New Grad Nurse Might Lose Job Struggling In Orientation

[Scrubba Dub]

I work on an oncology med/surg floor as a new grad nurse. I have been wanting to be a bedside nurse and I love working with my patients. But I am apparently not flourishing enough to be ready to come off orientation. I have trouble with time management but have been working diligently on it and have been improving bit by bit every day. But some days it’s so hard to finish on time when I am still learning a lot of new things and can’t always retain it all at once. I am also still struggling with understanding computer stuff and following all of the rules there are in everything I do. I am also a bit anxious and according to the nurses I work with on the floor, it shows.

I’ve cried already 3 times at work because of the way the nurses criticize me. They say they are trying to help but when they would talk to me, they would say things like, “you don’t know this yet?,” “you should know this by now.” And everything that they teach me, they make sure to tell my manager the things I didn’t know how to do and the mistakes I made (that I learned from and corrected).

They would also keep telling me to stop being so anxious and crying all the time and it just made me feel even worse and I would not be able to focus on my work and would make more mistakes.

My manager isn’t really nice when it comes to giving me feedback. She never had anything positive to say. It was always just about the preceptors complaining about me doing things wrong. She thinks I am genuinely failing at this job and told me that if I don’t improve enough in my last week of orientation, that my employment will be terminated.

I’ve been on orientation for about 11 weeks and I feel like I should be flourishing more than this and honestly, I am not happy here. I feel like I should be learning much faster than this. I know I am really new and it’s going to take a long time to get good, but I am not getting good enough after 3 months and that worries me that I am not cut out for this

I’m really really going to fight for my job but at the same time, is it worth all of this toxic behavior from my preceptors and manager? What do I do?!

[Quota, BSN, RN]

Sorry to hear you’re having a hard time with your orientation on Oncology medsurg. I’m just coming to the end of my orientation on an Oncology medsurg unit myself, just finished week 10 of 11 yesterday. I’m so grateful my unit is a very supportive unit and the hospital in general works very hard to support the new grads over their first year of practice. I think it also helps that I’m an older career changer who already had good time management skills from my previous career, just took a little time to get into a good rhythm to apply them correctly to nursing for me. The majority of my orientation shifts have been with my assigned preceptor but due to new grad training classes, preceptor being sick, or my own schedule conflict with my preceptor’s schedule I’ve worked with three other nurses on the unit as well. It’s definitely a good experience to get feedback from multiple people about how you’re doing and suggestions on things I could improve/try a different way.

I only have 3 shifts left on my orientation until I’m “on my own” and I’ve been handling 5 patients my last two shifts with minimal help from my preceptor. Our unit is supposed to be 4:1, with staffing issues 5:1 happens sometimes. With me and a second new grad coming off orientation in a week, a third new grad coming off in about another month, plus actively interviewing for a few more experienced nurses currently 4:1 should be the norm. Also 3-4 more new grads will start in August. Even through I’m very soon to be off orientation I absolutely know I’ll still be asking the other nurses on the unit questions throughout my shifts for a while. The vast majority are happy to help out when needed so I’m feeling pretty good.

There is just so much variety among the pt population on an Oncology floor plus the boarders when get sometimes, you can’t see it all in 11 weeks. That doesn’t even touch on the chemo aspect either. I’m slowly picking up on some of the chemo stuff but it’s not a huge concern for me at this time. You can’t hang chemo until you take the class, which you can’t take until about 6 months out anyways. I can do some oral chemo but that requires a second nurse to verify anyways so again a built in person to ask questions to if I need to. Oncology was not where I envisioned myself starting out but I do think this unit will give me a nice solid nursing foundation to build my career on. Stick around for a year or two (or more if I end up really liking it) then move on to another unit within the hospital that is more in my area of interest.

While it does sound the support you’re getting on the unit and from the hospital itself is somewhat lacking I agree with Ruby. If your preceptors are really only “mean/rude” when you make mistakes some degree of the issue could be your ability to take in negative feedback. If you’re making mistakes it won’t be all sunshine and rainbows. It needs to be pointed out to you that a mistake was made, why it’s important, how to avoid repeating the mistake, etc. The act of telling you about your mistakes isn’t rude, especially in the context of a preceptor student relationship. It is possible their delivery could use some work but it is their job to make sure you understand your mistakes and prevent them from being repeated. If you are repeatedly making the same mistakes then I can also see your preceptors getting annoyed/frustrated as well. What has served me well is the policy of if I’m not sure to go ahead and ask a clarifying question before I go make a possible mistake. Occasionally that is a “hey I haven’t seen/done this before what do I do?” but usually it’s more “for xyz I need to do abc first then jkl right?” It shows that you have thought it through yourself already but want to confirm before possibly making a mistake on a pt. In my previous career I did a lot of training for new employees myself so I know the frustration of being asked the same “how do I do this?” question over and over with no learning happening, or the attitude of “I’ve got this” when they absolutely don’t. I was always happy to answer clarification questions, repeated “I don’t know what to do” questions got annoying really fast.

Take some personal reflection upon what type of student you’re being because that could be a contributing problem to your issues on orientation. It could also simply come down to your unit not being supportive of new grads and that sucks. I hope you find your footing soon or a more supportive environment to learn how to get started in your nursing career. I wish you luck.

[Ruby Vee, BSN]

10 hours ago, LilPeanut said:

That wasn't her question, though. It was "Would I actually be put on a “do not hire list” if I am a new grad without any experience and just was not thriving at her job?", which is what I was answering.

And it was the question I was answering, too. Messing up frequently is not the same as "not thriving at her job," and I'm not sure how many reading this thread are getting that. If she's frequently making notable errors, she may be placed on the "Do Not Hire List," even if her manager is not petty.

[Ruby Vee, BSN]

10 hours ago, Workitinurfava said:

Maybe it is going both ways. Maybe the preceptor's don't have what it takes to train her and she doesn't know how to deal with it properly. For as much as this occur's you would think, there would be a moc training in nursing school. Angry/fustrated preceptor vs New Grad that can't handle it properly, to be held in Room 202.

In a follow-up post, the OP states that as she is making fewer errors lately, the preceptors "aren't as toxic." That indicates to me that it isn't toxic preceptors, it's normal people responding to someone whom they are trying hard to teach but who just isn't getting it. She also does not claim to have a problem with just one preceptor, but with all of them. The common denominator is the OP. Preceptors are human -- they get frustrated frequently, even angry. They may not be delivering necessary feedback in the manner that the OP desires. The bottom line here is that all of the players are human. The OP wants the preceptors to deliver the criticism in the way she likes it; the preceptors are responsible for delivering the criticism -- whether or not she likes it. Perhaps we should have classes on giving criticism constructively -- and on accepting in positively.

[Workitinurfava, BSN, RN]

28 minutes ago, Ruby Vee said:

In a follow-up post, the OP states that as she is making fewer errors lately, the preceptors "aren't as toxic." That indicates to me that it isn't toxic preceptors, it's normal people responding to someone whom they are trying hard to teach but who just isn't getting it. She also does not claim to have a problem with just one preceptor, but with all of them. The common denominator is the OP. Preceptors are human -- they get frustrated frequently, even angry. They may not be delivering necessary feedback in the manner that the OP desires. The bottom line here is that all of the players are human. The OP wants the preceptors to deliver the criticism in the way she likes it; the preceptors are responsible for delivering the criticism -- whether or not she likes it. Perhaps we should have classes on giving criticism constructively -- and on accepting in positively.

Perhaps we should have classes on giving criticism constructively -- and on accepting in positively.

This is my point, I agree.

[NurseTZ]

Shame on those nurses that are your preceptors. Every nurse needs a mentor, whether new or new hire. I have been a nurse for 25 years, just started a new job at a nursing home and am getting the same treatment. Those nurses don't remember when they were just starting out. They have forgotten the golden rule. There is never a reason to say to someone " you should know that by now". No one has the right to treat another disrespectfully. Leave there and document how you have been treated.

[boomshakelaka]

2 hours ago, Ruby Vee said:

In a follow-up post, the OP states that as she is making fewer errors lately, the preceptors "aren't as toxic." That indicates to me that it isn't toxic preceptors, it's normal people responding to someone whom they are trying hard to teach but who just isn't getting it. She also does not claim to have a problem with just one preceptor, but with all of them. The common denominator is the OP. Preceptors are human -- they get frustrated frequently, even angry. They may not be delivering necessary feedback in the manner that the OP desires. The bottom line here is that all of the players are human. The OP wants the preceptors to deliver the criticism in the way she likes it; the preceptors are responsible for delivering the criticism -- whether or not she likes it. Perhaps we should have classes on giving criticism constructively -- and on accepting in positively.

i agree that OP is probably the common denominator. she's messing up and the preceptors have to give feedback and criticism. whether or not OP is getting it, it should always be done in a respectful manner especially when its coming from someone in a leadership position.

[CTmom]

Just a few thoughts about anxiety - It can keep us safe by listening to our inner voice and recognizing unsafe situations, but it can sometimes be a barrier to health - loss of focus, insomnia, decreased joy, etc.

Therapy - the healthiest people I know have someone impartial to talk to.

Holistic self-care - aromatherapy, herbal teas, breathing exercises, mantras, meditations, etc can really help to recenter your thoughts and place a shroud of positive energy around you.

Best of luck.

[panurse9999]

Boy, its 20 years since I was a preceptee on a hospital oncology floor, and this post just hit me hard. It was one of many new nurse experiences I had upon entering the profession, and getting stuck with toxic, petty, jealous, insecure, nasty self important, arrogant staff nurses whose only goal was to sink the new hire. I put up with the sorority sisters laughing behind my back, directing me to falsify charting, accusing me of falsifying charting, sending me on wild goose chases while they giggled, ignoring me completely, ganging up, prank calling my phone, and the list goes on. I was 30 years old crying all the way home in my car, and decided to deep six the job. Best choice, yet I see things have not changed. I recently heard of this happening to another preceptee in my area, who actually relocated with his family to take the job, and was never transitioned out of training. Its hard to consider nursing a profession, when the unprofessionalism across this field continues to fester.

[Jbnurse19]

On 4/14/2019 at 6:14 PM, Rnis said:

Best wishes! I appreciate your drive to give it all you got. I know it's easier said than done, but no more crying. Put your battle face on. Crying is a dead give away that someone is really struggling/overwhelmed (and its NOT unusual for a new grad to cry) but if happens more than 1 or 2 times on orientation........I start to think they aren't right for acute care.

That’s the problem ! Who gives a *** about what you think the person is right for. That’s the problem with this field too many chiefs not enough Indians. No one can tell the next nurse about how good of a nurse they are. EVERY DOG HAS ITS DAY ! A lot of you experienced nurses been to court !

[vintagemother, BSN, CNA, LVN, RN]

On 4/12/2019 at 8:48 PM, boomshakelaka said:

When I was a new grad and just got hired I hated orientation. I hated the person orientating me, the educator and my manager. I felt that I wasn't being supported enough and they would only focus on my mistakes rather than the positive things that I've accomplished during orientation. I almost quit the job cause I hated the whole process and everyone, but I pushed through a couple extra orientation shifts and really took their feedback into consideration regarding why I couldn't time manage efficiently and somehow made it through. it came down to prioritizing and doing things 'their way' for now instead of what I've learned in school

This is so true! Do things the way they do, even if they dont align with your education. Once your off orientation and off probation, do things your way.

[caliotter3]

28 minutes ago, vintagemother said:

This is so true! Do things the way they do, even if they dont align with your education. Once your off orientation and off probation, do things your way.

No better advice can be given. Do it their way until off orientation. Then keep it to yourself if you do it differently.

[caliotter3]

Looks as if OP hasn’t returned here since her termination. Hope she was able to get it together at a new job.