My preceptor is driving me nuts!!

[CABG patch kid]

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

[CABG patch kid, BSN, RN]

Regarding the insulin: Yes, I can see that there would be a reason to give the insulin before eating, I'm not sure that 2 minutes prior to eating would be a very big difference as opposed to 2 minutes after the meal is given to the patient; it was a combo of short and intermediate acting.... To be honest I do need to read up more on that to see what would be the appropriate action. It would have been nice if she had explained the reasoning behind most of her directions.

I don't claim to know the right way to do things all the time, and I always always ask questions. I wouldn't be working in the CCU if I wasn't open and willing to learn every single shift. :)

[DeLana_RN, BSN, RN]

I feel for you... a bad preceptor can really ruin a new job for you. Fortunately, you're almost done with yours - celebrate!

In my years of nursing (I graduated in '98) I have never had a good preceptor, therefore I think I'll be highly paranoid when I start a new job (looking right now)... I've had every horror story you can imagine: preceptors who didn't precept; berated, corrected and humiliated me in front of pts/doctors/coworkers; sharing a preceptor with 2 other new grads and therefore never seeing her (at least never getting any useful advice; her method of working you up to speed on a busy med/surg unit was to increase your pt load week by week without any instruction on how to handle it); and the last one, in dialysis, really took the cake: when I didn't take too well to her method of "teaching" the machine ("Why haven't you figured it out yet???"), she asked me if I was on psych meds :angryfire and added, "I used to take antidepressants myself and it made me confused." Huh?

Anyway, just wanted to let you know that it could be worse

Put it behind you, some people make lousy teachers and it seems that there are many of those in nursing. I hope you get a really good preceptor now who enjoys teaching and has the attitude, "The only bad question is the one not asked."

Best of luck in your CCU career,

DeLana

P.S. I'm still hopeful that my next mentor won't be a tormentor!

[cherex74369]

Preceptoring is a BIG job, in my books!! I have this "unreal" idea that I need to turn out the greatest nurse for my unit, but yet I have some second thoughts about my own abilities and personal goals. By unreal I mean that there is NO WAY anyone can turn out the Perfect Nurse. I have to keep reminding my self that I can only do so much, and the best I can hope and pray for is that my preceptoree -??sp.??- has a firm knowledge base of what is needed for the unit and the patients there and knows where to go for answers in case something comes up that is problematic for them. And that I have built a relationship with them that allows them the freedom to asks those questions and to stand up to others if they think that something else might work better for the patient or for the unit as a whole.

Just some thoughts.............

[smilealot]

I am so happy to read your post I thought I was the only one! I love my preceptor but she was gone for two weeks so I had a substitute that told me everything I did was wrong. In fact at one point she said I hadn't progressed to where I should be! I'm in the ICU and with my normal preceptor I have taken on full care of both patients since the second day. Sure I am slow and getting all the charting done but I am still learning it! Any way my guest preceptor constantly told me I was slow and way behind learning things (even though I accurately answered every questions she asked and when the doctor came to do his rounds I was able to provide him with information on the pateint that she had to look up). With her I had a new patient that was on CRRT and I have never done that prior. I felt so horrible after my shift. Every time I went to do something she would stop me and tell me to do something else and then ask me if I finished the first thing yet. Or the best is I asked her for help on calculating the -fluid loss for the patient and she told me to just figure it out so I tried and finished it and told her I was off by 200. Her response was "you should never ever guess you should have come and asked me. I will just have to fix it now." I did!!!! I wanted to pull my hair out. I cant wait for my regular preceptor to come back.

Of coorifice my friend on the same unit had a preceptor that on the first day said she didn't want and student and to just stay out of her way. After the third shift the preceptor told the charge she needed a bereavement from precepting and now my friend has a new nurse to work with.

[nerdtonurse?, BSN, RN]

My preceptor drove me NUTS. I mean, she had me so flustered I was ready to walk. Finally, I'd just had it and told her (*sorta yelled, actually....*) "You are hovering and you are NOT cleared for this airspace!" Not my line, but i can't remember where I got it from....She looked at me flabbergasted, walked off, and I thought, "well, there goes a year of LPN school down the drain, I'm fired..." I went back to the nurse's station, and she told me that's what she was waiting for. She viewed the preceptee telling her to back off as a sign the person was ready to go off orientation....

[smilealot]

My preceptor drove me NUTS. I mean, she had me so flustered I was ready to walk. Finally, I'd just had it and told her (*sorta yelled, actually....*) "You are hovering and you are NOT cleared for this airspace!" Not my line, but i can't remember where I got it from....She looked at me flabbergasted, walked off, and I thought, "well, there goes a year of LPN school down the drain, I'm fired..." I went back to the nurse's station, and she told me that's what she was waiting for. She viewed the preceptee telling her to back off as a sign the person was ready to go off orientation....

Im not sure I understand nurses. I dont think I ever will and yet I am going to officially be one in a month! I think I might have to use your line. I like it!

[newnurse36]

OMG!! I drive home every night wondering if I should say something to my manager about my preceptor!! We have completely different personalities and it is affecting my learning. I feel like I am being talked down to all the time (even though I think anyone she talks to feels that way) I had a different preceptor for two days and it was awesome !!! I am stuck with this girl for at least 5 more weeks!!! I just want to get away from her!!!! I think I am going to have to say something!!! I am progressing just fine but I am miserable!!!

[stustressed]

Im just wondering (im almost a new grad so I don't know all of the in's and out's) If people hate precepting or aren't good at it etc then why do it ? It was my understanding that preceptors volunteer to do this job?

[newnurse36]

Regarding the insulin: Yes, I can see that there would be a reason to give the insulin before eating, I'm not sure that 2 minutes prior to eating would be a very big difference as opposed to 2 minutes after the meal is given to the patient; it was a combo of short and intermediate acting.... To be honest I do need to read up more on that to see what would be the appropriate action. It would have been nice if she had explained the reasoning behind most of her directions.

I don't claim to know the right way to do things all the time, and I always always ask questions. I wouldn't be working in the CCU if I wasn't open and willing to learn every single shift. :)

You can even give Novolog 15 minutes into eating!!! We hold trays for Novolog and I will sometimes give the tray to the patient so they can start and then go get there Novolog pen.

[DeLana_RN, BSN, RN]

Im just wondering (im almost a new grad so I don't know all of the in's and out's) If people hate precepting or aren't good at it etc then why do it ? It was my understanding that preceptors volunteer to do this job?

Oh, no, not always. Many of the good preceptors do volunteer, of course. However, it can be the job that no one wants in the unit (few get paid extra and some have to carry a full pt load themselves while doing this). Others do get paid and only precept for the $$. Others still (like my last one) absolutely hate it - and the orientee as well - but do it for a required project for their clinical ladder (where they should, IMO, dwell in the basement.)

Anyway, that's why there are so many bad and/or indifferent preceptors out there. The challenge is trying to find a good one (not that you often have that option if you want to work in a particular unit).

Best of luck to you,

DeLana

[cherrybreeze, ADN, RN]

I am sorry you had a bad experience with your preceptor. Hearing things like this bugs the heck out of me; I can remember being on orientation (almost 8 years ago now) like it was yesterday....most of my preceptors were awesome, but the one I had on my FIRST day as a new grad made me want to walk out, too. I still work with her, and I love her to death, but she is NOT preceptor-material. As a matter of fact, I can't remember the last time she was paired with anyone, and I think that's good. It's not her thing. I was SO green and SO scared, and she put me out there basically to watch me sink. It sucked, and made me feel so inadequate and not confident in the few abilities I had at the start. I was/am grateful that I only had her as a preceptor for that ONE day!

I am probably in the minority now in that, I LOVE to be a preceptor. I take on new orientees, and senior students, and I enjoy it immensely. I take a hands-off approach, personally. I try to be there as much as they want/need me to be, otherwise I stand back and watch them flourish. I don't stand so far back as to make them feel they are alone, though (I strive hard to achieve a balance in that). I let them know what my style is, and I ask them what they feel their strengths/weaknesses are and work from that. There are things that, IMO, I don't need to hover for/during (like assessments....I know they know how to do one, so I'm not going to watch every little detail on every single patient). I do my own assessment on my own in between their cares, in the beginning, so that I also have a handle on the patient's status (how much I do and when I do it depends on the status of who I'm working with...obviously a student would be a bit different than an RN with some experience who is new only to the unit itself, and not the career). Rather than saying, "do this next," I'd rather ask what they plan to do. Guide from there if prioritization is an issue. Throughout the shift I will ask, have we done this (or that) yet? (I use the "we," since we're a team!). I don't confront any issues in a room with a patient, that helps NO one. Right before we go in to a room to do a procedure/give an IV med, etc, I'll ask how confident they feel and we'll talk out the steps.

I feel like when a preceptor hovers, it can also make the patient nervous. KWIM?

I at least hope that I take the right approach....I have always gotten good feedback from those I've worked with, and from the nursing instructors whose students I take on. I believe the only way to feel confident in what you do is to DO it, and when someone shows you that they have faith in you, that's the most beneficial thing towards feeling it yourself. If you feel your preceptor doesn't trust you or your skills, it can be so damaging.

I also think I've been blessed with having very good people TO precept. With some, they just make the job easy to do!

Sorry, guess I got off on a little tangent there. It's certainly something I feel very strongly about! :heartbeat

[cherrybreeze, ADN, RN]

Oh yea.........and as far as the pay/incentive to precept, I don't think I've ever remembered to even claim it, LOL! *whoops*

Precepting is generally *supposed* to be something that's "volunteered" for, but that doesn't always happen. Often times our director will decide who does what. I'm sure that person could decline, but they aren't necessarily asked beforehand. My director/team leader know that I love doing it, so asking me isn't an issue, since they know I will.