Opinion About Situation with Preceptor (Long)

[AICU RN]

I was with a new preceptor a few times at the end of last week. I am in Stage II of my orientation meaning I am supposed to be caring for the sickest patients on the unit.

The first night I worked with her, she was funny and nice and we got along well. We had two stable vent patients that I was comfortable with. I noticed pretty early in the night that she would take long breaks and disappear while I was doing patient care without letting me know where she was going. There were lots of other resource nurses on the unit that night, so I knew where to go if I needed something. Anyway, I chalked it up to her having a bad night and sort of left it at that. Also, I knew I was the first full time orientee she had so I thought maybe she was still getting used to me just like I was her.

The next night we again had two patients. One was a stable GI bleed waiting to be transferred out. The other was a post-op patient who was pretty sick. His only IV access were two peripheral sites (A decent 20 G and a 22 G). At one point, his systolic drops to low 80s (it had been 115-125 previous). I let my preceptor know, she says to tell the PA. I do. PA orders fluid bolus which I run. Pressures are now back up to 110s.

About an hour later preceptor tells me she's going to lunch and will be off the floor. Also tells me who I can ask for help if anything goes wrong. About 10 minutes later pressures drop again and I still only have peripheral sites. I put his head down, wake him up and recycle. Lucky for me, two other experienced nurses come in. One places a new site (my 22 blew) and they help me get Albumin, Levo, etc. My preceptor comes back an hour later and is like, "What did you do?" She didn't really get why I was frustrated and just kept telling me I did everything right.

I was with her for a third night in a row. We are singled and only have the above pt with the BP issues. Difference is now I have the Levo, a central line and all that fun stuff. Lots easier to deal with. In the meantime the unit gets a really interesting admission. I went in to help and was learning tons. My preceptor pulled me out to chart VS on our stable vent because "she didn't feel like it."

That night one of the other experienced nurses who I respect immensely asked me where my preceptor keeps going. I told her the truth, that sometimes I new she would be off the floor and sometimes she didn't tell me. She insisted it was something I should let my manager know about because it was inappropriate to do to someone on Stage II. She said if I was ready to have these pts completely by myself, I wouldn't need orientation.

I didn't want to tell my manager. I was going to ride it out and hope that I got learning experiences from other preceptors and staff nurses. I didn't want to be the new kid complaining about her preceptor. I have said it on here and I'll say it again: I have had an awesome experience on orientation so far. I appreciate my preceptors immensely and have told each one of them that. I felt really, really guilty for telling my manager about the situation. She was really appreciative of the knowledge though. She told me that she put that particular preceptor with me because she knew my skills were stronger (compared to some in my orientation group) and that I didn't have to be babysat. She was hoping said preceptor was step up and become a really good preceptor for them, but obviously that didn't happen. She said she would take care of it and changed my schedule so I was with one of the two staff nurses who saved my butt with the hypotensive post-op patient.

Problem is, I'm her only orientee. There's going to be no way that she doesn't know it was me who said anything and I feel bad. She was excited to be a preceptor. I don't want her to think that I don't like her as a person. I also don't want to be labeled as the new grad who "doesn't play well with others" that you guys complain about so much.

Before you tell me that I should have taken it up with her first, I did. I was told "I keep leaving because I know that you can do the job and I don't have to hover over you." Fine. I don't need a preceptor to hold my hand, but it is nice to know that you're at the desk if I need you. Not to mention, she left the other morning before I even gave report to the oncoming shift and she didn't even tell me she was leaving :uhoh21:.

Did I do the right thing? What would you have done in my shoes? I guess I'm just feeling guilty because she won't get to precept anymore.

Sorry this was so long...

[Ruby Vee, BSN]

i'm one of the biggest advocates of "talk to the person first". if you talked to her first, you've done the right thing.

some folks like to precept because they love to teach, enjoy mentoring and are good at it. others like to precept because it gives them status, extra pay (not where i work now) or some other benefit. and still others like to precept because they think it gives them a license to sit in the break room all night or to disappear any time they feel like it. obviously your preceptor was one of the third variety -- or at least she is right now.

you're not learning anything from an awol preceptor, and it's a dangerous situation. those other nurses aren't responsible for you or your patient, and they may have had their own issues going on so they couldn't help. that's why you have a preceptor in the first place.

i wouldn't assume that you're the only person who discussed the situation with your manager. if i were aware of other preceptors behaving in this manner to the point where someone else had to rescue the orientee and the patient, i'd be talking to our unit educator or the nurse in charge of the preceptor project. (both of whom are less overwhelmed and more likely to get something done than our manager right now.) those other senior nurses may have already done so; they just needed corraboration from you.

[Been there,done that, ASN, RN]

#1 Preceptor is a slacker.

#2 it is your duty to report slackers.

#3 Preceptor should NOT be precepting.

#4 Cover your azz at all times, she should have been available to you, she dropped the ball.

[caliotter3]

One time I had a preceptor who should not have been precepting. I wish I had known that there was someone I could have gone to in order to get the situation worked out. As it was, I suffered because of it. Now that I look back on it, circumstances like this teach us early what to expect in the nursing work place. Why did I have to be on the receiving end of someone who had no business holding a title without doing the job? In discussion, it was pointed out to me that the only reason she was precepting me was that she was getting credit for it toward her next promotion. I would think she would have been more serious about doing a good job, but apparently she knew that she could slack off.

[CrunchRN, ADN, RN]

Youcan do no right in this situation. She will probnably always blame you even though it is her own fault. Hopefully she will realize her part in it and not hold it against you too much.