Dilemma

[rtx]

I am a current nursing student who is finishing up my practicum in the ER. I have also accepted a job there as a new grad. I had recently done a 12-hour shift in the ER from 7pm-7am and decided to leave early at 4am. I had started my clinical and my preceptor said that she had triage at 3am. I had remembered from the previous clinical, a week before, that I was allowed to work from 7-7 because my preceptor was taken off triage because she was with a student. I believed from that as students, we weren't allowed to be in triage while our preceptor was working. So, during my clinical I had asked a charge nurse if I could shadow her from 3-7am because I needed management hours and she replied, "sure". 

At 3 am., my preceptor and I are talking and she's about ready to go into triage and I tell her that I can shadow you there if you want me to. She replies, "oh I'm going to be just watching Netflix, it's going to be really boring and not going to learn anything." I feel some resistance and I don't feel like pushing the subject anymore. Instead, I began doing hours with my charge nurse and it's getting really slow in the ER at 4am and I can't find my nurse anywhere, I'm mentally drained so I decide to tell my preceptor that I will be going home. My preceptor replies, "OK, that's fine! I will tell the charge nurse that you had left." I figured everything was fine, I had finished my scheduled shift with my preceptor and I didn't feel like working anymore because I wasn't learning anything. 

The morning of when my clinical got done, I get an email from my school saying they had a few concerns and share with me that I am in trouble at my hospital for leaving early. The school faculty tell me that the CNS who is head of the practicum students, said that she didn't like my behavior and that I had left early and didn't want to work triage with my preceptor. The preceptor had reported me, I believe. The CNS was going to drop my practicum but said they would like to bring me back because I will be working there after the practicum.

I was exhausted emotionally from hearing the news that I was in trouble and now I have to go to a meeting to try to explain why I wasn't in triage. I'm faced with a dilemma of telling the CNS that my preceptor had said those things about Netflix and not learning anything because I don't want to be dropped from my practicum or have any bad blood because I will eventually be working with my preceptor as a coworker. I have no idea what I am going to say because there's 2 different stories being told. 

Sorry for the long article, any advice would be great. 

 

[Wuzzie]

Because you don't know who reported you to your school it would be a bad move to throw your preceptor under the bus. You were given an opportunity to shadow the charge nurse because your preceptor did not feel there was any clinical value to your sitting in triage during that part of the shift. That is what you say regarding the fact that you were not in triage.

Your going home early because you were "mentally drained" is an entirely different issue. It was a bad move on your part. A really bad move. When you are a working nurse you can't just decide you're done and up and leave. Your senior practicum is meant to transition you into what actually working is like. It matters not that things were slow.  And you couldn't find your nurse?! Really? That's what you're going with? You should have found something to do that would have enriched your knowledge. Read the policies for the ED (you need to know them if you're going to work there and any nurse could have helped you find them), help another nurse, read articles about ED nursing, do some case studies, stock rooms...anything but leaving. Your preceptor probably should have made you stay but you're an adult and your behavior is your responsibility. As of now you've likely shot yourself in the foot with the rest of staff who have most certainly heard about this and are forming nacent opinions about you. I'm annoyed just reading the complaints of being "emotinally exhausted". I think you can right the ship but so far all I'm hearing is excuses and why this is everyone else's fault. It isn't. This falls squarely on your shoulders and you are the only one who can fix it.

You asked for advice so here is mine. When you go to the meeting you tell them that your preceptor did not feel triage in the middle of the night would meet your educational needs so you were assigned to shadow the charge nurse. Tell them you understand a preceptorship is a privilege and an opportunity. Then you tell them that you made a poor decision when you left early and that you should have done xyz (listed above) instead. You've learned your lesson and are eager to make the most of this learning experience going forward. Drop the emotional stuff. Nobody cares. They want a team member that they can rely on to be there and do the job. So far you haven't proven that very well. I really hope you can turn things around but you have some work to do. 

[JKL33]

Not good. You should have found other relevant activities with the time you had. I agree that for your own part leaving was unprofessional.

Realistically? This is likely happening to preempt you going and telling anyone that you left early because one person was only watching Netflix and one couldn't be found. It also wasn't professional for your preceptor to tell a student that she would be watching Netflix when there was a perfect opportunity to do some actual teaching (which we are all complaining that we don't have time to do anymore). I would have loved a chance to sit with a student and review the triage role, the protocols, the ESI system, etc., etc. Sad day when any of us suggest a student go away so that we can watch Netflix.

Learn all of this now. Make good decisions and comport yourself as a professional  1) because you are a professional 2) for your own sense of self, for your own learning, for your own ethical integrity and 3) so you don't make yourself an easy target for people who aren't doing the right thing.

Your emotional exhaustion or whatever is not a tack that will be successful and you need to take things up several notches in order to have a successful orientation. You also need to play some mental chess, not checkers, as far as knowing how to tighten things up so that others have less chance to mess with you. Leaving because [so-and-so] said it was fine is a bad professional decision that doubles as a trap in this situation.

 

[Wuzzie]

Just now, JKL33 said:

It also wasn't professional for your preceptor to tell a student that she would be watching Netflix when there was a perfect opportunity to do some actual teaching (which we are all complaining that we don't have time to do anymore).

This is a good point and the preceptor needs to be spoken to about it but it doesn't hold a candle to leaving mid-shift.

[JKL33]

43 minutes ago, Wuzzie said:

This is a good point and the preceptor needs to be spoken to about it but it doesn't hold a candle to leaving mid-shift.

Yeah, if the preceptor needs to receive feedback that is someone else's issue and has nothing to do with this student.

I wrote all I did because....let's learn the ways of the world, here. ?

[rtx]

Thank you for the feedback and helping me realize the severity of the issue. Again, it was a very poor decision to leave during the practicum but I would never leave a shift as a nurse even if I thought it was boring. I thought my shift had ended when my preceptor went off to triage. So I misunderstood the communication there and lacked the judgement to stay with my shift. There's always something to do in your downtime. Hopefully I can turn things around in my meeting as this is a learning experience for me. I am here in the practicum to soak up a lot of knowledge and be a team player.  

[Wuzzie]

@rtx This is exactly how you turn the ship around. Take constructive criticism with grace and apply it to your work. Good job! ??

[Hannahbanana, BSN, MSN]

Slightly off-topic response, but I would like to compliment the OP on being able to spell “dilemma” correctly. 
You will be able to get past this. Even negative experiences are learning opportunities. In your case, you also learned how not to treat a student entrusted to you for precepting. Someday when you are a seasoned nurse with management potential you’ll remember that too. 

[CelticGoddess, BSN, RN]

6 hours ago, Hannahbanana said:

Slightly off-topic response, but I would like to compliment the OP on being able to spell “dilemma” correctly. 
You will be able to get past this. Even negative experiences are learning opportunities. In your case, you also learned how not to treat a student entrusted to you for precepting. Someday when you are a seasoned nurse with management potential you’ll remember that too. 

I never realized it wasn't spelled with an "n" until I read your post.  Wow.  I learned something new today.  ?

[Hannahbanana, BSN, MSN]

Then I have done my job for the day. ?