How can I get along with my preceptor as a neurodivergent student?

[nursetassie]

I'm a neurodivergent nurse (adhd, suspected autism) & I've worked as a CNA in a large hospital system's float pool (med-surg, ICU, pacu, postpartum, peds, ED, you name it) where every day I was in a new environment & didn't know anyone, didn't know where anything was, and had essentially no oversight from management. After getting my RN in Spring 2020 I worked cardiothoracic ICU (highest acuity unit in my hospital) however COVID ravaged my area so after a year I switched to home health where I currently work. I drive to patient's homes (usually rural/low-income areas) & provide disease education, wound/ostomy care, IV antibiotics, etc. The reason I provide this context is to illustrate how much I've had to adapt my communication style and build rapport with anyone under the sun. 

Here's my advice:

If you want to discuss or share info, phrase it like this: "I want to teach my patient about this topic/call the doctor about something/work on my care plan/etc - can you tell me if I'm understanding this correctly?" and then share what you know. This indicates that you are engaged in learning but acknowledging that they know much more than you & you have a lot to learn from them

Ask them open-ended questions that are relevant to what's going on in clinicals (again, rather than offering what you know & implying that you don't need their instruction)

Ask "how could I have done that better?" after performing a skill, even if you performed it correctly in your opinion

Talk less, listen more! When you talk rather than ask/listen, you communicate to that person that you think what you have to say is more important than what they have to say. The best students are the ones that act like a sponge - focus on taking things in, asking questions, reading policy/procedure manuals, asking to perform skills even if it's not already assigned to you, asking to follow along if a patient is going to a scan/etc. 

Final note - relax! No clinical rotation lasts forever. Personality conflicts are very common in nursing, both among staff and between nurse & patient. If you try all of the above and still can't connect with that CI, try to build the skill of detaching from their opinion and leaving work at work (or school at school). 

You got this! Neurodivergent nurses are the best!

[nursetassie]

Personally my best approach would be describe an area of improvement + how you intend to improve. For example, if they asked "what did you think of observing that chest tube insertion" you could say "I'd never seen that done before, I couldn't tell what exactly the nurse was doing and watching for. Can I sit in the conference room and read over the policy/procedure?" or asking specific clinical questions based on what you saw. They're looking for how familiar you are w/ the info, if you understand priorities, critical thinking etc. Focus on developing those skills & clinical competence, rather than worrying about what exact words to say (easier said than done but possible!)

[iNurs5, CNA]

In short, they understand that you have less to say anything outside your curriculum. Listen and observe. Save that intellectual itchiness of yours with other scholars. Listen. Don't insult people because nobody likes it. Perhaps, there's some minority who enjoys bickering, squabbling, and quarreling. You aren't there for your teacher to like or dislike you. Remain respectful and courteous. Be kind to your patients and everyone. You aren't there to prove to everyone that you're inquisitive. Always think that people are smarter than you. 

[MEDFET, CNA]

Sounds good and I’m never critical of anyone’s sharing. When I shadow a person I feel it’s real world experience (sorry a lot of EYES)

have now entered the doors to corporate America

where it’s lots of backstabbing cut throat and someone has to decide what click they belong to quick and fast. There is no such thing as a trip to Disneyland and what we though about care compassion and what we signed up for is quickly replaced with the order of how the hospital gets it’s funding and we are there to do direct patient care but have to constantly worry if someone is going to throw us under the bus while putting in our hours to make management happy orientation is the hardest part it’s the real audition to get the job done.

[MEDFET, CNA]

Preceptor are like teacher pets so they look up to the doctors people who make moves and are at the top so as long as the doctors like me is what matters and if someone deflated my tires because rod jealous tactics it’s always gonna be jealous people but like the one chick says some people can’t cry ? 

[Hannahbanana, BSN, MSN]

TL;Dr, but have you consulted the learning lab or academic advising office for asistance with modifications for learning, testing, and interpersonal relations? You aren't unique, and they could help you.

When a preceptor is asking you, "What do you think about...?" they want to know how you assessed something (exam finding, symptom, patient, interaction, family dynamics, a lab result... what ever you're talking about), what you concluded from it, what you think a nurse could do next, how you'll know if your intervention or plan of action is working, and what you'll do next if it's not (start over is the answer there).

If that sounds exactly like the nursing process (data collection, assessment, diagnosis, intervention, and reassessment), then you get a gold star. This is why you're in nursing school, to learn how to think like a nurse. They want to know what you think. Are you making progress towards thinking like a nurse? See how that works? Go forth!

[Ksan]

@nursetassie Thank you so much! If I could bother you with another question, when a preceptor and/or staff you're shadowing ask you something like "what did you think of..." what are they asking?

Like what kind of thoughts are they looking for? I would ask for clarification directly but I don't want people to assume I'm stupid or being pedantic on purpose, which tends to happen when I request clarification on vaguer questions ?

Do they want my thoughts on the case? My reflection on the learning opportunity? My questions for my learning? Something else entirely?

[iNurs5, CNA]

Ksan said:

I noticed that I struggle a lot with making and maintaining a good impression with some clinical instructors and preceptors. So far, my best clinical instructor has been one that suspects she might have autism, and our personalities and communication styles meshed really well together.

I really need some tips and tricks on how to interact with and communicate with my current preceptor to like me. 

I come from academia background where much of my way of talking and communicating was very normal, so the social skills I had developed in that time are actually detrimental in my environment where I am a student nurse. As an example, my version of small talk is sharing knowledge and discussing fun facts, and I found out a lot of neurotypical people see this as "stuck up" and this was detrimental to how I get along with some nursing instructors.

Mostly I am looking for a list of do's and don'ts for communicating with a neurotypical preceptor from the perspective of a neurodivergent person. I especially need advice on how to ask for feedback or interpret non-verbal feedback. I also need advice on the appropriate level of "closeness" with my preceptor, as I don't want to seem too cold but I also want to maintain professional boundaries. 

Thank you in advance to anyone who shares!

Seriously? You need to drop those chips from your shoulder. You don't know them. Don't underestimate people. 

Worry about your nursing classes and performance. Be kind to your patients and everyone else around you. 

Do not drop your patients. Don't do something against your school's policy and procedure. When in doubt, ask your instructor.

[iNurs5, CNA]

Were you abducted or limited from extracurricular activities? Did you grow up in a different culture or language?  You aren't in school to socialize with your instructor or professor. You're there to learn and get your license. If you're good at caring for people, that's what matters. If you dislike "small talk," you're in the wrong field because the patients are too tired to discuss quantum physics. 
 

[Ksan]

Honyebee said:

Seriously? You need to drop those chips from your shoulder. You don't know them. Don't underestimate people. 

Worry about your nursing classes and performance. Be kind to your patients and everyone else around you. 

Do not drop your patients. Don't do something against your school's policy and procedure. When in doubt, ask your instructor.

This was just advice I picked up from tiktok and a couple of threads on here about how to get along with preceptors and/or nursing profs. As soon as I implemented my interactions with my current preceptor got WAY better so it clearly worked ?

[iNurs5, CNA]

I'm fine with mine considering our cultures and languages differ. 

[Ksan]

Honyebee said:

Were you abducted or limited from extracurricular activities? Did you grow up in a different culture or language?  You aren't in school to socialize with your instructor or professor. You're there to learn and get your license. If you're good at caring for people, that's what matters. If you dislike "small talk," you're in the wrong field because the patients are too tired to discuss quantum physics. 

I never said I didn't like small talk, just that my version might involve sharing fun facts, which many people appreciate but those who don't like it *hate* it. I've never had any issues with patients and I went into nursing because the patients I volunteered with loved me. I've only had issues with nursing preceptors and in environments where expectations are not clear but rather implied because I don't pick up on implied things so I have no idea what people want from me.

I don't want to socialize with my preceptor, I just don't want them to think I am weird and/or a bad student which might cause them to pick on everything I do.