Bad preceptors and the demotivated state of nursing.

Vanilla101 · Mar 13, 2016

I've worked in large teaching hospitals for most of my career, and have been a student, a preceptor & a clinical instructor at both the undergraduate & graduate levels. I've been seemingly drafted into both precepting & into being a clinical instructor. I have had complaints from students who felt like they were not wanted by their preceptor. At my facility, it is part of the staff RN's title (after a year of experience) and written into their job description that they will be clinical preceptors for students who attend our affiliated schools. Staff nurses should not be surprised when they get assigned a student at 07:00, that's not nice.

lavenderskies, BSN · Mar 13, 2016

As for asking if you could put on SCDs, I agree with "better to ask than assume". I would just say yes and hope they weren't thinking when they asked.

They were correct to ask instead of assuming like a competent thinking nurse should do.

As to the OP. I wonder if you will alter your behavior accordingly once you are a staff nurse and have students assigned to you.

windsurfer8, BSN, RN · Mar 13, 2016

So because you had what you assume to be a poor instructor you have made the leap to all of nursing is uninterested?

Severe micromanagement...do you have examples? Please define what you mean.. Liability....yes liability exists. If you injure a patient you may be liable.. If a bus driver injures a rider they may be liable. How is this different than any other professional career? HIPAA concerns. What "concerns"? Are you implying patient confidentiality is making nurses "disinterested" in their jobs?

I must admit this post is the first I have seen where a nursing student is offended with the idea ..."to help people".

Lad345 · Mar 14, 2016

Goodness, it sounds like you have a very specific chip on your shoulder. It's a bit dramatic to expand your individual experiences to make statements about the field of nursing as a whole.

I know disengaged nurses that just punch the clock, and I know nurses invested in the health and course nursing is on. That's life.

I absolutely love precepting students. I enjoy teaching, and I like seeing the pieces come together for students as they develop their nursing skills over the semester on my floor.

The example of the SCDs is a joke. Maybe they meant have you used their brand yet. Maybe they were prompting you to show what you know. And, yes, maybe they just wanted to know if you knew how to use them. I don't think you should be offended by that. The nurse probably had no idea they'd have you, and they probably had no say about it anyway.

You're ultimately unlicensed guests at the facility. The nurses are giving *their* time to watch you give medicine and do invasives. It's not simulation lab, real people are really sick and the nurses you encounter are responsible for them. Rounding your education is not a priority of the floor, nor should it be. You need to seek what you can from clinical, but understand no one owes you anything. You have no license and you are not their employee.

Units that don't like having students exist, and they get students just like the welcoming ones. If nothing else, familiarize yourself with Mosby's, get an idea of what a unit layout is like, work with eMARs, study the facility policies, and learn how nursing work flow plays out. As student, you're honestly only guaranteed shadowing experience. You'll be put on orientation when you're hired somewhere, and then learning the ropes and doing nursing skills before a preceptor happens.

Ultimately, the onus of your education is on you. Welcome to real life, man. You have to adapt and seek things or our for yourself in actual nursing. You will be solely responsible for the currentness of your clinical knowledge and skills, your license, and your practice. Consider the disengagement you're experiencing your first lesson. You can whine about it, or figure out how to make it work for you.

BuckyBadgerRN, ASN, RN · Mar 21, 2016

Preceptors are usually licensed nurses who are taking another licensed nurse "under their wing" so to speak, and guide them in the ways of the unit they've been hired onto. You're still a student!

Why do nurses who obviously have absolutely no interest in the education or development of their students bother to volunteer to be preceptors?
Is it recognition? Feelings of importance? Standing within an organization?
Almost all of my clinical preceptors (bar a couple) have been so uninterested and so disengaged that my nursing education has suffered severely.
I graduate from my BSN program in May (which my preceptor knows) and my preceptor asked me yesterday whether I knew how to put an SCD on. How is someone allowed to teach students if you have absolutely no ability to roughly estimate their skill level and educate them accordingly?
The level of disengagement and lethargy permeating the nursing profession is really astonishing. How do people "fall in love" with a profession that, for the most part, devoid of the passion it probably used to have?
Severe micromanagement, liability and HIPAA concerns, disrespect from superiors, strict protocols disallowing any attempt at innovation... Why do it? To help people? Really? What about ourselves?

chacha82, ADN, BSN · Mar 23, 2016

Not another one of these posts. I showed up to work one day and was told I would have a student that night.

Your preceptor is likely stressed because nursing is stressful in general, and on top of getting everything they have to get done, they are now responsible for orienting you to a world of high stakes/low control stuff. Welcome!

You will work with all personality types. My capstone preceptor was tough but fair. I was dropped in her lap at the last minute, and she graciously accepted the assignment, even though she was returning to work from maternity leave and trying to coordinate things with her husband's new job. I learned quite a bit from her. She conducted herself in a smart and dignified way.

Look within yourself to improve your experiences at work without blaming your preceptors. In awhile you will be working on your own. Will you be prepared when you're off orientation if you have squandered your time sniping about your mentors? Patients may snap at you, doctors may make ridiculous demands, and sometimes the CNA is nowhere to be found. Time to get to work.

greenqueen · Mar 23, 2016

Sounds like you are in the wrong area/ hospital. Where i am they celebrate and empower nurses. Do some research and find a hospital where the culture of nursing is one involving passion and innovation. Typically a Magnet designated hospital is one of those places.

Also, stop blaming others for your lack of education. You may be put in a situation where your preceptor is sub par but you can still learn (even if its what not to do). Watch how she delegates, communicates. Try looking at your situation from a different angle. You will never again be in a situation where you are not the ultimate care taker. As a student you have an awesome position of learning how to be responsible but without the ultimate responsibility that your preceptor has. Maybe taking the situation for what it is worth is better than taking the stance of "poor me, my preceptor is mean."

Ruby Vee, BSN · Mar 23, 2016

Why do nurses who obviously have absolutely no interest in the education or development of their students bother to volunteer to be preceptors?
Is it recognition? Feelings of importance? Standing within an organization?
Almost all of my clinical preceptors (bar a couple) have been so uninterested and so disengaged that my nursing education has suffered severely.
I graduate from my BSN program in May (which my preceptor knows) and my preceptor asked me yesterday whether I knew how to put an SCD on. How is someone allowed to teach students if you have absolutely no ability to roughly estimate their skill level and educate them accordingly?
The level of disengagement and lethargy permeating the nursing profession is really astonishing. How do people "fall in love" with a profession that, for the most part, devoid of the passion it probably used to have?
Severe micromanagement, liability and HIPAA concerns, disrespect from superiors, strict protocols disallowing any attempt at innovation... Why do it? To help people? Really? What about ourselves?

What makes you think any of your preceptors were interested in precepting or volunteered to be preceptors in the first place? These days, anyone with a pulse and a license that has ever been renewed gets volunteered by management to be a preceptor. For the most part, the staff nurse doesn't get any choice about precepting. Those who are interesting in precepting, like to teach, passionate about staff development and are good at teaching are usually busy precepting actual staff. That means that the students get those who aren't interested in precepting, don't like to teach or are horrible teachers.

Preceptors don't get paid to ensure that your nursing education doesn't suffer; that is the job of your school and your clinical instructors. Preceptors get paid to take care of the patients, and that is about all they have the time and energy to do.

As far as passion and loving our profession -- that sounds suspiciously like you're beating "the calling" drum. That's not going to make you popular among actual nurses, although your fellow nursing students may agree with you.

allnurses Guide · Mar 30, 2016

I am an LPN of 20 years who decided not to bridge after the treatment my fellow students and I received from the RNs who were in charge of us. It is interesting to see the old cliche, "Nurses eat their young" is still going strong. How can things for students and aspiring RNs progress if these conditions prevail? I work under difficult conditions, as well as being among the "redheaded stepchildren" of the nursing field, yet this article lets me know I made the right choice to stay where I am.

If you have 20 years of experience and have not yet encountered the reality that there are almost as many personality "types" in nursing as there are in other professions as well as the world at large you've been very fortunate.

The flip side of that coin is it appears to have led you to curtail your education, and assign a clichÃ© "nurses eat their young", (which I was blessedly unaware of until I saw it here) as the reason for your decision.

If you are happy with your decision then for our purposes the reason is irrelevant. To be fair to other prospective bridge students I think its fair to point out your negative characterization is one of a spectrum we talk about here, and for every RN who treated you badly there's another who loves to teach, who you just click with, or who can be a mentor to you. Again, though being at peace with your decision is something that eludes many of us, and wish you well!

Ruby Vee, BSN · Mar 30, 2016

I am an LPN of 20 years who decided not to bridge after the treatment my fellow students and I received from the RNs who were in charge of us. It is interesting to see the old cliche, "Nurses eat their young" is still going strong. How can things for students and aspiring RNs progress if these conditions prevail? I work under difficult conditions, as well as being among the "redheaded stepchildren" of the nursing field, yet this article lets me know I made the right choice to stay where I am.

If you have made a choice with which you're happy, I'm happy for you. But it's sad that after 20 years, you didn't make the choice for positive reasons but because, as you say, the RNS were mean to you and "nurses eat their young."

There are just as many personality types among nurses as there are in the population in general -- and you don't often see articles proclaiming that "Coal Miners Eat Their Young!" Or "Lawyers Eat Their Young." If you haven't figured that out, then I have to wonder whether all of these people who are mean to you have something in common . . . YOU.

Tenebrae, BSN, RN · Dec 31, 2016

I got to work yesterday to find one of my patients was being put onto a syringe driver. Which involved a fairly lengthy set up process, not to mention contacting the patients family and having to advise them that if there are any family members they may want to come and see the person sooner rather than later. Those phone calls are never fun.

About 3 hours into my shift the patient woke up and began to moan, and they didnt stop. They kept trying to get out of bed and pulling at their lines. I gave the patient all the maximum PRN analgesia I could and still nothing made a difference. Back onto the phone to the patients doctor who upped the PRN which still made no difference to the patient who continued to moan wail and thrash around. Eventually about an hour before the end of my shift we got the oncall doctor out to see the patient and through a process of elimination we felt the patient may be in retention and the doctor put in a catheter. Within about five minutes the patient had passed about 1000ccs of urine and was the most settled that Id seen them in the past five hours.

I barely had the time or ability to do anything with the other fourteen patients on my unit except pass meds and do one dressing. and I sure as hell would not have had anytime what so ever do have any input into a student and would have probably been the stereotypical example of a grumpy horrible preceptor.

Guess what students, its not about you, my patient's welfare will out every time.

FutureNurseInfo · Dec 31, 2016

So I am writing it soooo late! In any event, some preceptors, as noted before, may not have choice and were asked to do so without being consulted first. Others may do so just to look nice in the admin's eyes. However, I do agree with what you are saying: those chosen to percept/teach should have passion for educating nursing hopefuls and, in fact, have some mastery of pedagogy. I have always said that being skilled at something does not mean you can be a great teacher at it. And I know, I AM a teacher and have been one for a long time.