New Grad with bad progress report in Orientation

Backtoyou2011 · Jan 8, 2012

Before I went to nights, I did have a similar experience of having my preceptor jumping in and performing tasks for me. I think you made the right call by telling your preceptor that youd like to do more. Remember this is your orientation, don't be afraid to say how you'd like things Togo . If she jumps to do something, politely request that you would like to give it a shot. Good luck with everything!

mamiepascuala · Jan 8, 2012

I had an experience during my time as a student nurse at a local hospital with 2 different preceptors on 2 different floors. One was really odd in that she would help one particular student out whenever he had a question but if anybody else had a question she would literally yell at us to "look it up." The next preceptor told me nothing about how he felt I was doing until that last day. He lambasted me saying he didn't know why I was going into nursing. He offered no explanation. I should have asked him why but I was so stunned by this I couldn't talk. The first preceptor said I was doing fine. Because of this I was made to repeat my clinicals during another semester and pay for it all over again. I was delayed by a year in graduating. The second time around I was with only one preceptor during the whole semester. I made sure my attitude showed and acted VERY enthusiastic. I'm typically a laid back personality and wonder if this was interpreted as not interested.... Anyway, going through clinicals again, I passed with flying colors.

KSGMaine, ASN · Jan 8, 2012

Hello Everyone,
I am new grad and I am 8 weeks into my 12 week orientation in the ED. I received a progress report from the Nursing Education department yesterday that stated my preceptor does not feel I am making any progress. I was sited as "lacking initiative in Learning" and "Ineffective Time Management".
In the meeting, I felt the educators were biased. Of course, they have the preceptors words against mine. But the discrepancy lies in reality of what happens on the floor. In the first two weeks of the orientation, my preceptor told me I was doing very well and that she could see my confidence. And at the end of each week, I would meet with the educators to review and discuss the weeks events. At no time until now, was I made aware of such extreme disappointment in my work.
My preceptor is very hands on in her mentoring. She shadows me as I am handling my patients. Many times she takes initiative to do certain tasks and then to remind me of things to do. It seemed to me that this is how 'preceptorship' works. I have been assigned about 3 to 4 patients. The goal is to handle 5-7 depending on the patients acuity. My preceptor is quick. She's been doing this job for several years. I feel that she doesn't give me an opportunity to do the work when she jumps in to assist. Now, if its an emergency situation then I get it, but mundane tasks of transferring pt to the floor; giving report to the floor; other desk procedures etc I feel she could step back.
This progress report and meeting felt like a slap in the face. To say I lack initiative in my learning is like saying I am sitting there filing my nails and doing the least possible work. However, I decided to take the meeting as opportunity to improve. So, last night was my first shift since the meeting. Her behavior was the same; she's hovering and jumping in and giving me assignments with my patients; reviewing my charting. How can she judge my time management this way?
Then there is the matter of bias. We were working on Hep drip calculation. It was a simple calculation of 5840 units, how many mL do you give? One vial is 5000 units/ml, so you calculate the difference (840 / 5000 = 0.168). I said this to her she ignored me. She leaves the med room to ask another nurse, her friend, who says the same thing. She tells her friend, you're so smart! I was like okay, that was biased.
Then we had a patient brought to our zone who was unresponsive from alcohol consumption, according to her friends that brought her to the ED. Of course, this is treated like a code situation because the patient is unresponsive. My preceptor is yelling for me to get the Narcan. I get the Narcan quickly, from the Pyxis and return ready to administer the push. The docs, the charge, another RN (who is starting a line are at the bedside). My preceptor says get the nebulizer mask because we are going to give the Narcan via nebulizer. I go get the nebulizer, my preceptor comes running after me to move fast. One of Dr. tells her Narcan is not given by nebulizer, which I questioned myself but wouldn't dare bring that up in front of these doctors. Then my preceptor tells me to do a fingerstick. I get the machine and then the other Dr. takes it from me. My preceptor then says get the portable cardiac monitor and a urine cup and pregnancy test. I go to get them. She runs after me and gets the cardiac monitor. The charge returns with a foley kit and then my preceptor says help with holding the patients legs in position for the foley insertion. I could have easily inserted the foley, but she didn't give me the opportunity. I feel as though she is trying to make herself look good at my expense. This progress report proved it and last night sealed it.
Needless to say, my blood was boiling by the end of the shift and I told her going forward I would like for her to allow me to handle everything with my patients.
My question is has anyone had a similar experience and if so, how did you handle it? Am I correct in my approaching her? I feel like I'm being sabotaged.
Thanks for the replies.

I too am a new grad and orienting to a neuro floor - I have had several preceptors and several who have done the same exact thing of jumping in and doing things. Most recently just the other night - with two of them I said I realize you are trying to help me and I appreciate it, however, I am not learning it if you do it for me and I really need to learn it! There was another nurse who did the same, but since I was only with her that day I didn't say anything. I also went to my unit educator and told her that I wasn't sure if one of my preceptors was a good fit, and I told that preceptor the same thing. Maybe you can do the same. I have come to realize that I need to be an advocate for myself and I am going to ask for what I need. I know it's hard being a new nurse and all but you really need to stand up for yourself and what you need. For me, I decided this and said, you know I'm 47 years old, have been around the block, had a successful career and decided to pursue a new one in nursing and I will not LET someone else ruin my dream, I have worked hard to get here!! There are plenty of nurses who are willing to help. Good luck to you.

doodledee · Jan 10, 2012

coolnurse42-

I'm sorry you have to go through this frustration - I am a new grad too and in a fairly similar situation (almost done with a 12 week orientation unless it gets extended, and have a preceptor that doesn't want to let me do much). It sounds like you are far ahead of where a lot of new grads (including myself) are, and I think you were right to tell her you want to take charge more often. Good luck with the rest of your orientation.

coolnurse42 · Jan 10, 2012

Thanks so much for the encouragement! I really need it!

Just to keep you up-to-date! Last night was my first do-it-myself shift! Well, she interfered a little bit, however, we met at the end of the shift in the conference room outside the educator's office. Of course, the educator was in the office with his door open.

She proceeded to tell me that although I had 5 pts last night, I STILL did not manage my time well. My preceptor proceeded to sight situations with patients that were out of chronological order! She deliberately left out facts about where she interfered and decided to have teaching moments and add tasks that slowed down my process. I really feel sabotaged.

So, I listened and interjected when appropriate, but it is clear she is doing this on purpose. I decided to tolerate the rest of the meeting. She ended the meeting by saying, 'I feel like with you, we take two steps forward and then we go two steps backwards'. Ugh! As I left the conference room, she immediately went into the educators office. I arrived back home about 30 minutes ago and I called the Nurse educator and asked to meet with him before the end-of-the-week, as originally scheduled. He agreed to meet with me tomorrow morning. I will give my side of this madness and hopefully, get assigned a new preceptor.

I feel as though I have been schooled big time! Nurses do eat their young and I've been my preceptor's meal!

shoegalRN, RN · Jan 11, 2012

Something similar happened to me when I was a new grad in the ICU.

I had SEVERAL preceptors and I felt I was being set up for failure. I had one main one, who would not let me do ANYTHING on my own. Then she would go to the educator and tell her "she needs help with time management", when the fact was I was never given the chance to do anything on my own. I tried to talk to her about it, and the very next shift she practically sat back and let me drown since I can "do it all on my own now".

I left the ICU with only one more week to go in my orientation. There was no way I was gonna be successful there after that so called orientation.

Is it possible you can request another meeting with yourself, the preceptor and the educator and let them know it's just not a good fit? Maybe say something along the lines of "your teaching method and my learning method are just not compatible". Then give examples of you being a hands on person and how your preceptor tends to hover over you, and won't give you the chance to prove yourself.

Also give examples of how she responded in that emergency and how she delegated certain tasks to you but never gave you the opportunity to learn, nor do them.

Good luck!

Morainey, BSN, RN · Jan 12, 2012

Yikes! I was scared when you told her you would like her to allow you to handle everything with your parents, you'd get thrown to the wolves. I hope your meeting went well :)

RNHURT · Jan 15, 2012

Hi coolnurse42

the biggest problem these days with preceptorship is that the preceptors are assigned to new grads based on their skills level or quick service on floor but mentoring needs motivational skills to motivate and encourage new grads to succeed. Most of these mentors forget that they also started from somewhere new. Be calm and document all the good things you do on floor. Like you intelligent assessments which many night nurses missed, your customer service, your compassion and your hunger to learn more. time mgmt can be learned by practice and guidance. it all depends if preceptor really wants the new grad to succeed or not.

NevadaFighter, BSN, RN · Jan 19, 2012

How did your meeting go?!?!

KSGMaine, ASN · Jan 22, 2012

This past week I was in week 8 of my orientation - technically my last week! I had a new preceptor, I have had many over my orientation, which is hard because they don't know you, you don't know them, etc. So the first night of my 3 - 12's this individual ran circles around me, if I was with a patient she'd come in and tell me what I needed to do next, how I should be priortizing, etc., it was a bit overwhelming and then to top it off everytime I would hang something, the pump would beep, beep, beep. Made it through the night but was very frustrated with her "style" of teaching. Next night, same patients, same thing, rushing me, etc., she said "well this is how nights are, and you need to do it!" I was like, well I'm only one person, can only do one thing a time and having someone constantly at me, isn't helping me! She kinda backed off and let me do my thing...pumps were still an issue and I ended up having a melt down (crying, first time!)I think I was tired and just frustrated. Night three, I had the same patients with the exception of one new one who had a vp shunt - anyway, I'm in with one pt. and here she comes, trying to tell me what we need to do for this women with the shunt - I said - can we discuss that when I am done here! Later we get someone with a rash and we have to call about the women with the shunt - she asks me, who is priority here, the women with the rash or the shunt - I was like, duh - the shunt!! I should have said, geez let me think about this.....there were other issues on night two as well, she would help one of the patients to the commode, but not hook them back up to iv fluids, etc., felt like I was being set up the whole time....I'm on my own starting this week - I'm scared to death, but as my unit educator said to me, go slow, keep pt. safety in mind, and ask for help!

I hope your meeting went well and you have a new preceptor - it definetly is a learning curve - hang in there and as I stated before don't be afraid to say what you need - it's your career, your license, etc.

nurseprnRN, BSN, RN · Jan 23, 2012

not to be a wet blanket on this little pity party here, but has it occurred to you that those mean and nasty preceptors and nurse educators know the floor, know the floor needs more staff, it's their job to train and evaluate, that's why they are dealing c new grads, they have seen a lot of new grads and just maybe, compared to most of them, you are exactly what they say you are?

i strongly recommend, with all charity, that you put your entitlement/specialness aside and pay attention to what they're telling you. if they say you are not managing your time and priorities well enough by now, realize that they've seen new orientees enough to have a decent comparative data set, and you probably aren't. if someone else always has to jump in and do things, it's because they need to be done for the sake of patient care, not because some meany has a hidden agenda to sabotage you. it really is not all about you.