Asking Former Preceptor for Some Space

[betterinthesun]

Hello, I'm looking for some ideas on a way to ask my former preceptor for a little bit of space without offending her.

Here's some necessary background info: I used to work in a step-down unit and earlier this year changed jobs to work in an ICU. I had a 6 week orientation. I've been on my own for a few months now and feel like I'm starting to feel more comfortable but every time I work at the same time as my former preceptor she is still acting like I am on orientation.

For example, I was admitting a patient from a nursing home and apparently she was looking through my patient's chart and saw that his potassium was 1.8 . We had already started him on IV potassium and given him some through his peg tube but because the resident and I were both so busy we hadn't put it on his eMAR yet. So when my former preceptor was looking him up she thought we hadn't done anything about the low potassium yet and instead of approaching me with her concern she went straight to the resident. I overheard her doing this and the resident was saying we were already treating it and she was confused because she thought that was a different nurse's patient. My former preceptor then says something like "yeah its not my patient but that's a new nurse and she might not know what to do".

I know as my preceptor she saw me look clueless many many many times and that I probably asked her some pretty dumb questions. But at my eval at the end of my orientation both she and our supervisor agreed I was ready to be on my own so I don't know why she is doing this. I honestly do appreciate her continued support and plan on continuing to use her as a resource, but I wish she would back off a little bit. I want to tell her this without seeming unappreciative or giving off an air of know it all attitude.

Any ideas on how to best approach this? If anyone has dealt with a similar situation I would love to hear how you handled it.. Thank you in advance.

[cracklingkraken, ASN, RN]

So when my former preceptor was looking him up she thought we hadn't done anything about the low potassium yet and instead of approaching me with her concern she went straight to the resident. I overheard her doing this and the resident was saying we were already treating it and she was confused because she thought that was a different nurse's patient. My former preceptor then says something like "yeah its not my patient but that's a new nurse and she might not know what to do".

Given that this is the only example that you have given, it doesn't seem like she's babying you. Granted, I was not in this situation, but as a completely objective 3rd party, it sounds more like she had your back. As a new nurse, it is possible that she was watching to make sure nothing was missed for your pt. I agree that she should have approached you first. Is she a newer nurse?

FWIW, I would much rather have a preceptor who watches out for me rather than throw me under the bus.

[ixchel]

I'd be annoyed, too. Why not just ask you if you need help? She had no legitimate need to be in the patient's chart if that patient was not in her care, which means what she did was a HIPAA violation. If she were witnessed doing that at my facility, she would have been approached by management for it.

She may have the best intentions, but I would be bothered, too. Maybe she needs to hear that you will ask for help when you need it. Maybe she thinks you won't. Regardless, do you feel comfortable talking to her about it?

[NanikRN]

Talk to her. I think she's looking out for you but she really should have gone to you first.

You can also asked to be scheduled different shifts from her. It's not that unusual for preceptors/nurse to need some space to adjust to new roles. Sometimes its the other way round and preceptee doesn't want to let go.

[llg, PhD, RN]

I read the potassium example and laughed, thinking "The former preceptor just made a fool of herself in front of everyone who heard that. If she keeps doing that, she'll soon learn her lesson."

I would just take that type of opportunity to laugh it off and say something like, "See? I know what I am doing. You taught me well. Now just give me a chance to do it right before you assume the worst," with a smile. She'll learn.

[cardiacfreak, ADN]

I can see myself in this example as the preceptor. I've been told that I am a control freak by coworkers and family! When I precept I make sure my orientee knows that I don't mean any harm and that at some point I may become overbearing. At that time s/he can pull me to the side and tell me "It's okay, cardiacfreak, I've got this."

When I get told to stand down, I don't get angry or upset. I kind of smile on the inside because I remember my preceptor who was the same way with me, and I how I felt when I cut the apron strings by telling her, "It's okay V, I've got this." V is an amazing nurse that taught me so much, and she still questions me to this day, I just smile and say, "I've got this."

I would not have questioned the physician, but I probably would have asked if you were aware of the K+ level. I work with a lot of brand new nurses and as a charge nurse I do feel like I am responsible for all the patients. Maybe that's another thread in itself!

[Been there,done that, ASN, RN]

OUT OF BOUNDS!

There is no reason for her to check on you, zip, zero, nada. To go past you to the resident with her "concerns".. boggles my mind. As I'm sure it did to the resident.

She is interfering with the functioning of the unit. You don't have to say anything to her.. say it to management.

[aeris99]

You don't have to say anything to her.. say it to management.

That sounds like a great way to burn a bridge and possibly make the work environment very uncomfortable.

What the preceptor did wasn't right. But if you have respect for this nurse ( and it sounds like you do OP) the best action would be to discuss it with them.

[calivianya, BSN, RN]

I wouldn't mind being checked up on... but I would have real problems with a former preceptor going to a physician about MY patient's labs before talking to me. I'm all about collaboration. I have no problem with others being in my room/asking me questions/etc... and I am that annoying person that I am always sticking my head in other people's rooms and seeing how they are doing! However, I would NEVER go behind someone's back and talk to a physician without talking to that nurse first. That was unacceptable.

I would definitely say something, and it would be along the lines of, "I am so glad you're looking out for me! It makes me feel good knowing you have my back. In the future - could you just ask me first if you have a question about what I'm doing? It would probably save us both a lot of confusion."

[quiltynurse56, LPN, LVN]

She should have gone to you first. On the other hand,she may have also just learned that you do know what is going on. I would definitely suggest that you talk to her and ask her to come to you first if she has a question about the care being give.

[BostonFNP, APRN]

My two cents, take it was a grain of salt because I don't work in the same role.

If this patient hadn't been started on K (because for some reason it was missed) would everyone still think the preceptor was out of line?

I would always rather a co-worker double-checked me than let harm come to a patient. My ego is ok with it.

Providers do this all the time and I count on the floor nurses to do it for the patients I am responsible for as well. There are times when a floor nurse calls me to "remind" me about something that is redundant but I would take 99 of those phone calls for the 1 the I needed reminding about.

[bebbercorn]

Good point, Boston, FNP. But if it were me as the preceptor, I would have gone to the nurse first. It was immature for her to go to the resident in that way.