If you ever yo work in ltc you will look back on this and be so grateful, trust me. Guess how much orientation néw nurses get where I work? At most 2 days!! The last one got only a day and was thrown to the dogs , she quit shortly after. This goes for new grad lpns RNA ltns whoever they hire where I'm at. My boss thinks you should get all you need to know on day one. At my pt job I got 3 wks and I took every bit of it. They even gave me a night of training on a shift I'd never worked before because I asked for it . I didn't want to go blind on an odd shift. I was so appreciative of it and wish all places would do new hires like that

Lamesz · Mar 29, 2011

Thanks everyone for the input. I am going to take these extra 2 weeks as a learning opportunity, and only that. I just hate to have a bad start because I always have strived to do the best I can do.

nurse2033, MSN, RN · Mar 29, 2011

Swallow your pride and just figure out what you have to do to get through this. Once you are cleared no one will care how long it took. After six months you will just be one of the crew. Even if you think it is silly, jump through every hoop they lay out. Bad precepting is a pet peeve of mine, but you have to deal with it. It might be helpful to have a frank discussion with your preceptor and just ask how you can best succeed. Good luck.

sistasoul · Mar 29, 2011

You are getting an extra 2 weeks precepting because the nurse manager sees your potential. 4 weeks is not enough time for a new grad.I received 3 weeks of floor orientation and a week of administrative/in class training as a new graduate because I never went through a new grad orientation. I got put back on orientation for a couple of days. New grads in my facility get 3-4 months if they go through the new grad program. Usually experienced nurses get 4 weeks of orientation if not longer where I work. If i had to do it again I would have insisted I receive more training.

Don't beat yourself up. Nursing school does not prepare you for the realities of floor nursing. I think you will be glad to have the extra 2 weeks.

Ruby Vee, BSN · Mar 29, 2011

last, i think the preceptor was immature and non-professional to discuss your orientation with anyone outside of you or the unit manager. i wish you the best.

if the preceptor was sitting in the break room ridiculing the orientee to all of her friends, that's immature and unprofessional. if she was overheard discussing the orientee's progress with other preceptors who might have worked with her or might be about to, with the nurse educator, the chair of the education committee, the person in charge of writing or updating a policy that the orientee isn't understanding, her own evaluator (because after all, she gets evaluated on how well she precepts), the person responsible for the schedule or for assignments, or the orientee's future evaluator, that's necessary and appropriate. not the best idea to discuss it where it could possibly be overheard, but sometimes there aren't too many choices of where to discuss things.

Ruby Vee, BSN · Mar 29, 2011

so i am a new grad nurse on a surgical unit. i am on orientation and got my 30 day eval today. come to find out my manager told me my preceptor raised concerns about my critical thinking skills, and being to "rough" with a patient with pulling a central line. they also said my preceptor was concerned because i gave a pain med with tylenol to early to an actual tylenol dose (it was one hour early- you get one hour each way to give a med). now i am so upset!!! i have to spend 2 extra weeks orientating with another preceptor. i feel very betrayed by preceptor. i am the first person she has ever precepted. she has been short tempered with me, and gets fustrated when i ask how to do something over again. it's like she expects me to get remember everything only after one time of being taught. i have been thankful and kind to my preceptor, and honestly feel like i am doing ok at being a new grad nurse. i know i have so much to learn and want to learn the best practices, but i feel as if i got pushed under the bus on this one. i told my managers i was fine with doing 2 extra weeks of orientation. now i feel as though i will be labeled as the "dumb" or "bad" nurse on my floor. i work really hard and am giving this my all and it is really tough to hear this after all my time and effort! i have cried for a whole day about this, and i don't cry! two other new grads on my floor, whom i went to nursing school with, have got the ok to go out on their own. this is what is making me feel really inefficient! i heard my preceptor talking with other nurses and cna's today about me having to do these two extra weeks....so fustrating! i am just hoping for advice on how to handle my situation! i really would appreciate input!
-lost new grad

there seem to be a number of things going on here -- one of them is a new preceptor who probably is doing ok at being a brand new preceptor just like you're doing ok at being a new grad nurse. or maybe you're really not doing ok and she has some valid concerns. just like you're feeling stressed at being "expected to remember everything after one time of being taught", that preceptor is feeling stressed at being responsible for your being able to learn what you need to know.

i'm concerned about your assertion that giving the tylenol an hour early was ok because "you get one hour each way to give a med." sounds to me as if you're being defensive and justifying your mistake rather than listening to the preceptor's criticism and doing your best to understand her point. could be she's wrong to bring that up. could be she's tried over and over to impart that particular concept to her and you're resisting learning because you think you know better. which is it? give it some honest reflection and if you're wrong, admit it to yourself even though you don't want to admit it to anyone else. just a hint, though -- admit it to your preceptor and she'll feel more comfortable giving you feedback on the spot rather than being afraid of your reaction and "backstabbing" you with the manager.

here's another thought -- you say you've been thankful and kind to your preceptor. what would she say? would she say you're being a sarcastic know-it-all? a thankful and kind newbie who is nevertheless just a bit slow? someone with lots of potential who is worth spending the extra time on?

i hope you're being honest when you say you really appreciate the input . . . that's a sign of maturity and a good indicator of potential growth. if, however, you just wanted us to rally round you and play a game of "ain't it awful", i'm sorry i wasted my time.

Lamesz · Mar 30, 2011

Ruby- I really am thankful for this feedback from other nurses. I am having a hard time with this because I really like my preceptor, but I just felt as though she gave me no heads up when my managers talked with me. I even had asked her how I was doing before, but she told me it was hard to say because she had no past experience to compare it to. Any confidence I had went out the window. I don't want a pity party at all! I guess what I am feeling is that I am being labeled as "the bad nurse". I have taken full responsibility for my Tylenol mistake, I did from the beginning. Again thanks everyone for the input, it honestly has helped me put things in perspective!

Katie5 · Mar 30, 2011

It's just two weeks. Yeah it sucks, but hey you're still there.

Sometimes, we let what people think get in the way of what we should be doing. So people think, yup they do? But hey, what does it matter? Your attitude matters more.

Do your two weeks with the new preceptor. Learn all you can. Don't say nothing bad about your previous preceptor. And soon you'll join the ranks on the floor. Have a fun time when you do.

Sometimes, it's not just the destination, it's the journey:)

Lamesz · Apr 10, 2011

Just wanted to post an update. I have got a great preceptor, and she told my managers that I am doing great...what a difference. I realize now that my other preceptor is new as at this as well, but I am trying to put this behind me and just learn all I can...Thanks for all the input!

looking for work · Apr 10, 2011

I am very sympathetic with you. 10 yrs ago, my first job gave me a preceptor who wanted no part of precepting at all. I was sunk like a skunk. Throughout my subsequent 10 years in this field, I have found the entire new hire experience to be backwards, stressful and void of reality. Places still make you precept with years of experience. I once was precepted by a new grad when I had 7 yrs experience. The entire precepting notion needs to be wiped out and re-vamped. Most people do not learn well when they are getting bossed around and criticized like a small child, and slapped on the nose for spilling milk. In my last hospital job, I left after 2 shifts because my preceptor was a nasty, argumentative bi*ch . Been there, done that...I am too old for it, and if a new job requires an extensive "pre-cepting" I turn the job down. I could go on and on about this, but I'll leave you with one thought:

Never let other nurses destroy your confidence. They will try to...hold your head high. I had my confidence destroyed by evil nurses early on in my career. All I can hope is that KARMA will eventually speak its mind. Best of luck to you