(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 haven't noticed this comment until just now, but please don't give her any feedback. This is not the personality type who would do well with that and it will just cause her to put you on her "list"! I'm sorry, but this is real life. Retaliation really happens.Instead, buddy up with someone nice who answers questions. Then finish out orientation without asking your orienteer anything else that she will target you for.
That's what I'm worried about, that's exactly why I NEVER complain about her to anyone at work. I'm scared of the backlash.
I wish I could give you a hug right now because your kinda going through what I did 6 years ago as a new nurse. I worked as a tech in critical care for 7 yrs before becoming a nurse and then had to find a job at a different hospital due to them not having any openings for an ADN nurse... I was devastated. I thought I then landed my dream job in a SICU....in the biggest hospital in Ohio . My preceptor was OCD, crazy, mean, never had anything positive to say, yelled orders at the residents, redated iv tubing because I put it on crooked, remade beds because it wasn't strait enough. She would tell me she needed to seek psychiatric help even. You probably get that she was bat crap crazy. The problem was that I was naive, shy, and had no assertiveness about me. I was actually progressing quite well and felt pretty comfortable doing the job, but she would never give me the space to take over and be the actual nurse. I would cry my way to work and even broke down in front of her crying one night. Sadly, I let her get to me and she ended up making me out to be the bad guy. My job ended there when I was cornered in the directors office and her saying bad things about me. I basically told them I was having difficulty because I missed my old place of employment. After that, a huge weight was lifted off my shoulders. I worked in home care for a while where I gained a tremendous amount of confidence, then a small community hospital, then a step-down unit in a larger hospital, and now I recently began working in ER. I now have had my BSN and am working on my Acute care NP. Please hear me, you need to confront your preceptor and be honest with how she is making you feel, then speak to the director and ask for a different preceptor asap!! If your director doesn't understand then try changing units or leave this hospital. 6 weeks is not enough orientation for a new grad either...hold your head high, have confidence. You are a new nurse and aren't supposed to remember everything. I still ask a ton of questions, and learn something new every day.
Yes, sounds very similar to what I'm going through right now! I'm glad it worked out for you. Everything happens for a reason, it just sucks that this has to happen and so early in the game
Aloe_sky, you are most certainly not a dumb nurse although I can guarantee you that you will feel incompetent for at least six months. It's because that's how long it takes to get used to a unit. I'll tell you what kind of nurse is a dumb nurse. Someone who is unprofessional by speaking inappropriately in front of her patients. Or someone who isolates herself from help by talking badly about her colleagues. It's also the nurse who thinks she's a pro after only a few years of experience. She tries to rush through her shift by using shortcuts and urges others to do the same. But the dumbest nurse of all doesn't believe in asking questions and mocks those who do. Gee, your preceptor fits all of those descriptions! I guess that makes her dumber than I thought!
That's exactly it, I feel that I need to get into my own groove right now I'm working based on what my preceptor believes to be important, how she thinks I should carry out my tasks, what she thinks is important to chart...but I don't even know if I'll get that 6 months chance, she's really hard on me and is complaining about me to staff.
After reading your response about the permacath and her accusing you of doing drugs, you need to report her ASAP to your manager and human resources. She is really an ***hole!!
I sympathise with your situation - very difficult to learn in hostile environments such as these. If it helps, keep in mind that this is a valuable learning experience of the type of preceptor you do not want to be. Btw, no one has mentioned this on this thread (I think), but your preceptors sedation approach is currently proven to be detrimental to patients. We no longer deeply sedate patients for "peace of mind" or whatever bogus reason (seriously, to not have to go see your patients every so often??... That sounds... Slacker-ish.)There is a study in the New England journal of Medicine about sedation and delirium in ICU patients. It is interesting and if you have time, read it. The conclusion is simply that :"Currently available data suggest that the best outcomes are achieved with the use of a protocol in which the depth of sedation and the presence of pain and delirium are routinely monitored, pain is treated promptly and effectively, the administration of sedatives is kept to the minimum necessary for the comfort and safety of the patient, and early mobilization is achieved whenever possible."
Her motto is to get paid and by doing less work. Sedated patients are the best patients for her because she does not have to worry about them trying to get out of bed, extubating themselves, talking or pushiNG the call bell. If half of the fentanly vial is ordered she will give the whole thing. If there's a fentanly drip and there's any movement, she will bolus them.
After reading your response about the permacath and her accusing you of doing drugs, you need to report her ASAP to your manager and human resources. She is really an ***hole!!
She is, she's just unreal. I don't know why I think if I report her, it will backfire on me.
I suggest writing down all the issues you have had with your preceptor. Then put in order the top issues. Have time to process it and when you are in a calm place, make an appointment with the nurse manager to discuss your concerns. I would meet her without your preceptor. Bring in your thoughts in bulleted format and discuss each concern. Have a notebook to write down your managers suggestions. I would not tell anyone that you are meeting with admin. You don't know who you can really trust.
This situation is going from bad to worse and I am worried that this is going to escalate to where you will get into it with your preceptor. It sounds like she is trying to get you to lose it so that you could lose your job.
One can only take so much. This is not healthy for you.
I am truly sorry this is happening to you. Enough is enough. You need to go to admin. NOW.
Do you belong to a union at your hospital?If so, they can assist you.
I am a current student ICU nursing intern at a floor. The ICU has a certain culture where they will break new grad nurses. It is not FINE but it TOUGHENS you very well. This is why I firmly believe that grads need to learn the true fundamentals before going to the ICU. I was in a medical oncology floor 5 week internship before my ICU experience. I felt more confident. I also took initiative. I would also make friends with the other nurses, bring some food for them!! I went to icufaqs.org I studied, read when I got home. I would impress my preceptor by showing how I am writing down all the medications what they are for and what they do.I have a current medicaiton list what are the common ICU drugs and what their physio mechanisms are for. The first thing I do when I go in is write down all the lines, tubings. drips, doses, ml/hr. As a student nurse you really have to toughen it out. This is ICU culture. Most nurses have this certain OCD, crazy, physician-questioning personality. Mind you I never wanna work in an ICU but I know it will make me a greater nurse by interning there.
I am a current student ICU nursing intern at a floor. The ICU has a certain culture where they will break new grad nurses. It is not FINE but it TOUGHENS you very well. This is why I firmly believe that grads need to learn the true fundamentals before going to the ICU. I was in a medical oncology floor 5 week internship before my ICU experience. I felt more confident. I also took initiative. I would also make friends with the other nurses, bring some food for them!! I went to icufaqs.org I studied, read when I got home. I would impress my preceptor by showing how I am writing down all the medications what they are for and what they do.I have a current medicaiton list what are the common ICU drugs and what their physio mechanisms are for. The first thing I do when I go in is write down all the lines, tubings. drips, doses, ml/hr. As a student nurse you really have to toughen it out. This is ICU culture. Most nurses have this certain OCD, crazy, physician-questioning personality. Mind you I never wanna work in an ICU but I know it will make me a greater nurse by interning there.
I would understand that if all ICU nurses were like that but they aren't...most of the ICU nurses on my floor were new grad ICU nurses including 1 that has been on my unit for over 20 years, my manager and supervisor. I have done internships on other units, including surgery. ICU is still very different, the mindset of preceptors are also different, some are understanding, others not so much. I have a nurse that's new to ICU that was an ER nurse for over 10 years tell me that she struggled in the beginning learning the role of becoming an ICU nurse. She went from being an experienced ER nurse to a novice ICU nurse and wrote a paper on it.
My problem is my preceptor not having the patience and expecting me to work at her level. I just can't. My biggest problem is her inappropriate unprofessional behavior that is just killing me.
This behavior by your preceptor is an example of lateral violence. It is unsafe for you and your patients. Your institution probably has written policies against it. You need the get some legal help if your nursing managers are allowing or condoning this behavior. No need to be a victim. Learn your rights and stand up for yourself.
...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.
. My preceptor was OCD, crazy, mean, never had anything positive to say, yelled orders at the residents, redated iv tubing because I put it on crooked, remade beds because it wasn't strait enough. She would tell me she needed to seek psychiatric help even. You probably get that she was bat crap crazy. The problem was that I was naive, shy, and had no assertiveness about me. I was actually progressing quite well and felt pretty comfortable doing the job, but she would never give me the space to take over and be the actual nurse. I would cry my way to work and even broke down in front of her crying one night. Sadly, I let her get to me and she ended up making me out to be the bad guy. My job ended there when I was cornered in the directors office and her saying bad things about me. I basically told them I was having difficulty because I missed my old place of employment. After that, a huge weight was lifted off my shoulders. I worked in home care for a while where I gained a tremendous amount of confidence, then a small community hospital, then a step-down unit in a larger hospital, and now I recently began working in ER. I now have had my BSN and am working on my Acute care NP. Please hear me, you need to confront your preceptor and be honest with how she is making you feel, then speak to the director and ask for a different preceptor asap!! If your director doesn't understand then try changing units or leave this hospital. 6 weeks is not enough orientation for a new grad either...hold your head high, have confidence. You are a new nurse and aren't supposed to remember everything. I still ask a ton of questions, and learn something new every day.
Aloe_sky
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