Ok, so I feel like I've had the crappiest (if that's a real word) day of my residency......The day starts off with me being assigned to a substitute preceptor because my preceptor decided she wanted the day off. Not a real problem....Our room assignment is in the area for the higher acuity pts. Around 0930 the flood gates begin to open...STEMI alert...Stroke Alert...one after the other. In the meantime I'm running from room to room trying my best to take care of my pts (ALONE...my substitute preceptor basically abandoned me). When I got report from the monitor tech that I was getting a stroke alert pt (complete with textbook deficits), I went and told my preceptor so that he would know to at least stay nearby since I had not had one of those pts before and the ETA was only 5 mins. All he says to me is "ok" and continues the convo he was having with co-worker he was chatting with. At several points throughout the day I would notice him sitting at the desk fiddling with his ipad, while I'm being pulled in different directions. ALONE (well without my preceptor), I took care of an "at home abortion" c/o vag bleeding, a stroke alert, 2 chest pains, and an elderly person w/ multiple complaints (who came in circling the drain)
At no point did he ever ask me if I was ok, and when I would ask for help, he would just come in and take over. I was only assigned to be with him for the first 8 of my 12 hr shift. As were wrapping up with a pt. before he leaves, he asks me what I thought about the day...what I think I need to work on. I told him that I thought I needed to work on being able to think ahead to what I will have to do next w/ a pt, and knowing what labs and procedures etc go with what chief complaints. I also told him that I think I need to work on starting IVs (I missed the first three that I tried today).
So his feedback to me was that my IV technique was good, and that its just a practice thing that will come with experience. He also suggested that I look up disease processes and what goes with them so that I can know what to expect next and also keep the pts better informed. I thought that was good constructive criticism and had no problem with it. However, he went on to tell me that he mistook me for another resident who is an experienced nurse, so he was wondering WTH was going on with me. He also said that he said to my supervisor " I dunno about this one, she's acting like a new grad". So when the supervisor tells him that I am a new grad his response is then "oh, well in that case I guess she's ok then".
So here's what really irritated me .....at no point during the 8hrs we worked together did he feel the need to 1) clarify who he's working with, 2) at no point did he feel the need to actually precept, and 3) he went to my supervisor about my performance without first addressing it with me. His new grad comment came off to me like "new grads suck and you're acting like a new grad"......and then when he finds out that I am, he basically says its ok cause I'm supposed to suck. All the residents have been rotated through about 10 different preceptors, and all my other preceptors had positive things to say about my performance with some suggestions here and there. Now I second guessing everything because I don't know if they were rating me as a new grad or just as a nurse period....Now I don't know if the ALL felt like I suck as a nurse, but I'm good as a new grad
I just really needed to vent. Thanks for reading.......and if you ever have to precept anyone, please actually try to teach them something before you completely flush their confidence down the toilet
So sorry you had such a bad experience. ER's are chaotic by their nature. When new grads tell me they want to ge strait to the ER I warn them it can be like getting you driver's license and going strait to the Indy 500.
I don't know what was going on with your "preceptor." He certainly wasn't paying attention. Being an RN doesn't automatically mean you're a good preceptor.
When I precept in the ER I see it as a continuumn from hand holding to staying out of the new nurses way but always available. This way they learn and take on responsibility as their comfort level allows.
My view of the ER is that it's where the patients chaos is changed to medical order. And the best ER nurses will have bad days. To survive in the ER it has to be exciting. If it's only stressful you're hurting yourself by being there.
That's my view of ER's after >20 years. I hope it helps you to put it all in perspective and don't let the bad days get to you. Good ER nurses aren't born, they're nurtured. Take the good with the bad. Pat yourself on the back for the good, learn from the bad, and remeber the bad walked in the door, you didn't cause it, you were saintly enough to want to help.
that sub preceptor sounds like a complete jerk. Lazy and too bothered to precept. New nurse or experienced in the ED, I'd say something to him and then to management (or probably in reverse, since he'd likely use it against you if you were to approach him first).
You were thrown in and guess what you doggie paddled!!! You didn't sink or give up, you did it!!! Way to go.Remember you are new, as we all were, give yourself a break. It sounds like you did just fine.
I think getting "thrown in" is totally inappropriate! And do you really want someone who is "doggie paddling" to care for your child, mother, father, husband in a life threatening situation in the ER? I agree you should not give up, yup...you'll have other bad days...But the personal rewards are so worth it! How would you know this new grad did "just fine"? She's frustrated and unhappy about how the day went (rightfully so) and that makes it NOT just fine. Hope things are looking better this week:)
Feel fortunate that you don't have a "preceptor" (and I use the term loosely) like this regularly. On the + side, take stock of what you undoubtedly learned today. I had days like this as a new RN, and while I was mentally and physically exhausted at the end, the lessons I learned through these "trials by fire" were invaluable.
.....at no point during the 8hrs we worked together did he feel the need to 1) clarify who he's working with, 2) at no point did he feel the need to actually precept, and 3) he went to my supervisor about my performance without first addressing it with me. His new grad comment came off to me like "new grads suck and you're acting like a new grad"......and then when he finds out that I am, he basically says its ok cause I'm supposed to suck. All the residents have been rotated through about 10 different preceptors, and all my other preceptors had positive things to say about my performance with some suggestions here and there. Now I second guessing everything because I don't know if they were rating me as a new grad or just as a nurse period....Now I don't know if the ALL felt like I suck as a nurse, but I'm good as a new grad 
And do you really want someone who is "doggie paddling" to care for your child, mother, father, husband in a life threatening situation in the ER?
dthfytr, ADN, LPN, RN, EMT-B, EMT-I
1,163 Posts
So sorry you had such a bad experience. ER's are chaotic by their nature. When new grads tell me they want to ge strait to the ER I warn them it can be like getting you driver's license and going strait to the Indy 500.
I don't know what was going on with your "preceptor." He certainly wasn't paying attention. Being an RN doesn't automatically mean you're a good preceptor.
When I precept in the ER I see it as a continuumn from hand holding to staying out of the new nurses way but always available. This way they learn and take on responsibility as their comfort level allows.
My view of the ER is that it's where the patients chaos is changed to medical order. And the best ER nurses will have bad days. To survive in the ER it has to be exciting. If it's only stressful you're hurting yourself by being there.
That's my view of ER's after >20 years. I hope it helps you to put it all in perspective and don't let the bad days get to you. Good ER nurses aren't born, they're nurtured. Take the good with the bad. Pat yourself on the back for the good, learn from the bad, and remeber the bad walked in the door, you didn't cause it, you were saintly enough to want to help.