My preceptor is writing her novel during my orientation... at WORK!

[CS1234]

.... you read that correctly.

i recently transferred to the icus after three years med-surgical experience. i have been on orientation for approximately a month now and the precptor i have is absolutely experienced in icu nursing after spending 20+ years in a trauma i level hopsital. while the hopsital in which i work is definately not that acute, we still have critically ill patients.

this weekend i worked three twelves with the same patients all three days. these patients were assigned by my preceptor (who also doubled as the charge nurse all weekend long). these two patients were what we call "pcu status" patients, meaning, they should be in pcu, but pcu is full. so, these two patients are in the icu. pretty much glorified medical surgical patients with nothing acute...no ventilators, no titration of drips, no arterial lines, swans, no "get-the-crash-cart-ready" etc. these cases were nothing that i have not received in medical surgical nursing.

my preceptor, checked e-mail, texted, and worked on her novel all weekend long. she checks in with me occasionally and asks if everything is "okay", which is nice of her....

i have asked her for higher acuity patients in the past, and expressed that i am afraid to come off of orientation not having but one vent patient etc. instead i get pcu status patients. and when i ask "what happens if i am not ready at the end of orinetation to come off" she replies, "you'll just be on it longer". not acceptable! i hope she is joking, but i overhear her making jokes to her coworkers "im not doing anything, [this writer] is here, she's doing the work". she obviously feels that i am more then capable to handle these pcu patients or else she wouldnt leave me alone with them for hours upon hours while she is in another area of the unit working on her novel. she even told me on saturday that she was going to sit by c (our team mate) because her patient was looking pretty critical and she thought c would need some help. she stranded me on my orientation and went to assist with the critical patient that i should have!!!!!!! arg!

i feel as though i am given the easiest assignment on the floor so that she doesnt have to do work/teach me. and thats not fair to me. i have a lot to learn about icu nursing.

so here are my questions... i have already adressed with her that i want the hardest patient and the first admission every day and i continue to get non-acute, non vented, non titrating drip etc patients. should i reiterate that before i go to our nurse manager? should i request a new preceptor?

what is interesting is that on the med-surg floor that i came from, i was a preceptor. and i would never give my orientee an easy patient to get out of having to do work. but do i want to make a cannon-ball splash in my new department by demanding a good preceptorship? do i allow my orientation experience to suffer and keep quiet?

[tothepointeLVN, LVN]

It sounds like she trusts your experience but would be there in a heartbeat if you needed back up like your teammate C.

I would try and tap into her experience. If your not getting the critical patients you want grill her about what to do if you did.

[sleepysnr]

I had somewhat of a similar experience. Talk to the nurse educator or your nursing supervisor and tell her nicely that you feel you arent getting a rounded experience in your orientation. If you dont get the training you need, patient safety is a risk.

[klone, MSN, RN]

Is she always charge when you work? If not, next time there's a different charge, can you request the more challenging patients?

[Ruby Vee, BSN]

while i cannot defend your preceptor writing her novel and work -- and wouldn't dream of trying -- i'm not so sure that your orientation is suffering. you need to be competent to handle the more stable patients -- not just to do the tasks but to understand what's going on and do some critical thinking, too -- before you move on to the complicated patients. it sounds like you're getting there. but i wouldn't dream of giving the sickest patient to an orientee who hadn't proven herself with the more stable patients and didn't understand the tasks and concepts involved.

everyone wants the hardest patient with the most drips every day; everyone wants to admit. we cannot all do it every day. if there are other orientees, their needs may supersede yours, especially if they're nearly ready to come off orientation. perhaps your preceptor is trying to teach teamwork -- she's hanging out by c's room to help out if needed, but she trusts you to handle your patients. i suspect she's reading your charting and keeping track of what you're up to. c may be a newer nurse who needs some mentoring because she's just starting to take difficult patients on her own. her needs may supersede yours.

newer nurses often seem to think it's all about them and their orientation. you've precepted in the past; you know that it's not all about you. it's about the patient, the needs of the unit and the needs of other newer nurses or orientees as well. i'd advise against going to complain to your nurse manager or requesting a new preceptor. if you did that on my unit, my manager would just tell you that part of learning to function in the icu is learning to get along with your co-workers and to work with folks whose style is very different from yours. you have to learn to take excellent care of the stable patients before you're given a chance with the sickest. you have to walk before you can run. and then she'd make a note to watch you more carefully in the future to determine if you're really going to fit in . . . or not.

[DeLana_RN, BSN, RN]

Hi,

I once had a similar orientation in a stepdown unit - preceptor texting, doing personal stuff on the computer and/or totally ignoring me, while at best asking "Is everything all right?" (and expecting "Yes" for an answer). This resulted in (a) my orientation being extended and (b) my getting thrown under the bus for not having learned what I should have. My fault was not speaking out and demanding to get the orientation that I really knew I needed.... a very hard lesson to learn.

You have been in orientation for a month now, and have 3 years of med/surg experience - there is no reason while you need more exposure to stepdown pts (which are, basically, somewhat more challenging med/surg pts). But you do need to learn all you can about the highest acuity ICU pts!!!! Believe me, they will not hesitate to throw you under the bus if you're not ready after your orientation.

The time to go to your manager is now; I doubt your "preceptor" is getting it, and it seems that she's enjoying the break she's getting from doing her job while you're being cheated out of your orientation. Be factual and diplomatic about it (without mentioning the novel etc., of course) and say something like your learning style and her teaching just don't match well (or something neutral like that).

I wish you the best of luck,

DeLana

[klone, MSN, RN]

but i wouldn't dream of giving the sickest patient to an orientee who hadn't proven herself with the more stable patients and didn't understand the tasks and concepts involved.

really? she's been a m/s nurse for three years, and been in the unit for a month now. i don't think she's asking for "the sickest" patients, but rather, just some experience with something a little more challenging. her preceptor has already said that if she's not ready, they will have to extend her orientation. well, she's never going to be ready unless they give her more challenges and at least allow her to have one pt that's on a vent or a drip or whatever the higher acuity pts in icu are doing (sorry, it's not my area). i think at least one higher acuity pt along with a more stable m/s pt isn't too much to ask. after all, she's supposed to be working with the preceptor, so it's not like she's all alone.

[DeLana_RN, BSN, RN]

Really? She's been a M/S nurse for three years, and been in the unit for a month now. I don't think she's asking for "the sickest" patients, but rather, just some experience with something a little more challenging. Her preceptor has already said that if she's not ready, they will have to extend her orientation. Well, she's never going to BE ready unless they give her more challenges and at least allow her to have ONE pt that's on a vent or a drip or whatever the higher acuity pts in ICU are doing (sorry, it's not my area). I think at least ONE higher acuity pt along with a more stable M/S pt isn't too much to ask. After all, she's supposed to be working WITH the preceptor, so it's not like she's all alone.

I agree, and just wanted to add that it's rarely a good thing to have one's orientation extended (usually, it's a sign that it's time to update one's resume).

DeLana

[SummerGarden, BSN, MSN, RN]

why is it that in nursing we do not treat those on orientation with respect???? doctors are treated like doctors when on orientation and so are pas. nurses on orientation are treated like unlicensed lay people. the point of orientation, as others have pointed out, is to train. a nurse with three years med surg experience in an icu setting should be given low acuity patients the first week or two (new grads should get a longer time for obvious reasons). after that, all patients should be high acuity so that he/she learns how to care for such patients off of orientation. otherwise, orientation is a waste of time imo.

[klone, MSN, RN]

I also think that if this preceptor was not busy writing a novel or texting or checking email, they could (TOGETHER) probably handle TWO high-acuity patients, and the OP would probably be learning a lot more, a lot faster than she is.

The point of orientation and having a preceptor is to do it together, and to challenge the nurse to learn new things, is it not?

[CrufflerJJ, BSN, RN, EMT-P]

... everyone wants to admit.

ummm...we do?

[nurse2033, MSN, RN]

If you have been a preceptor you know she is short changing you. She sounds like she is not engaged in her responsibilities and it stealing the hospital blind for her time. I would try to get another preceptor. Once you are cleared and have a track record it might be a good time to pass along your input to management. By then you should have the pulse of the unit and know if that would do any good or not. I've worked places where management is clearly aware of how low the performance bar is, and doesn't care. Unfortunately it seems that a well run unit is hard to find. Get your experience, learn as best you can, and you will have the option to stay or shop around. Good luck.