Multiple preceptors = multiple "rights"

[cherokeesummer]

I was wondering how do you deal with all the different preceptors and all of their different ways of doing things? I've not had a bad experience yet thankfully but some of my coworkers are experiencing it a lot, not bad, just frustrating because you do something the way your first preceptor explained and then you get a new preceptor and they do it differently and you almost feel dumb b/c they look at you like what? LOL! I think many of them know that each person does it differently but then I think some just don't LOL...

So how do you handle that? Do you say I do it this way b/c.... or do you just say ok (and do it their way while you are with them)? There is no way to know what the person does before doing...if that makes sense.

I.e. charting by exception. One preceptor says that means you only chart what is outside parameters. The other preceptor says you make a note on every system, regardless of if its normal or not. Yowsa!

[Piki]

I'm in a similar boat. I've had different preceptors throughout my orientation. I just go with the flow and take whatever suggestions each gives. I'll say something like that's not how XXX showed me, but tell me why you do it that way instead. I figure everyone has something to show me and at least this way if I have just one preceptor, I'll know multiple ways to do things, and organize things. The charting we have is all on computer, albeit there are different ways they each do it. Since my preceptors are all also my coworkers, I figure it's a good way to get to know everyone and see how everyone ticks.

[AprilRNhere]

If it's something I know people differ on...I ask at the beginning of the shift.

exp..."preceptor....I know different nurses do XX different ways...and since you're responsible for me this shift..I'd like to learn your way until I discover my own pace/groove/niche..etc.."

If it's something that doesn't really matter...I just nod and say "ok".

If it's something that makes me look like I didn't know what was going on....I just say "oh, I must have misunderstood the last time I was shown..." that way it doesn't look like you're blaming anyone for your difference... I don't worry that I won't look like I know it all. From what I've been told on the floor...the nurses don't like the new nurses who act like they know it all. So I hardly mention it if there are differences between preceptors. You're liscenced...and unless it's protocol or pt safety...it won't matter in the end.

[suanna]

That is the most common complaint of new staff in our unit. The truth is that how one nurse looks at a problem and finds a solution may be very different from his or her peer. My best advise is find 1 or 2 people who have good outcomes and are respected by the docs and other nurses and try to emulate them. As you develop your own approach you may find compairng the different "right ways" of doing something will lead to a completely new right way that works best for you.

[deeDawntee, RN]

I don't know what to tell you, because when I was new, I remember going through about 4 preceptors, then when I got to the 5th one, she reamed me for not doing something that noone else had mentioned. It DROVE me nuts. I do think it is useful to see how different people's practices are. You have to decide how you want to practice and use that person as a role model. Good luck, believe me, I know how you feel!

[patwil73]

I was wondering how do you deal with all the different preceptors and all of their different ways of doing things? I've not had a bad experience yet thankfully but some of my coworkers are experiencing it a lot, not bad, just frustrating because you do something the way your first preceptor explained and then you get a new preceptor and they do it differently and you almost feel dumb b/c they look at you like what? LOL! I think many of them know that each person does it differently but then I think some just don't LOL...

So how do you handle that? Do you say I do it this way b/c.... or do you just say ok (and do it their way while you are with them)? There is no way to know what the person does before doing...if that makes sense.

Someone else mentioned it, but i would also go with "I must have misunderstood when i was last shown. . ." People often have favorite ways of doing things and think every other way is wrong - what you need to find is the rationale behind why they do things a particular way. Once you have the rationale you can apply it to your own practice, that way when you do something differently you have more to fall back on than "well that is how I was shown."

I.e. charting by exception. One preceptor says that means you only chart what is outside parameters. The other preceptor says you make a note on every system, regardless of if its normal or not. Yowsa!

Charting by exception is tricky. It really only works well when "normal" is well defined. For instance if your charting section simply lists [Neuro] and gives a blank box to write in - you can't chart by exception because you have no idea what normal is in that situation. However, if they clearly define [Pt alert and oriented *4, no memory loss, no slurred speech, no difficulty following commands, etc] then you are more justified in charting by exception.

That said I have found nurses mostly don't like exception charting. WNL = we no look

Hope this helps,

Pat