Difficult Orientee

[ejnjj143]

Hey all! Need some help and maybe just some venting on my part. I'm a new preceptor and I do have experience training other RNs experienced and new grads. This is the first time I've have a new grad for a length of time. I have had my new grad for about 6 weeks now and I'm about to rip my hair out. She's a recareerer and old enough to be my mom. Ok enough background info. She got the short end of the stick with her preceptorship at a fellow hospital and it has put her far behind. She was supposed to know our computer program for charting and I've had to take A LOT of time showing her that. (Yes I've told the educator and she won't be sent to the class again. ) I have to show her how to do the same things in the computer everyday and have gotten her a notebook to write instructions down. She freaks out about everything and I'm typically very laid back and feel that I panic when necessary. She panics when we have a patient that has a central line and we need to draw blood for example. She just wants to watch and not do it. At first I show her skills and she's very reluctant to even try to do it the next time. I make her (I'm there instructing) and she's incredibly upset the whole time. I've tried many different approaches like being all in her chili and micromanaging her day so she can get things done. After a few days, I back off and she crumbles and is in tears. Yes, she is in or almost in tears everyday. We got notified of an ED admit at 5 pm and she just shuts down and won't talk to me when I tell her not to get frustrated. She's on the verge of crying and won't respond to me. Whoa! Is it me as the preceptor or what?!?!

[icuRNmaggie, BSN, RN]

The hardest part of being a preceptor is giving feedback. It should be given verbally as needed and in writing on a weekly basis. The almost daily tearful and crying episodes need to stop. I have worked with too many people who use tears to avoid responsibility for their shortcomings.

Document everything as factually as possible. Speak to your manager privately and say she is not progressing and I am getting very frustrated. I think it would be best to assign somebody else to precept her.

I do understand how uncomfortable the age difference must be for both of you. Maybe she'll be happier and you'll definitely be happier if she is assigned to someone else.

[danielle2000, MSN, RN]

Be constructive and fair. By what you describe maybe ICU isn't for her.

[Tex.]

She sounds like a hot mess. I sure hope she can pull herself together soon, if that is possible.

[Jules A, MSN]

I'm jaded because I have historically not been impressed with most older >40yo new grads but this behavior sounds over the top and if she is that unhappy this early on it is likely not a good fit for her. I'd definitely document every attempt to encourage her to do a task that is rebuffed as well as the times she is in tears. I have never been the type of nurse who isn't supportive to new coworkers but for Pete's sake there needs to be some standard expectation of skills and professionalism even for a brand new grad, imo.

[Glycerine82, LPN]

What about talking to her before hand? I know for me I need a lot more information when in a new situation than I am usually given. Maybe if you let her know that you need her to do xyz today or try asking her whats making her nervous, etc. Maybe try looking at it as if it were you and you knew nothing about the situation, not assuming she knows anything you aren't sure of, etc.

Maybe I'm way off? Tired and wandering around, lol

[iluvivt, BSN, RN]

What was the short end of the stick she supposedly got at this other sister hospital? Yikes.... it is probably too soon to tell but she does not sound like she is cut out for this dynamic environment. You must have self learning modules for whatever charting system you are using. If you look at the top after you log in it may say something like "Live Learning". When I show nurses this most of them did not even know that resource was there. If you are a big healthcare system your main employee web site may have on line classes too as well as Healthstream and other like programs

At this rate and based on her level of nervousness,her inability to assertively try new skills,her coping skills she is not going to be able to safely work on her own unless she makes some serious changes. Make sure she knows where to locate all the policies and procedures and how to print them out for reference. Make sure you teach her how to locate and use all the other available resources and then watch how she chooses to use them and that includes you. This will give you a good idea on how self motivated she is or isn't! You do your best and give it 100 percent and the rest is on her. She must also get a grip and stop the freaking crying. She is professional and must act accordingly or she has no business taking care of anyone!

[Been there,done that, ASN, RN]

Refusing to respond to the preceptor is a deal breaker.Sounds like she can't handle the transition to the real world.

You should be making weekly reports on her progress. What is management's response?

[weirdscience]

Be constructive and fair. By what you describe maybe ICU isn't for her.

By what you describe, maybe HOSPITAL nursing is not for her.

[OCNRN63, RN]

I'm jaded because I have historically not been impressed with most older >40yo new grads but this behavior sounds over the top and if she is that unhappy this early on it is likely not a good fit for her. I'd definitely document every attempt to encourage her to do a task that is rebuffed as well as the times she is in tears. I have never been the type of nurse who isn't supportive to new coworkers but for Pete's sake there needs to be some standard expectation of skills and professionalism even for a brand new grad, imo.

Kind of ageist.

[Jensmom7, BSN, RN]

Kind of ageist.

True-there have been many new grads, both young and *er* well-seasoned, that I have wanted to hold their heads, look deeply into their eyes and ask:

"Is there anybody in there??"

[canigraduate]

Find out what her problem is.

Is she overwhelmed by the tech? Is there too much going on around her? Is she not processing the info she is getting? Is she having stress at home that is translating to being unreceptive? Is she too dumb to get it? Is she not cut out for the unit?

Decide if her problem is fixable and decide on a plan of attack. Let her know that you are frustrated with her progress and that she needs to develop some backbone or she won't make it to the end of orientation. Some people need to have things spelled out for them.

If her problem isn't fixable, let your management know so they can cut her loose.

Step back and be objective, the solutions will most likely present themselves to you.