Feeling like the dumbest nurse on earth

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Hey All,

(I am using my very dear friends laptop and account to write this). She told me about how awesome this site/forum was and that it will help me through this tough time (I am also writing this on my break so I really am doing this to vent). I am a new grad ICU nurse, I thought this was where I wanted to be as a nurse but I am so depressed and feel like the dumbest person on earth. I am usually a relaxed person but I am very nervous going into work. My preceptor likes to work FAST, her motto is "I come to work to get paid, not work all night" so we have to move fast and do as little as possible. I think she is a very smart nurse (seriously i do!) and I think she's a good preceptor, I just think that I am so stupid and need to work somewhere with a slower pace.

I can have things written down but because I know it irritates her to wait for an answer (she has mentioned this MANY times) I just open my mouth without thinking instead of saying hold on and reading my sheet. I don't let things process before I blurt something out. For example I go to work really early, I check the order for G feeds under nutrition, I know that's where to look but as soon as my preceptor asks, I'll blurt out in the medications tab! SMH, I can't understand why I get so nervous.

One issue was during report a patient was to be titrated down from his levo. This patient had his MAPS above 100 the entire shift, while we were giving a bath he had a seizure, during his seizure his MAP tanked to 54 my preceptor yelled to change his levo. I asked: increase or decrease? Stupid question! This is my 5th week of orientation and I got so nervous and she even mentioned that I'm too nervous.

Another incident during report a nurse said a patients levo was on hold. I looked at the monitor (we use space labs) she had an A line and a cuff reading. I looked at the cuff pressure (MAP 52) and asked what the levo was on hold for. Well stupid me didn't look at the A-line reading and I didn't look at the time the BP cuff reading was from. My preceptor and the nurse looked at me like I was the dumbest person on earth. The nurse just looked at me and asked if I knew what levo was for in the rudest way possible.

Another incident was I was told to draw a venous gas. I got the ABG kit and was going to do a venous draw from it. She then stopped me and said that I can never do a veni poke for a venous blood gas, that can only be drawn through a central line. She said that she's mention this before in the past to me but I don't remember. She also had to remind me that the patient had a central line and that I could stop his fluids to draw the blood.

I was giving report and I gave the patients temperature readings during my report on neuro, she said ..I told you to report on neuro, NEURO not cardiovascular, temperatures are cardiovascular.

I am also suppose to cluster my tasks so we will look off his orders and will say "patients is getting these meds, tell me to get the meds, tell me the color tubes I need for labs, the vitals machine and IV fluids...that's way we don't go back and forth which is a waste of time. Well of course my luck, I ALWAYS forgot something! :-(

My preceptor will give a lot of "if you ever get a patient" "when you get a patient" and I honestly can't remember all of that when the time comes, which irritates her.

My preceptor is very blunt, she will straight out tell me who the "dumb nurses are"(I kid you not, that's howshe refers to them) I can only imagine what she's saying about me :( ...I overheard her talking about me today that I'm dumb and it makes me cry but she's right, I have done some very stupid mistakes.

I may now be out of a job, she said she can't guarantee I'll pass orientation (we get 6 weeks orientation).

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Specializes in Emergency Nursing, Pediatrics.

Everyone makes mistakes. For her to be bad-mouthing you definitely isn't okay. I would discuss your concerns with your unit manager.

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Honestly, nothing mentioned counts as a "very stupid mistake". None of those situations put a patient in danger. Your preceptor is over the top. And really, how is a new grad suppose to learn when they fear asking questions? New graduates need someone patient, and kind. This allows them to ask any question, no matter how insignificant. I would ask your manager for a new preceptor. What do you mean by "pass orientation", aren't you already hired as a new grad? It takes time to mold yourself into the ICU rhythm, I learned that myself. What's important is that you stay receptive to feedback.

Hang in there, and you are not dumb. I'm sorry she hurt your feelings.

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Have you read Patricia Benner's From Novice to Expert theory? It explains how nurses develop skills and understanding of patient care over time. It typically takes a nurse two-three years of experience on the job in the same area to become competent. It typically takes a nurse five years of experience in the same area to become expert. Sometimes expert nurses, with their well developed intuitive grasp of clinical situations do not teach novice nurse's at the right level of clinical knowledge. The problem is the preceptor's know what to to teach but don't know how to teach it in a way that is suited to a novice or advanced beginner nurse.

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Wow thanks ICUman. I had two preceptors during my PICU orientation and one was an angel and the other was as mentioned above. I was thrown into my orientation, stated I need more time than given but taken off early???? (Oxymoron situation). Again wow to your response and I agree with you 100

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Honestly, nothing mentioned counts as a "very stupid mistake". None of those situations put a patient in danger. Your preceptor is over the top. And really, how is a new grad suppose to learn when they fear asking questions? New graduates need someone patient, and kind. This allows them to ask any question, no matter how insignificant. I would ask your manager for a new preceptor. What do you mean by "pass orientation", aren't you already hired as a new grad? It takes time to mold yourself into the ICU rhythm, I learned that myself. What's important is that you stay receptive to feedback.

Hang in there, and you are not dumb. I'm sorry she hurt your feelings.

I agree with most of this advice, but caution against asking for a new preceptor, depending on the work culture it can be a double-edged sword and may be perceived as a passive aggressive way of handling conflict. If it were me, I wouldn't lay blame on the preceptor, I would explain to the preceptor that where I am at on the learning curve (novice nurse) and where they are at on the teaching curve (expert nurse) are at different points and we need to find a way to meet in the middle.

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If it were me, I wouldn't lay blame on the preceptor, I would explain to the preceptor that where I am at on the learning curve (novice nurse) and where they are at on the teaching curve (expert nurse) are at different points and we need to find a way to meet in the middle.

Not sure that would work on someone who has a rush rush rush attitude, and on someone who considers several of their coworkers "dumb nurses", but worth a shot.

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Not sure that would work on someone who has a rush rush rush attitude, and on someone who considers several of their coworkers "dumb nurses", but worth a shot.

People who use aggressive communication styles, often respond better to people who use assertive communication styles than they do to people who use passive communication styles.

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Specializes in VA, Ortho, Med/Surg.

This makes my blood boil. I like you would have bawled my eyes out. I can't stand mean people. I am too sensitive I'll admit but there is no excuse for trainers to treat trainees like that. I wish you the best.

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Everyone makes mistakes. For her to be bad-mouthing you definitely isn't okay. I would discuss your concerns with your unit manager.

I don't think it's right either especially since she did it standing in the doorway of a patients room with another nurse that I don't even know, I was standing near the med cart which is past the nursing station. Ifor I could hear it, the staff at the station could also hear it :( . I think it is so unprofessional, I get I make stupid mistakes and ask the dumbest questions but it doesn't need to be shared with everyone on the unit. I think she is a smart nurse and I think I can learn a lot from her but that part is just inappropriate.

I would also talk to the manager but she's been there so long, I don't feel it would do any good. She has horrible nicknames for other nurses...2 nurses have names that rhyme with retarded and lazy, when she's talking about them she will say "and you already know lazy ____ was just sitting" or " retarded ____ had the nerves to ask me..."...for the most part the other nurses or clerks just laugh. I'm sure this is not new behavior.

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Specializes in VA, Ortho, Med/Surg.

Are you freaking KIDDING ME? And this is acceptable by the nurse manager? You have to say something then get the HELL out while you still can lol.

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Honestly, nothing mentioned counts as a "very stupid mistake". None of those situations put a patient in danger. Your preceptor is over the top. And really, how is a new grad suppose to learn when they fear asking questions? New graduates need someone patient, and kind. This allows them to ask any question, no matter how insignificant. I would ask your manager for a new preceptor. What do you mean by "pass orientation", aren't you already hired as a new grad? It takes time to mold yourself into the ICU rhythm, I learned that myself. What's important is that you stay receptive to feedback.

Hang in there, and you are not dumb. I'm sorry she hurt your feelings.

I am already hired but orientation I guess is whether or not I'm able to handle the unit. She said she doesn't think I can handle it. I don't know the "why's" behind the tasks eg. A patient dx with acute Renal failure was having hemodialysis she asked me why, I said I assumed because Renal failure. She said no, I didn't look up her history to see that they believe she had overdosed on medication and were trying to filter out her system.

Also when she asked what the A-line was for I said BP and pulse. I think that nearly knocked her out her seat. She said "what!?!? You're in week 5 orientation and don't know what the A-line is for?!" I don't know why I freeze when she asks me things and I can't think straight. I explained about a previous nurse telling me if the pulse is good the waveform is good. She then gave me a lecture of how to manually check pulses and to assess my patients and not the monitor. I knew how to check pulses and I never said that's how I check pulses but I just said ok instead of explaining further :(

Not all nurses are good at being teaching and she has mentioned it to me almost everyday she will never precept again. She actually said this is the reason why she will look to join an agency so she doesn't have to deal with it ever again. 1 clerk said that she's a good teacher ( I agree for the most part). Her response was "yeah, I like it when I get Smart people, if I get dumb nurses, it really bothers me"...I know that was a jab at me. Patience is key, and she does not have it!

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