(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).
Listen, this post makes me feel very bad and I'm sorry you are being treated so awfully. My suggestion to you is to set up a meeting with your educator and/or your nurse manager. Be sure to also invite your preceptor to this meeting. You need to sit down ahead of time and write down what is going right and what is going wrong with your orientation and write everything down; how things are going, how your preceptor is making you feel, what your goals are for your learning your job duties. Whatever you do; Don't discuss the topic of the meeting with your preceptor prior to the sit down. I would gently suggest to you that you make this meeting at a time you are not expected to be working your shift. You need to be honest about what is going wrong; and you need to choose your words carefully, and be gentle in describing the shortfalls of you preceptor. Going in you need to know a few things: you are not dumb, you obviously went to nursing school and that is no joke! The result of this meeting will end in two things, either you can "start over" with you preceptor, clear the air tell her that you are not getting what you need from her in order to be successful in your job (then tell her what it is you do need to become successful) OR you will be assigned a new preceptor and you can start over. This is YOUR job, YOUR license, YOUR life; you need to make a stand and fight for your job. Where ever you are working has hired you and they also have a responsibility to you to give you a good orientation and it's your responsibility to make sure you get a good orientation. Do not let this other nurse use you for her fodder, but confident in your skills and continue to build on them. You are a brand new nurse; they knew that going in and therefore, no questions should go unanswered and you should certainly not be made to feel like you are stupid for asking them. 6 weeks also seems so short for a brand new nurse....Good Luck and remember there is a place for you at that table and you have every right to sit at it.
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.
I like that you said she knows what to teach and not how to teach to a novice nurse, I agree 100%. She does expect me to think at her level and I can't.
A patient will have many IV fluids/drips and ask me what port each med is running through and the rate, off the top of my head at the nursing station I don't know so I will say I'm not sure, I need to check the pump and the iv lines. She said I'm suppose to know this right away and the back and forth going into the patients room to reassess my lines isn't going to cut it (she hates seeing nurses go in and out of the room frequently).
She tells me I need to write things down then TWICE she's literally removed my papers from my hand and said that I need to hurry with my assessment.
I was suppose to have 1 more week to go but today she said she will tell the manager I'm not ready.
Listen, this post makes me feel very bad and I'm sorry you are being treated so awfully. My suggestion to you is to set up a meeting with your educator and/or your nurse manager. Be sure to also invite your preceptor to this meeting. You need to sit down ahead of time and write down what is going right and what is going wrong with your orientation and write everything down; how things are going, how your preceptor is making you feel, what your goals are for your learning your job duties. Whatever you do; Don't discuss the topic of the meeting with your preceptor prior to the sit down. I would gently suggest to you that you make this meeting at a time you are not expected to be working your shift. You need to be honest about what is going wrong; and you need to choose your words carefully, and be gentle in describing the shortfalls of you preceptor. Going in you need to know a few things: you are not dumb, you obviously went to nursing school and that is no joke! The result of this meeting will end in two things, either you can "start over" with you preceptor, clear the air tell her that you are not getting what you need from her in order to be successful in your job (then tell her what it is you do need to become successful) OR you will be assigned a new preceptor and you can start over. This is YOUR job, YOUR license, YOUR life; you need to make a stand and fight for your job. Where ever you are working has hired you and they also have a responsibility to you to give you a good orientation and it's your responsibility to make sure you get a good orientation. Do not let this other nurse use you for her fodder, but confident in your skills and continue to build on them. You are a brand new nurse; they knew that going in and therefore, no questions should go unanswered and you should certainly not be made to feel like you are stupid for asking them. 6 weeks also seems so short for a brand new nurse....Good Luck and remember there is a place for you at that table and you have every right to sit at it.
Thanks, I really do need to have a talk with my manager and preceptor. I think 6 weeks is short also but that's the time line all new hires are given. My preceptor said she will tell the manager I'm not ready so I guess I will see what the manager has to say on Monday and if I will be given more time or the boot
(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).
I am a pre-nursing student, so I obviously do not have the experience, but I will say that from what I have read new grads are not typically accepted into ICU. Being that you are, I would assume that it is safe to say that you are far from the "world's dumbest nurst." Hope that helps
I would also recommend that when she does something specific that throws you off, such as taking your papers from you or belittling you, you need to call her out on it! Be kind and be appropriate, but do not let her get away with that bull! It's scary, but you need to look her in the eyes and say, "Excuse me, I need my papers back please, it helps me to record my findings as I go," or, "I'm grateful for your feedback, but to be honest, the words you are using to describe my performance and that of certain other nurses are not encouraging, and I feel very distracted and put down when you do that." It has probably been a long time since this nurse was a student or a novice, and you may need to draw her back into what that is like for you. At the very least, it will get you what you need to finish out orientation. Remember, every nurse develops their own flow, and you are still working on yours. You're going to be slower than she is and not always have the answers right there to recall. This is your orientation time, so don't let her intimidate you out of it! Take your time and do what you need to for accuracy and safety - who cares if she gets annoyed with how long it takes?
OP, I'm very early into my icu orientation. Six weeks is awful short depending on what kind of icu you are in, but your preceptor sounds awful. It's not conducive to learning.
I will say many seasoned nurses do not understand that nursing school teaches you nothing these days. Their focus is NCLEX and not what actually being a nurse is. Clinicals are a joke and that is due to accrediting bodies for nursing programs. Not the actual programs. You are trained on the job.
I'm lucky to have a great preceptor. I've made simple, dumb mistakes. I ask lots of questions, and I write everything down. I carry a notebook with me. I'm sure I look like a dork. I don't care. Writing helps me remember.
If I was in your shoes, I would sit with my educator. That's what they are there for. You may not be the first having an issue with this nurse. If you say nothing, the behavior continues. Maybe your preceptor doesn't understand she is doing wrong. Don't you think she deserves the courtesy of knowing? The chance to fix it?
An ICU that is a. hiring new grads and b. giving them only 6 weeks of orientation and c. assigning preceptors who are openly hostile and resentful of their preceptees?
There is a problem in this scenario, OP, but it isn't that you're a dumb nurse.
By the time a unit is hiring in the pattern shown here, this may be the last experienced nurse even theoretically capable of precepting available, though obviously she is not suited to the task.
I agree that you should go to your manager about this but I think you should also be prepared for the possibility that there will not be a happy outcome. This situation has a lot of hallmarks of a dysfunctional, desperate unit. If you are not able to resolve the issue satisfactorily or even if, in the worst case scenario, the manager takes your preceptor's view and declines to keep you on in that ICU, know that it is NOT because you are dumb, but because you were not remotely given the appropriate training to the task. On a better run unit with an appropriate preceptor, you might well find you aren't struggling to give simple answers out of sheer nervousness. If it comes down to it, finding such a unit to start your career, even if it isn't ICU, might not be a terrible idea for you.
Hang in there, I think it's good you're asking questions. I think it's dangerous when people don't or act as if they know everything. Keep your nose clean, try to get through your orientation with her. I would not take her remarks personally, they are unprofessional but she probably speaks to many new nurses this way. If you like the unit and want to stay, do not let her opinion convince you otherwise. Focus on being the best, safest new nurse YOU can be. You do not have to adopt her "do as little as possible" attitude. I'm not an ICU nurse but that seems pretty unsafe; however, as an experienced nurse she is probably able to work at a faster clip than us newbies (I've been a nurse for a year). That is not necessarily unsafe. Keep the lines of communication open with everyone...your preceptor, your supervisor, etc. Look to the feedback you get from your supervisor. You may have a different nursing "style" than your preceptor...that's OK! I had 2 preceptors, very different styles. I took parts from each of them. Good luck to you.
Without knowing anything more about your preceptor, it sounds like she's the kind of person who's forgotten how stressful the first few months of work on a critical care unit can be. We have a ton of autonomy to make nursing judgments and decisions, especially with titrating medications. That responsibility alone is enough to make me somewhat nervous. Add to that a preceptor that is essentially taking part in "nurses eating their young" (hate the phrase, but it's a good descriptor)...and you have a recipe for disaster. Obviously, as a new grad nurse myself, I don't believe it's necessary to have floor experience prior to going to ICU/SICU, but I do believe new grads in specialty units need a little extra time to settle in and learn their trade. Give yourself some grace, obviously you're qualified or they wouldn't have hired you in the first place. YOU just need to remember that.
I had a similar problem, my preceptor was nice enough but she wasn't patient with me. She took over everything I did because she did it faster, which left me feeling less than adequate when I was finally off orientation. It's not fair, it's not right, and honestly I wish it were easy to ask for another preceptor but you and I both know that it's not. You have control of your destiny. You know your knowledge base. Try to give yourself some time to think about clinical pictures and answers before you speak (your preceptor can wait, seriously). And hopefully you have people on your unit that you feel comfortable going to when you have questions (never stop asking questions!). If you have any doubt that you'll be keeping your job after orientation, get ahead of it. Ask your manager for more orientation or for more resources. They want you to be a good, prepared nurse when you are off orientation. Good luck!
Specializes in home health, hospice, SNF, geriatrics.
Listen, this post makes me feel very bad and I'm sorry you are being treated so awfully. My suggestion to you is to set up a meeting with your educator and/or your nurse manager. Be sure to also invite your preceptor to this meeting. You need to sit down ahead of time and write down what is going right and what is going wrong with your orientation and write everything down; how things are going, how your preceptor is making you feel, what your goals are for your learning your job duties. Whatever you do; Don't discuss the topic of the meeting with your preceptor prior to the sit down. I would gently suggest to you that you make this meeting at a time you are not expected to be working your shift. You need to be honest about what is going wrong; and you need to choose your words carefully, and be gentle in describing the shortfalls of you preceptor. Going in you need to know a few things: you are not dumb, you obviously went to nursing school and that is no joke! The result of this meeting will end in two things, either you can "start over" with you preceptor, clear the air tell her that you are not getting what you need from her in order to be successful in your job (then tell her what it is you do need to become successful) OR you will be assigned a new preceptor and you can start over. This is YOUR job, YOUR license, YOUR life; you need to make a stand and fight for your job. Where ever you are working has hired you and they also have a responsibility to you to give you a good orientation and it's your responsibility to make sure you get a good orientation. Do not let this other nurse use you for her fodder, but confident in your skills and continue to build on them. You are a brand new nurse; they knew that going in and therefore, no questions should go unanswered and you should certainly not be made to feel like you are stupid for asking them. 6 weeks also seems so short for a brand new nurse....Good Luck and remember there is a place for you at that table and you have every right to sit at it.
Best advice here.
New grad straight into icu? That's a he'll of a lot of stress. Most people start on med surg or other use its to get basic experience and then go into specialty areas like icu, labor and delivery, nicu, dou, etc. I know I wouldn't feel comfy going into icu as a new grad, I graduated and got my license 3 weeks ago!
I think you are very smart to get to learn all these stuff. I have been a nurse for 11 years. I have no clue what you are talking about. I am not kidding. There are different levels of nurses on earth. Some nurses are specialized in ER, ICU, they do those stuff every day, that's why they know everything in those area. If I tell them to go inject botox or filler, they probably have no clue what they are doing and they don't know anything about the muscles and blood vessels on the face. Don't feel bad. Some people have miserable lives, they enjoy trashing others and NOT Lifting. I am a good teacher, I understand how people feel when they are new and inexperienced. I have been there, done that. No big deal. That's why you need a preceptor. I don't know why some people have to be such jerks. Sorry about your experience but things will get better once you get through the training.
Believe me, I am making more money than those preceptors who were nasty and mean to me 11 years ago. I know you need to vent. So I am giving you hugs here! Don't give up.There are people like that even at my current job. They act like they are better than me just because they have experience in ICU and I don't . Oh well, whatever, I am making more money than they do anyways. And I know I know stuff that they don't know.
...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.
target98765
194 Posts
Listen, this post makes me feel very bad and I'm sorry you are being treated so awfully. My suggestion to you is to set up a meeting with your educator and/or your nurse manager. Be sure to also invite your preceptor to this meeting. You need to sit down ahead of time and write down what is going right and what is going wrong with your orientation and write everything down; how things are going, how your preceptor is making you feel, what your goals are for your learning your job duties. Whatever you do; Don't discuss the topic of the meeting with your preceptor prior to the sit down. I would gently suggest to you that you make this meeting at a time you are not expected to be working your shift. You need to be honest about what is going wrong; and you need to choose your words carefully, and be gentle in describing the shortfalls of you preceptor. Going in you need to know a few things: you are not dumb, you obviously went to nursing school and that is no joke! The result of this meeting will end in two things, either you can "start over" with you preceptor, clear the air tell her that you are not getting what you need from her in order to be successful in your job (then tell her what it is you do need to become successful) OR you will be assigned a new preceptor and you can start over. This is YOUR job, YOUR license, YOUR life; you need to make a stand and fight for your job. Where ever you are working has hired you and they also have a responsibility to you to give you a good orientation and it's your responsibility to make sure you get a good orientation. Do not let this other nurse use you for her fodder, but confident in your skills and continue to build on them. You are a brand new nurse; they knew that going in and therefore, no questions should go unanswered and you should certainly not be made to feel like you are stupid for asking them. 6 weeks also seems so short for a brand new nurse....Good Luck and remember there is a place for you at that table and you have every right to sit at it.