(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).
Give serious thought to finding another job, there is no one to adequately mentor the staff. If you stay, there is a high possibility that you will see and/or be a part of preventable sentinal events and cases where nurses failed to rescue patients because they did not have the clinical competence necessary to intervene in time. These kind of work environments can haunt a nurse.
Yes, this place sounds like really bad news...When you are starting out on your career, you don't necessarily know what is dysfunctional. When someone with only three years' experience and the attitude of a silverback gorilla is regarded as preceptor material, you are looking at a dysfunctional unit. You sound like a conscientious nurse with a great deal of potential; you are too good for this.
Your experience reminds me of my first job as a RN. I had a preceptor that was very similar to yours. She even called me stupid in front a patient. It was constant put downs. She was best friends with the nurse manager and admin. So I had no where to go. I was a new grad and had been an intern on the floor and had worked really hard to get this job. I was not going to allow her to chase me off. It was one of my hardest experiences a nurse.
I have been a nurse for over 17 years and look back on those times as my foundation. I promised myself I would never treat another nurse like that and I can say I never have. When I am precepting I remind myself when I start to get frustrated with my student I remember how I felt and find kinder words to say. You will be a preceptor someday. Never forget how it felt to be treated the way you have. I am not saying that any of this is ok. But I am a true believer that you can learn from not only good experiences but the really ugly ones too.
I am thankful for the experience because I truly believe that it has made me a better nurse and teacher. It is obvious that you are smart to be working ICU as a new grad. Give yourself credit for working on a had unit.
A suggestion is on your time off take an area that you need to learn more about and look it up and write notes down. I had a small notebook I kept in my pocket with me at all times that had formulas, med info. Etc for when I got nervous. I also wrote little phrases in the notebook that would make me laugh or remind myself I am smart. One of my favorites is "this is a fabulous experience and I am getting smarter by the minute".
You will make it through this. And all that matters is that you are giving the best care for your patient. You are not there to make friends but to do a job. You have worked hard for that license.
One last thing is to make sure you have a good support system and outside activities to balance. Exercise is always good.
Nursing is constant learning. You will never know it all or remember it all. A good nurse is constantly looking things up and educating themselves. That is why working in medicine is such a cool job. Everyday is a new learning experience.
You got this. Please keep us updated on your journey. And always know you are never alone. Thank you for being honest.
So sorry you are having a hard time. My opinion only: You making mistakes does magically allow your preceptor to use demeaning terms to describe colleagues ("dumb nurses") or her trainees. As a preceptor, that person is also required to model professional ethics, behavior, chain of command, roles, etc., right? Keep working hard, stay calm, understand your options in case you want to make a calm, reasonable request.
I could NEVER, EVER work under those conditions. I am so sorry that you are experiencing this right now. How awful! Your preceptor doesn't sound like she is a nice person (very well may be a great nurse but not a nice person) You need to talk to your manager about getting a different preceptor. It might not go over well with your current one but can you afford not to try to make a change??
Some people mentioned just looking for another job right now which might not be a bad idea if the whole place -unit and/or hospital- is a dysfunctional mess.
YOU are not dumb!! There IS a place in nursing for you it just might not be this unit or hospital or even the ICU. There is a lot out there in nursing and you just need to find the right fit.
I am also a new grad and in the process of my 3 month long orientation, and uh 6 weeks is NOT enough time for a new grad. i honestly would not feel comfortable taking patients at this point. I would ask your manager to extend your orientation and possibly with another nurse preceptor.
Also i know ICU is a stressful environment but try and relax. I think you are just nervous because you don't want to sound like a dumb nurse but who cares!! You're a NEW GRAD. Probably 80% of what you're doing everyday you didn't even learn in nursing school! I say literally the dumbest stuff on probably an hourly basis, but it just doesn't bother me because i'm LEARNING.
Also-it sounds like your preceptor is lazy-ish so maybe ask if you can try and take a patient and do all cares on them. and only get her when you need help or don't know something. Maybe that way she will be more willing to take the time to show and explain to you the process of something.
OP, I feel for you. Unfortunately, your preceptor is one of "those" nurses. One of "those" nurses who "forgot" what it was like to be a new nurse.
If you are able to extend your orientation, then, I, too, suggest that you ask for a new preceptor (though, be forewarn that that will piss off your current preceptor and her minions, but, if you could care less, then, go for it).
Tip: Ask for someone that your preceptor dislikes, but you know deep down is competent If you end with one of your preceptor's minions, you will just find yourself in a similar situation.
High turnover, several nurses with only one year's experience, most of the nurses do not want to precept, one very burntout preceptor, are all red flags that it's a poisoned workplace, you might be better off finding a new employer.
^This. This described a unit I left not too long ago.
OP, if you are childless, not having financial difficulties, able to relocate, and the manager refuses to extend your orientation with another preceptor (or is unable to find a suitable preceptor for you), then, by all means, bounce. Life is too short to be miserable.
Sure, you will have to look for a new employer, and you will have to take the time and effort to look for a new job, but, in the end, it will be worth it. Your mind will thank you. Your body will thank you.
EDIT: Just out of curiosity - OP, did you sign an employment contract with your current employer...or a training contract?
Give serious thought to finding another job, there is no one to adequately mentor the staff. If you stay, there is a high possibility that you will see and/or be a part of preventable sentinal events and cases where nurses failed to rescue patients because they did not have the clinical competence necessary to intervene in time. These kind of work environments can haunt a nurse.
There are very few nurses that have been there for more than a year on the unit but there are 2 that have been on the unit for more than 20 years. They SEEM very nice but they do not want to precept, i know one of them said shes too old and not good at explaining. they also do not interact with my preceptor. One of them my preceptor nicknamed "retarded ______" I spoke to, she asked me how I was doing. I told her I was slow to catch on to certain things and it takes me 3 or 4 times to do something to get it. She responded "it takes time, we were all like that at the beginning ....just remember, YOU GOT THIS" I could have hugged her at that moment. I really needed to hear that.
I am an ER nurse, and I'm damned good at it. I ask a ton of "stupid questions". I've saved more than a few lives by asking those questions and then hearing the answer of "well that isn't right" from the person I was asking. I draw VBGs from veins, not arterial lines (thus the name VENOUS blood gases!). Central lines rarely happen in the ER. I haven't done TPN since nursing school. I don't have to worry if something is important enough to call MDs at home at 0300. They are all at the desk with me at 0300.
Ask me me about venticulostomies and I start shaking in my danskos. While I have caught an occasional precipitous baby, don't ask me to check dilation or feel a 30 week belly for fetal positioning. Don't ask me to juggle 35 sun downing patients and do a med pass at the same time. I certainly don't know anything useful about CRRT.
I'm sure that your questions can't be any more stupid than mine would be.
Personally your preceptor sounds like an a-hole. I love students and precepting. I don't pretend to know stuff that I don't, I would certainly never call a survivor of nursing school stupid, and sometimes the answer to a student's "stupid question" is "I don't know. Let's find out."
HUGS! You are not the only one who thinks your orientor is a jerk. Previous posters have the right idea. I hope it works out for you because you sound like a good nurse in training.
I hope it works out, I love nursing and I love the ICU. I still smile going into work. Crazy thing is they tell me I'm new but my smile won't last long.
We are always told theres no such thing as a stupid question. I agree, these types of questions can save someone's life.
Yes, funny thing is my preceptor has 3 years experience and considers a nurse on our unit that has worked in the ER for 17 years "dumb".
I'm starting to see that it's nurses that don't value her opinion she also sees as dumb. The ER nurse will question her recommendations and does not always follow it.
I am also a new grad and in the process of my 3 month long orientation, and uh 6 weeks is NOT enough time for a new grad. i honestly would not feel comfortable taking patients at this point. I would ask your manager to extend your orientation and possibly with another nurse preceptor.
Also i know ICU is a stressful environment but try and relax. I think you are just nervous because you don't want to sound like a dumb nurse but who cares!! You're a NEW GRAD. Probably 80% of what you're doing everyday you didn't even learn in nursing school! I say literally the dumbest stuff on probably an hourly basis, but it just doesn't bother me because i'm LEARNING.
Also-it sounds like your preceptor is lazy-ish so maybe ask if you can try and take a patient and do all cares on them. and only get her when you need help or don't know something. Maybe that way she will be more willing to take the time to show and explain to you the process of something.
Yes! Most of what I'm doing I did not learn in school. It is a steep learning curve. My preceptor is VERY lazy-ish, I think she is smart but her main thing is SEDATE SEDATE SEDATE!!!! That way we don't have to go into the room as much. She will bolus sedations at any finger movement!!!
Your experience reminds me of my first job as a RN. I had a preceptor that was very similar to yours. She even called me stupid in front a patient. It was constant put downs. She was best friends with the nurse manager and admin. So I had no where to go. I was a new grad and had been an intern on the floor and had worked really hard to get this job. I was not going to allow her to chase me off. It was one of my hardest experiences a nurse.
I have been a nurse for over 17 years and look back on those times as my foundation. I promised myself I would never treat another nurse like that and I can say I never have. When I am precepting I remind myself when I start to get frustrated with my student I remember how I felt and find kinder words to say. You will be a preceptor someday. Never forget how it felt to be treated the way you have. I am not saying that any of this is ok. But I am a true believer that you can learn from not only good experiences but the really ugly ones too.
I am thankful for the experience because I truly believe that it has made me a better nurse and teacher. It is obvious that you are smart to be working ICU as a new grad. Give yourself credit for working on a had unit.
A suggestion is on your time off take an area that you need to learn more about and look it up and write notes down. I had a small notebook I kept in my pocket with me at all times that had formulas, med info. Etc for when I got nervous. I also wrote little phrases in the notebook that would make me laugh or remind myself I am smart. One of my favorites is "this is a fabulous experience and I am getting smarter by the minute".
You will make it through this. And all that matters is that you are giving the best care for your patient. You are not there to make friends but to do a job. You have worked hard for that license.
One last thing is to make sure you have a good support system and outside activities to balance. Exercise is always good.
Nursing is constant learning. You will never know it all or remember it all. A good nurse is constantly looking things up and educating themselves. That is why working in medicine is such a cool job. Everyday is a new learning experience.
You got this. Please keep us updated on your journey. And always know you are never alone. Thank you for being honest.
I love this! This is a lesson, as ugly as it is right now it truly is. I will never forget this traumatic time, I can't see myself ever treating a nurse this way.
...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.
If you end with one of your preceptor's minions, you will just find yourself in a similar situation.
bellini
66 Posts
Yes, this place sounds like really bad news...When you are starting out on your career, you don't necessarily know what is dysfunctional. When someone with only three years' experience and the attitude of a silverback gorilla is regarded as preceptor material, you are looking at a dysfunctional unit. You sound like a conscientious nurse with a great deal of potential; you are too good for this.