New Grad feeling like I can't do anything right!

Wuzzie · Sep 12, 2017

Nobody is asking for false reassurance, if that's what you're trying to say. The mistakes can be addressed, but if the patients did not suffer any adverse effects from said mistakes, the new nurse should be aware so she could breathe a little easier. She obviously feels bad enough with the mistakes. And likewise, if adverse effects resulted, she should be aware of them as well. I don't think I can state it any simpler.

Listen, you got all pissy when someone misunderstood you, well, pot meet kettle. Where did I say anything about providing "false reassurance"? Sometimes mistakes are made that require a healthy reality check without a follow-up head patting. Sure, you don't verbally beat someone up but you can't always say "it's okay, the patient wasn't harmed", because some mistakes can be deadly. A serious enough mistake should scare the pants off the orientee. They shouldn't "breathe easier". They need the emotional impact so they never do it again. There are plenty of nurses who are obtuse enough to think if someone tells them "the patient is fine" that the error wasn't that big of a deal. As a preceptor it IS a very fine line we walk making sure we don't put the beat down on our orientees while at the same time letting them know the gravity of the situation. I don't think I can state it any simpler.

Wuzzie · Sep 12, 2017

My preceptor has only been a nurse for 1 year and is my age. Last night I worked with a new preceptor. I felt even more like a total idiot because everything she told me to do conflicted with my training thus far. This new preceptor is very Type A and slightly abrasive but a very good ''by the book'' sort of nurse.

You're in a CVICU and your preceptor has been a nurse for a year????!!!!! It takes at least that to become competent in basic nursing. What were they thinking? No wonder you're having issues. For the next two weeks you need to be an absolute sponge. Ignore the "abrasiveness" it isn't personal. Ask questions. Ask her how she keeps track of things. And don't forget she only has two weeks to undo all the bad your previous preceptor has done. If you can, in an extremely diplomatic way, let her know that you aren't sure you were taught the correct way previously and that may make you seem unsure about things but you are ready to learn. If she is a good nurse you need her as an ally. Good luck to you.

guest52816 · Sep 12, 2017

My preceptor in CVICU had been a nurse for two years. And I was only the second person she precepted. Not unusual.

These nurses are often the most highly-skilled in the hospital. And many of them don't stick around because they use the experience as a springboard to becoming a Nurse Anesthetist.

But just because someone is skilled. doesn't mean they can, or even want to teach.

Best of luck to the OP. You will figure out what you need to do. I hope the next few weeks with the new preceptor give you new insight and skills. Please don't let this experience cause you to doubt yourself.

Follow the suggestions that folks have given you in this thread. Some good advise has been shared.

Been there,done that, ASN, RN · Sep 12, 2017

You are not being ambushed, you are being trained. A new grad in CVICU would require more than 12 weeks.

There is a problem with your orientation. You should still be 1:1 with your preceptor, who is assuring these "mistakes" are not occurring. YOU cannot make mistakes, your preceptor is responsible for patient care while you are in orientation.

Sounds like you are being given the bum's rush through a short orientation, in order to fill a staffing hole. Do NOT let them do this to you.

Wuzzie · Sep 12, 2017

You are not being ambushed, you are being trained. A new grad in CVICU would require more than 12 weeks.
There is a problem with your orientation. You should still be 1:1 with your preceptor, who is assuring these "mistakes" are not occurring. YOU cannot make mistakes, your preceptor is responsible for patient care while you are in orientation.
Sounds like you are being given the bum's rush through a short orientation, in order to fill a staffing hole. Do NOT let them do this to you.

I agree. It also sounds like her preceptor really fell short of the mark. She's 10 weeks in and these kind of mistakes should not be happening. But if she isn't getting the proper oversight it's no wonder they are.

JKL33 · Sep 12, 2017

My preceptor has only been a nurse for 1 year and is my age.

Everything, literally everything else, aside -

It is a humongous job to be a preceptor; especially when one is expected to do the role while caring for a normal patient load. Any nurse with one years' experience is not an expert in his/her area - - a motivated and information-hungry nurse with one years' experience may be well on his/her way to becoming an expert and may be functioning at an appropriately advanced-intermediate or advanced level, but I haven't yet seen where the knowledge and especially the wisdom was sufficient at 1 year to be able to be responsible for the patients and for teaching someone else what you yourself are in the process of learning at the 1-yr mark.

It may not be a popular thought but my $.02 is that this is the single overriding factor in this orientation that is being described. I'll put myself out there as one who thinks it is inappropriate. I feel sorry for the preceptor as well as the OP. I believe this unit, by definition, has a problem.

acc1223, BSN, RN · Sep 13, 2017

I'm brand new too and being oriented to a surgical, med surg and cardiovascular ICU. So I know how you feel, my preceptor told me she is expecting me to make mistakes and I have. Although, she doesn't wait until the next day to tell me. She pulls me to the side and we talk it through. Just ask her/him to change her approach so you can have hands on rectification as opposed to a purely theoretical approach (can't do much about it the day after). I can speak from experience that any mistake I've made, I've never made again because she gives me the opportunity to fix it right then and there. I feel more confident everyday and I'm sure you do too!! It only gets better!

Here.I.Stand, BSN, RN · Sep 13, 2017

Where did I say that it's not serious? Of course if the patients weren't fine she should be aware of it, but if the patients did not have any serious issues because of her mistakes, why shouldn't she be reassured that they are indeed fine? I don't understand how people on these boards just misread my post and then go on to "disagree" when it's not even what I wrote.

You never said it WAS serious either, and you did say that the mistakes weren't the issue -- the lack of support was. If the pts were fine, it was either divine intervention or dumb luck.

Now, reading that her preceptor is new as well, that does explain some things... but I stand by my assertion that these mistakes are huge and most definitely the issue -- or at least one of two issues. Med administration should be a non-issue. It's nursing school basics, and she needs to have a wakeup call. The other issue is not that the preceptor isn't supportive or reassuring, but that her preceptor is marginally competent.

ashrnbsn12 · Sep 13, 2017

You never said it WAS serious either, and you did say that the mistakes weren't the issue -- the lack of support was. If the pts were fine, it was either divine intervention or dumb luck.
Now, reading that her preceptor is new as well, that does explain some things... but I stand by my assertion that these mistakes are huge and most definitely the issue -- or at least one of two issues. Med administration should be a non-issue. It's nursing school basics, and she needs to have a wakeup call. The other issue is not that the preceptor isn't supportive or reassuring, but that her preceptor is marginally competent.

I'm sick of you both. Stop arguing and getting offended by one another. I asked for advice and you both are misreading the entire situation and contributing nothing but snide comments. For your information I KNOW the issues are SERIOUS and I know they needed to be dealt with. Why do you think I got on here in the first place? Just for kicks? No, I am legitimately concerned about my performance and was looking for ADVICE. Get off your God complexes and address the real issue. You were new and made mistakes once too. Help me figure out what the best plan of action is. I don't need the reminder that I screwed up royally. I'm already aware of those facts. I need advice.

guest52816 · Sep 13, 2017

In an earlier post, I asked OP how weekly reviews were going. If you responded, I didn't see it.

When I was a new grad in the CVICU, my orientation was to be six months. The first three months to spent working side-by-side with a preceptor. The second three months, you were essentially expected to be independent, but with back-up if necessary.

Since the learning curve is so steep for this specialty, if your hospital is only offering 12 weeks of orientation, perhaps this isn't where you should or need to be.

What are your feelings? Do you think you will be happy in this specialty?

The new grads who did well in my cohort were the ones who had previous experience with CVICU. Either they worked as CNAs there, or did a Capstone in the unit. New grads like me, with NO previous experience tended to fall by the wayside.

It was extremely stressful trying to learn how to be a new nurse, learn the ways of CVICU and do all the Global ECCOS that were required and taking classes the hospital required.

I hope you have found some useful tip and suggestions amid the in-fighting.