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.
hmmm.....maybe so, but most of my preceptors are fairly new themselves. Believe me I have no entitlement/specialness issues, being this is my second career, I have been around the block a time or two. Thanks for the insight though!
my comments were directed at the op. i ought to have made that plainer, sorry; but they may be taken to heart by anyone in her mindset. or not. thanks for the feedback!
Let me say I have no sense of entitlement or specialness issues!!! I specifically said that I was taking the progress report as an opportunity to improve. But what I will never do, is dismiss unprofessional behavior.
At any rate, the meeting went well. I thought long and hard about what had been said and how frustrated I was feeling. I discussed my options to transfer to another floor. As of today, I have a meeting scheduled with the nurse manager on a Med-Surg floor. The ED educators and the hospital nursing department were in agreement and helpful with finding the MED-Surg position. We are parting ways in a professional manner and my creditability intact. I thanked the ED educators for the opportunity.
As for the last two weeks, I was only given a different preceptor for one day. She was excellent. Very patient and allowed me to do my job with little interference. There was no tension whatsoever. The last few nights I have had the primary preceptor. And it was business as usual. She was impatient and condescending. I ignored it and tried to kill her with kindness. I picked up the pace in handling my patients. In last meeting, she cited an intubation patient in the Resus room has not neat. I was the transcriber and I ran into the room as the pt was coming in from EMT. I used the piece of paper in my pocket, a half-sheet, and just worked it out as best I could. So, it was a lesson learned. But the way she talked about my notes you would have thought I killed a patient.
This experience has been a learning lesson. ED is a challenging environment. But I still say my preceptor did not do much to instill confidence or encourage a learning environment. That is what I feel could have made a significant difference, there was alot of unnecessary tension.
The Med-Surg position was offered to someone else. Now, I am confused. What is my employment status? Doesn't the hospital now have to deem me LAID OFF, since I have no department? I have sent a message to my HR representative.
Can anyone please advise what to do? Has anyone been through a situation like this? I have to take care of my life and its been two weeks without working. During this time, I started looking for work elsewhere.
OP - I am so sorry that you have such a difficult time getting your career off the starting blocks. Full disclosure:I have been a clinical educator for a hundred years in critical care & ED. I know that it can't fix what has happened, but the "I-am-such-an- expert-supernurse" is an archetype that is found pretty often in specialty care areas. They feed their own egos by continually belittling and demeaning the skills & knowledge of their colleagues. I call them "anti-preceptors". In my opinion, they should NEVER be allowed to come into contact with any new staff, particularly new grads.
First, meet with your HR folks and get them to agree to provide a positive or neutral reference for any future employers. You can subtly hint that if you are unable to secure a job within a reasonable time you may be forced to take actions re: "hostile workplace" or "unfair termination".
When you start your next job, make sure you are absolutely clear on the orientation/competency expectations, including the specific criteria that must be met. Ask for regularly scheduled feedback sessions with the people who are evaluating your progress. If any deficits are noted, ask them to outline the steps/plan to correct them. As each goal/expectation is met, make sure you are "checked off". Take advantage of every developmental opportunity that comes around - even if you have to do it on your own time. Maintaining a focus on the objective requirements for successful orientation can help you decrease the impact of subjective (personality) judgement.
Best of luck to you. A few years from now, this may just be a dim unpleasant memory... but I hope it has a positive effect on your interactions with new staff when it's your turn to be a preceptor.
Thanks for the reply. This will have a positive effect on my interactions with new staff when it's my turn to be a preceptor.
I would never treat anyone in this manner.
Another question for you....you stated
First, meet with your HR folks and get them to agree to provide a positive or neutral reference for any future employers. You can subtly hint that if you are unable to secure a job within a reasonable time you may be forced to take actions re: "hostile workplace" or "unfair termination".
I received a reply from HR and they are saying they can get me an interview when a position becomes available. How long is a reasonable time? I'm assuming I need to seek legal advice about my state's employment laws and the statute of limitations.
KSGMaine, ASN
31 Posts
hmmm.....maybe so, but most of my preceptors are fairly new themselves. Believe me I have no entitlement/specialness issues, being this is my second career, I have been around the block a time or two. Thanks for the insight though!