BAD Preceptor, HELP!

[Lizzy84, RN]

Hello to all, I recently graduated from nursing school, passed my boards, and was offered a job in the ER at my local hospital, where I did my preceptorship. Sounds like a fairy tale right?? WRONG. Here is my dilemma, since I am a "New grad," going into emergency care, there is a 6 month probationary period during which two days of our shift are spent on the floor with our chosen preceptor, and one day a week is spent in the classroom, where we cover basic emergency scenarios and practice how we would react, etc. This is all seemed great at first with wonderful support from the educators running this "new grad orientation to ER," program, until I met with my preceptor. She does not offer any guidance, or support what so ever! I feel like I'm "shadowing" her more than anything, and when I ask her to allow me to participate in providing patient care, she basically IGNORES me. I'm not lying. I ask her questions regarding the patient's we get and why she does the interventions she does, how this affects the patient physiologically, etc., and she answers me with "you should know that." Don't get me wrong, I know that I should research and continue studying to be more prepared, however, isn't a Preceptor's "job," to offer guidance and education, especially if one is actively involved?? I really thought that this is what a preceptor was! PLUS, during our classroom day, we are told that if we aren't asking our preceptor questions, then we aren't doing our job. So in a nut shell, I have gotten to a point where I feel so uncomfortable asking her any questions at all, for fear of a mean reply or even just being ignored by her, that I have considered quitting my job... I feel so stressed everytime I have to go to work, not only because I AM AFRAID I will NOT make it through the six months of the probationary period, but because she is really mean and unwelcoming. I have thought of speaking with my educators regarding this ( they are responsible for us new grads during this probationary period) but I don't want to sound like a tattle tale or an immature person, especially because my preceptor is supposed to be a "REALLY GOOD," experienced nurse. I honestly don't feel like I'm benefiting from the preceptorship experience, especially because I hear the rest of my colleagues speak so wonderfully of their preceptors and how much they learn from them. I'm totally missing out PLEASE ADVISE! God Bless.

[NurseLoveJoy88, ASN, RN]

uh oh...:chair:

Seriously: I'm sorry you are having a bad experience with your preceptor. My advice is for you to sit down and have a one on one with her. Tell her what you are sharing with us. If it helps have a mediator present such as your boss. Maybe she does not know how she is coming off. On the same note, continue to do your research and study. Yes she is there to guide you but at the same time there are some things you should know. Good luck to you.

[Double-Helix, BSN, RN]

The only way that this situation is going to change is if you talk to the educators or the nurse manager and request a change of preceptor. This nurse doesn't seem likely to change her habits any time soon. You don't have to blame the preceptor or call her out on her behavior. Just say something like, "I don't think I'm really clicking with my preceptor. We seem to have different perceptions of our roles and I don't feel like I'm progressing as I should be. I was wondering if there was another preceptor available that I could work with."

[I<3H2O, BSN, RN]

There is one nurse in our department who is a great nurse. She gets mad if she is not allowed to precept the new employees. HOWEVER, she is NOT a preceptor. She is not a good teacher. She runs around and you follow her and you learn nothing. She will not allow you to do the care, she will not answer your questions, etc. So, I have SEEN this happen first hand. My advice to you is to talk with your preceptor directly. Tell her that you feel as if you are not getting the preceptorship you thought you would get. If this does not change her attitude any with you, then go to your educators or mgr. This is a hard lesson to learn but I think you absolutely NEED to speak with the preceptor prior to going above her. Give her the chance to correct this.

I find that those who are farther away from nursing school are usually the ones with the most knowledge and the least patience in dealing with new grads. Hope you get this figured out.

[CCL RN, RN]

The only way that this situation is going to change is if you talk to the educators or the nurse manager and request a change of preceptor. This nurse doesn't seem likely to change her habits any time soon. You don't have to blame the preceptor or call her out on her behavior. Just say something like, "I don't think I'm really clicking with my preceptor. We seem to have different perceptions of our roles and I don't feel like I'm progressing as I should be. I was wondering if there was another preceptor available that I could work with."

Not true at all. This is not the ONLY way to deal with this.

How about some introspective thought and reflection?

I felt this EXACT same way as a new grad. I thought my preceptor sucked and that she hated me, that I couldn't say anything without a quick retort like, "I've already told you this" or "you should know this..."

Uh-huh. I was there. Then I sat down and really thought about my role in how other people treat me. I reflected on my actions, my self confidences (or lack thereof) and my insecurities.

I came back to work with a new attitude. I was going to work at not just learning my pt diagnoses, by knowing them. I was going to predict every possible question that she may ask and be prepared to wow her with my answers.

Amazing what an attitude change did for me-and my preceptor. I began to be challenged, pushed, and learned more that I had anticipated.

My preceptor and I are good friends now-and she is the reason I am a great nurse.

[xtxrn, ASN, RN]

Another possibility...maybe she's seeing how well you'll hold up to stress and 'demand' to be listened to- something I'm sure is critical in an ED setting ??? Next time she says something unhelpful in response to one of your questions, be firm but calm, and simply ask her how you're supposed to know what to do FOR THE PATIENTS in that facility (knowledge is great- but application, and knowing the specific way that facility does things is huge) if she won't answer your questions... it can't hurt :)

Maybe she's waiting for you to stand up and demand to be listened to... if someone comes in and is circling the drain, you have to be able to get the doc and other personnel to notice... This way of doing things COULD be a test of sorts :)

This could be one of the best lessons to learn (if that's what's going on- if not, she's not helping at all- but all preceptors/orienting nurses have different techniques based on their assessment of YOU ).

New nurses aren't used to speaking up 'enough'...and that's no fault of yours- it just "is" when you graduate. It takes time to grow a set of cajones.... and in the ED, ya gotta have balls

Just an idea

[FLoat RN]

Here is the simple solution! Tell your educator what's going on. They may set you up with another preceptor. Move quickly! Every day of your internship is precious.

[xtxrn, ASN, RN]

There is one nurse in our department who is a great nurse. She gets mad if she is not allowed to precept the new employees. HOWEVER, she is NOT a preceptor. She is not a good teacher. She runs around and you follow her and you learn nothing. She will not allow you to do the care, she will not answer your questions, etc. So, I have SEEN this happen first hand. My advice to you is to talk with your preceptor directly. Tell her that you feel as if you are not getting the preceptorship you thought you would get. If this does not change her attitude any with you, then go to your educators or mgr. This is a hard lesson to learn but I think you absolutely NEED to speak with the preceptor prior to going above her. Give her the chance to correct this.

I find that those who are farther away from nursing school are usually the ones with the most knowledge and the least patience in dealing with new grads. Hope you get this figured out.

I'm sorry you've had this seem like the norm w/older nurses

[sweetnurse63, BSN, RN]

Every preceptor is not good at orienting and some of them really don't want to do it especially if they have a full patient load. I really hope that hospitals have preceptor classes to teach them effective ways to orient/ new nursing graduates while reminding them that they were new grads at one time and that patience is one attribute that is needed for efficient orienting. This is why new grads become discouraged and leave after a year. Now on the other hand, new grad nurses should not expect preceptors to hold them by the hand all the way neither, but come to the floor well prepared showing the initiative to learn and grow as they become more independent; just my thoughts:cool:

[gcupid]

Keep a log of patient diagnosis and interventions performed. Go home and study the information. You should be able to tell her why she is doing what she is doing if the same diagnosis walks in the next day and if the same diagnosis follows the day after the next you should be able to have a general idea of anticipating what will be the next steps in providing care.

Now after seeing a few patients with similar diagnosis and backgrounds, you should be able to beat her to the punch when it comes time to perform some interventions. Be proactive by being independent. What do you think the doctor will order next? Do not step on her toes but act as if you are helping her to have an easier shift.

If you have any questions that are emergent bring it to another nurses attention who may not be as busy.

Personally, I would run the situation you described by the educators first regarding not given the chance to participate in active patient care and then if need be go to the manager just to cover your a**.

I always address issues with the person I have a problem with first so they are not caught off guard. If there is no resolution then I follow the chain of command. It has to be an egregious action in order for me to jump straight to the top in regards to handling a situation.

[KateRN1]

Consider the nursing process. Always start with assessment. And always start with yourself. What is *your* assessment of *your* knowledge and skill level? Are you asking questions about treatment in front of patients? Are you asking the same questions over and over? If she's telling you that you should already know that, should you? Seriously take a good, hard look at yourself and your own contribution to this situation. Asking for a different preceptor may not be what you need because if the problem is you--wherever you go, there you are.

If you can't be honest with yourself, ask your preceptor to be honest with you. Ask for a meeting off the floor when you can have some time to talk and ask her to be brutally honest about your strengths and weaknesses. Be prepared to cry, bring tissues, because you will most likely get your feelings hurt. But you know what--that's okay. Because it will be a learning experience like no other. And then you take every word she says to heart and really REALLY put her advice into practice.

Then come back and tell us if it's really the preceptor who needs to change.

[NeoPediRN]

In this economy you may only have one shot at your career dream for a long time to come. It's up to you to advocate for yourself. This is YOUR career on the line. I would definitely sit down with the educator and let her know that this isn't a good fit and you feel you may benefit from switching preceptors. You don't have to bash your current preceptor, this can be handled maturely. Don't worry about making waves, in the ER you're going to step on a few toes no matter what you do.