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New Grad, anxiety and possible issues with preceptor

Nurses   (601 Views | 8 Replies)

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Hi,

I'm at the tail end of my new grad orientation into a specialty unit.  I've already had it extended because I wasn't ready to be on my own.  I have had both good and bad shifts, like anyone else.  I'm beginning to feel that my preceptor has been impatient with me.  I can feel anxiety from her... does that make any sense?  When I feel her tense, I get nervous and I end up messing up.  I thought that I was improving, I have begun implementing plans to remedy my major mistakes.  I was pulled in by my director and she went over my evaluation.  It wasn't a very good evaluation.  All I heard was the negative, and nothing positive.....  and the issues that were addressed, I had already begun to implement plans.  I know I made mistakes.  I owned up to them.  Based on this evaluation, if I don't improve in the next 4 shifts, they will let me go.  I have been grateful to get this job, and it has been tough to find a job.  I love the patients, but I don't feel comfortable with my coworkers since they are so tight-knit.  I also work night shift, so it has been a tough adjustment for me to retain information as well.  I have modified a good brain sheet that will work for me, and I'm constantly modifying it.  I don't want to say bad things about my preceptor because I do have to work with her even after I'm off orientation (if I survive that).  I have told my Educator that I'm having issues adjusting to night shift and she replied, "Well, this was the position you applied for."  With that said, I'm keeping my lips sealed.  Everyone says they are helpful, but I don't quite feel that vibe.  Maybe it's me?  I am considering asking my preceptor if I'm doing anything right since all I have heard from her are my mistakes.  I also conveyed that to my Educator and she was quiet.  I think she had to think about what I had just said as well.  

I do have an alternate preceptor, and I work better with her. Unfortunately, she will be off for the next 4 shifts that I will be on.  I am considering asking her for her feedback as well.  In another way, I fear that it will turn out negative.....  Like I mentioned before, I don't want to cause any rifts or waves with anyone.... I can't ask for another preceptor since they said they have been "nice" enough to extend my orientation.  Any other suggestions?  

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Sour Lemon has 9 years experience.

3 Followers; 4,507 Posts; 33,770 Profile Views

1 hour ago, clamchopz said:

Hi,

I'm at the tail end of my new grad orientation into a specialty unit.  I've already had it extended because I wasn't ready to be on my own.  I have had both good and bad shifts, like anyone else.  I'm beginning to feel that my preceptor has been impatient with me.  I can feel anxiety from her... does that make any sense?  When I feel her tense, I get nervous and I end up messing up.  I thought that I was improving, I have begun implementing plans to remedy my major mistakes.  I was pulled in by my director and she went over my evaluation.  It wasn't a very good evaluation.  All I heard was the negative, and nothing positive.....  and the issues that were addressed, I had already begun to implement plans.  I know I made mistakes.  I owned up to them.  Based on this evaluation, if I don't improve in the next 4 shifts, they will let me go.  I have been grateful to get this job, and it has been tough to find a job.  I love the patients, but I don't feel comfortable with my coworkers since they are so tight-knit.  I also work night shift, so it has been a tough adjustment for me to retain information as well.  I have modified a good brain sheet that will work for me, and I'm constantly modifying it.  I don't want to say bad things about my preceptor because I do have to work with her even after I'm off orientation (if I survive that).  I have told my Educator that I'm having issues adjusting to night shift and she replied, "Well, this was the position you applied for."  With that said, I'm keeping my lips sealed.  Everyone says they are helpful, but I don't quite feel that vibe.  Maybe it's me?  I am considering asking my preceptor if I'm doing anything right since all I have heard from her are my mistakes.  I also conveyed that to my Educator and she was quiet.  I think she had to think about what I had just said as well.  

I do have an alternate preceptor, and I work better with her. Unfortunately, she will be off for the next 4 shifts that I will be on.  I am considering asking her for her feedback as well.  In another way, I fear that it will turn out negative.....  Like I mentioned before, I don't want to cause any rifts or waves with anyone.... I can't ask for another preceptor since they said they have been "nice" enough to extend my orientation.  Any other suggestions?  

It's difficult to judge these types of situations without actually observing them and without knowing what the "major mistakes" are, but the best I can advise is:

- Don't talk "bad" about anyone to anyone. This includes the educator.

- Don't be passive aggressive. "I am considering asking my preceptor if I'm doing anything right since all I have heard from her are my mistakes. " BAD IDEA.

- Don't complain about things that cannot be changed or fixed (like working nights), because that may give the impression that your problems cannot be solved.

- Try to make your preceptor feel invested by giving honest and positive feedback about the things that have helped you.  "Thank you for showing me xyz this morning. It's really helped me stay caught up today."

- Be positive with a "we are going to do this" type of attitude. They need to feel that you're invested, and you have nothing to lose at this point anyway.

 

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Nurse Beth has 30 years experience as a MSN and specializes in Med Surg, Tele, ICU, Ortho.

19 Followers; 115 Articles; 2,170 Posts; 238,270 Profile Views

The only thing that will save you here is an actionable and measurable performance plan. Something  like " in the next 4 shifts you will pass meds on time, etc."

You can ask for one if you didn't receive one. "I'd like to know exactly what it would look like to improve my performance so I can meet expectations"

 Best wishes

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Hi, 

I'm glad you shared this post. I'm in almost the exact same spot as you, and it's nice, but, unfortunate, to hear that there are others going through this as well. My orientation for a critical care unit is over in about two weeks. I've had issues with a preceptor in the past that had anger issues, would yell, chastise, mock, and was even make racial comments. And my other one is a nervous wreck. She gets stressed over talking to doctors, calls them for every minute thing, which I can let go, because I get it protect your license, is in-general all over the place, overexplains the simplest of concepts but can't explain things I actual need clarification on, and runs around like a chicken with her head cut off, which gives me anxiety when I rarely feel like the situation warrants it. I, too, make silly mistakes because I'm too busy listening to what is stressing her out, when that should be a therapist's job. I feel like they expect perfection, perfect charting, perfect time management, etctera right off the bat. They say they don't but their actions dictate otherwise. When I ask our educator how we're doing, the response is oh you're doing fine. The feedback is never anything concrete. I don't even bother asking the preceptor for feedback anymore because it's always about the most minute things that will come with time. I am naturally prone to be a stressed person, so I found out early on that asking her for feedback would only increase my stress because I know the things she will say are things that will come with time, example time management. The funny thing is I'm never far behind with my charting, only by an hour, and she still panics. Have we ever, ever gotten out late? Nope. 

I'm sorry you're struggling with night-shift. I personally don't even get much sleep before shifts anymore, something I'm just accepting. My anxiety level is continually high, and I just dread going into work so it makes things tough. I did express my dissatisfaction with my level of patient interaction and my manager asked if I thought day shift would help so at least they were kind enough to offer that. 

I agree with your sentiment, "everyone says they are helpful but I don't quite feel the vibe." I have been saying this for months. People will peak into the room to ask if we need help continually, which I guess I should be grateful for, but for some reason, it feels like if I accept that help, they'll turn around and stab me in the back. It's like someone offering to help you, but you see in their face that they truly don't want to. It's like your mouth is saying yes, but your face is screaming no. It's very confusing when you're new and don't know who to trust. 

Just know you're not alone in how you're feeling and be careful who you trust on the unit. One of my good preceptors told me that, and as off-putting as it was to hear that, I know she's right. And I know she senses the same vibe as me, even having been there for years she says there are only about 1 or 2 people she trusts and that it's very clicky. And ask them to write down concrete skills that you need to improve on in order to succeed. 

I hope it gets better for us both, keep us updated! 

Edited by cl549

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14 Followers; 4,220 Posts; 32,924 Profile Views

7 hours ago, clamchopz said:

I was pulled in by my director and she went over my evaluation.  It wasn't a very good evaluation.  All I heard was the negative, and nothing positive.....  and the issues that were addressed, I had already begun to implement plans.  I know I made mistakes.  I owned up to them.  Based on this evaluation, if I don't improve in the next 4 shifts, they will let me go. 

Two different things, here: 1) Don't give up. Conduct yourself professionally, put forth your very best efforts. Be pleasant/kind even if it isn't particularly deserved. 2) We would be remiss not to advise you to be prepared. You need to decide whether it would be better for you to resign in upcoming days. They have told you they plan to let you go unless you can improve everything they have critiqued, which also/inherently involves making them see your performance in a completely different light (I.e. improving your practice and changing opinions they have already formed) within the next week.

I am sorry you have not had a good experience. Salvage what you can; try not to burn bridges. Is there any chance your manager might believe your strengths could be used in a different area of the company (would s/he help facilitate a transfer) if you aren't doing well in this specialty? Consider these and other alternatives (right away). Unfortunately it is too late at this juncture for worrying about interpersonal dynamics that may have affected your orientation or anything else.

Best of luck to you ~

 

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18 Posts; 169 Profile Views

Thank you for all for your advice and words of encouragement.  No, I'm not going to give up yet.  I do have a performance plan and I will verbally say it out loud with my preceptor.  I will thank her at the end of each shift.  A friend of mine read the evaluation and can see why I'm feeling the way that I do.  I'm definitely going to do everything I need to do to keep this job.  I will keep to myself as much as possible.  I will not confront and ask other coworkers for feedback. 

Unfortunately, my director did not offer to transfer me to another unit.... I am thinking that this unit may not be a good fit for me.  First, I need to keep this job.  After some time and experience, and another position pops up that will be more suitable, I will see if a transfer would be possible.  First things first, I need to keep my job and be a safe nurse.  

After I complete this orientation, I will have an opportunity to evaluate my preceptor in return.  If anyone asks why I didn't speak up sooner, I will say that I didn't want to "rock the boat."  I came to the unit to be a nurse.  I can take constructive criticism, but I will not be constantly belittled or contradicted.  Unfortunately, my preceptor's anxiety of my mistakes made me more nervous.  I will not focus on petty little things.  We all have to work and deal with each other.  I will make the best out of the situation.   Thanks again and I will keep you updated after 4 shifts.  Please pray for me....

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Update.  I tried my best.  I did not make the same mistakes such as not getting a witness when wasting a narcotic and not being able to re-assess a patient within an hour.  However, I was still behind on my documentation, and was asking for a lot of help.  It did not satisfy my preceptor and I was written up.  My director did not give me 4 shifts as she said.  After the third shift, my educator and preceptor pulled me aside AFTER I had already clocked out and pretty much told me that I wasn't progressing in the direction they had wanted.  For example, I came in to give scheduled medication to my patient.  When I walked in, he was in pain.  I had to pre-medicate him with Benadryl before giving his scheduled antibiotic.  As part of my remediation, they said I needed to give my scheduled medications ON TIME.  I decided to give him his scheduled medication first, then go get his PRN pain narcotic while that is running on his IV.  I chose to do it that way because it would take me more time to put everything down and go get his PRN narcotic, find a witness to waste, etc.  But I guess that wasn't the "right" thing to do and my director decided to call me to go with her to HR.  

According to my director, she said this meeting will "help" me.  I have worked at this hospital in a different position long enough to know that you NEVER go to HR with a supervisor without a union rep.  I called my union and explained what was happening.  They were able to get someone to come with me to meeting.  I presented to my union the documentations and the scenarios.  She understood that I was struggling like any other new grad.  She said they were being too "nit-picky."  

When we arrived to the meeting, HR would not allow my union rep in with me. BIG RED FLAG.  My union rep got on the phone and listed some rules and regulations that I had every right to have representation with me since it's "2 against 1."  After some going and forth, they allowed my union rep to attend this meeting with me, but she was not "allowed to talk."  During this meeting, my union rep can see why I felt the way that I did, and the mistakes that I had made did not harm a patient.  They were honest new grad mistakes.  My preceptor may be a great nurse, but not all nurses are good preceptors.  She concluded that if I didn't bring representation with me, they would have torn me to shreds.  

This department had already decided my fate.  They were trying to get rid of me and set me up for failure.  My union rep even saw that. I didn't have to tell her much.  She could tell based on this meeting and the evaluations. As a result, I have been suspended without pay.  They are "investigating" my performance and will let me know.  

I have asked the union to see if they can transfer me to a different department since there is too much animosity.  Is this a form of "linear violence?"  Regardless, I feel that I should start applying elsewhere.  Any thoughts or advice?  Should I even mention this nursing job in my resume and interviews?

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DextersDisciple has 7 years experience as a BSN, RN.

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7 minutes ago, clamchopz said:

Update.  I tried my best.  I did not make the same mistakes such as not getting a witness when wasting a narcotic and not being able to re-assess a patient within an hour.  However, I was still behind on my documentation, and was asking for a lot of help.  It did not satisfy my preceptor and I was written up.  My director did not give me 4 shifts as she said.  After the third shift, my educator and preceptor pulled me aside AFTER I had already clocked out and pretty much told me that I wasn't progressing in the direction they had wanted.  For example, I came in to give scheduled medication to my patient.  When I walked in, he was in pain.  I had to pre-medicate him with Benadryl before giving his scheduled antibiotic.  As part of my remediation, they said I needed to give my scheduled medications ON TIME.  I decided to give him his scheduled medication first, then go get his PRN pain narcotic while that is running on his IV.  I chose to do it that way because it would take me more time to put everything down and go get his PRN narcotic, find a witness to waste, etc.  But I guess that wasn't the "right" thing to do and my director decided to call me to go with her to HR.  

According to my director, she said this meeting will "help" me.  I have worked at this hospital in a different position long enough to know that you NEVER go to HR with a supervisor without a union rep.  I called my union and explained what was happening.  They were able to get someone to come with me to meeting.  I presented to my union the documentations and the scenarios.  She understood that I was struggling like any other new grad.  She said they were being too "nit-picky."  

When we arrived to the meeting, HR would not allow my union rep in with me. BIG RED FLAG.  My union rep got on the phone and listed some rules and regulations that I had every right to have representation with me since it's "2 against 1."  After some going and forth, they allowed my union rep to attend this meeting with me, but she was not "allowed to talk."  During this meeting, my union rep can see why I felt the way that I did, and the mistakes that I had made did not harm a patient.  They were honest new grad mistakes.  My preceptor may be a great nurse, but not all nurses are good preceptors.  She concluded that if I didn't bring representation with me, they would have torn me to shreds.  

This department had already decided my fate.  They were trying to get rid of me and set me up for failure.  My union rep even saw that. I didn't have to tell her much.  She could tell based on this meeting and the evaluations. As a result, I have been suspended without pay.  They are "investigating" my performance and will let me know.  

I have asked the union to see if they can transfer me to a different department since there is too much animosity.  Is this a form of "linear violence?"  Regardless, I feel that I should start applying elsewhere.  Any thoughts or advice?  Should I even mention this nursing job in my resume and interviews?

I would secure new employment elsewhere ASAP. This is going to continue to be a never ending nightmare. Good job getting a rep. So sorry you’ve had such an awful experience.

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Sour Lemon has 9 years experience.

3 Followers; 4,507 Posts; 33,770 Profile Views

2 hours ago, clamchopz said:

Update.  I tried my best.  I did not make the same mistakes such as not getting a witness when wasting a narcotic and not being able to re-assess a patient within an hour.  However, I was still behind on my documentation, and was asking for a lot of help.  It did not satisfy my preceptor and I was written up.  My director did not give me 4 shifts as she said.  After the third shift, my educator and preceptor pulled me aside AFTER I had already clocked out and pretty much told me that I wasn't progressing in the direction they had wanted.  For example, I came in to give scheduled medication to my patient.  When I walked in, he was in pain.  I had to pre-medicate him with Benadryl before giving his scheduled antibiotic.  As part of my remediation, they said I needed to give my scheduled medications ON TIME.  I decided to give him his scheduled medication first, then go get his PRN pain narcotic while that is running on his IV.  I chose to do it that way because it would take me more time to put everything down and go get his PRN narcotic, find a witness to waste, etc.  But I guess that wasn't the "right" thing to do and my director decided to call me to go with her to HR.  

According to my director, she said this meeting will "help" me.  I have worked at this hospital in a different position long enough to know that you NEVER go to HR with a supervisor without a union rep.  I called my union and explained what was happening.  They were able to get someone to come with me to meeting.  I presented to my union the documentations and the scenarios.  She understood that I was struggling like any other new grad.  She said they were being too "nit-picky."  

When we arrived to the meeting, HR would not allow my union rep in with me. BIG RED FLAG.  My union rep got on the phone and listed some rules and regulations that I had every right to have representation with me since it's "2 against 1."  After some going and forth, they allowed my union rep to attend this meeting with me, but she was not "allowed to talk."  During this meeting, my union rep can see why I felt the way that I did, and the mistakes that I had made did not harm a patient.  They were honest new grad mistakes.  My preceptor may be a great nurse, but not all nurses are good preceptors.  She concluded that if I didn't bring representation with me, they would have torn me to shreds.  

This department had already decided my fate.  They were trying to get rid of me and set me up for failure.  My union rep even saw that. I didn't have to tell her much.  She could tell based on this meeting and the evaluations. As a result, I have been suspended without pay.  They are "investigating" my performance and will let me know.  

I have asked the union to see if they can transfer me to a different department since there is too much animosity.  Is this a form of "linear violence?"  Regardless, I feel that I should start applying elsewhere.  Any thoughts or advice?  Should I even mention this nursing job in my resume and interviews?

First off, I'm sorry things didn't go well. You should definitely start looking for a new job. I would be honest on any job application about having had a job, but don't volunteer too much information, and DO NOT throw around phrases like "linear violence". It's just a job that didn't work out.

A lot of new grads get off to a bumpy start, but I think at least some of your problem may be the way you relate to your coworkers. Keep in mind that people are much more tolerant when they like you on a personal level. At the next place, don't speak a negative word about anyone to anyone and be mindful of your expressions and body language.

Best wishes. Things will be rough for a while, but plenty of people manage to overcome bad first experiences and excel. You will be one of them.

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