preceptor/preceptee, hanging by a thread.

Nurses General Nursing

Published

Specializes in Med-Surg/ER/Mat.

Hi all

First id like to say that this may seem paranoid on my part but i dont know where else to ask where people wont just run off and tell my preceptor of what i said, dont get me wrong i'm not assuming that everyone gossips but i tried to ask another nurse on the floor if she knew anything about the situation, she said no and then later my preceptor brought it up.

so without further delay here is my problem, i graduated recently and got a job in a tiny broke town, figure id start wherever till i have experience to move up. i started eager to learn, in school they go over how to do a dressing lab values and that sort of thing right. well thats great but they never went over all the paper work, arrangements, med-vacs, and the little things that make up most of a nurses day. so here i am in this setting which i didnt do my clinical in, and my preceptor is getting frustrated i cant keep up with her pace. i feel apologies would land on deaf ears here since they wont make me faster when i did apologized she smiled at me and told me oh its ok, you will get faster with time, i felt so much better then but to this day she still makes comments that indirectly tell me im too slow for her pace.

today i felt like i was treated like yesterdays left over's i had 5 pt's 3 of which where super heavy, and 1 was pretty much 1:1 care. so its 4 am i finally sat down to do my chart checks and she comes up to me and she says those were suppose to be done by 12, i tried to explain my self to which she replied, i know and smiled. 5 mins later she comes up to me and says i dont care how slammed you are you are takeing the next admission. i didnt argue because that would have been a loseing battle. so the short of it is... im burned, i dont take breaks i dont eat lunch dinner snack, im grinding on metal here. i have no idea where to go from here. any advice is greatly appreciated... please dont mind the spelling.

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Its not clear what you are asking for a reply to

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Specializes in Med-Surg/ER/Mat.

general tips on what you expect out of your preceptee, that sort of thing

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Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.

How long have you been on orientation now? You are a new grad nurse. You should not be expected to keep up with her experienced pace. I also find it strange that she would just say I don't care how behind you are, you're taking the next admission. That is not a good way to learn.

Are you at the end of your orientation, so she is expecting you to carry a full load? I would sit down and have a talk with her, explain that you are getting very overwhelmed, which you are afraid that is going to cause you to make mistakes. You could ask for a group meeting with your preceptor and your nurse manager.

Rather than coming at her accusingly, you could ask for her input on ways to help you with your time management. A good preceptor should offer suggestions on how to improve. Not just keep dumping on you.

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Simply Complicated said:
I also find it strange that she would just say I don't care how behind you are, you're taking the next admission. That is not a good way to learn.

I can see a preceptor saying this out of frustration if they all have more patients - sometimes it falls that way. If the preceptor and the staff nurses all have 7/8 patients, I can see that happening - especially if they're extremely understaffed and there's no way they can handle another patient. I've seen some nurses on the floors almost get to fistfights over pt assignments.

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Specializes in Med/Surg.

I would suggest sitting her down and saying that this "sink or swim" learning style isn't conducive to your needs. Find her and ask her when you come across something you don't recognize. Ask to spend a day just following her to see how she does her routine. Take notes, then find where yours differs. Is it in assessment? A lot of new grads can take 20-30 minutes doing a full head to toe assessment whereas a more seasoned nurse may skip the neuro assessment on a 20 year old lap appy and be done with their complete assessment in 5 minutes. Is it familiarization with the medications you are passing and need to look them up? Ask your preceptor to write down a list of the most commonly given meds. Is it organizational? Ask her in what order she does things, all assessments, vitals first, then pass meds, or a combo 3-1 round. Does she take pain medications into the room of patients pre-emptively and return it if they dont need it or wait for them to ask?

Just some advice from having been a preceptor for the last 2 years.

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Specializes in Med-Surg/ER/Mat.

Thank you all for the advice, as for my orientation time, its a way away from ending, she just said that if i was working on my own and the only RN on cause we were short i would take this and another admission just cause they would be critical care and the wouldnt fall within the RPN's scope.

as for my time organization, i try my best to consolidate my tasks before i go in the room if i have to get vitals ill do a dressing if i have to give medications ill do my 2nd set of vitals, and try to kill 2 birds with 1 stone, but i just am not famliar with paperwork. they dont teach it to me in school and its a whole lot of work i have little experience with. granted i have done the work before but when i make a mistake she just gets mad at me. they switched my first preceptor, when i asked why they just told me that it is because they wanted me to get more experience on other floors. then the preceptor i went with told me that is a lie, when i asked again they told me the same thing, i didnt want to bring up the preceptors name so she wouldnt get in trouble to so i left it at that. then my 2nd preceptor switched because she had to move to another floor, and i was left with this preceptor. i am so frustrated with this whole ordeal, i dont know if its just that i dont organize my day exactly the same way they do, but i dont find doing someone's bath a top priority if it can wait, i would do assessments first and vitals give morning meds THEN do a bed bath where as some of the nurses here do their bedbaths as soon as the person wakes up. i just dont know what else to do :crying2:

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

sounds like you need to have a chat with your preceptor and clarify expectations: both yours and hers. go prepared with a list of skills you need more practice with and some specific questions about where you're lacking in time management. listen to her suggestions carefully and make sure you understand exactly what you need to do to succeed. and try to understand that not everyone is a good teacher -- you can learn from those who aren't good teachers, but you have to take responsibility for your own education. good luck!

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The reason why the seasoned nurse do the bed bath first thing is because you can do assessments and VS right there while doing bath. Start thinking of some shortcuts. Dont be afriad of being creative, and tell your preceptor thta you dont appreciate being bullied. Amazing things happen when you stand up for yourself.

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Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.

I would recommend having a talk with her, but try to involve your nurse manager as well. It will show initiative on your part, that you are trying to take control of your educational needs. It will also hopefully keep your preceptor from just getting mad, and bullying you. She will be forced to give you solid feedback.

When I was orienting on my last job, I had to go to my nurse manager and request a new preceptor. I was an experienced RN, but was new to ICU. My preceptor was a great nurse, but we had VERY different learning styles. I felt like I wasn't learning as I should. She would get frusturated with me, I was getting frusturated with her. I thought long and hard before going to my manager, and in my case she was very understanding.

Not saying to request someone new. But I would definitely sit down and talk. As Ruby said, clarify some of those expectations, on both sides.

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Specializes in ICU, ER, EP,.

I want to paint a picture and you see where your experience is falling short.

We start out with an assignment, we get report. We stop talk and form a plan, I ask you what your priorities are and how you'll tackle this. If I have another option, I'm giving it and we're doing it my way and we'll discuss briefly why your plan isn't the best in time management.

I follow you through each assessment, med pass and nudge, prod you to move along in a different path if needed. While we're in the room, after improving on your assessment skills, I"ll teach you safe short cuts, time saving advice.... pull your meds, your supplies and enter the room. Do your assessment, pass your meds and bring in all the night supplies with linen and everything, so you're not running back and forth and so on.

Leave the room, discuss differences in assessment, areas to focus on... more abnormal heart sounds, chart quickly, next room... bring all the expected supplies, meds, linen... assess head to toe, chart... discuss move on.

when you finish that first busy rush... we then talk about the plan of care, who needs what to be ordered long before it's 2am... what can wait, what needs to be called. Take care of all the household chores... it's time for midnight runs... assess pass meds, chart check.... lunch

My point is that I do the same thing every time, short of a paitient crumping or admits. You need to learn a normal flow, and have it down long before admits and what not. Knowing that you can't make a patient not crump!

I'm just thinking that you and your preceptor do not have a designated flow of how nursing activities occur and because you lack that basic, you have no way to adjust to a change. You need to talk to preceptor and MANAGER, so you can at least get three shifts of a normal flow down to then see how to adjust to something like an admit, which takes forever.

Right now, I'm assuming you're running in circles not knowing what is expected of you to accomplish and being put in a variety of situations where you couldn't do it if your tried your hardest.

nursing process.... evaluate... meet and talk about your precepting exp. with goals and not groans as the priority.

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Specializes in ER/Ortho.

As far as what a normal preceptor is like ...I think it really varies. I have worked at two places, and at my first I had the preceptor from hell. I was a new nurse fresh out of school, and it was horrible. She spend a majority of her time on her cell phone texting, sexting, watching videos, and then telling me about her sex life, personal life etc. She left me with a crumping pt in CT to go meet a guy she met online in the lobby. She would disappear to go outside and smoke often. When I asked a question she would make me feel stupid loudly in front of the patient, and other nurses. If I had to ask her something and she was texting, or sharing personal stuff with another nurse she would ignore me. She gave me assignments I couldn't handle, things I had never seen with no support, and taught me very little.

I went to my manager who told me to listen to her because she was a good nurse. I learned a lot about office politics. The people you work with are NOT your friends they are you co-workers and don't forget it. Anything you say to anyone will make it back to your preceptor or manager. Some of those things will be innocent, non-relevant things, but they will be twisted in some way to be the days hottest gossip. The majority of people who work there have known each other longer than they have known you. You are new, expendable, and the first to go. Unless someone does something terribly wrong and you have witnesses, and documented proof the manager will take the other persons side. Even if some of the other nurses see that you are being treated badly, and even tell you they see it, and are sorry. They will NOT stand up for you for fear they will be fired.

That being said my second preceptor was much better. She spent time, and actually educated me. I asked questions and she didn't make me feel stupid. Once I realized she wanted me to ask questions I took advantage of it, and learned everything I could. I came in with a smile everyday, I was polite to everyone, and I tried to stay under the radar. Don't complain, don't rock the boat, don't appear to pose a treat to anyone. Just get in and learn what I can, do my job, and go home.

I graduated from orientation a couple of months ago, and I am slowly finding my way. Still trying to get the time management down. I do feel I am fitting in, and eventually I will be one of the ones who has been there for a while instead of the newbie.

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