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

[Keepstanding, ASN, 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

you sound like a wonderful nurse ! thank you !

praiser :heartbeat

[glasgow3]

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.

And your authoratative source for administering Novolog insulin in this manner (as opposed to 5-10 minutes BEFORE the meal) may be found where?

[nurseeB]

CABG patch kid, I hope your new preceptor is working out better for you.

As for being asked to precept, I've never been asked. It's always been assumed that I would agree to precept. To tell you the truth, I loved every minute of it. I've heard it said that if you want to learn something, teach it. I've learned something every time I've precepted either because the preceptee asked a question I didn't already know the answer to and therefore had to look it up or they learned a different way to do something in school or at another facility. It was also refreshing to be around someone who wasn't bitter or burned out. :flowersfo