Having trouble precepting new orientee

Nurses General Nursing

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Specializes in ccu cardiovascular.

I've been a nurse 11 years in critical care and stepdown nursing. I've been precepting at my hospital for the last 4 years and have seen alot of nurses come, go and really grow. I love new grads and most new nurses have rated me high on my evaluation as their preceptor. My new grads I keep a close eye on the floor even after orientation and I believe I am an excellent teacher and prepare them well before they hit the floor on their own. Enough said. I currently am precepting a nurse that has been in nursing for over 20 years in a field totally different from what we do on our stepdown unit. To say the very least, our personalities are clashing. She is inappropiate to families, she can be abrupt and rude at times. She is very disorganized and does not use time wisely or know how to prioritize. She is so slow in everything and when i make suggestions to make things easier or more time efficent, she is rude to me and says she has been a nurse longer and knows what she is doing. We took over 20 min giving a patient a pain med. She cannot even read an ekg strip. She was only given 6 weeks to orient since she is"experienced" and i told her on friday if you think you need more time, to let the educator and our boss know and that we would give it to her. I have talked to the manager about her and she says "everyone really likes her, I'm not sure what your problem with her is, you are too much a perfectionist" A few of our staff members told me they are not impressed with her and worry about her being on the floor. I really don't know what to do? I'm ready to go to my manager and tell her to please find another nurse to orient her because i don't feel comfortable signing her off on orientation. She has next week off for thanksgivning, so i'm trying to come up with a plan to either make things better or get her another preceptor. I honestly don't trust her to work on our floor.

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Specializes in OB.

I think your plan of telling the manager that you don't feel comfortable signing off her orientation is the best idea. Ask her to have another experienced staff member evaluate and perhaps precept her a bit longer. This will assure that any problems are real and not viewed as just your perception.

One thing you may want to keep in mind is that it takes a whole different education plan and way of approaching things when you are orienting an "old" nurse to a new area than orienting a brand new nurse. You really do need to let her know that you do respect her years of experience and understand the expertise she may have in another area and plan to build on that rather than start from the "ABC's". Ask her to evaluate what she feels her strong points are and where she feels she needs the most instruction. (Not to say you won't see other needs as you go along)

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Specializes in Trauma ICU,ER,ACLS/BLS instructor.

After 6 wks of orientation and 20 yrs experience, she should be able to read an EKG. Maybe she has not been given the proper tools to succeed. An ekg course prior to starting on the floor, a critical thinking evaluation and class. You did not say what she did before, but some work habits are difficult to break after 20 yrs. It should be interesting to see how she does. I agree with maybe going back to your manager and have her do some time with another precepter. I also agree that experienced nurses are sometime harder to retrain then a new grad! Good luck and let us know how u do.

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Specializes in LTC, Med/Surg, Peds, ICU, Tele.

If I were you, I would request to step down as her preceptor. It sounds as if your manager has 'warm body syndrome' and is engaging in wishful thinking. At the very least you and your preceptee have a personality clash.

Incidentally, I've seen this same problem with longtime nurses being oriented to new units. She sounds difficult to work with.

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RN Jane...I was sitting here thinking...wow...what a great teacher, when I decide to get back to acute care I wish I would have a preceptor like you. Then I noticed I'm in your same area;)

Anyhow, I wouldn't sign off on her. If you don't feel like she is ready, she isn't. Sounds like she isn't doing her part in learning from you. Maybe another nurse could take her? It might seem funny, but sometimes it is hard to teach that old dog new tricks or maybe she needs a longer adjustment period.

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Specializes in Geriatrics, Med-Surg..

I think that you sound like a great preceptor. I would have killed for one that actually likes to teach and is willing to share information. It sort of sounds like your orientee is not listening and she should be.

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Specializes in Utilization Management.

Sounds like too much of a clash for it to be successful. I'd have a chat with your manager asap and see what can be done.

Speaking for myself as an experienced nurse that transferred to another unit, I have to agree that the teaching methods are different. I'm also considered "slow" to learn/orient and I have had problems with that in the past. Yet, once I know what I'm doing and finally "get it," I'm considered pretty good.

The reason I am slow might be different than the reasons she is slow, so I would have to recommend giving her another preceptor and having a chat about it with your manager about your concerns, with her present, before you actually write her off.

Edited to add: Please be specific enough with your critique that she has a chance to improve her performance. Please don't do what my preceptor did and just say, "I just don't think you're going to make it, you're just not getting it," after the first day of orientation. Kinda turned me off to the whole deal, KWIM?

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Specializes in LTC, Med/Surg, Peds, ICU, Tele.

It sounds to me that this orientee is getting really defensive and developing an attitude. Maybe with a new preceptor she'll get a fresh start, or else crash and burn, depending on whether the problem is mostly with her or else it's a personality clash.

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I think your plan of telling the manager that you don't feel comfortable signing off her orientation is the best idea. Ask her to have another experienced staff member evaluate and perhaps precept her a bit longer. This will assure that any problems are real and not viewed as just your perception.

I definitely would not sign off if you feel this strongly. I totally agree with this statement.

RN Jane...I was sitting here thinking...wow...what a great teacher, when I decide to get back to acute care I wish I would have a preceptor like you. Then I noticed I'm in your same area;)

Anyhow, I wouldn't sign off on her. If you don't feel like she is ready, she isn't. Sounds like she isn't doing her part in learning from you. Maybe another nurse could take her? It might seem funny, but sometimes it is hard to teach that old dog new tricks or maybe she needs a longer adjustment period.

:yeahthat:

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Specializes in anything that I had my clinicals in.

I'm a new grad and my preceptor didn't work out. Can you be my preceptor!!! :) Wow, sounds to me she thinks she has more experience than you with her having 20 years experience and you having a little less than her. She has these bad habits and it is only going to be you that feels that she is inappropriate because your her preceptor. I had the same thing happen at my job before nursing. This lady came off days to help out with nights and she thought what she was doing was right. I tried to show her easier ways but no cigar. I think i am very patient but she tested my patients all the time. Tell that nurse manager that you're guy's personalities clash, nothing wrong with that, and she needs a different preceptor that will fit her learning needs better. Good luck

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Specializes in Hospital Education Coordinator.

This points out the value of frequent, objective competency lists and meetings between the manager, preceptor and trainee. Makes it less of a personality issue. 20 years doing anything does not mean she is doing it right or even the way it is done in your facility. I would certainly talk to the manager and then ask the Educator what resources there are for preventing this issue. We try to evaluate technical skills, but also interpersonal and cognitive. A person may know how to give an injection, but making the patient comfortable psychologically and knowing about the medication is a whole different animal.

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Specializes in ccu cardiovascular.

Yesterday I had to go to a cpr class at the school of nursing and my orientee was with with another preceptor on our floor. The girl is good, she actually was my preceptor when i started at this hospital 5 years ago. I never said anything about my problems with this orientee i feel it is not the unit's business to know about everybody's performance on the floor except the preceptor and the manager . Well while i was gone for the hour she sorta crashed and burned herself. First of all let me give you a brief info on my orientee, she came from another state and has not worked for 10 months. She is 60 years old and very set in her ways. We are a intense stepdown unit constantly moving people in and out, basically a revolving door. The patients are here with mi's, open heart recovery and chf, ect. We have a block of 7 patients. Some doctors will just send them to our floor because we give fantastic care compared to other units in the hospital. Our satisfaction rating is very high. This oreintee constantly puts down the unit, hospital and the way we do things. This stepdown unit is slow in comparison when i worked in pittsburgh and i really love working here and am very proud of the unit we have.

Anyways I never saw her resume and don't care to but claims she worked in pediatrics at a small hospital with a light patient load(4). Every morning I print out our med sheet and give her a copy. We have lpn's that pass all our po meds and piggybacks. For our medications we use a handheld pda to dispense drugs to id with the patient's armband. Yesterday she made a serious med error. This orientee has been giving meds with me for the last month with the handheld and though extremely slow has been doing this okay. I got back from my cpr class and asked her how it was going? She told me she thought she gave a med to the worng patient. I told her "it was impossible you can't with our hand held system", you need to scan the med then scan the patient's bracelet after verification with the patient of their name and birthday. Well she never scanned the med or the patient! Next I made her call the doctor. We got new orders. The doc was cool and i saw him later on the floor and he understood the best he could. I talked to our manager about this later in the day after i had to do a incident report and I had a very long talk with her. The orientee was in her office last week and asked for another preceptor but she said she decided to keep her eye on her the last few days and now understands what was going on. I told her from my nursing opinion, this nurse was not safe to put on the floor and i would state that in my evaluation. The mistake she did because she did not use the handheld would have to be sent to risk management to be dealt with. I told my manager she is welcome to give her another preceptor, I found out they were going to release her from orientation next monday, man what a scary thought! My manager said she wanted her with me because I'm good on keying on a orientee's weaknesses, ect. So we are giving her another 6 weeks of orientation. I told my orientee all my thoughts on what was going on. I told her she was very disorganized, had poor time management and did not know how to prioritize. I gave her all the copies of videos and information material we give to patients. I told her she needs to start reading to be able to teach a patient. I have been in this field for a long time and i constantly read on things in my field, go to seminars ect. I think all good nurses do, and we all do that on here. We keep up to date. She is off til next week, and i think i gave her alot to think about at least i hope i did.

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