Preceptor telling me to cover things up....

[KayceeLeeRN]

So I think it is safe to say that the honeymoon is offically OVER and I have stepped into REALITY :uhoh21: ...........

I have quickly realized that nursing school is pretty far from the truth when it comes to what really goes on. I am seeing a lot of "covering up" to protect yourself type of stuff. I actually feel terribly guilty about something. Here goes.....

So other day I got an order to give K-Dur 20mEq x 3 now. I gave the first dose....then I went about my busy day, and completely FORGOT to administer the rest. The next morning in report the night nurse mentions that I need to sign for the K, my heart jumped into my throat. Once she left I called my preceptor over and I told her that I had made a big mistake, and asked her what should I do, she said "The K is still going to be low, and the md will order more, so just give that." I asked her what would happen if I just came clean and told the md that it was never given, she told me that he's one of the "nasty" ones so just give it when he orders more, because the patient needs it anyway. She then proceeded to tell me that one of the most important things I have to remember is to "NEVER ADMITT TO ANYTIHNG."

Then yesterday I had to give Dilaudid (sp?) IVP, I went to go do it but the patients IV was clotted and no good. We called the IV nurse to come and put a new one in (she wouldn't be there for an hour or so). So I'm standing there with a syringe filled with a narcotic in my hand and I ask my preceptor what should I do with this? She tells me to put it in my pocket. I ask her again, "in my pocket? are you sure we shouldnt waste it?" She told me again to put it in my pocket, and if the IV nurse can't get a new lock in we will waste it. I felt very uncomfortable walking around with a narcotic in my pocket. But I wasn't sure if this was the right/wrong thing to do. The way she told me to "put it in my pocket" just sounded very shady to me.

I just feel so guilty. Covering up like that. Is this the norm? Does this go on everywhere?? I'm not sure if this is common, or if my preceptor is showing me bad habits. I feel so naive to all of this. Can someone explain this to me???

[KayceeLeeRN, BSN, RN]

UPDATE: I offically start with my NEW PRECEPTOR Thursday :yelclap:

I went to my manger today. I said all of two words before she told me "say no more, you're getting a new preceptor." I was SO RELIEVED. I didnt have to explain anything to her (not that I was going to start pointing fingers)...she said she already knew something was up and she was just waiting for me to come to her. THANK GOODNESS, what a wonderful manger I have. She even told me not to worry, that she was going to explain it to my preceptor in a way that wouldn't look like I asked to be switched. She really made me feel protected and that I could trust her.

This new preceptor is a much more experienced nurse, who has precepted most of the newer nurses. She has a "tough" reputation....and I am looking foward to her kicking my butt......

....into a GREAT nurse

[CRNI-ICU20]

If you get a reputation of dishonesty, or even the hint of impropriety with a patient, medications, or orders....as soon as something happens, like drugs missing, or whatever....whom do you suppose the ones in charge will come looking for? YOU!! YOU!! the one with the narcotics in your pocket!! YOU who didn't call the MD with the missed medication.....if the patient were to code from dysrhythmia from a low potassium, could you live with that??

Your preceptor is way off base here....

WE are here to protect our patients.. not ourselves, and we need to own our errors and mistakes....

Otherwise, we are no better than the many professions that lie, cheat, and steal to protect themselves....and that isn't what nursing should ever be...

[sissiesmama, ASN, RN]

Hey! Just wanted to say congrats on the new peceptor!! Sounds like that's just what you need. and sounds like the manager knew it all along. Who knows, I know it sounds farfetched, but the manager may have been testing you. I know I may sound a little paranoid, but you never know. And, if she was testing you, sounds like you passed wih flying colors. You are mature enough and smart enough to (1) recognize that something wasn' right with the instructions your preceptor gave you concerning narc in your license!

With the narcotic in your pocket and the k+ pills, and you had the maturity to come to her to get assistance without causing difficulty between your preceptor or any other staff. That alone shows you have the makings of a great nurse!!

Just please always remember in the future about the narcotic issue. And if someone else tells you to do something like that and it's not policy, state boards will have a field day with your license! Anne, RNC