My preceptor is driving me nuts!!

[CABG patch kid, BSN, RN]

Vent warning here, please don't flame me!!

So, I've been orienting in CCU for three weeks now, took my ECCO class before starting on the unit. I have worked tele for a year prior, at the same facility, so the nurses in the CCU give me some credit for that. Anyway, I have been with my same preceptor for a few weeks now and I think our personalities are really starting to rub.

She is constantly on my back about what I'm doing. For example, if I am charting vital signs on the flowsheet, she will ask me if I've documented my meds in the computer; when I tell her no, I haven't gotten to that yet, she'll say "okay, go ahead and do that so you don't forget" then I have to stop what I'm doing to do what she wants me to do. Its even more irritating when she gives me a specific task to do and then when I'm in the middle of doing it, she tells me to go do something else. And I'll say "oh, but I'm still working on getting these meds" she'll say "that's okay, we dont' have to worry about that right now, just go do such-and-such". It would be okay if it hadn't happened about 10 times yesterday. It really pushed my last button when I told her that I was going to go and grab the patient's dinner tray, then give his insulin and she said, no, give the insulin first. Really? Does it make that big of a difference? Like why can't I just do something my way if its not going to harm the patient?

I'm the type of person that gets stressed easily as it is. Adjusting to the CCU has been a challenge for me because of the pace. Now its not like I want to give up, quite the contrary. I just don't like someone breathing down my neck, asking me what I'm doing every 5-10 minutes. How am I supposed to get anything done when I'm constantly getting interrupted?? And I already have a complex about taking longer to do things than she does but I know that's just natural for a newbie. It just makes me feel like a failure when she acts like I'm not moving fast enough.

I understand that part of her asking what I've done and what I'm doing is because she doesn't want to fall behind on her workload (which technically is still her workload) and I realize that part of her asking is because she might be trying to get me to prioritize differently, but if prioritization is the reason, she isn't trying to explain it to me.

Anyway, I'm just irritated, yesterday sucked and I couldn't wait to get out of there. I would talk to my manager about it but I only have 1 more day until I go to a different shift and already have a different preceptor assigned. From what I've seen, this new preceptor has a much more relaxed personality (current preceptor is very high strung) and being a slightly high strung person myself, I need someone that will balance me better.

Thanks for listening

[truern]

Good luck with your new shift and new preceptor!! :)

I think I would have blown a gasket dealing with your present preceptor..hehe

[SDA3694]

Thank God! Seriously....I thought I was the only one who went through this! Normally I am very vocal, and it was so hard not to be able to just say something. I precepted in ICU...and my preceptor would disappear everytime I turned around but then pop up and have all of these ways that she thought I should do things....example, she suggested that I use her tape method where you come in first thing in the morning and write down everything that you need to do on a piece of tape and then as the day progresses write things down on the tape that I did for the patient that I need to remember to chart later and keep the tape on the table in the patients room ...now im not denying that this does help BUT is it really necessary to come into the patients room and ask me "where is your tape...did you forget" while im in the middle of giving meds, How stupid did that make me look? OHHH the worst part was she would constantly tell me how good I was doing and then wait until the doctor would make rounds and just come up with all of this stuff and I had no idea what she was talking about ...I dont know , maybe she just needed to feel important. I was assessing another patient and had no idea that the doctor was in to see my second patient and she pulled me out of the room and was like you need to always be in the room when the doctor makes rounds...which is true but I had no idea he was there. TO me that just made me look like I was lazy and not doing my job. SO MAD!

[Flightline, BSN, RN]

I suck as a preceptor. I tend to work at a fast pace, and having a fondness for math, I tend to see everything as either factored or not factored, that is, either efficiently done or not efficiently done, either the right way or the wrong way. I'm pretty OCD, and I am a fanatic, as most of you know, about the "glory" of nursing.

I had a preceptee last night. Fortunately, she was really smart, showed me something on the new IV pumps I didn't know, and agreed with me when I said tangled tubing and wires are about the worst possible evil in this world.

I have no dout, however that after three days of me, she'd come in shooting.

I think the best preceptee would be Minime!

[SDA3694]

I can imagine that it would be really hard to precept someone, but at the same time DONT do it if you're not trying to help to promote them or give them a good experience bc it cheats the students out of learning. I think alot of preceptors take on the task because the management "supposedly" lays a guilt trip on them but if you know that you're gonna be miserable...then trust me we CAN tell, so atleast have the guts to say no! Some obviously do it for gifts...I forgot to mention earlier that the first day I went to my preceptorship my preceptor said you know my last preceptor got me a gift and she wasnt just saying it as a joke she was serious. I was going to get her something anyway..but that really turned me off!

[MB37]

I think I'd go nuts! My preceptors have mostly been pretty hands off, especially as I progressed through orientation. I had one a couple of times (in CCU) who tried to micromanage everything I did, and I thought I'd go crazy if I had to work with her again. If you weren't switching shifts I would definitely suggest talking to your manager, but at least it's only for one more day. Better luck with the next one - sometimes people just don't match personality wise.

[canoehead, BSN, RN]

SDA.3694

No gift for you!

I mean it, the minute someone starts hinting around they get shafted, in my world.

[CABG patch kid, BSN, RN]

I think I'd go nuts! My preceptors have mostly been pretty hands off, especially as I progressed through orientation. I had one a couple of times (in CCU) who tried to micromanage everything I did, and I thought I'd go crazy if I had to work with her again. If you weren't switching shifts I would definitely suggest talking to your manager, but at least it's only for one more day. Better luck with the next one - sometimes people just don't match personality wise.

Micromanage is the perfect word for it. There have been a few days when I was paired with another person for various reasons, and those nurses were more "hands off" which I guess is the style I need, because when someone tries to manage me and I'm trying to manage myself..... well that's just a bad combo I guess!!

[barefootlady, ADN, RN]

I hate precepting, but I try and ask what the new person is comfortable with and what they feel strong in, then I ask if I can observe quietly, if I see some issue I attempt to talk to them away from the stressful area of the nursing area. I also try to tell them everyday one thing they did that was great. It may only be the way they smiled at the patient, or family, but everyone needs stroked and nurses need it more than others at times. You seem to have many positives going for you coming to CCU, a year on Telemetry, a attitude to learn, and patience. I wish you the best on the new shift with the new preceptor. Blessing.

[glasgow3]

I hope that you will not take this as a "flame"; I waited for others to pick up on the point I am about to make.

Look, I DO understand how you feel. There ARE limits to micromanaging a preceptee. And no doubt about it, personalities and learning styles DO make a difference. But her suggestion that "pushed your last button", to give the insulin first, was a good one....it was NOT arbitrary, and depending on the patient and the type of insulin it CAN "make that big of a difference".

The key is really 3-fold: 1)Her directions/suggestions should be evidence-based 2) She has to KNOW that her suggestion is evidenced-based and is willing and able to explain the supporting rationale/evidence and 3) You have to be willing to listen and learn. Which of these is missing, if any, is impossible to say from here.

But take this time while you are NOT the one who is ultimately responsible (lol Well, actually you are too, but that's another topic), then question, research and learn. If you think a practice may be just the way a certain nurse prefers things to be done, or is essentially a nursing "custom", then ask----and/or research the topic to see if there is evidence in the literature to support one method or another.

Just a thought.

[oldladyRN]

Oh, thank goodness. I thought I was the only one on God's green earth that had an experience with a preceptor that almost made me swear off of nursing.

I was working in the ER. I had dreamed of the day and it had arrived. Although I was over forty, I was not deterred after all the stories I had heard about this particular hospital's ER staff being "cliquish" and treating those over the approximate age of 30 as outcasts. I am very thorough and very organized, and my clinical skills aren't too shabby, either. I had five rooms, and was buzzing from room to room, assessing, starting the IVs, drawing labs, getting people to x-ray and back. I was also keeping an eye out for labs coming back on the computer, printing them out, attaching them to the front of the chart, putting the chart back in the MD's rack. I did my very best to keep up with the pace, and did a pretty good job of it.

I was surprised to find my charts constantly out on the counter with little "stickies" stuck all over them for things that I had not done yet (because it wasn't yet time to do them). If I gave a p.o. pain med, there would be a "sticky" on the chart five minutes later that said "vital signs, reassess for pain". I did recheck vs and reassess the pain, according to policy, 30-45 minutes after the p.o. pain med. If I sent tubes of blood off to the lab, the chart would fly right out of the rack where I had placed it (while waiting on the lab results) and onto the counter and I would find a "sticky" on it that said "lab results, then chart to doctor". Hello!!!! The blood just got to the lab!!! I was miserable. To add to this, she would roll her eyes and let out a big sigh, like announcing to the rest of the ER occupants "what terrible sin did I commit to have to precept this moron?" Assuming that we were both professionals, I asked her to please refrain from the sticky note business. I told her that I was taking care of each patient and also following the policy and procedure regarding pain medication follow-up, and would she please allow me the time to complete the follow-up before assuming that I would not remember without her "sticky" note. Well, you know what they say about assuming.

A few days after that, I was called into the Nurse Manager's office and told that it had been reported to her that I was unable to complete the most basic of tasks without Nancy Preceptor reminding me. She didn't think it was a good fit and that was an understatement, as far as I was concerned. Without the top of my head blowing off, I politely submitted my resignation.

I am happy to say that I am now employed at a facility that happens to think I'm fabulous, and I love my job. I will never forget the negative experience with that preceptor as long as I live. We often have nursing students doing their clinical rotation at our facility and I encourage them to pursue whatever field interests them and that everyone has their niche.

Folks, if you precept, know that it's an important job and don't see it as a hindrance or a burden. Don't micro-manage, assuming that someone is too stupid to know better. Give people some credit and they just might surprise you.

oldladyRN

[David13, MSN, RN]

I believe that a lot of the issues that have been mentioned in the scenario have to do with simple self esteem. Why would the preceptor need to discuss sensitive issues with the learner in front of the physician or patient, when they could just as easily discuss these concerns in a private area? The preceptor obviously desires to make someone else look bad in order to make herself look better and/or to feel better about herself. This is, in my opinion, unprofessional behavior, and it has a negative impact upon the perception of nursing not only by other professionals but also the public.

It is also worth adding that no one is going to learn very well when they are consistently criticized and micromanaged, particularly when they aren't given the reasoning to back up the commentary. A bit of positive feedback goes a long way.