[CountryGirl1]

I'm a newly graduated RN (Dec 2006). I've been orienting with a nurse and at my position with a hospital surgical floor for about 5 days. The first few days, I noticed that my preceptor was not very verbal and at times did not explain info completely. The first day she tried to give me 2 patients and I had not a clue as to what to do. At first, I thought "Oh well I'll just give myself a little more time to settle into the flow of things." However, I've noticed that she has started raising her voice (basically yelling) at me over things that I have no clue about, such as hospital phone numbers to call and certain procedures done at the hospital. Now, I really hate it when people raise their voice at me!!! With her, I feel that I am not learning what I'm supposed to learn and am feeling woefully unprepared. I know I've only been there 5 days, but I don't know if this is going to work. What is the best way for me to approach the situation? Should I give it more time? Should I speak with the clinical manager about this? I'm not sure what to do.

[jmgrn65]

Yes by all means talk with the cnm she may not have a clue on how the nurse is as a preceptor, I know mine doesn't have a clue she just knows whether the nurse is breathing or not.

[loricatus]

I really think you need to go to the manager right away. I made the mistake of not doing that in a situation just like yours and assumed it was my problem to overcome. Needless to say, the internship didn't last long & I had to start all over again at a different hospital. Your preceptor should have a set of goals for you & work with you to accomplish those goals. Patient safety is at stake and your manager should be made aware of it immediately; otherwise, all your manager will here about your situation will be from your preceptor's slanted viewpoint. Also, you should ask for a new preceptor because you have the right not to work under an abusive environment.
Hope all works out for you.

[Indy]

I'll give you some examples of goals. You should get the "routine" of the day down with 1-2 patients and that includes starting to figure out where information can be found, like hospital phone numbers, etc.

Until you can manage your time with two, the preceptor should not give you more patients. Within the time frame of orientation, you should get patients having different procedures done so that you can learn about how your hospital handles them. The preceptor should be readily dispensing information to you, not yelling at you because you don't already know it.

Other goals should include good charting, safe med passes, etc. If you have to go a couple of weeks with two patients, so be it. Add one patient, go a few days or a week, add another. If the preceptor fosters an environment where you can ask him or her anything, no matter how dumb you think it is, then it will be better for you, because we never stop asking questions.

So yeah. I think your nurse manager needs to get you a new preceptor.

[greentea]

You could always talk to your preceptor directly about the fact that you don't like the way she has been talking to you and you feel like you need some real goals....that is if you really think she'll listen to you and you feel like you could learn something from her (other than what NOT to do). Going to your nurse manager and letting her know that you're having a hard time no matter what you decide to do is a really good idea. It's your orientation and you have a limited amount of time so it's good that you're realizing you're having preceptor problems right now so that you can be proactive about it all. If your preceptor has had other orientees I wouldn't be surprised if your nurse manager has heard this before. I would not give it any more time if you feel things aren't working out. There's no reason at all that someone should yell at you just because you don't know some things yet.

[Altra]

While I agree that it's possible that you & your preceptor are simply not a good match, if it were me there are a few things I would do on my next shift to try to turn the situation around.

Can you ask your preceptor, charge nurse, or unit secretary where the hospital phone directory is kept & make yourself a list of frequently needed numbers (lab, pharmacy, radiology, whatever) that you can carry w/you?

Talk w/your preceptor: "I've seen that we do a lot of xyz procedure on this unit. Is there a video I can watch/policy to review/printed review material from the nursing education office/etc. so that I can get comfortable w/this procedure/skill?"

If you weren't given this info in the form of an orientation binder or something like that, start putting together checklists: new admissions need abc, discharged patients need xyz, to get set up for this certain procedure I need 1, 2 & 3, standing orders for patients w/x diagnosis need ____.

Find out from your preceptor how often you'll be formally or informally reviewing your progress.

If, after discussing these things over the next day or 2 it seems that you're still not comfortable w/your preceptor, then yes, at that point I would speak to the nurse manager about a change.

Good luck to you.

[CountryGirl1]

After another crappy day, I finally had a talk with the unit clinical manager. Actually, she initiated the conversation because apparently my preceptor felt that I was "lagging behind schedule". My preceptor felt that I should be fairly independent in taking care of 2 patients with little outside help by week two or three. I don't feel quite that confident yet. I also told the clinical manager that I had difficulty connecting with my preceptor and could sense her displease with me and my slowness. I'm sorry but I AM SLOW!! I'm not trying to kill anyone by accident. I want to know that what I am doing is safe and effective. I sort of have the feeling that others on the unit also have issues with my preceptor and her tendency to raise her voice. In the end, the clinical manager decided to get me a new preceptor. So I'll see how this goes. If not, maybe I should have stuck with my first degree in psychology . Oh well...

[MelissaRealityRN]

I found a great video about understanding your preceptor better, if you're having preceptor problems. It's on YouTube: http://www.youtube.com/user/RealityRNVideo

I found it very helpful!

[Butterflybee]

Whew...glad Im not alone here. Your situation isnt all that unusual for alot of us. Sounds like you and I are in the same boat. Here is the thing, you risk being looked at as not being able to cut it, you may be looked at as a person that makes excuses etc. Try to learn how 'they' get things done. Ive had a person or two where I work give me some tips. Remember these people have been working together probably for years and you are the outsider. They have a bond already... be careful what you say....and to whom.

Dont be discouraged though, it takes time. That is what I tell myself too. I work at my own pace knowing I will build up to a quicker pace as Im familiarized with all of this.

It is a plus though that someone came to you. Hope things get better. Also, maybe that just isnt the place youre supposed to be.