I want to like my preceptor, but...

Nurses General Nursing

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No, I'm not here complaining about NETY or any form of eating. Lol! :D I am a couple days into my preceptorship & it has been going well, I'm just not fond of my preceptor. I find her teaching methods harsh & direct. I'm not a new nurse, hell, I've been a nurse longer than her! So obviously I don't need a lot of coaching or hand holding since I'm just new to the hospital.

I try to joke around with her & nothing, just straight faced. I get text book lectures & how everything is *suppose* to be, when I know this is the real world & doesn't go by the book. She also tells me to do this & that which gets under my skin. I can't tell you why, it just does. Lol.

We had a pt. admitted for chest pain & ETOH withdrawal. She was young & I was trying to gain her trust, especially since she really didn't want to be there & was talking about signing out AMA. I can gauge people & how to talk to them, so I dropped the f-bomb infront of my preceptor. Obviously this was a special case & I don't cuss in front of *every* patient. But by the end of my shift, she was very relaxed & stayed. She was more relaxed with me than she was with my preceptor. I know you have to speak to every patient differently. But holy COW did I get an earful after that.

My preceptor will come up to me & tell me to go do this, go do that. Instead of asking me what have I done & explaining what needs to be done next, she just spouts off a list of crap that needs to be done then walks off. Generally when I'm in the middle of something. I'm not your *****, I'm your preceptee. I'm here to learn & I can't learn if you just tell me to do the crap you don't wanna do. I can tell that's just the way she.

She does knows a lot but man. Lol. I was with two different preceptors before I started with her & they were great! But then when I started with her I was really bummed out. Hahahahah! :D I know it's not permanent so I'm just gonna suck it up & just keep swimming.

Specializes in ER.

Lol, the F word isn't the best during orientation. It's actually, generally a bad idea with patients. You can establish a rapport without the F word. *******' or Freakin' work.

Trty to stay at least a bit a couple of notches above your patients. Don't cut loose until you are off orientation.

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A couple things:

1) Preceptors can suck, but they can also be fountains of knowledge even if you don't like them personally. The biggest thing I tell people is after they're done being your preceptor, they're still your coworker. And when you have a horrible shift and are drowning? That coworker might be the one that can help you out. Be nice, be approachable, and don't disappear without telling the preceptor--even if it's just a bathroom break.

2) I work in an ED and I try *really* hard not to swear because there are a lot of kiddos around. To the point where my coworkers were shocked when I swore in the medroom after I got report on a patient who dropped in oxygen saturation from 98 to 30% in three minutes, no response to sternal rub, crash intubation/head ct, etc. Even with psych patient's I try not to swear because me swearing gives them permission to swear and then they'll start cussing loudly.

3) If they're want to leave AMA, explain the risks, *always* include "up to and including death" and be serious about it, and then notify the MD, d/c the IV,and have them sign the paperwork. Be clear with them that just because they are leaving AMA does not mean they can't come back through the ED if the symptoms worsen. The only people who can't leave AMA are people who are AMS/Psych/5150s/Dementia. We had a pt. be d/c from the floor who was A+Ox1 at baseline; she wanted to leave and the floor RN let her. 24 hours later she was back in the ED, with jewelry she bought at Target and a gallon of iced tea, unsure of who she was but very happy to show off her jewelry.

4) Lastly, use your instincts. You did corrections, you know what people are trying to manipulate you/use you and you know that you can be stern and call them on it. That will help *SO MUCH* on med surg!

Congratulations on the job!!!

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Just to add, I enjoy jokes too, but they're not really appropriate for the orientation period. You, OP, probably see them as trying to lighten the mood, getting your preceptor to lighten up. Your preceptor however probably sees them as you not taking orientation seriously, and not paying attention. I would lay off the jokes during orientation. Best of luck to you.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
i can not see any situation swearing in front of a patient.Sorry I have dealt with many psych drug addicted patients in my 40+ years of nursing. If I-was precepting you I my have taken this to the Nurse Manager while she chose to talk to you one on one.

Seven years of experience but zero hospital experience and you are looking for short cuts, once again as your preceptor this would alarm me.

Use this time to learn, and remove the chip off your shoulder ( I have more experience) and learn.

This sounds like a great opportunity try to follow your preceptors's lead.

I'm not looking for short cuts, I just know the real world doesn't go by the book.

I still don't regret what I did & I won't, ever. I was trying to get her to calm down & cheer her up & at that time it did. I wanted her to relate to us & not see us as any holier than thou nurse's because I could tell at the time she thought that.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Even if your preceptor has half of your years of nursing experience, if she's spent it in med surg, she undoubtedly has experience with psych patients. Not only is M-S a notorious dumping ground for admitted psych patients, but many, MANY med surg patients have secondary psych issues (diagnosed or undiagnosed). Be mindful of possible manipulation/staff-splitting from some of these patients.

Also...it's the patient's prerogative to leave AMA. You are not personally responsible for a patient's decision to do so. Document thoroughly and move on with your shift.

I'm not trying to say my preceptor has no psych experience, I was just trying to make the patient's hospital experience a good one & help her/stop her from leaving AMA. Because while I was there she DID stop from leaving. Unfortunately, I did find out she later left AMA.

Oh yeah, I know all the mind games psych patients play all too well. I wasn't there long enough for her to do anything. I just wanted to be there for her because I could tell how anxious she was & clearly didn't want to be there (obviously since she left AMA).

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Lol, the F word isn't the best during orientation. It's actually, generally a bad idea with patients. You can establish a rapport without the F word. *******' or Freakin' work.

Trty to stay at least a bit a couple of notches above your patients. Don't cut loose until you are off orientation.

I felt like it worked in that one situation & that one situation only. I haven't used it since & won't. I had the best patient interaction with her & left work very happy that day feeling like I made a difference (even though she ended up leaving AMA later).

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
A couple things:

1) Preceptors can suck, but they can also be fountains of knowledge even if you don't like them personally. The biggest thing I tell people is after they're done being your preceptor, they're still your coworker. And when you have a horrible shift and are drowning? That coworker might be the one that can help you out. Be nice, be approachable, and don't disappear without telling the preceptor--even if it's just a bathroom break.

2) I work in an ED and I try *really* hard not to swear because there are a lot of kiddos around. To the point where my coworkers were shocked when I swore in the medroom after I got report on a patient who dropped in oxygen saturation from 98 to 30% in three minutes, no response to sternal rub, crash intubation/head ct, etc. Even with psych patient's I try not to swear because me swearing gives them permission to swear and then they'll start cussing loudly.

3) If they're want to leave AMA, explain the risks, *always* include "up to and including death" and be serious about it, and then notify the MD, d/c the IV,and have them sign the paperwork. Be clear with them that just because they are leaving AMA does not mean they can't come back through the ED if the symptoms worsen. The only people who can't leave AMA are people who are AMS/Psych/5150s/Dementia. We had a pt. be d/c from the floor who was A+Ox1 at baseline; she wanted to leave and the floor RN let her. 24 hours later she was back in the ED, with jewelry she bought at Target and a gallon of iced tea, unsure of who she was but very happy to show off her jewelry.

4) Lastly, use your instincts. You did corrections, you know what people are trying to manipulate you/use you and you know that you can be stern and call them on it. That will help *SO MUCH* on med surg!

Congratulations on the job!!!

Lol. Yeah, true. I think she's starting to come around because I can joke around her now (more so when we're on break) & she will laugh! But every shift I think she is seeing if I am progressing & letting her guard down more with me. I understand I don't have to be best friends with everyone I work with, but it does help if I can at least *stand* to work with them & not want to pull my hair out. But I'm the kind of person who will have their back at work as long as they have mine.

I cuss like a sailor under my breath & try really hard to make sure family/patients don't hear. There aren't many kiddos up on med/surg, I've seen a handful so far. But I know it's not appropriate to just be cussing left & right like I normally did in corrections but the way I spoke to the other patient was the exception, not the rule & I don't see myself doing it ever again.

I talked that patient off the AMA cliff a couple times during my shift but she eventually did leave AMA while I was off. Can't say I was shocked because this was probably her 3-4 attempt & I don't think it was her that wanted to be there.

lol! :D I know. She was detoxing & alone most of the time (her CIWA score was high) so her anxiety was through the roof (she was complaining of chest pain, on release but has normal sinus rhythm). I could tell she needed someone to talk/vent to. When I had a spare minute I would let her just talk a little. I have the time now, I know I won't when I'm off of orientation.

Thank you! :)

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Just to add, I enjoy jokes too, but they're not really appropriate for the orientation period. You, OP, probably see them as trying to lighten the mood, getting your preceptor to lighten up. Your preceptor however probably sees them as you not taking orientation seriously, and not paying attention. I would lay off the jokes during orientation. Best of luck to you.

My preceptor is starting to come around & lighten up. The longer I'm on orientation the more my jokes stick. :) Of course they're not rude or inappropriate. Things are getting better.

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Specializes in Med Surge, Tele, Oncology, Wound Care.
I'm not trying to say my preceptor has no psych experience, I was just trying to make the patient's hospital experience a good one & help her/stop her from leaving AMA. Because while I was there she DID stop from leaving. Unfortunately, I did find out she later left AMA.

Oh yeah, I know all the mind games psych patients play all too well. I wasn't there long enough for her to do anything. I just wanted to be there for her because I could tell how anxious she was & clearly didn't want to be there (obviously since she left AMA).

I actually agree with you. I want to relate with patients. If that means putting on a different hat when I walk into their room to be something for someone I will. If I am working with a bunch of priests, I am going to relate differently in general than when working with a bunch of say clowns. It's being fluid in your personality to relate to others based upon what they need, so that you can "meet" their needs.

I had a patient the other day saying that all this "$hit" was too much and this $hit was just making her crazy, the $hit was keeping her up at night. I went in, sat down in a chair next to her bed and said "sounds like there is a lot of $hit bothering you" we both laughed and she opened up to me. Now the OP said the F word, but it's hard to pass along the context of it on a forum like this. I feel like in my situation it was appropriate and it allowed for her to open up and we established a good rapport. I wouldn't just do that with a bunch of priests in a room, but with her it made sense.

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Chaos, you will find your people once you get established at wok. For now, head down, mind on, mouth shut, ears open.

Love ya to pieces.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
I actually agree with you. I want to relate with patients. If that means putting on a different hat when I walk into their room to be something for someone I will. If I am working with a bunch of priests, I am going to relate differently in general than when working with a bunch of say clowns. It's being fluid in your personality to relate to others based upon what they need, so that you can "meet" their needs.

I had a patient the other day saying that all this "$hit" was too much and this $hit was just making her crazy, the $hit was keeping her up at night. I went in, sat down in a chair next to her bed and said "sounds like there is a lot of $hit bothering you" we both laughed and she opened up to me. Now the OP said the F word, but it's hard to pass along the context of it on a forum like this. I feel like in my situation it was appropriate and it allowed for her to open up and we established a good rapport. I wouldn't just do that with a bunch of priests in a room, but with her it made sense.

Exactly!!!!! I wasn't being rude & didn't tell the pt. to go eff herself. This is what I was doing to a T. But you are right, it doesn't transition well over text.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Chaos, you will find your people once you get established at wok. For now, head down, mind on, mouth shut, ears open.

Love ya to pieces.

You are right. Love you too!

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