Background: I was a good student. Graduated magna cum laude, excelled in class but felt my clinicals were a bit of a let down. I was basically used as a CNA when I went to clinical.
I graduated in May and got offered a job on a Med Surg/Telemetry floor six days after I graduated. My preceptor is okay. I know she is putting forth every effort with me. I've only had five floor shifts so far. The first 3 were spaced weeks apart because of education classes through the hospital so there was some disconnect there having such a span between training in the floor.
My preceptor is a good nurse. She is great with the patients. This is her first time to be a preceptor. I feel like she and I think very differently. I like her fine as a person i just don't know if she is a great fit for me. But I have been trying to make the best of it.
This past weekend I had two shifts back to back and I was DETERMINED to become vastly more independent. I was pulling meds without my preceptor, passing them mostly without her, charting on my own and doing a really good job with keeping up with the routine of things. She remarked early in the shift how shocked she was at how quickly I was improving and coming along. Then yesterday around the middle of the shift things started to spiral out of control. I got overwhelmed and panicky.
Throughout this orientation, my preceptor has told me she is "OCD and crazy about charting". She does a lot of double charting, sometimes I see the rationale, other times I don't. She's also really critical of those around her...she reviews their charting and pokes fun when she sees a spelling error (usually it's simply a typo). Yesterday she was halfway across the nurse station and hollers over at me (laughing) about a typo I had made. It rubbed me a little wrong...maybe I'm being sensitive....but I'm new. I certainly don't want people to think "Oh, there is that dumb new girl." I just didn't like the approach. Everyone could hear and it embarrassed me.
There really was a culmination of several things....me feeling like I didn't keep up well at the end of the day, wanting to do a perfect job, feeling nit-picked, feeling stupid about a few mistakes I'd made, a reprimand from another nurse that I tried to help by putting her patient on the bedside commode because nobody was around to help him (I had quickly earlier surmised she isn't well-liked and doesn't have the most pleasant or grateful attitude), etc. I was doing chart checks and my preceptor says, "You didn't document reevaluation of so and so's pain". There was a cutting edge to her voice. I could feel myself inside working up to crying...huge internal struggle to keep it together. She kept needling me and wouldn't let up and finally she said, "You're really ticked off at me, aren't you?" I wasn't at all...I was probably just acting awkwardly because I was on the verge of crying. That was it, and I lost it. I just busted out crying right there at the nurses station. It was like a dam broke.
I feel like an idiot for allowing my emotions to overcome me. I knew I'd have days like this. I knew the first 6 months-1 year was going to be draining and difficult. I never thought I'd not be able to keep myself under control though. I figured I could at least make it to my car before the tears came.
Just venting, evaluating, thinking. If you have suggestions, throw them my way.
you said your preceptor was doing it for the first time. i think that if she was "needling" by asking if she was really ticking you off, then in part she needed to hear that yes indeedy, she was ticking you off. later on when things have normalized and if you have an off-the-floor moment for coffee or something, you could bring that up; she will probably look at her preceptorship management style a bit better.
somebody here has a siggy line that quotes maya angelou about (paraphrasing here) you do the best you can and when you know more you do better. applies to all of us.
"At least you're not a male nurse breaking down in tears!
To BrandonLPN's post... I agree to an extent because as guys and our social upbringing it's very common for your best friend to be someone you beat the crap out of over a disagreement (or vice verse). Of course this isn't applicable in a professional setting, I'm just making a point on the differences in gender socialization. In male dominated professions (fire fighting, policing) we tend to have things out in the open and be "confrontational" if the situation merits it, and otherwise, the ball-busting carries on without issue.
I'm not saying that it's wrong or right, but that just seems to be the reality. As far as the topic creator is concerned, high-stress situations can produce emotional outcomes, but it's professional duty to control that. You didn't want to be labeled as the new-girl-who-can't-spell, but now you may be the new-girl-who-has-emotional-eruptions. Take things in stride and don't let your confidence be so easily shaken Miss "magna cum laude," it's unbecoming. Sometimes you just gotta let things roll or take the time to have an adult conversation with someone about what you feel comfortable with as far as "joshing around" is concerned.
If you fear the stigma of being "up-tight" by having a conversation like that with a preceptor or a co-worker, well, maybe you should re-evaluate your position and consider the idea that you were being a little up-tight. That's okay, everyone is from time to time.
Hope it all works out."
Obviously, this "Miss Magna Cum Laude", wouldn't have ever wanted to have an crying spell in front of her peers. I'm not exactly sure why you referred to me as that.
At any rate, it's not my intention to ever allow it to happen again. I was mortified and viewed it as extremely unprofessional.
I'm sorry, but am I missing something here?!?! Am I the ONLY person on here that has worked with some of the most emotionally sensitive male nurses on the planet?!?!.....such as homosexuals??? I don't care about ANYONE'S sexuality, but as a female nurse I am EXTREMELY OFFENDED at being stereotyped as "the typical over-emotionally sensitive female"!!!!! And YOU should be EQUALLY OFFENDED by being stereotyped as the "typically insensitive, unemotionally uncaring male"!!!! I have had the most wonderful experiences working with some of the most caring, sensitive, passionate, and emotionally sensitive people I have ever met. Doctors, nurses, male, female, gay, lesbian, straight....And the medical community is lucky to have people like that in their field. YOU SHOULD reconsider "YOUR OWN IMAGE" as a complete, insensitve JERK!
During my orientation, many times I needed to take a "potty break", go into the restroom, close the stall and either have a bit of a cry, or do some self-talk to get myself under control. If there was an "issue" I needed to discuss with my preceptor, I reheorificed what I needed to say. This worked for me most of the time, but then, I am one who was let go at the end of orientation, so who knows...! I do believe we need to control our emotions in the workplace, but none of us is superhuman. We can improve with practice, tho. Some of my self-talk was just of the put-it-in-perspective variety: "It's not personal. It's a learning experience," etc. I think we have a right to respectful treatment and someone pointing out your errors over the intercom does not strike me as respectful. Probably just a poor choice of behavior by your preceptor, but something you might ask her/him not to repeat!
Breaking down in tears is not acceptable, you are not dealing with the stress of orientation. I hope you have an Employee Assistance Program.. and get counseling. Otherwise.. I really don't think you can succeed.
Dang that is cold!Sometimes, people cry. It's a way to release tension. It's a natural response. If it happens a lot that's an issue, but it happened once. I cried after my first shift in the ER. I've talked with plenty of nurses who have broken down at some point on orientation. Somehow we've managed to dust ourselves off and soldier on.
good lord you people are mean and cruel! it's people like you that give nurses a bad name. shame on you!!! awful, simply horrible advice!!!
i concur!
aem31: orientation is difficult, frustrating, exhausting, trying, and can be embarrassing until you find your footing. actually nursing can be all those things too.... you've recognized what happened as out of character for you, and now you move forward.
i feel quite a bit of disappointment and embarrassment for the nasty, negative and demeaning comments here. (like the one who states you won't succeed unless you get counseling?!? knows you that well after reading .... what.... 6 paragraphs?!? geez)
and just a besides: [color=#333333]miss magna cum laude,
i think most of us know what that comment is about.... a certain number of people believe that if you are "book smart" you have no common sense, which is total malarkey. (just wanted to go on record with that :-):thankya:
aem31; you are going to be just fine!
don't be afraid to tell anyone when their actions or words have demeaned you. (there are some who have no idea how cold or brass they come across---(as evidenced by posts here:cheers: ) open communication cuts down a huge margin of misunderstandings.
I have been a nurse for two years (as of this month). I, too, started on an acute, hectic telemetry floor. You are not alone in feeling the way that you feel right now.
Work is stressful which totally heightens (exagerates) how you respond to things emotionally at work. I have cried, and been ashamed: I remember crying when my husband called me at work towards the end of a 12 hour shift to tell me that he had to take my baby son to the ER. He said that he was unable to console him and had been sick. I felt very powerless and worried. I only wanted to be with my son. Thankfully, a nursing colleague who was a floating RN that day took my team so that I could go and be with my son.
I have also cried when I have lost a patient. I have been impacted by the sorrow of family members who are trying to cope with such a loss. At work, you must remain objective for your patients. No matter what is going on, as long as your patients are safe and stable, take a break. Walk away into a private place, a break room, whatever...breathe and collect your thoughts. This usually works for me.
As far as dealing with my stress regarding the nursing profession (things that I love, all of the things that eat away at me), I vent to my nursing buddies who have been my friends for a while now. It is good to talk to other nurses. Only nurses know what nurses endure every day. I do not expect that my husband will every truly understand my worst days, for example. No one really knows what someone goes through in life without "walking in their shoes".
Do not beat yourself up or feel ashamed. It is acceptable to feel vulnerable and a bit overwhelmed. You must learn how to handle it at and off work (as I previously brought up). This is essential for your mental, physical, and emotional health.
Off the subject: You are in the perfect setting to learn critical care. My critical thinking skills have developed to the point where I feel confident, yet humbled, by the nursing profession. You are going to learn and do so much in telemetry! :hug:
I have read that the chemical composition of tears differs with each emotion felt that prompted the tears. So it truly is a release of emotions.
However, like you, there are time I don't want my emotions flowing all over the desk in front of everyone. But don't beat yourself up. It happens, especially on orientation. Sometimes its what gets us through.
This is a difficult job because it uses everything we have: our head, our heart, our feet! Its intellectually, emotionally and physically taxing. And then after we give our all, someone gets to tell us all the nitpicky things we should have done better --and maybe laugh at our spelling. Talk about tears made up of pure frustration!!
Its nice to see your approach is: what/how can I change this to improve the situation or the self. Looking for what can be learned will get you far in every setting. (as evidence, i am sure even the 'cna' clinicals taught you something)
It helped me to learn that picky when it comes to charting is important because of lawsuits and how the hospitals get their pay. Continue to be open to input on that, it may save you grief. And many times the foolish redundant new policied paperwork is the result of something that went wrong before you and now they are trying to fix it. So that is what gets audited by those assigned to review. (snarls and rolls eyes) Frustrating, but its part of the job.
Other people have posted this but its so true: communication can make a world of difference. And in the end remember, we can't change other people and how they act, so don't make that your goal, make it your goal to either better understand or be understood. And if after honestly consideration something said to you is invalid or plain mean you don't have to refute, just think to yourself "flush" and know it went where it belongs. And then decide not to behave that way yourself.
Don't lose heart!
ps Kudos on magna cum laude! and all spelling errors are intentional for comic effect!
Med-Surg/Telemetry is hell on earth for most nurses, and many that I have met on such units are unhappy. I graduated in 2010 and I've said many times that if I had started in med-surg or general telemetry, I would have probably left the field in the interim or have lost my job. Unreasonable patient loads and acuities dumped on staff without the resources to safely handle them. Don't feel bad for getting upset, but you will better serve yourself in the future by letting people know when their behavior is bothering you. There is always a tactful way to call someone on behavior that rubs you the wrong way without allowing the issue to simmer until you boil over as you did that day. Stay strong--no job is worth your sanity.
there are some realcockroaches in this forum, and nursing in general:mad:. this forum in a microcosm of how nursing really is. i wish nursing wasn't so hard, but it is, and facilities require a lot of stupid double charting. and if you don't, you have to worry about being sued or written up. i've been written up for things i didn't even do before! there are so many uptight - type a - anal retentive personalities in this field, it's unbelievable!
you will make it, don't worry, the fact that you take your job to heart is a good thing, you're not going to kill anybody. that's the heart of the issue, lets not forget, taking care of the pt's. if it matters to you that you know what you're doing, then awesome! you're already a good nurse!
don't let the jerks get to you.
but love, you will have to learn to suck it up for a while, because nursing is hard for an experienced rn who can run circles around you, so it will be overwhelming for you. after the first few upsetting months of being a rn i decided to try and do everything people said, even mean people. i decided it can only make me a better nurse, and eventually it did. so even though some people may be nitpicking, it doesn't mean they're wrong. they just have wrong motivations, but they aren't wrong. so try. try to be better than them. try to do everything as best you can! remember why you got in this field, to take care of people.
you are not weird, it wasn't unprofessional, it's normal. :hug: but it's a normal part of being a novice, you should grow past this. we've all been where you are. you are doing ok. but don't stay here, grow past this....
and never forget this feeling when you become preceptor! (then you will be the best nurse!)
First of all, ALL of us who have prior hospital or LTC experience somewhat feel like CNA's when doing our clinicals or preceptorship. However this is done on purpose because there are RN's who have graduated with ZERO experience and boy does it show! Some don't have even the most remote basic skills like moving a patient properly at various ages or degrees of illness.
It's good that you were excited about nursing and wanted to be independent. However it's not a good idea to do it without your floor preceptor for you even admitted that you didn't have the best clinical training.
Nursing isn't all about being "smart" or "top of your class". A lot of it is about having common sense, observation and the art of putting pieces of a medical puzzle (input from the patient, family, MD's, RN's report, clinical tests, etc) to show the whole picture of the patient.
Why are you trying to prove yourself? There's nothing to prove, really! :) You don't get points for proving yourself!
Enjoy being an RN, step back, breathe, okay breathe again, and allow your preceptor to teach you something. Remember, we have two ears and one mouth. USE your preceptor, I'm sure she's seen A LOT of things, ask her questions like: "What are three things that you wish your own preceptor would have told or taught you that you had to learn on your own?"
Or how about asking her about a skill that you can do quicker and much more easier way?
Don't try to "prove" any one. Let your skills speak for themselves. Take your time if you can. Take time to really get to know your patients, when they trust you they speak out and that's when real medicine happens. That's when you may realize the true problem of their health and can really help the docs out...
Check and double check your work. Go easy, rushing and trying to create an ego makes mistakes and can cause death...
NOT saying you're trying to create an ego but it's the path you're choosing without realizing it. (((HUGS)))
I'm glad the preceptor is checking the spelling and the work you all do in charting. There's been plenty of times an MD or RN wrote something and it didn't make sense and/or the spelling was off by 2 letters and it almost caused miscommunications about medicines or care we were about to give. That's dangerous!
LAUGH about it! You're so focused on "proving" yourself that you don't realize this person probably wants to help you. Step back and LAUGH about the error, thank her for finding the issue, correct it, then go back to work. Thankfully she found it to let you know so the doc doesn't see it first or the NM.
My suggestion is to enjoy nursing, breathe, take your time when you can, thank people who notice your mistakes (you want them on your side to save your butt from errors) and LAUGH often! Life is short! :)
Great advice. I really am trying to prove myself. I'll take what you said into account. Thanks.
Thank you, thank you, thank you for the encouragement! It means the world. Today was so much better. Without my even saying it, my preceptor said maybe she shouldn't have pointed out the typos. She was sincerely trying to come up with a way to show me the right way of doing things without embarrassing me. She spoke about placing a call to a mentor of hers and discussing how she could better help me. She is trying so hard and I appreciate every bit of it.
I used a new organizational tool today that worked wonders for me. Everything wasn't perfect but that's okay. I didn't feel totally overwhelmed and know what I will work on tomorrow.
I'm going to be fine. I can weather this storm. I don't expect to feel wholly competent now or anytime soon but at least I have a way to feel somewhat in control even in the midst of chaos.
Side note, she mentioned something I forgot to say in report today and shortly after I went to a patient room to help move her from chair to bed. I had already clocked out. My preceptor said, "Oh gosh, I thought I had upset you and you left." I explained that the shift before was just a bad day for me and I'm not a delicate flower. I told her I want her to give me feedback no matter what...good or bad. I feel so much better just knowing she really has my best interests at heart.
What constitutes as "mean" is subjective. What some people consider "mean" others consider just joking around. I had a nurses note where I tripped up spelling 'diarrhea'. I had several crossed out attempts and the final attempt was STILL wrong. The doctor, reading the chart loudly commented something to the effect that this is what happens when LPNs are trained at those "vocational" schools. Said it right in front of everyone. And you know what? We all laughed. The same doctor sometimes asks me things in an impatient tone. Sometimes I ask the CNAs things in impatient tones. Sometimes I poke fun at other nurse's work. Sometimes they do the same to me. I personally don't consider any of this "mean".
that's the heart of the issue, lets not forget, taking care of the pt's. if it matters to you that you know what you're doing, then awesome! you're already a good nurse!
nurseprnRN, BSN, RN
1 Article; 5,116 Posts
you said your preceptor was doing it for the first time. i think that if she was "needling" by asking if she was really ticking you off, then in part she needed to hear that yes indeedy, she was ticking you off. later on when things have normalized and if you have an off-the-floor moment for coffee or something, you could bring that up; she will probably look at her preceptorship management style a bit better.
somebody here has a siggy line that quotes maya angelou about (paraphrasing here) you do the best you can and when you know more you do better. applies to all of us.