My externship is not going well

[NP2BE]

I posted this somewhere else but want some opinons. I am in between 2nd and 3rd semesters in nursing school and taking an externship.

I just started my externship and so far I have found many precpetors to be hlpful and informative. Expect for mine. My preceptor is an arrogant, whiny nurse who likes to power trip, thinks she knows everything, and doesn't want to teach me anything. Its quite obviuos she is in the precpetorship for the $2 an hour extra. I distinctly got that feeling when she asked me why I was in a hurry to learn things (as this was slowing her down). She was hoping I would be a lazy extern content to take up space. Too bad for her. This is an optional gig for us at our school, so we are all externing (those of us from my school anyways)because we are the best in our class, and the one who want to learn the most before graduating. I am so aggravated!

[NP2BE]

Well, if your preceptor is popular on her unit, she's probably a team worker and well respected by her peers. This is only a very subjective response and please don't be offended but it sounded a little cocky when you stated that you were "the best". This is not a productive image to project when in a student position. Your summary is full of characterizations of this preceptor (judgments) but short on specifics. Perhaps she would like you to research some of your inquiries on your own... or perhaps you may consider the timing of your questions. If you really want this unit and she is the only preceptor available, I would do damage control and make the changes necessary to appeal to her m.o. Perhaps consider the way she would like the interaction to proceed instead of the way you would. The preceptorship doesn't last forever and if you repair the relationship, she might be a great future ally in establishing relations with others on the unit. You can achieve this goal by approaching her in a private space and expressing your concern about your relationship and how to improve it (" I sense that you are frustrated with my questions, is there a more appropriate time for me to ask them?").

Well, that's just my .02 This is a profession where you must chose your conflicts very carefully because the sequellae will remain with you for a long time. For example, if this popular nurse gives negative feedback about you to your supervisor or other nurses, it will take a long time to defeat your "rep", trust me.

So far I have not had any direct conflicts with her. But she certainly seems to wish I was the lazy type. That is all I mean by the saying we are the best, there are no lazy externs because this is optional work we elected to do because we care (from our school.) I think that is not cocky, but well put. As for the poster re NP, That is just a nic, I am currently in trainining to be an RN, I may never ne an NP, I have to be an RN first. I am not going to address our relationship, it won't last long enough. She can go ahaead and talk about me behind my back, just like she does her coworkers, I am not playing that game.

[loerith]

Calling a meeting, talking about her to superiors will only put you in a questionable light. You said she was "well liked" on her unit. As you said "dont play that game."

Go with the flow; smile and nod.

Then after graduation go work in the largest teaching cardiac hospital you can find. That my dear is when the true learning starts anyhoo.

One more thing....good luck!

Love and Peace,

loerith

[AcosmicRN]

I wasn't trying to be rude with the comments about NPs, and certainly, I wasn't trying to be rude to the OP. Hopefully, I was persuading her not to be an NP. It's sound advice; that's how NPs are treated where I come from. NPs derive their status because they retain an RN, and this doesn't get them anywhere with MDs. To the MDs, they are the assitants who go and do daily rounds for them on patients who aren't critical. That's just the way it is. The nurses where I work don't consider NPs doctors, nor do they consider them part of the "RN" profession. They're just out there somewhere in-between. Granted, they typically earn more than an RN, so there you go.

I would encourage anyone with a good heart, energy, and intelligence to be a nurse. I believe in nursing. The array of assitants an MD uses (PA, NP, tech, etc) is not something I'm going to encourage. I'm a nurse. The world needs nurses. There is no shortage of MDs.

That's just my opinion; feel free to disagree, but don't acuse me of being everyone in this group you never liked before. It's just not me.

Acosmic

[jaimealmostRN]

OP, I'm very sorry about your situation. I would be polite (as others suggested) but say something like, "Is it possible for me to observe in the MICU or on Nights or the next week?" and then make it permanent. My perceptor is wonderful, but I am not on the unit where I want to work so I am feeling kinda "down" about my externship as well. Learn as much as you can, even if it is just interaction wtih other staff and patients, how to juggle a full patient load,etc. Also, if all esle fails, bring your preceptor Dunkin Donuts, coffee or some other treat just for her/him. Good luck, I feel your pain!!!

[bluesky, BSN, RN]

I think that is not cocky, but well put.

Listen, I was just trying to show you what the (surely unintended) impact of your statement was so you could see how it was interpreted, not what your original intent was. As a multiple question asker myself, there are some lessons that I have had to learn the hard way and one of them is that unfortunately often our naturally inquiring, intellectual nature (which is only seeking to learn more for the betterment of our patients) can be viewed negatively by others. It's not fair, it's not right, but it's true. The greatest challenge I have faced in this profession is finding just the right level on which to communicate with the educators many of whom have self-confidence issues.

If you haven't had any outward conflicts with your preceptor yet, then your next task is to determine whether (sorry I always spell that word incorrectly) she is a conflict averse person who is harboring negative feelings but doesn't want to talk about it OR just a stressed out nurse with no antipathies in your regard. Either way, I think I would still approach her humbly and inquire generally about your performance and what specific steps you can take to "further our collaboration", or something equally innocuous sounding. That gives her some space to express her opinions without feeling as if she's attacking you.

[A/A/OX3]

Funny... your quote stands in direct opposition to your recommendations.

You tell NP2BE to cave and suck up to this self-indulgent, egocentric preceptor wannabe, then close with the following words: 'Well behaved women rarely make history'.

You also beat her up for saying she is 'the best'. I say, if you got it, flaunt it. There is more than enough low self-esteem in the field to go around. After getting our self-confidence kicked out of us over the years by doctors, managers and other nurses, cowering in the corner seems to be the body English of the profession.

NP2BE... I say face her head on. Draw a line in the dirt. Going to the charge nurse, manager or your instructor puts someone else in charge of your life.

Remember... most bullies are cowards underneath.

Go make some history NP.

[AcosmicRN]

What you all say about self-esteem is critically important, I believe. I think low self-esteem is at the root of most interpersonal problems between nurses and people in general.

Acosmic

[loerith]

Funny... your quote stands in direct opposition to your recommendations.

You tell NP2BE to cave and suck up to this self-indulgent, egocentric preceptor wannabe, then close with the following words: 'Well behaved women rarely make history'.

You also beat her up for saying she is 'the best'. I say, if you got it, flaunt it. There is more than enough low self-esteem in the field to go around. After getting our self-confidence kicked out of us over the years by doctors, managers and other nurses, cowering in the corner seems to be the body English of the profession.

NP2BE... I say face her head on. Draw a line in the dirt. Going to the charge nurse, manager or your instructor puts someone else in charge of your life.

Remember... most bullies are cowards underneath.

Go make some history NP.

Go ahead and wage war.

See who wins.

Right now, she has a bigger pencil than you do ....if ya get my drift.

Love and Peace,

loerith

[lady_jezebel]

I quit my externship at the local VA hospital about 1.5 months before it was over & took a job as an NA at the Burn Unit in another hospital. The VA hospital was shoddily run, the nurses were the worst I've ever seen, and the pts received really poor care. The Burn Unit was just the opposite, and I never regretted my decision. I will NEVER work for a VA hospital!!!!

Externships were a required experience in my program, so I had to do something (work as a nursing assistant allowed me to have a "hospital experience", get my required hours in, and finish up the class). Since your program does not require it, why not just give 2 weeks notice and leave? You'll still get many, many job offers for nursing positions once you graduate.

[lady_jezebel]

The NPs I know in my hospital are really awesome. They are great advocates for the pts. If we believe that a pt is not receiving the best of care from an MD & we can't get anywhere with the physicians, we call up the NPs. They stand to bat for us. Additionally, they have excellent training and knowledge -- all that I know were RNs for many years before obtaining advanced education. I love the NPs!

There are a couple of PAs that work with the spine surgeons on my unit. In these cases, where a PA is directly connected to a single physician and follows them wherever they go & assists in care for the MD's caseload, I HAVE seen tense/unequal relationships. These PAs do work with very difficult docs, and often get sh** upon. It can be a very difficult situation for the PAs. But maybe that's b/cs some surgeons can be really arrogant and lack people skills.

I think a lot depends on the type of relationship NPs/PAs have with their docs or hospitals. In my hospital, the PAs tend to shadow the docs while the NPs work with physicians AND the nursing staff. The NPs provide a lot of useful in-services and continuing education for us. They are viewed by RNs and administration as advanced practice NURSES, which is what they are.

I did have an NP clinical instructor in nursing school, on the East coast, who felt that she did the majority of the grunt work for her associated docs in a GI clinic. She did not recommend working as an NP, but did appreciate all that she learned in school. I think there may be a difference in NP autonomy b/twn the East and West coasts, for the NPs here in Seattle are very fulfilled!

[bluesky, BSN, RN]

Funny... your quote stands in direct opposition to your recommendations.

You tell NP2BE to cave and suck up to this self-indulgent, egocentric preceptor wannabe, then close with the following words: 'Well behaved women rarely make history'.

You also beat her up for saying she is 'the best'. I say, if you got it, flaunt it. There is more than enough low self-esteem in the field to go around. After getting our self-confidence kicked out of us over the years by doctors, managers and other nurses, cowering in the corner seems to be the body English of the profession.

NP2BE... I say face her head on. Draw a line in the dirt. Going to the charge nurse, manager or your instructor puts someone else in charge of your life.

Remember... most bullies are cowards underneath.

Go make some history NP.

I was merely trying to accomodate her goal which is to have a successful career on the unit she has chosen as the only one she cares for. You are blindly accepting her characterization of the preceptor which clearly stands in contrast to that of all her peers. Your ad hominem argument about my quote is not relevant here. Women chose the right historical moment to make a stand, a carefully chosen one which will have historical meaning. This other nurse is just as disempowered as she is, in the end. She is not defeating an oppressive power or making working conditions better for herself or others with some kind of inflammatory exchange. I have had my share of inflamatory exchanges in the workplace in the past and have found that it does none of the things which I strived for i.e; build solidarity among workers, earn the respect of the "victim", or resolve the conflict.

[moia]

The fact that someone is popular on their unit can have nothing to do with their nursing ability...we have a few that are very kind..constant note senders and party planners but they would never be on my list to look after any of my loved ones.

I respect them for entirely different reasons.

More importantly as a student it is impossible to know if a preceptor is well respected...the exposure to other staff is limited and controlled to people the preceptor likes.

I think the real issue is this time is DONATED time...the hospital and the nurse are benefitting from having an extra hand and they have a real obligation to fulfill their end of the bargain.

The nurse volunteered and took a course..she knows what is expected of a preceptor so she has NO excuse...she can't hide behind personality conflict bull because she took a program specifically designed to train her to work through that issue.

The preceptor has taken on a student under false pretenses and needs to be called on it.

The student may have sit and grin and bear it but this needs to addressed so this preceptor doesn't continue to put another student through the same situation.

This student could have taken a paying job that gave her nursing experience...instead she chose a learning experience...why should she be penalized?

And like her I was a great student...a great student nurse ...and a great CVICU nurse and if anyone didn't like my self confidence in my on abilities that wasn't MY issue.

Poor self esteem and this nasty attack dog attitude to anyone that has confidence and belief in themselves really needs to stop. It is pathetic.