help

lifelong · Feb 29, 2008

Ugh! What a bummer. Every story has 2 sides right? Well either way you probably should seek another preceptor after speaking with them on the phone (sort of interview) to see if your styles are similar. It could be something as simple as that differences in styles. Did your preceptor really want to precept or maybe the preceptor just precepted someone and needs a break. Maybe they aren't a suitable preceptor for anyone.

I would have a conversation with the person and say something like. "Yesterday (or whenever) I seemed to upset you when I asked about tapering steroids. It's something I learned in my class and just trying to understand things a little better....really not question your practice and if I came across as that, I am sorry, I am just trying to learn. Do you think we can work together during my time with you...or would it be best for me to find another preceptor? I want to make sure I can learn (and unfortunately I learn by asking questions) and not offend you (who by the way is doing me a favor by allowing me to be here). So what do you think"? May this will open a dialgue for you.

You may have to eat a little humble pie, but I do not think you need to be in a position of weeks of he--. Yeah, the preceptor is doing either the school or you a favor by agreeing to precept, but you also have the right to learn and understand practices. You also need to learn current practices based on guidelines etc. Maybe the preceptor couldn't explain why they were doing what they were doing and were embarrassed(bigger ugh!). It seems like your school is behind you in finding another preceptor. Is that an option? Would it be your responsibility to find and contract with them? You will need to move fairly quickly to meet the requirements timely.

Long winded answer...but do whats best for you. If it's best to thank the person and move on, then do it, but do ti fast! But if you don't have another preceptor lined up and will lose precious time finding and contracting with one...then maybe you use it as a learning oppty and have the conversation and do your best to get through it. If you choose this way though, I would have daily or weekly updates with your instructor and document/journal your experiences. Who knows, maybe you can present the situation as a case study somewhere in your study. But I would definitely have your instructor clued in frequently as to how your experience is going.

Let us know how this goes.

Advanced Practice Columnist / Guide · Feb 29, 2008

I don't think you should quit. But I do agree that you need to do damage control and try to get on this preceptor's good side as much as you can because one, you may not be able to find another preceptor, and two, your evaluation for this clinical rotation is dependent on this preceptor's opinion.

However, if your program can find you a clinical placement somewhere else, start a brand new rotation, and act as if the 5 days of clinicals you had didn't happen at all, then, I would say go for this last option.

Good luck.

Trauma Columnist · Mar 1, 2008

Just like when you were an RN, sometimes styles don't mesh well. I was a preceptor and one time had a new RN that just seemed very argumentative with me. However, when we both sat down with the educator (who assigned us) I realized that I'm very much a type A person who swishes thru life while the new RN was very much a type B more laid back person. Nothing wrong with admitting that the fit wasn't good. We went our separate ways for her orientation yet we are still friends and she is an excellent ER RN.

So...cut your losses and move on.

pedirn57 · Mar 1, 2008

Thanks everyone for your support, I did call the preceptor yesterday to let her know that I was not coming back, I did thank her for her time, her response to me was well I have precepted alot of students, this was supposed to have been a fun thing to do, considering I dont get paid to do this, but I was totally exhausted after a day in clinic with you I dont know what your problem is. I spoke again with my advisor and the only thing we could come up with was when she would ask me a question I would reply with what I had learned in didatic, such as dosing of amoxicillin for OM, I learned it depended on certain factors such as is the child in day care, the same with motrin, I learned that it depended on how high the fever was, etc, etc, when she would tell me what she does I would respond oh, this is how I was taught, I guess she took this as being argumentive and defensive, that was not my intent, I just wanted to let her know why I responded the way I did, we were talking one day about Tamiflu, and that a mom had heard that there were reports of psychiatric side effects, I told my precepter that I had just read an article on that and that this had happened in Japan, she told me that I had to be carefull of where I got my informaition, I replied that it had come from the CDC, she gave me a look that said yeah right, well later on the Tamiflu rep came in and my preceptor asked her about it and the drug rep replied oh yeah you have last years insert, and there was reports of this but it only happened in Japan, did my preceptor bother to acknowldege that I had told her the same thing earlier NO,so tell me do I sound argumentive or am I just a NP student trying to clarify information, sorry this is so long but now that I am over the humiliation of being told that I am uneducatable which I know I am not I can think more clear about things that happened in clinic, and any suggestions for improvement is appreiciated, I got the feeling with her that I was in dog obedience school,but with out any praise for the knowledge I do have.

BChapp3182 · Mar 1, 2008

I am a student myself and if you have a question as to why the preceptor is prescribing off guidelines I always phrase it like this "I learned in school that the first line DOC for AOM is Amoxil, I'm a little confused as to why you gave her augmentin, I feel like I'm missing something here...?" Then let her explain the rationale. Don't say, "I learned amoxil was first line so why are you prescribing augmentin?!" Wording it that way puts the person on the defense.

Always act humble and grateful, as if you are a guest in their home.

Don't quit just get a new preceptor if personalities are conflicting.

yellow finch, BSN, RN · Mar 2, 2008

I would have recommended just sticking with it and be willing to accept and learn from your preceptor. After all, they have years of experience that we don't and they often have insight into interventions that we can't see. There have been times when I question what my preceptor does (in my head, first) then ask for rationale from a learning perspective. She and I are not a "perfect" match personality-wise, but I know that in her 8 years she has picked up on a few things. Just like I've done at the bedside that a new nurse wouldn't know.

In the long run, this is your degree and future. Take what you can from the preceptor and move on. It's not forever. Plus, this sort of thing helps you learn to work with other professionals at the same level. You'll be coming across similar people in the future. Learn how to work with them now and not against them.

Good luck to you with the remainder of your program!

pedirn57 · Mar 2, 2008

Thanks, my preceptor is an MD, I realize she has much more knowlege and I do respect that, and I do appreciate every ones input, but I have pretty much decided to call it quits , I dont see the point in continuing to drive myself nuts over this, I dont see how this could be a good learning enviroment when I only get stressed going to clinical

Trauma Columnist · Mar 2, 2008

You mean quitting the program??? Isn't that a little extreme? Or...are you really very dissatisfied with this career choice? Life is too short to be miserable. Learn something from this experience and move on.

pedirn57 · Mar 3, 2008

no just quits with this precepter, and actually I spoke with a nurse I used to work with, to get some precepter suggestions and she gave me a list of pediatricians in the area who are well thought of at the hospital she works at and she then said what ever you do dont have Dr. XXX because that Dr. is very hard around the edges and is known to put nurses down, and doesnt like to be questioned, I did not mention that I had already done 5 days of clinic with her and that it was not a good fit. I dont want to burn my bridges so to speak, it would not be wise for me to say anything against the Dr. as it would easily get around , she is very smart, knows her stuff, but it was not a good fit for me, so I am moving on:redbeathe

lifelong · Mar 3, 2008

Sounds like a great plan and hopfully one that doesn't put you too behind. Definetly a lesson in grace and tact.

Keep us posted on how things are going for you.

Dixiecup · Mar 4, 2008

Last semester my preceptor did several things I did not agree with and would liked to have questioned, but didn't.

I just took it with a grain of salt and made a mental note of "how NOT to do cedrtain things." Basically, I just kept my mouth shut and went with the flow.

This semester I have a different preceptor and it's going great.