Help! My preceptor is very difficult to deal with

[Scarlettanager]

I feel like I need advice about how to approach and learn from my preceptor.

My first day precepting she was very surprised that I didn't know how to empty a JP drain and was very annoyed that I asked.

"Where did you do your clinicals"? It's not the fact that she was surprised, it's her dismissive tone of voice. I feel like she does feel obligated to "teach" me, and she does accommodate me and allow me to follow her, but it is an obligation and a duty for her and not something she voluntary chose. Yet she DID choose, so I am wondering why if she is not patient and happy teaching.

As a senior in an accelerated program, I feel like I am at the same level as my peers, but she makes me feel like I am stupid and I sometimes I feel like she is waiting for me to mess up, as opposed to supporting me to succeed. I simply did not come across a JP drain in my previous clinicals, since I have only had one med-surg and the other med-surg was in a neuro floor.

Another incident where I almost cried is when she asked me to get a needle to puncture capsules for G tube. I accidently got an IV catheter. She flashed the needle in my face and said in a loud voice: "NEEDLE! NEEDLE! NEEDLE". And then left. I held back my tears and continued.

Despite of everything, I dont feel like she is a mean person, but just snappy and impatient. Even w/ other nurses, she doesn't hide how she is feeling at the moment. When she wants to work with others, she is very pleasant, but when for whatever reason you irritate her she snaps at you, and then moves on like nothing happened. Right now what has happened is that a patient actually complained that she was mean to me to one of the floor managers. I did not complain to this patient at all, but she just didn't like the way this nurse was talking down to me. She called me: "Do you remember so and so...well she complained that I was being mean to you. Am I mean to you?". My answer: "No...but maybe it's your tone of voice. We'll talk about it when I see you".

Should I bring anything up with her? I just want to learn and finish my preceptorship with no drama, so I don't know what the right thing to do is.

[starxxx]

Sorry about your experience. I imagine how it must be difficult for you. I am a nursing student as well but I havent had any preceptorship yet but I know what you mean by saying you havent learnt about JP drain.In My program and in most school clinicals you cant learn every skill because not every skill is available for all students. In my class some students have passed meds only once and yet we are graduating in May. The sad thing is some preceptors act like they skipped nursing school and dont know how nursing program is dah! She is not the only 'mean' preceptor so you might tell her, she reports you and get a worse preceptor. On the other hand she might grade you as incompetent and not capable. So it all depends how long you have her as a preceptor if its a very loong time it I would talk to my instructor and if its a short time I would hang in there and ignore her comments.. Time goes fast in nursing school and before you know it it will be your last day with her:yeah:

[roser13, ASN, RN]

Since the patient complained (and you didn't), I think it's a golden opportunity for you to be honest with your preceptor. She may truly not feel that she has been short or dismissive with you. The fact that someone else picked up on it likely was a shock to her.

Be honest but low-key. Remind her that this is your first-ever orientation and that you may not immediately meet her expectations. Reiterate that you're eager and willing to learn from her. Keep in mind that she may not have ever precepted anyone before.

Good for you that you recognize that she is not a mean person in general. Hang in there - I think you've got a great attitude.

[dudette10, MSN, RN]

This has got to be hard for you. In the scenarios you presented, it seems like she's blaming you for what your school didn't teach you, and that's not right at all. It also dashes any confidence you might have had going into this preceptorship, and it becomes a difficult learning environment.

Whatever you do...DO NOT attempt to move forward with a procedure if you are not familiar with the equipment. I know that you will want to just wing it to avoid her remarks to you, but you just CANNOT do that. It's dangerous.

What she doesn't realize is that she is creating a dangerous patient environment for those students who do stop asking questions. Not good.

[Altra, BSN, RN]

I agree with the poster above who has stated that your current relationship with your preceptor is creating a potentially unsafe environment where you may go to any length to avoid having to ask this nurse a question, and that needs to be addressed.

There is a possibility that if you discuss this calmly and without showing emotion, your nurse preceptor may change her behavior. However, since you can't control her behavior, you may want to consider how you can change your reaction to her behavior. Hers will not be the last "dismissive tone" you will encounter -- how will you deal with a similar tone from others, so that it does not impact your patient care?

[EMT-newbie]

I think you have the kernel of how to work with your preceptor, you mentioned that they snap at irritations and then just move right along. I've noticed this in friends from the midwest, they're very straightforwards and once done griping it's over, case closed.

Don't take it personally =) Drama is OK, it's grudges that you don't want! I think that if you hunker down and focus instead of getting flustered at your preceptor's quick bursts your two personalities may mesh much better.

[eCCU]

ugh being a preceptor myself this makes me cringe!

i am not sure what type of hospital you work in. But here is my 2 cents.

If you are in a magnet hospital you can speak to your icu educator and see whether you can be matched with another preceptor who is perharps trained to precept new graduates and more patient.

Or you can have a meeting with your clinical manager to find a common ground. Again this all depends on the institution and the management level and the interest they take in educating new Nurses. I can however empathise with your situation. I hope you get it taken care of soon before you are signed off to be alone!

In the mean time try to familiarize yourself with different icu procedures they have a very good book on ICU procedures and what is normally needed during that procedure and what is expected of you.

Some of the Nurses can be quite unprofessional rolling eyes infront of patients and such things. Avoid growing into that sort of behavior, dont let them drag you to that level but stand up for yourself by being firm.

Finally if you decide to complete your preceptorship with this Nurse and you are still not comfortable find another expert Nurse on the floor that can mentor you and you can ask questions.

You can always ask questions on this website am sure tons of Nurses will be happy to share!

All the best.

[beast master RN]

u have to have tough skin in nursing, really tough, your gona mess up your first year in the biz , the key is learning from your mistake and not doing it again , leave work AT work dont take it home , dont dwell on it, some time that can be hard but do whatever you have to do to try and get it off your mind

[VICEDRN, BSN, RN]

Forget it: You are a senior in nursing school. You are paying for this learning oppurtunity. As gently as you can, confront her about her behavior if it bothers you this much.

If she can't stop, go to your instructor and say something like maybe the preceptor would do better with a different student but it isn't working out for you.

In a few short months, you will be practicing under your own license and whatever you didn't learn from this final experience will become clear to you and you will regret not speaking up.

As for nursing itself, part of nursing IS having a thick skin: thick enough to stand up for yourself and your patient whenever people try to tear your down. Now stick up for yourself already!

[nerdtonurse?, BSN, RN]

I don't know about your program and situation, but with us, we find out we're precepting when the preceptee shows up. No warning, We don't get paid extra, we don't get fewer patients; if anything, we get an extra since we have "help." And, like your experience with the JP drain, if you've never done it, then you're not "help." I apologized to my preceptor a lot because I knew I was slowing her down, as I asked endless questions that weren't covered in my nursing program. She would ask me, "Didn't they teach you ANYTHING?" And for actual floor work, no, they hadn't.

Sometimes you get someone who's fast on the pick up, someone who's hopefully had good clinicals or who's been a CNA/LPN/EMT or had some hands on somewhere, but sometimes you don't. Then you spend your shift endlessly chasing your tail because you're trying to keep the patients safe, get the work done, and try not to scare off the student when they see things go bad (dissecting esophageal varices, for instance).

Keep in mind, it's rarely personal; most of us don't actively seek out being a preceptor, we're told to do it. We don't get to pick a good personality match, it's just "here, take this one." When I have a student, I try my best to let them do what they can, but even the best ones slow me down. Then I get yelled at because I was late getting out, I've seen other nurses get yelled at because their preceptee complained about them -- a few with merit, most not. I had a patient coding, and ask the student (first day on the floor, didn't know where anything was) to do compressions. She said she didn't feel comfortable, so I told her to stay in the corner and out of the way and watch. Then I got fussed at because the student "wasn't allowed to participate."

Just wanted you to see how it can be from our side....

[EricJRN, MSN, RN]

I feel like she does feel obligated to "teach" me, and she does accommodate me and allow me to follow her, but it is an obligation and a duty for her and not something she voluntary chose. Yet she DID choose, so I am wondering why if she is not patient and happy teaching.

Unfortunately, there are several motives for voluntarily "choosing" to precept. The reality is that it doesn't mean you have an innate passion or talent for teaching.

Maybe she needs one more activity to meet or renew a step on the career ladder. Maybe she was "encouraged" to precept during an evaluation with a manager. She might have been guilted into it. At some places, you can either "choose" to precept a newly-hired nurse or "choose" to precept a student.

I'm not sure what went into her decision to precept, and it doesn't excuse unprofessional behavior, but these are realities that might help you understand why you see this stuff from someone who volunteered to precept you.

[Scarlettanager]

Wow! Thank you so much everyone for the encouraging remarks! It feels really good to know that I have support and that I can turn to all of you nursing students and nurses out there for support and advice.

Roser, I agree with you. I think next time if we have down time, I will bring it up in a gentle tone of voice, and also just to clear the air and move forward from the incident. It must have been very hard for her to get called out on her behavior, and to have a meeting w/ her manager.

Altra and Xylearner, Thank you so much for your advice! I do think I need to focus and stay confident in the things I DO know how to do. I know how to give heparin for instance, but even with that I got a little flustered b/c like I said she is a little tough, and maybe I was trying to impress her as opposed to just focus on the what I was doing and on the pt. I think dudette you are very right; I do NOT want to endanger someone's life b/c I am afraid to ask. Despite of everything, I still ask questions and often admit that I DO NOT know. This is just the reality and she has to accept that I am a student and don't have the 30+ years of experience she has. I just really will she had the empathy to realize that, and serve as my supporter and mentor more.

It's all good. I am trying to be proactive by reading up as much as I can and watching youtube videos of procedures I haven't done.

I definitely do need to have thicker skin, and in a way I am grateful for this challenge which is making me learn how to deal with different personality types. Thanks all! I will keep you updated and I really hope I will be able to learn from her despite of everything.