My preceptor gets frustrated with me.

Nurses General Nursing

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I feel down and I just need to get it out.

I'm a new grad and I'm in orientation. This is my 2nd week on med/surg floor with my preceptor.

I might be a slow learner but I am trying so hard to become a good nurse. My preceptor on the floor doesn't explain a lot to me but she just tell me

what to do. I just started working and I wanted to LEARN.

I had to discuss my pts' condition with Dr today (they do this every Friday) so she told me that I had to read almost everything in the chart (operative note, progress note, H&P, lab results in like 10 mins). She told me that I had to know everything because I needed to be able to answer any questions he'd ask. She told me that she'd be right there with me when they do this discussion thing but she didn't even come out from the break room because she was eating. When I asked her to be there with me she got very frustrated. This was my first time and I felt so overwhelmed. The only good thing was the Dr was very nice. He even said that my preceptor should have been there with me since I'm a new nurse and this is my first time.

There are a lot of things that I don't agree with her. Is that because I just graduated from nursing school and the real life is different than textbooks???

One of my pts was taking k-dur tablets but she had a hard time swallowing so I asked my preceptor if we could ask Dr to change the order to capsule ones. She said "there's nothing we can do about it so we would just crush and dissolve in warm water, and give with apple sauce" but it clearly stated "DO NOT CRUSH". I reminded her twice but she told me it's okay. Is it really???

My other pt was using PCA. She was confused so there was a sitter in the room. This sitter was CNA but my preceptor told her to push PCA button when the pt gets agitated and if he looks like he's in pain. CNA shouldn't push the button right??? or is it just in the textbook??? My preceptor argued with other new grad that it's the right thing to do because we have to take care of his pain.

I am not learning from her and I feel like I'm getting behind. I only have a few more days with this preceptor and I will move on to different floor with different preceptor. I hope things will be different. Thank you for reading.....

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I only have a few more days with this preceptor and I will move on to different floor with different preceptor.
CONGRATULATIONS! :yelclap:
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Your preceptor sounds like she is bending the rules too far. No one, I mean no one, should push a PCA button for anyone! I can't believe a preceptor would say that!!!!! It's a huge and very real no no!!!!!

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Specializes in Geriatrics and Quality Improvement,.

Your preceptor is a 'institutionalized' nurse. The facility you work for created her, and you will be lucky to get away. Stick to your guns, you do know what you know. If you think is wrong, ask anyone else. If it isnt wrong they will simeply tell you that. And, if you want to ask the nice doc while giving this friday report, do that too.

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Specializes in NICU.

I'm going through the same thing right now... I have 2 preceptors... 1 is good... 1 does things "her way".... And she told me "we crush everything up here" Whats up with that? She even crushed enteric coated meds... PROTONIX??? KDUR??? ECASA? Can doing this be detrimental to the patients?

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If you had more than 2 days left, I would suggest you requesting to your nurse manager for a different preceptor. Still, I think the NM may need to know how this person is training new grads. Either she doesn't know what she's doing herself or just doesn't care. If she continues to train other new grads the way she's done you, that hospital may wind up with lots of nurses with bad nursing practices. Stick to what you know is right and don't let her bad judgement influence you. As you know, PCA stands for Patient Controlled Analgesia...meaning, the PATIENT is to control the button for pain relief. If the patient isn't capable of doing that for themselves, then they need some other form of pain relief. By the CNA pressing the button, to me, that is the CNA dispensing meds and they don't have a license to do that.

I hope you have better luck with your next preceptor.

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Sorry to hear that you have a bad preceptor. It is nurses like this that discourage new grads. Do what you know you learned in school. You know what you were taught and you just have to worry about your license, not hers. I do know that you are allowed to put a K-Dur in warm H2O and dissolve it and put it in applesauce for a patient that is unable to swallow it. I asked our pharmacy what to do for patients who have a hard time swallowing it. But you still do not crush it. Just let it dissolve completely. The reason it can not be crushed and put into something is that the pieces are very sharp if you just crush them. Our pharmacist compared them to glass shards. As for crushing meds that are coated, you have to get a Dr.'s order to crush those meds. We have had to do that also in some cases. But you can only do it if you ask the MD about each specific med and get an order for each one. I have had some that will allow you to crush then and others will change the meds to something that you can crush.

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Specializes in ER.

Potassium comes in a liquid too, many drugs do.

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Specializes in Burn ICU.

I am sorry you are having preceptor trouble. Stick to your guns. If you have doubts about the medications, contact the pharmacy. I am a new nurse in orentation myself. I do have an awesome preceptor, and I am still feeling a bit overwhelmed. Hang in there.

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Look what you DID learn from that preceptor....that in the real world it's up to you to know the rules and let your critical thinking skills...and your ethics, decide what's right. It's your license and the patient's safety on the line. You don't have to argue with someone like that, just don't accept at face value what doesn't seem right to you. I've taken advice from 30 year veterans and after nodding and thanking them, walked away to do it the way I believe was more appropriate. Then, as you just did, I would research to find out for myself if their method was acceptable.

Luckily it sounds like you can move on and hopefully find a better preceptor and a mentor! When you do, ply her with sweets and kindness! She'll be invaluable to you.

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I'm happy that you'll be getting a new preceptor in a couple of days. This one sounds terrible. Just as your preceptor evaluates you for nursing ed, you should be able to evaluate her. She should not be allowed to precept.

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You know what is right. I applaud you for questioning. If you are not sure, ask someone else, research it etc. Remember this situation when YOU are precepting a new nurse in the future.

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