Confused

[jenal77]

I have a question, I am a new grad and got hired for ER. My preceptor was never with me, always sat at the nurses station and if I needed something I had to go find her. She was scheduled as charge nurse on days I was working with her or on the main floors doing IV's or Midlines because she really awesome at it. I couldn't handle the stress of being left by myself anymore and always feeling like I wasn't safe because I never had any validation, so I turned in my two weeks notice. Two days after turning it in my manager called and said I didn't have to finish out my notice, I informed HR to CYA, fast foreword 3 months later, I contacted my old manager to see what my standings were, he told me he put me as non rehire able because of my pace, critical thinking and because my preceptor asked for 3 weeks more time because she was pulled so much during my orientation. Again I emailed HR to contest this, but yet again like before no one is responding. It's to the point of where I want to give up on nursing all together. How can I gain experience and learn if I can't get a chance to?

[manager123]

There are a variety of preceptors out there. Some are nurturing and caring and others will do as little as possible for their preceptee. Having a preceptee can slow 'their' routine down. . . the preceptor has to be a role model for performance AND teach the nuances of their unit and try to have some sense of time management. May do it well. Others see the preceptor role as a way to earn prestige and more money if there is a differential for being one and orienting a newer nurse. Some, sadly, see it as a way to make themselves look good and awesome and fail to give positive feedback and encouragement . . . especially to the novice nurse.

I hope in your next experience, you will have a more mentoring and positive relationship. The cliques and failure to truly fill out the expected role are an early warning of horizontal violence. You may have done yourself a favor by leaving that environment early in your career. There is valuable advice in the thread for courage to have needed conversations with manager and preceptor to ensure you get what you need and what was promised. It is scary to have those conversations and sometimes it needs to be done with great diplomacy. Learn also how to resign in good standing if it is necessary to leave any job in the future.

Keep looking for positions. Even if your next position is not in an ED, you will learn valuable skills for the future and may find that the ED isn't where you really want to be or isn't really the best fit for you.

[Ruby Vee, BSN]

About the "license on the line," if the new grad RN does do something incorrect, depending on the error, couldn't it be classified as negligence and malpractice and a lawsuit could happen?

In most states, the Board of Nursing puts out a newsletter quarterly or semi-annually or whatever, listing the actions taken against nursing licenses in that state. The vast majority of action taken against a license has to do with fraudulent charting related to narcotic diversion. Or sexually assaulting the patients. People who don't sexually assault the patients or lie in their charting to cover up narcotic diversion rarely have action taken against their licenses.

[Kooky Korky, BSN, RN]

I would have to leave my patients and track her down if I had questions. I was basically left by myself in orientation with no feed back on anything, and people would ask where she was, I brought this up to management more then once and my clinical educator in our one on one meetings would specifically say we are one and should be joined at the hips.

And did she do anything to make those hips join?

Sounds like you should have followed the preceptor to wherever she went.

[Kooky Korky, BSN, RN]

I am so sorry this experience did not turn out well for you. Hopefully you can learn something from it and bounce back stronger than ever before.

Nonetheless, no one's license is on the line. The "my license is on the line" chant is exaggerated and overused. Nurses hardly ever have actions taken against their licensure for sloppy patient care or mistakes made during the provision of care.

Per disciplinary action records from most state boards of nursing, most nurses who have had their licensure censured were involved in theft, narcotic diversion, intemperate use of alcohol and/or drugs, impaired nursing practice, and other issues related to addiction.

Again, your license is not on the line. Good luck to you.

I don't know that a new grad would understand this line of thinking. And our licenses really are on the line in some instances. You say "hardly ever". That alone tells the truth about licenses being on the line. Sometimes they really are. And a new grad would understandably not be real good at distinguishing when and when not.

Seems to me a new grad could be "dealt with" for being presumptuous, not having her preceptor present in situations she's not familiar with. And the dang preceptor is miles away - at the desk, off to another ward.

[Kooky Korky, BSN, RN]

Sounds like you just took the first job they offered without considering whether it's something you really wanted to do.

"My preceptor was never with me, always sat at the nurses station and if I needed something I had to go find her."

Orientation is not skills or tasks training. Orientation is more like being introduced to the way business is conducted day to day at the facility, understanding your role in relation to the health care team, and what duties your expected to perform as a functional team member.

While some facilities offer training programs prior to entry into specialty fields, others expect you to hit the ground running. The latter seem to be the case with your situation. If being proficient at a new job requires new skills, most people are expected to engage in methods of self study, finding a someone to mentor while performing a task, or doing whatever else it takes to become proficient. That's the hallmark of professionalism.

I'm not sure what you mean by validation. Health care is largely 'management by exception'. If you're screwing up, plenty of people will tell you, sometimes to your face or other times to your back. But you will find out. Validation occurs every time you don't injury a patient, perform all duties as expected, and don't get called into the DON's office for a reprimand.

What a screwed up profession.

It's not OK for a preceptor, who is supposed to be teaching, to sit at the desk, especially in early orientation. Toward the end of the weeks of O, it's different. The orientee should be more on her own that she should initially. But it's still a training period, not a time to totally cut the cord. And even using your business method, the trainer has to be present, not off the ward or at the desk - unless telepathy is involved.

Today's new grad is very short on hands-on skills. Some haven't even given an injection. Even you say that one should find someone to mentor while performing a new skill or task. Someone who has a preceptor should get the preceptor, but how come the preceptor wasn't there to begin with?

[Kooky Korky, BSN, RN]

Why didn't you ask another nurse on the unit? I always ask another nurse who is just as qualified and experienced to answer my questions, some of them may have way more experience than your preceptor. My preceptor only had two years working experience at that facility and 4 years in total but there were other nurses working that had 10 years plus at that facility. your not restricted to your preceptor for questions, I find that the nurses on the unit are always willing to help you if you have questions wether your preceptor is there or not.

Be confident in your abilities as a nurse!Figure out why you lack in confidence (if this is the case), are there areas that you are unsure of?, if so educate yourself, go back to your textbooks they are your best friend and a lot of hospitals offer online courses, does this facility offer online courses for specific areas of practice? They usually do and this is something they would have told you in orientation. I had no experience with telemetry and I took it upon myself to register for the hospital rhythm strip interpretation course and several others.

There often isn't time to research at work. Sometimes one needs an immediate answer. And maybe OP thought she had to have the preceptor and was not allowed to tap other staff.

Also, it has been my experience that not all staff are thrilled to answer questions, show skills, etc.

[Kooky Korky, BSN, RN]

We all want that magical preceptor who will gently mentor and guide us, standing ever close so we don't have to hunt for them but far enough away we don't feel them breathing down our neck. We want the preceptor who loves to teach, is good at it, and teaches us in the way we feel most comfortable learning. We want a paragon who never brings personal problems or bad moods to work but who will cheerfully overlook any and all personal problems and bad moods WE bring to work. Sadly, there just aren't that many perfect preceptors out there, and most of us have to settle for the one we get. Learning from a bad preceptor is possible and probably necessary. Bailing because of a less than perfect preceptor, as noted above, says more about you than about the preceptor or the facility.

I'm not at all sure about this showing more about her than about the facility. I think she got a raw deal, although maybe she's not telling the whole story.

[Kooky Korky, BSN, RN]

I did ask others and they would respond by asking where my preceptor was, they weren't the friendliest and if you weren't in their click you were basically ignored.

clique not click