I recently started in a level 2b NICU and have been there for 4 shifts so far. My preceptor was rude to me right from the start and this has continued for every shift. I am not a new grad, I worked in an ED for 3 years, but I have no previous NICU experience or experience dealing with preterm infants.
It started on the first day when I got yelled at for comming in at 7 am (the start of the shift) instead of 6:45. No one bothered to tell me this previously.
I feel like I am constantly being belittled by her and some of the other nurses and disrespected. I ask a qusetion and get treated like I am an idiot for asking it and then yelled at becuase I don't ask enough questions! The other day we had a 32 weeker on a warming table, my preceptor gave me a senerio, and asked what the first thing I would check on this baby if it was intubated and had just been transferred from isolette to warmer. My answer was ABC ie tube placement to make sure the tube did not become dilodged or pushed into the right main stem, but no I got yelled at in the middle of the nursery with parents and other nurses present stating that I didn't know a thing and she went on an on about temperature and CBS. I understand that is a worry, but that is not going to kill a baby as quickly as not having their ariway squared away!! The same baby was on the warming table and she said we have to wear gloves with this baby because he has not had a bath, so assuming we were going to feed and assess the baby I went and put some gloves on, got yelled at for that too.
She has not once bothered to teach me about things, except for everything I am already familar with wroking in the ER. It was my fourth day before she bothered to teach me how to work the isollette!! I am planning on calling out sick tomroow, and I know thats not a good thing, but I really cannot stand to work another day with this preceptor until something is done. She volunteered to precept me and knew ahead of time that I had no experience, but clearly she does not have the personality or the patience to be a preceptor!
Having precepted a new grad in teh ER myself I know how time consuming it can be and it takes patience and understanding. I never once felt the need to belittle or disrespect the person I was precepting!!
I am going either tomorow or the next day to meet with the nurse educator on this subject, any ideas on how to be tactful and remain calm?
Oct 25, '10
my first advice is to not call in sick! that shows them nothing good about you and your character or work ethic...
Oct 25, '10
Step 1: You need to decide what you want to come out of the meeting. What action do you want to be taken? What are you prepared to risk/sacrifice? Are you willing to quit your job if the educator gives the preceptor the benefit of the doubt and doesn't back you 100%
My #1 recommendation is for you to think that all through before you go into that meeting -- because it is likely that the preceptor has friends and supporters in the unit who will defend her. You need to know how far you are willing to go with it.
Step 2: Make a list of specific instances of inappropriate behavior. Be very specific. You might not want to present the entire list at the meeting, but have it handy just in case you do. Also, the process of making the list will help you clarify your thought and find words to use to describe what has happened.
Step 3: Rehearse what you are going to say. For example, if you have met other staff nurses and/or preceptors and begun to establish positive relationships with them, say so. If you are really committed to working with a neonatal population, say so. It would help if you had positive things to say as well as negative things. So make a list of positive things you can say that demostrate your desire for this situation to work out in a positive way.
I suggest that you not accuse your preceptor of inappropriate behavior unless forced to. I would say simply that it is not a good fit and that you are having trouble communicating. The example you gave about the first priority of assessment is a great one. Use it and say that you still don't understand why the assessment of airway and breathing would not come first. (Your preceptor was probably assuming airway and breathing were OK in the scenario because she could see that the baby was pink and breathing -- and all the monitors were saying all that stuff was fine. A lot of NICU nurses "skip over" that step on a pink and breathing baby because the respiratory and circultory status is constantly obvious.) But that example is a good example of poor communication between the 2 of your.
I would use that example as an example of poor communication -- emphasizing that such a learning experience is not promoting your learning. Ask for a switch in preceptors and see what that gets you.
And I agree -- do NOT call in sick. That just puts a neon sign on your back saying that you cannot be relied upon. It will make you look bad -- and you don't need that right now.
Oct 25, '10
Great advice above...but do NOT call in. That will put you in a bad light even with nurses who may have sympathy for you at this point.
It is within your right to ask for another preceptor.
Oct 25, '10
Just ask for another one. Surely this person isn't the only one who can precept. Just tell them you feel you might have personality conflicts w/ her or something ... sometimes that's just how it is.
I think some people volunteer to precept because they feel maybe it will make them look good in front of the managers, or maybe they ARe really good nurses .. .doesn't make them good teachers, or patient, or even good people in general.
I've never understood why anyone would be cruel to a future co-worker -- just doesn't make sense. Everyone I precepted became my ally and friend on the unit.
Oct 25, '10
Definitely support all that llg said. And remember, try not to make this a confrontation. You can always fallback on the preceptor's teaching style and your learning style aren't a good mesh, using the examples as llg said. There's nothing wrong with requesting a new preceptor. All preceptors can't teach everyone...key component to remember.
Also remember, this is YOUR orientation. Calling off isn't advocating for yourself, it's admitting defeat. Requesting this meeting, going in with a positive and professional attitude IS advocating for yourself. You're not a new grad, you have highly specialized ER skills. But in someways, you are like a new grad in that you may have to learn some skills from the beginning. (Not sure how much you dealt with babies in your ER work.) Your preceptor may be struggling in remembering that. Assuming you know things you don't then becoming flustered when they are reminded you don't know these things. This can be dealt with in a positive way. Keep your head up and advocate for yourself. Just like you've advocated for your patients in the past. Good luck to you.
Oct 25, '10
Ask your preceptor to stop with the yelling and public displays of humiliation (in a tactful way, of course). You're not her scapegoat. If she gives you the "huh?" expression, and says something to the effect that she doesn't know what you're talking about, then definitely change preceptors. No need to call out tomorrow, that's too passive aggressive a behavior tactic that will only make things worse.
You are an experienced nurse, and even if you weren't, there is no need to have to put up with that kind of crap. Speak to your nurse educator ASAP about this if the talk doesn't work; trust me things will only get worse with this preceptor if you try to put up with it with no intervention.
Oct 25, '10
Have you tried resolving the issue with her? From my experience managers prefer people in conflict situations to try and resolve things before taking it to the next level. As a professional you should be able to stand up for yourself when required.
Next time she starts yelling call her out on her behaviour. Tell her that you do not feel comfortable and that it is going to stop right now. Make it clear that you know you have a lot to learn but being put down publicly and being belittled is not helping you.
Write down the date and time of every incident you can remember and if her behaviour continues despite approaching her then take it to management with your diary of incidents.
And don't call in sick, it will make you look bad.
Oct 25, '10
I would be matter of fact with the educator. I would also bring the manager in on that meeting, or request him or her to be present. I would explain that you are not a new nurse, but new to this specialty of nursing, and need to learn the specifics of this population/department in a professional manner. Not to be belittled, humiliated, or treated in any other way that is less than professional. Demand this. Let them know that you have precepted new nurses in the ED and understand that the learning curve can be quite varied, but that you are quite smart and can adapt to any situation (hello! ED nurse!). Don't take that lying down. Go get 'em! Post here and let us know! Good luck! I can't imagine goign to NICU, so good for you! I won't ever go to the babies!!!
Oct 25, '10
i wouldnt trust her with my orientation another day. making you feel less than obviously is some kind of currency for her.
i would not suggest calling in.this will not do you any favors. when you return, the problem will still be there.
Oct 25, '10
Just a suggestion here but a few weeks ago we had a new nurse orienting on my unit. He had two different preceptors (switching back and forth) and after a few shifts he told one of two "I appreciate all you've done to train me so far, and I've learned a lot but I just think our "styles" and ways of doing things are very different" and then he told her he would prefer to finish off his orientation with the other preceptor. He then talked to the floor nurse educator (who sets up precepting schedules) about it, and his schedule was changed. The only person who this upset was the preceptor who he "fired" (and myself and others don't blame him at all because this nurse is very controlling and bossy). I thought he went about it in a really respectful manner though, that still ensured he got a good orientation and took care of himself as a nurse and a person. Don't call in sick, just be assertive and ask for what you want (a different preceptor).
And as someone who just got out of orientation a while ago, it isn't fun no matter what, even if you like your preceptor just fine. It's hard being watched and critiqued and followed and told what to do. And it's hard for the preceptor too, in different ways. Like they have to be patient and correct your mistakes, and teach you in ways that you will understand and patiently wait while you do something that would have taken them 2 seconds. I'm sure that's frustrating too. Anyway, the woman you have sounds like although she knows her stuff and is probably a good nurse, your personalities and teaching/learning styles don't mesh well. And there is nothing wrong with that! So IMO, go ahead and talk to whoever set up your precepting schedule and just ask for a change.
Oct 25, '10
Thank you all for the advice. I emailed the educator a couple of hours ago and was told we could sit and talk about it... She also asked if I could talk to my preceptor about how I feel, but in my oppion, this person is not someone you can change and it will just set me up for failure.
The problem is the educator is not availalbe tomorow and neither is the nurse manager, so its either call out sick tomrowo or work with a miserable person all day long. I was near tears yesterday and I am sure tomroow will be no different.
Should I still go in? Just the thought makes my anxiety level climb!
Another thing I forgot to mention is the other day we had a demise, 28 weeker didn't make it, even after 3 rounds of epi, and she never once bothered to ask if I was ok after it!
Last edit by AnnieOaklyRN on Oct 25, '10
Oct 25, '10
Once I had a preceptor who told me she was doing it because it would help her to get promoted. Her lack of enthusiasm showed. Others in the department were willing and eager to answer my questions and show a positive attitude where this person was doing the minimum to get her benefit from the situation. Ask for another preceptor.
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