Ready to be freaked out!

Nurses General Nursing

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While orienting a 20 yr veteran with a CCRN on her badge I asked the following situations happened: (she had been in orientation approx. 10 days with other staff)

1. Monitor set up incorrectly.

2. Bed plug in was getting more priority than PA cath plug in.

3. Pt. not assessed for 35 min. ( I did it after about 5 min.)

4. Did not pick up on chest tube leak or slurping sound

coming from insertion site.

5. Attmepted to take off dressing with bare hands to apply

vaseline gauze.

6. Was asked what could be done with SVR of 460. (?)

7. Was asked what SVR is and what is acceptable. (?)

8. Was asked what actually happens during wedge. (?)

Ladies and Gents I could go on but what till you hear what happened next.

I was called into the Unit Managers office and told that this nurse felt uncomfortable with me because I put her on the spot too many times with all these questions. Therefore I took her away from patient care. These 8 things took no more than 15 minutes to address. About the same time as the 3 personal calls she made.

Specializes in ICU, CM, Geriatrics, Management.

New2 -- Think Erin makes some great points.

Always good to assess other experienced folks' viewpoints and to ponder what we could've done to achieve a better performance. We all must continue to learn -- not only technical stuff, but interrelationship skills as well.

All the best!

Why do you all insist that she was learning under duress or that she was being lambasted with questions?

Probably because you said, in your original post:

I was called into the Unit Managers office and told that this nurse felt uncomfortable with me because I put her on the spot too many times with all these questions.

That's what you just said....that you were called into the Unit Mgr's Office because you were lambasting her with questions.

No offense, but I wouldn't want you for a preceptor, either.

Shezam,

You are being far less polite with me than I was in any of my conversations with the orientee. I feel the tone of your letter is hostile. Does that make me resentful. Again, No. Do you like that I am saying this, probably not. But we are all entitled to our feelings and opinions. I would also like to ask why, it appears, are you taking this subject so personally due to the fact that you attempted to personally insulted me whether you meant to offend or not.

Please excuse my misspelling of insult(ed).

New

It sounds like the orientee didn't feel like she was learning from you and that is what it is all about. I have recently had to start helping both my kids in different subjects and felt like I was hitting a brick wall with my head so I asked my sisiters what I could do differently..one teaches in China, the other HS biology..both told me to approach teaching from a learning standpoint rather than from a teaching one. At first I really couldn't see the difference but there truly is one. ANY type of education is about learning it is not about teaching..individuals learn differently so teaching styles need to be altered not the other way around. If the preceptor is precepting in a way that is not accomplishing the goal of the orientee learning the preceptor must change the approach or the goal will never be met. This gal obviously did not respond well to your style therefore both of you ended up frustrated. A good teacher teaches to her or his audience..just like a good nurse interacts with each patient differently..I remember discussing this concept with other RNs in the ER..it is kind of like "Showtime" before you go in each door..you have to assess more than just the person's knowledge or lack of..you have to assess personality, state of mind, culture etc etc then "perform" accordingly" to be successful. Even though at times you are not truly being yourself you will meet the needs of those thatare looking up to you for support, encouragement or whatever and overall the outcome will be more favorable for both of you...Erin

Erin, what a great post. You taught me something, and I love to teach and have been told that my students enjoy my teaching. You have articulated exactly what I try to do. I am in a clinical now where my preceptor is very passive - just tell her what I want to do, and she is an excellent teacher. However, I am not a very assertive learner (I need direction and encouragement), so I feel that I am not accomplishing much. Learning styles make all the difference. Also, just an aside, your post is so positive and constructive. Thank you!

Well thank you repat..it is a fine line and one which I could not quite grasp in the begining but the bottom line is the burden is on the teacher not on the learner. I have had a very hard time with helping my kids because they both learn very differently. It sounds like your students learn from you not because you teach to them rather you allow for them to learn..make any sense.?

Both my sisters got their Masters from Antioch which while an elite university is no where near the conservative..they both learned many techniques in teaching. A teacher or preceptor will never be successful unless they are able to facilitate an environment unique to the learner which allows that person to understand what is being taught. If the learner does not grasp whatever the material is, in my opinion, the failure is on the teacher not the learner.

Based on the first post it just sounds like the environment and dynamics were not conducive to learning..just my opinion. I can attest though that if a preceptor put me on guard or frustrated me I would learn very little from her..Erin

originally posted by new2cvicu

1. monitor set up incorrectly.

2. bed plug in was getting more priority than pa cath plug in.

3. pt. not assessed for 35 min. ( i did it after about 5 min.)

4. did not pick up on chest tube leak or slurping sound

coming from insertion site.

5. attmepted to take off dressing with bare hands to apply

vaseline gauze.

6. was asked what could be done with svr of 460. (?)

7. was asked what svr is and what is acceptable. (?)

8. was asked what actually happens during wedge. (?)

i was called into the unit managers office and told that this nurse felt uncomfortable with me because i put her on the spot too many times with all these questions.

i would be freaked out if you were precepting me.........questions 6,7, and 8 were way out of line.....i think you are trying to get across is the fact that she is a 20 yr veteran and should automatically "know what shes doin" but thats not true in all cases. maybe she was so stessed out about all the new things she had to learn, she couldnt function properly. and i bet any amount of $, the personal calls she made was prolly to a family member so she could vent and get some reassurance. obviously shes new and doesnt really know anyone. shoot, if that was me, i would be calling my dh for some mental support....jmo

Just my 2 cents, but in my in my last job (maxiofacial/ Oral SX assisting) I was asked a ton of question on my interview. I was taken off guard.

After I answered to the best of my ability the Dr told me the questions where asked to put me on the spot to see how quick I think on my feet. He said, and I agree, emergencies don't wait to see if your well prepared or relaxed. They can happen at anytime.

He asked these questions of everyone who started there and it didn't matter if you had 22 or 2 years of experience. Letters behind a name dosn't mean you remember every bit of training you have.

Ego's and pride need to be set aside and pt saftey needs to be the main concern.

1. Monitor set up incorrectly.

2. Bed plug in was getting more priority than PA cath plug in.

3. Pt. not assessed for 35 min. ( I did it after about 5 min.)

4. Did not pick up on chest tube leak or slurping sound

coming from insertion site.

5. Attmepted to take off dressing with bare hands to apply

vaseline gauze.

6. Was asked what could be done with SVR of 460. (?)

7. Was asked what SVR is and what is acceptable. (?)

8. Was asked what actually happens during wedge. (?)

Ladies and Gents I could go on but what till you hear what happened next.

I think that its not so much the questions that you presented, its probably in how you did it. You stated that on #3 you did it after 5 minutes, and #8 what actually happens during wedge, #7 what is acceptable. I think its just because you "appeared" to be grilling her. Why did you feel the need to do that? IMO that's not what a preceptor does, a preceptor is a support person who teaches, and allows things to happen. Unfortunately we learn by our mistakes, and as a preceptor you are there to prevent grave mistakes, but to assist, not dominate. Just because you can do it after 5 minutes doesn't mean she SHOULD. She's got to learn and figure out her own pace. I know that in my past preceptors and i clashed because i didn't do things the way they did. But just because its your way, doesn't mean its the only way. I think that you were trying to be there for your patient, but at the same time maybe being a little domineering. I DON'T mean this as disrespect, because i don't think your intention was to intimidate and domineer her. BUT were you feeling threatened at all due to her credentials? Your screen name indicates you are a new CV nurse, so maybe unconsciously you were feeling a little intimidated? Just a thought, and i DO NOT mean any disrespect because you do deserve support during this time. Just maybe try to use this as a learning experience so next time you have to precept, you can be the best one possible. Good luck!

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