Being a preceptor means you can sit all day???

ckc6977 · Dec 7, 2007

When I precept, I always "make" the orientee watch me the 1st clinical day. (with assessment, asking questions, educating pts, give meds, etc etc etc)

On subsequent days, I am attached to their hip. I watch them start iv's, give meds, chart, perform assessments, use equipment, etc. (not to mention if the pts have any questions that the orientee cannot answer). Once I've "checked you off" on giving sq/im/iv shots, injections, perform tasks, etc). I give you space because I don't want the orientee to feel like he/she is back in nursing school.

Our hospital's outlook on precepting is: let the orientee and the preceptor take care of all the patients together (not you get 2, I get 2). For example: we do all of the work together, then you do 65% to my 35% (together), then 75% to 25%, etc unless the preceptor feels the orientee is beginning to "sink".

I work nights, so I do have extra time to make sure the orientee understands things that are pertinent to our floor (what specific cardiac meds actions are, the purpose of the medication, CP protocols, iv titration gtt protocols, interpreting telemetry, etc.)

As far as suggestions: I would speak to your preceptor first. Because if you go to your NM without having said anything to your preceptor, your NM will probably revert you back to him/her first. I'm sorry you having to deal with this. I know it is hard enough trying to "fit in" to your new role and floor without having any additional stress.

GL and keep your head up!

Dorito, ASN, RN · Dec 7, 2007

Some people make better preceptors than others. She should't be sitting at the desk while you are doing all the hard work- especially since it's only your fourth clinical day. If it were me I'd be attached at the hip on day#4. I would discuss it with your manager to see if someone else may be a better "fit" for you. Best of luck.

caliotter3 · Dec 7, 2007

I wouldn't be surprised to find out that your preceptor is getting some kind of incentive (probably in the form of a higher pay rate) for precepting you. She is obviously not doing her job. I doubt that talking to her first is going to help, but you might at least try, before you go to the nurse manager. But if talking to her doesn't help, then go to the nurse manager. Your orientation is very important and should not be taken lightly by this person. She obviously is not cut out to be a preceptor and I'm surprised that the manager hasn't already figured this out.

LanaBanana · Dec 7, 2007

Maybe you could try asking her at the beginning of your shift if she could spend more time with you to help you with x,y,z (time management, interpretations, giving meds/IVs, etc - whatever you feel like you need help with.) You can also ask her if she can give you more input.

If/when you do decide to go to your manager or education coordinator, maybe instead of saying "she's not helping" you could ask what the expectations are of the preceptor/preceptee relationship. Then if they say she should be observing and offering help and suggestions you can tell them that you're not getting that. Tell them what YOU need. Our hospital has a guideline for the progression during orientation that is then adjusted for the individual - and we don't take 4 pt's until after more than a month on orientation! But I guess it also depends on how long your orientation is....mine was 3 months mandatory.

As it's already been said, some people make better preceptors than others. My preceptor was the opposite of yours - she always did everything before I got the chance and I was constantly telling her to step back and let me do it. Every day she cleared my pumps while I was doing something else. Her excuse was that she was bored and needed something to do and was just trying to help me out. That's all well and good, but now I've been on my own 6 months and I still forget to clear my pumps!

Good luck!

fultzymom · Dec 7, 2007

When I am precepting, I make sure that I am with my person at all times. I always want to be with them when they are doing each procedure, assessment, ect for the first few times in our facility. I make sure they learn the policy and procedures. I have them watch me for the first day then the second day I let them start helping. After the first few days, I give them a patient in which they are entirely responsible for and I watch them. I am there with them for any questions they may have and I try to remember what it was like when I was new. I also take time in the day just to say, "Is there anything that I am not telling you that you have questions about." I had two nurses who were awesome. They both have had years of experience and knew things frontwards and backwards. I try to remember how helpful they were to me and be like that for someone else.

Daytonite, BSN, RN · Dec 7, 2007

if you're running around like crazy all day how are you even able to notice that your preceptor spent her time sitting around at the nurses station chatting, eating and talking to her bf on the phone and not observing anything you did? were you watching her? there will be days when you will also have a lighter assignment than your coworkers and may find yourself sitting down for a few minutes while others around you might be running around like crazy. they, unbeknownst to you, may feel very angry at you for sitting down. to you, it may only be a few well-deserved minutes; to them it will look like you are goofing off. perception is a funny thing.

when i precepted i gave my orientee the patients to take care of and stood back and let them go and only stepped in if they asked for, or i felt they, needed help. you will never learn anything by watching. you need to get your hands into the work. you had plenty of time to watch things when you were a student. you are in a working situation now and you are expected to perform for the money you are earning. nursing is hard work. there is not much time for sitting down or potty breaks. if your preceptor had some time to do a few things like sitting down and relaxing then she must have felt you were doing ok. did you ask her for feedback on your performance? you should have. that's part of your responsibility of learning your new role. that's just the way it is. if you don't like your preceptor, ask for another one.

snowfreeze, BSN, RN · Dec 7, 2007

I have also had a bad preceptor, I tried to return to ICU after a 5 year break. I had 14 years of experience in ICU, med/surg, CCU, trauma, neuro, flight, sub-acute and geriatrics. My preceptor had about 4 or 5 years experience and figured I could handle the patients. I needed a lot of help figuring out the computer system as I had done manual charting for the last 5 years. I had done computer charting in the past but not recently. My second day on the unit I was given a crashing patient and not assistance from her as she decided to help her other co-workers instead. My next week I was told to get my assignment and report then she would assist me with the things I wasnt certain of protocol wise etc with each of my two patients. I arrived at work printed my assignment and got report, she arrived about 15 mins late and totally changed the assignment then told me I should have waited for her. OK, at that point I gave up on ICU, then I found later in the day while I was doing teaching for a family member that she wrote me up for poor time utilization...I should have been doing the charting I was behind on. The next week I transferred to the telemetry unit.

MiaKeaRN · Dec 7, 2007

I'm sorry that you are having to deal with such a mess. I have heard this from many nurse graduates from my program, so I don't think yours is an isolated incident. I just don't understand why people offer to precept or accept an offer to precept if they don't want to do it. I guess it's the same in nursing as it is in other professions, so to make a blanket statement would be wrong......but you will deal with LAZY people no matter where you are in life.

You hang in there and don't let HER get you down.

Agnus · Dec 8, 2007

I just don't understand why people offer to precept or accept an offer to precept if they don't want to do it.

Right or wrong nurses are not always given an option as to whether they will or will not precept.

MiaKeaRN · Dec 8, 2007

It must be done differently at different hospitals. The hospitals in my area (at least the ones who deal with our graduates) asks for volunteer preceptors. They are paid a differential (I'm not exactly sure what's it's called), to take on the role of preceptor.

I certainly would not want to be assigned to a preceptor who did NOT want to be doing that type of job and would not tolerate being brushed off or left alone to fend for myself. To each his own.......

sasha1224 · Dec 8, 2007

I have been a preceptor on and off for several years. I actually like it, esp when the new nurse is new!(experienced nurses have a harder time taking direction, myself included!!) Since I work nites, I rarely get an orientee who hasn't been on the unit. So most have had time with others who style is different than mine. I always tell the orientee upfront the few things I do not waver on(order check at beginning of shift, bringing a drug handbook or having one at their "station", tools needed including callipers, highlighter, redpen, penlight) and "breathing rounds"). More flexible is an organization system, someway to "plan" the shift. I personally use a time block system and it works for me. I also let them know that I am the type of preceptor who doesn't follow them around constantly. I will observe them doing the different skills several times then "check" them off to do without me at the hip. I also do a med review with them. We go over the different meds the patient is on and they are to tell me what they are for and how they can be given(such as how fast IVP). I also tell them to ask questions. With different environments, things can be done differently. I also encourage them to ask other staff(aides, other nurses) for help with basic tasks(turning, snacks, etc) as they need to learn to ask for help and delegate when appropriate. This also helps other staff members get to know the orientee and their skill level. For the orientee, this lets them get to know other staff and there work style, esp helpful for when they are on their own and I am not there! There are times that I may not have to be attached at the hip of my orientee(aka sitting?) however I am always aware of what they are doing and what is going on. Sometimes I am observing them from the station(small unit) to see how they are doing and intervening as appropriate. If things are going well, and the orientee needs less intervention, I let the other nurses know that i am available and to come get me if they need help. I guess this way is working so far as several different people have told me I am a "good" preceptor.