Please... what is going on??? objective opinions needed

[cherilee]

SO I started a new job two weeks ago, in a long term acute setting.

first week, lots of confusion, but did what I could , paid attention and followed preceptor.

second week, Im taking two pts., giving meds independently, documenting on computer, answering call lights, asking any one ifthey need help, etc. My preceptors are different culture, and sometimes I dont understand their accent, or they are giving me quick answers, and im learning in a very busy environment, complex medical telemetry unit.

SO today I m thinking everything is fine; I m giving meds, my documentation is done independently; i am getting to know the pts, etc. I havent recieved any feedback except one meeting last week where the preceptor says "IM not feeling comf. with giving you two pts yet, theres some confusion with iv pump, etc" . In front of the manager she says this. I tell everyone at the meeting,that yes its new, new equipment, I just need my time to become acclamated,( and im supposed to get six weeks).

So today my preceptor says "You ask the same questions over and over to more than one person, everyone will think you are not paying attention or that you are not learning" .

Now I have not exactly been walked through anything here. Usually my response to questions is "Didnt they go over that in class with you?"

I said "i have to ask questions, thats how I learn, you are training me, and If I have to ask more than one person, its because I didnt get a sufficient answer." "I need instruction". And I disagree. Sometimes I do ask more than one person, but not constantly.

Anyway, the conversation got a bit weird, she said

"The last time they asked me to step down from preceptor they fired the girl two weeks later". Excuse me:angryfire "Are you implying?"

I am one of the easiest people to get along with. I have been working so hard to learn, I have been on the floor8 DAYS. will someone please tell me what the hell is going on here??? She said they all have been "communicating" to ea. other Im asking the same questions too many times. Am I supposed to have a photographic memory? I dont think I have to defend asking questions!!!!:angryfire NOW WHAT AM I SUPPOSED TO DO> I HAVE TO WORK!!! can they just up and fire me for NOTHING???

ALL of my documentation of everything I do is there. It is ALL FINE>

IM so angry . Thank you whoever you are for reading this..

ANy words appreciated!!! ive been a nurse for almost a year,and the people at the other hospital were nice, kind, and instructed me as they should have.

Lisa

PS the preceptor KNOWS IM PAYING ATTENTION.

[Daytonite, BSN, RN]

thanks for the responses, they are appreciated.

if i go to the manager, and tell her things that are said to me, i just feel like ill make more enemies... and look bad for pointing fingers at other people....

but if i dont stick up for myself, im just in the same situation where im not getting enough instruction, etc.

i guess well see

thanks again

lisa

are you a (wo)man or a mouse?

first of all, if you go to your manager and report this, the only people who are going to know you reported it are you and the manager. the only way you are going to "make more enemies" is if you start telling other workers on the floor that you went to the manager and what you talked about! it is nobody else's business what goes on between you and the manager with regard to your orientation and evaluation of your performance. if you are talking to other workers on the floor about these problems you are having, that is the wrong thing to do and you need to clam up right now! that is how you get enemies. if the manager opens his/her mouth to the other employees about what is going on, minus looking for information to make a judgment about what is going on and keeping your name out of it, then he/she is a bad manager and doesn't respect confidentiality. if your preceptor is going around talking about you, that's another issue i would report to the manager--that's inappropriate gossip and a violation of your right to confidentiality about your job performance and evaluation issues. loose lips sink ships!

since you didn't take me up on the offer to see the powerpoint on what a preceptor's role is, i went through it and took some notes. please read this information. if your preceptor isn't doing these things, then you need to point this out to your manager and ask for another preceptor and ask the next preceptor to follow these guidelines. this is your orientation and you have part of the responsibility to make the most of it because you only get one orientation as a new grad.

guidelines for preceptors

• explain expectations, duties and objectives
  
• accept responsibility to teach and evaluate
  
• manage the workload and the workflow
  
• lead by example
  
• explain your thought processes
  
• assess and address needs of learners
  
• demonstrate procedures during the "coaching" method
  
• evaluate often and provide instructive feedback
  
• recognize and acknowledge your own limitations
  
• teaching strategies
  • build confidence - express confidence in the orientee's ability to handle a situation if you are sure that they have the necessary skills
    
  • use confrontation to identify a discrepancy between verbalization, behaviors or feelings expressed by the orientee, e.g. "you say that you are comfortable with starting an iv , but you have avoided doing one each time an opportunity has come up this week. help me understand what is going on."
    
  • give mini-lectures of factual information that are brief, short and do not stray from the topic
    
  • share your own experiences to use as an illustration that have direct application to a particular moment
    
  • ask questions of the orientee that:
    • promote their thinking
      
    • help them to organize their thoughts
      
    • correct inaccurate reasoning
      
    • help them refocus on important points
      
    • help them to evaluate their thinking

evaluating performance

• guidelines for evaluation of orientees
  • from the very beginning, each orientee should know the criteria (goals and expectations) upon which they are being evaluated
    
  • establish open communication during orientation
    
  • schedule regular evaluation sessions
    
  • base evaluation on specific, observable situations
    
  • all evaluations should be shared with the orientee
    
  • the orientee should participate in the final written evaluation

[cherilee]

This is what transpired today

I was given two patients. I independently documented, gave meds, processed orders gave report to interdisc. team.\

the preceptor was nice to me all day , explaining things, etc. much more so than she had been.

At the end of the day, We had a meeting, the manager, practice leader,and preceptor...

the preceptor said"I still dont feelcomft. giving her three patients"

She mentioned how I forgot where antibiotics are kept. {There are four places where meds are kept, and I gave two antibiotics my first week, yes, I did forget.

I didnt ask the nurse before I lifted someones head up in the chair that was on a tube feeding. and the first week, someone was to be a hoyer lift, and I looked at the board and saw partial weight bearing and almost tried to get the pt. up.yes, I made these mistakes.

She did mention that I gave meds, and gave report ok, thats about it.

The practice leader told me I seem to be going in a circular motion and that asking too many questions is an indicator that Im not

"coming along". The preceptor also mentioned that the last orientee was on her own in three days.

I said Im definately making progress and coming along. the practice leader said "someone with SUPPOSEDLY one year med surg experience should not have trouble with iv pumps. I explained that im fine now with the pumps. I just feel like Im constantly defending myself. this sucks. The manager seems to side with them, speaking down tome, etc. I just am not motivated to fight. They seem to want someone who is willing to go on minimal training. Thats not gonna happen with me.

I cant leave the job, I have bills! What do you do if you get fired??

It seems like Im just not accepted here.

[caliotter3]

You ask what to do if you get fired? You get another job. In anticipation of that happening, which looks very likely, follow up on the other job applications you had in the works when you accepted this job. Or start a new search. It seems from your description, that it won't be long until you are asked to leave if you can't find a way to fit in before that happpens.

You even state yourself that you are not very motivated to fight to keep the job. I don't think this is a very good attitude. This may be the only job opportunity for you at the present. Do your best to keep the job until you find one that you want to switch to. Go on your own terms.

Did your supervisors state anything about a plan of action to bring you up to par? If not, I suggest you devise one on your own. That shows initiative and that you care about their concerns. Write down each of their criticisms, then come up with a way to remedy your shortcoming, and then separately, on a piece of paper, write down the instances where you have acted to correct the deficiency. When it is time for your next meeting, bring this plan and your record with you and present it to them in your defense. It will be harder for them to criticize you if you can give instances where you are improving. Good luck and I hope that you at least keep this job long enough to find a better situation.

[caliotter3]

I forgot to add. Prepare yourself mentally this coming weekend, and next Monday, go to work and request three patients. That would be another plus on your side. Be proactive.

[cherilee]

thank you for your suggestions, Ill take them

Lisa

[Poochee]

Wow, I've been in your shoes.

I was just abt the only person of my ethnicity to work, my shift.

I got through orientation (not in a hospital).

But when it came to the regular shifts. They ALL would go to lunch together, sit at the same table. I'd be working like a dog.

It takes more than orientation, to find that routine that works, down to a niche.

I never got a lunch or potty break.

No one asked if they could help.

The day shift was down right awful during report.

Often pointing fingers at this and that, things that really had insignificant relevance.

I repeatedly went to the DON, several times.

I was not intimidated, I had sufficient funds to leave, if necessary. She did nothing. Eventually, I got another job, and gave notice.

Oh, they begged me to stay, we'll make you a desk nurse, you can be the wound care nurse.

I said no, no and no. When I had something to say, it was not important to you then, it's surely much too late now!!

Other ppl, were leaving as well, even ppl in that same ethnic group.

It's really sad, how a few bad apples, can ruin a good orchard.

Best way to break ice, bring in food.

Best of luck to you.