Confused and Depressed about Performance

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So I've been orientating on my floor for 1 1/2 to 2 months now and feel like absolute trash. I started off training on days, the nurse I was trained with seemed please with me, was very informative, and encouraging, and it was great. Now I'm on nights, my intended shift. It's been about 3 weeks now and I am utterly confused by the feed back I'm getting from my new trainer.

Im at a point where I do about 95% or more of the job independently taking care of 4 to 5 patients a shift. I ask questions when I'm unsure of something, I'd rather look dumb then cause and problems serious or non serious. I can feel like I am absolutely rocking it all shift, but then by the end of the shift the feed back from my trainer gets me so confused, makes me feel so stupid, and often doesn't seem to match with the day I thought I'd had.

I have my areas I need to work on, mostly stuff school doesn't cover, or facility specific things, but I feel I do better in these areas each shift.

So here is how feedback usually gose: I can feel like I nailed time management but get coached about it end of shift as if I'd fails it miserably. Today I was coached about not relying on others for help or to do my work. I was told to be self reliant and independent. I was left speechless as I hadn't had help this shift at all, other than the very few questions I had for her. I check often to see that the CNAs had charted and that patient condition reflected that, but I was coached that some CNAs aren't as good and basically informed that I should just do that work too if I had too to be more self sufficient.

I am very uncomfortable when talking to her. she makes me very anxious. This is in no small part due to the fact that she doesn't give much, if any, positive feed back. I respect her, trust he judgement and experience, but I feel like an absolute screw up when I work with her.

She talks about learning to cluster care after I will have thought I had been doong so. She'll preach time management at the beginning of the shift when I will have finish with plenty of time to spare. I just don't get it at all. I wrack my brain going over my day trying to see where I messed up.

I do miss a few things here and there, but it will be things I haven't encountered or I know I need to work on. I own up to mistakes (missing a new order, forgetting to make a note) I go over them in my head, I try and think how I could do things more efficiently. I go in next shift determined to do better, and I'll feel like I do. But then I get coached once again for things I thought I'd done well.

Maybe I'm just bad at the job and don't realize it? It's all very discouraging and really makes me feel like a failure. Like maybe I'm not cut out to be a good nurse. Now I have 3 days left until I'm on my own and I'm just here feeling like absolute trash.

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Specializes in PeriOp, ICU, PICU, NICU.

I am assuming you're a new grad. The first year is hard, acute care is hard and nightshift is hard. It takes about a year or so to feel like you got this. Seems like your preceptor may not be a good fit. Do you have a unit educator you can set up an appt with?

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Graduated late 2017, this is technically my second job, but I don't truly count the first because I wasn't there long enough to do any good. I had to move out of state on short notice. There is a nurse educator in the hospital, yes.

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Specializes in PeriOp, ICU, PICU, NICU.
14 minutes ago, drinndalynn said:

Graduated late 2017, this is technically my second job, but I don't truly count the first because I wasn't there long enough to do any good. I had to move out of state on short notice. There is a nurse educator in the hospital, yes.

Start communicating effectively now before you get further in the process. Ask for an extension and with a new preceptor.

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Specializes in ICU, ER, Home Health, Corrections, School Nurse.

How much is your preceptor actually watching you? If you're basically doing OK (which you indicated you think you are) then, maybe your preceptor doesn't really have that much to say, so she's just saying stuff, because she's a preceptor and feels she has to say something. You have not indicated that you are in any danger of losing your position. You have not indicated that anyone else has expressed any reservations about your performance. It sounds like you just need to finish up with training, and once you're on your own, you will be fine.

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Agree with the above.

On 12/1/2019 at 12:45 PM, drinndalynn said:

Im at a point where I do about 95% or more of the job independently taking care of 4 to 5 patients a shift. I ask questions when I'm unsure of something, I'd rather look dumb then cause and problems serious or non serious. I can feel like I am absolutely rocking it all shift

Sounds like someone about ready to be off orientation.

It's possible that the person who is giving you all the feedback at the end of a shift is just trying to help you fine-tune in your last days of orientation. It may not be the "this isn't going well" type of critique that you think it is.

This person shouldn't be unloading all of this at the end of 12 hours, anyway. If there are things not going well they should be bringing them up in real time. I suspect this individual is just throwing their two (or fifty) cents in because that's what they think preceptors should do ("give feedback").

I would carry on unless you have heard of concerns from other sources.

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Specializes in School Nurse, past Med Surge.

When she mentions what you need to work on is she talking about specific things that happened that night or just general? If you can rebut her generalizations with specifics maybe she'll realize that you are doing OK. For example, if she talks about clustering care you can say - well, I did do A, B, and C together...what else specific can you suggest?

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13 minutes ago, SaltineQueen said:

When she mentions what you need to work on is she talking about specific things that happened that night or just general? If you can rebut her generalizations with specifics maybe she'll realize that you are doing OK. For example, if she talks about clustering care you can say - well, I did do A, B, and C together...what else specific can you suggest?

DEFINITELY not worth the emotional energy. Those ^ are fightin' words.

This OP is almost done and doesn't need to make this preceptor realize anything. There is nothing at all to be gained by taking this tack.

Smart wins.

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55 minutes ago, SaltineQueen said:

When she mentions what you need to work on is she talking about specific things that happened that night or just general? If you can rebut her generalizations with specifics maybe she'll realize that you are doing OK. For example, if she talks about clustering care you can say - well, I did do A, B, and C together...what else specific can you suggest?

It's general broad statements she says in little monologues, which is why I get confused. Like, when and where am I not doing these things?

I agree with your advice. I need to stop just agreeing with her because I'm new. I need to take up for myself and my work. Like I said, I know I have a ways to go, but I think I'm letting that get to my head, and in turn getting steam rolled.

I also want to mention that she is not with me a majority of the time while I'm giving care, so I'm not sure where she is able to tell if I am or am not doing these things she's advising.

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Please listen to JKL33 !! You are almost done with orientation and it sounds like you are doing just fine. Listen to your preceptors "advice", thank her for "helping you learn" and just move on with getting off orientation.

Do not let this throw you off and do not pick a flight. Right or in this case probably wrong if you force them to defend their critique they will only look at you harder to justify their comments. As they mainly leave you alone and mention one or two vague things at the end of the shift, trust me they don't really have an issue with you.

Keep a smile on your face and your eyes on the finish line.

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Specializes in PICU.

Perhaps others are watching and reporting to her. It could be that you are appearing to not be managing time effectively even if you are.

See if you can draw out specifics. It could be she has a specific way she does things that is different from you? Is there anything with prioritization?

I think simply giving your perspective of the shift, and then ask what ways could you have been more efficient.

I think her talking time management at the start of the shift is actually a good idea. Try plotting your time out and telling her what your plan of the day looks like, this not only lets her know about your time management but it also shows your ability to prioritize and organiza time between patients, charting, cares, etc.

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Specializes in Neuro step down.

We are feeling the same and experiencing the exact same things just dont give up i believe all nurses/md/np etc were the same way

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