New Grad Feeling Unsupported

[Hazex6]

I started a nurse residency program a month ago on a neuro floor. I was told during my interview with the manager that the unit consisted of neuro which sometimes has med-surg patients if there is an overflow. That is not the case, I have had more med-surg patients than neuro patients. I was also told that I would have one preceptor, but I have two preceptors assigned to me. 

From my very first day, I have felt unsupported and unwanted. I had requested to change one of the preceptors because she had berated and belittled me during the first two weeks. I requested to change to another preceptor. The manager honored my request. However, I think they are retaliating.

During my third and fourth week, both preceptors threw me to the wolves. The second preceptor told me he had assigned me three hard assignments to make sure that I would be able to handle those types of assignments when I was off orientation. I was left to take care of them alone while he took care of the other two patients with little support. 

I met the new preceptor that I had been assigned to me a few nights ago. She was cold and distant and assigned me hard assignments with no help. Her reasoning was also the same- to make sure I could handle it once I was off orientation. She would come into the rooms with me, but she would not walk me through tasks or how to do things. Or tell me if I was doing something wrong. 

I am about to begin my fifth week of a twelve-week orientation. I have not been checked off for any skills for the duration that I have been there. I am given an excuse when I ask for opportunities. I was told that they did not want to take away opportunities from the other orienteers and that I would have more opportunities after some had finished their orientation. Some orienteers have completed their orientation, but I have still not been checked off for any skills. 

I feel like I am being set up for failure. I do not know what to do anymore. 

[Been there,done that, ASN, RN]

Run.

[JBMmom, MSN, NP]

It sounds like this particular unit is not friendly to new grads, or you've just had the worst of luck with getting the three worst nurses as preceptors. Either way, I would consider going to your manager and laying out the whole situation and see where they take it. If they are really invested and have your back, things could improve quickly. However, you may up in the same situation if they don't do anything, which wouldn't really be any worse- and then I would suggest you look for other opportunities. You're still new enough you will qualify for new grad programs and you may find a much better fit out there. Good luck. 

[JKL33]

Well we know that one of your options, the obvious one, is to leave. That's a reasonable option if it's what you want to do. I'm going to put a few other thoughts out here--

Just about all new relationships require communication and significant effort at rapport-building. Just my personal preference but I would try that before walking away. For you, it feels like this is all about your orientation and how it isn't meeting your needs. The reality for these nurses is that they're showing up for work every day and training or supervising another new person in addition to taking care of patients.

They don't know your personality, your skill levels or knowledge base or what you specifically need. I've seen many different types of nurses not help an orientee much--sometimes for negative reasons (laziness, having a challenging personality/sink-or-swim mentality), but I've seen many nurses, who I knew to be some combination of kind/humble/shy, hang back because they didn't do well with being what they saw as "bossy." They didn't want to overstep or offend the person they were training or make them feel like a baby who didn't know anything. And there are yet others who want to act chill with the new grad by taking a "you got this" stance. Alllll kinds of people out there. Many different root causes of not being all that helpful.

Well--you have to communicate and get to know people to know what's really going on. You also have to let them know about you.

I'm writing all of this out because if you are showing up with a smile and an eager attitude and communicating in a pleasant and professionally assertive manner and trying to develop good collegial rapports with your new coworkers and are getting nowhere - that's more of an indication that there are likely better opportunities elsewhere.

On the other hand, if you're just showing up....and feeling disappointed because this isn't a well-oiled orientation machine, you're bound to be disappointed wherever you go.

$.02

Good luck to you ~

[JKL33]

A note about the type of unit you're on, just FYI:

You were hired onto what is generally known as a med-surg specialty floor (ex: ortho, neuro, GI/GU, hem/onc, etc). These often having a core staff that is certified in the applicable specialty; if there are beds open when a patient with that particular problem needs to be admitted, they go to that respective specialty floor. But they need the rest of beds full, too, and other more general patients need beds, so they will be placed wherever there is an open med-surg bed.

You will likely get anything from a fair to large amount of non-neuro patients on this floor; sometimes you will find a significant portion (or even most) of your beds are occupied by patients with neuro problems, other times it might be almost the opposite.

[Hazex6]

I have decided that I am going to seek opportunities elsewhere. I do not want to risk further retaliation. I noticed a change in my second preceptor's behavior after I had gone to the manager to request to change my previous preceptor. I did not have any issues with him up until then. The manager spoke to the previous preceptor. After meeting with the manager the preceptor told me that she wanted to speak to me privately. The preceptor told me that I should have come to her first. I did try to talk to her first. When I would have discussions with her, she would either scoff or make a belittling comment. She told me that I should follow the chain of command. She also said that I should be careful due to workplace politics.

Last Friday, the new preceptor stood back and watched while I nearly made a mistake. I had almost given a patient the wrong fluids. Luckily, another nurse was present. He and I both noticed the error, which was something the preceptor should have done. I had it corrected with his assistance.  I am all for preceptors hanging back, but only when they provide guidance.

[delrionurse]

It sounds like not a good fit. Tell them to try to switch units, or you will have to give your two weeks notice. You have addressed the preceptors not being supportive, they are aware. It won't get better with unsupportive staff. 

[Crystal-Wings, LVN]

I feel your pain 100%. Unfortunately we live in a capitalist society where hardly anyone wants to help anyone anymore unless there's a benefit for them. It's nothing but office politics and bad attitudes now a days. I'm sorry you are going through this and I wish I could help you. Hell, we've all been new before but nobody seems to give a crap anymore. All of the people you work with sound like snakes. I think your best bet is to look elsewhere for work if you value your mental health. I know that's easier said than done, but it seems like those a-holes have already put a target on your back. 

[EW323]

Hi - I hope you have left this situation safely and without consequence. I have experienced this behavior from preceptors at more than one facility and was actually let go by both places when I went to HR about the situation. Now I know it's much better to bow out gracefully. The number of nurses with the whole 'I'm going to train my preceptee with the 'nurses eat their young' way because that's how I was taught' mentality is really sad. It is why I'm leaving nursing altogether... Good luck! 

[NurseEducator2015]

I hear and understand the need for a more supportive New Grad program. I've been in that "sink or swim" situation where preceptors are sort of "testing" us to see if we can manage a situation since we will "be on our own soon". It's really distressing because the patient's well being is at stake, and what we need to support through the process so we can both learn and care for the patient adequately. 

What are some aspects of a good new grad program? If other have gone through other programs, what did you like? What made you feel supported? What made you feel prepared to care for patients?