first shift of preceptorship: told that my IV priming is wrong - page 3

by seks

9,697 Views | 53 Comments

The hospitals in this city use the Alaris pump and this kind of Alaris infusion set: Prior to my preceptorship, I've always twist that end cap a little bit so that the IV solution can dribble out while priming. However,... Read More


  1. 11
    Why in the world would you want to start a peeing match with your preceptor? Even if you "win", you lose. Just do it her way.
    Last edit by Esme12 on Oct 14, '12
    psu_213, tokmom, nursel56, and 8 others like this.
  2. 8
    Quote from seks
    So are you all saying my past clinical instructors are incompetent and don't know what they were thinking?

    So who is right or wrong or too anal or giving unecessary steps in this situation? My current preceptor or my past clinical instructors/buddy nurses?

    That is my MAIN question.

    It really is frustrating when you get different opinions on a technique and I don't know who to believe or abide by. Guess that is part of the so-called "reality shock"
    No one said your past clinical instructors are incompetent -- or even unobservant. Your main question is a huge error. There are many "correct" ways to do things, and when you're in class, you want to do them the way your instructor wants them done. When you're in orientation, you want to do them the way the preceptor wants them done. But with your attitude, you're not going to have to worry long about how your preceptor wants things done, because you probably won't last very long on the job.
    hiddencatRN, tokmom, nursel56, and 5 others like this.
  3. 0
    Quote from Ruby Vee
    Why in the world would you want to start a peeing match with your preceptor? Even if you "win", you lose. Just do it her way.
    Exactly what I was thinking. Just do it their way.
    Last edit by Esme12 on Oct 14, '12
  4. 10
    OK, OK, OK, me thinks you all are a little harsh on the OP (well, except a few).

    Most of you act like you were never there once. Don't you remember it being overwhelming??? Don't you remember being told to do it one way or fail your clinicals? OP, I think you are doing just what EVERY nurse does, and it's normal. You came here to double check because everything is so different than what you knew, that you are in disbelief and maybe this is your first real job in life.

    But here is the deal. You need to not sweat the little stuff. Follow what you are told and do it that way until you are out of orientation. Then, just like everybody else, you are gonna naturally decide what you will keep and what you won't keep from those who taught you. School is never the real world, for any profession. Do a little mind-sorting when confronted with something different: Is it gonna kill me or the patient to just shut up, follow instructions and say "Oh, thanks for teaching me this tip"?

    Hold on to your horses, unless something wild happens -- and if you spend time reading here, you should know when you need be upset. Right now, be glad someone is trying to teach you. Lots of nurses don't get any kind of orientation.
    catlvr, tokmom, nursel56, and 7 others like this.
  5. 2
    If the process is truly bothering you, do some evidence-based research and find peer-reviewed studies on IV tubing and infection/bacteria. That way, when you do things *your way* and *within policy*, you can rest assured that you are acting as a prudent nurse would with nonmaleficence.

    Everything else is just politics.
    SweetOldWorld and Maevish like this.
  6. 5
    After reading this thread, I think it probably doesn't matter a whole lot what any of us say to you. I hope you understand that you are not going to do well if you think your way is better especially after your preceptor educated you on how she wants you to do the the set up. If she can't get through to you to do it the way she insists, do you really think she's going to find you a team player or a loose cannon? Where does it go from there? When you screw up sterile technique how will she handle it or even better, how will you handle it?

    Please take a minute to realize she will be your coworker and knows so much more than you right now, period. Soak it up like a sponge because when you're on your own you will appreciate her. Looking back, even though I had healthcare experience before becoming a RN, I didn't know squat. Even though I graduated with honors, I didn't know my back from my front. I learned everything I could from my preceptor and we are very close 2yrs later. She told my nurse manager that she was grateful to have a new nurse who wanted to learn and grow. I still go to her with questions and she still guides me as needed. Good luck and be the sponge!
    nursel56, AheleneLPN, TheCommuter, and 2 others like this.
  7. 4
    Quote from seks
    So are you all saying my past clinical instructors are incompetent and don't know what they were thinking?

    So who is right or wrong or too anal or giving unecessary steps in this situation? My current preceptor or my past clinical instructors/buddy nurses?

    That is my MAIN question.

    It really is frustrating when you get different opinions on a technique and I don't know who to believe or abide by. Guess that is part of the so-called "reality shock"
    No one here EVER said that your past instructors were incompetent or wrong. Nursing is not a 1 + 1 = 2 equation. Very few things in life are that black and white. There is more than one way to do things correctly. For now, you are her student so do it her way. She's the one who's going to evaluate you at the end of the semester. When you have your own license and your own job, you can come up with your own way to do things.
    nursel56, nrsang97, Maevish, and 1 other like this.
  8. 5
    With respect to work, and life in general, you need to choose your battles wisely. Sometimes, although you may be justified in questioning the rationales of others, is it worth it? That depends, especially when that individual can determine your fate. Look at her teachings as an alternate way of doing things. It's always helpful to realize that you have options.
    nursel56, redhead_NURSE98!, netglow, and 2 others like this.
  9. 10
    OP, Do it your preceptors way while on orientation and then decide how you would like to do it when you are on your own. Better yet ask your preceptor to explain her methods with rationale to you. You may learn something new.

    I had a very similar experience while on orientation. I always draw my heparin boluses in a regular syringe as opposed to using a tb syringe like we use with sub-q heparin. My preceptor had a fit and asked me why I thought that was appropriate. I honestly wanted to respond "because I know how to do math and because I am giving it IVP not sub-q" lol. Instead I just told her that it was how I was taught previously. I was then treated to a 20 minute lecture about how stupid that was because heparin is dosed in units not ml's and I was adding an extra step. I really wanted to argue that it was not an extra step because I always figure out my drip rates myself so that I can double check the rate pharmacy states I should set the pump at. Instead I said "oh that makes sense" and redrew my bolus in a tb syringe. She was quite pleased that she had "taught me something" that day. I still grin from ear to ear whenever I convert my bolus doses to ml's and draw them up in a syringe.

    The point is that some people are inflexible. I have precepted and have no problem when a nurse wants to do something his/her way. Other people are not like that and insist that their way is the only way. Now if someone can present evidence based practice that their methods are superior that is a different story.
    Hoozdo, nursel56, redhead_NURSE98!, and 7 others like this.
  10. 0
    Wow! Welcome to the world of "eating our young!" ;-)Unless you (seks) get an attitude and aren't teachable (and in that case, probably won't be around long anyways) there are nicer ways of saying things. Maybe "get over yourself" isn't as beneficial as "try looking up the policy and see if your facility has a clinical standard for this". Irritating your preceptor definitely isn't the way to go so get your proverbial ducks in a row before you make something of it.I've seen people do this both ways (and a couple other variations!) so it comes down to what the standard is for your place of work.Some people you just won't ever be able to please (on our unit of 70+ RNs there's only one who is like that so we're lucky) and when it's your preceptor that can be really tough. Just take into account the experience she/he has that you don't and pick your battles wisely.If there's documentation at your hospital stating her way is the correct way, then change your ways, but if not, just try to remember to do it her way when she's around and save yourself a headache. A lot of what's perceived as "nit pickiness" is simply attention to detail/protocol and the desire to not see a newbie cut corners or develop bad habit so early on.Everyone has an opinion, but your best bet is usually to look up the policy guidelines for your hospital on whatever topic in question. If there's no info/old info, set about changing the policy if you have the resources to back yourself up :-)Good luck!! :-D


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