New grad--old story: I am in orientation hell.

Nurses General Nursing

Published

I am a new grad, but I also have about 30 years in the work force (as a paralegal and an editor). I am would give my left arm (as I am right handed) for a positive comment from my preceptor. I am about half-way through a 16-week orientation and just last week they changed preceptors. I was just starting to gain some confidence and get a rhythm and I feel like I was back at square one (or nearly). Last night I had four patients and overall I was thrilled with the way it was going, though I got bogged down with two patients in the same room who weren't critical, but were total care, and one was a safety concern). Bottom line is I was late with routine HS meds on another patient. My preceptor's comment as I came out of the one room to give these meds was "I am going to give XX her meds, it's after 10 and some of these were due at 2100. I don't know how that happened." and later, get this, "Are you familiar with military time?" Not one single attagirl all night. I am devastated and would like to go to the educator with this, as what little confidence I had is slowly draining away. I am afraid if I will be marked a complainer or who knows what else. I honestly feel like I will be a good nurse and I will get there, but I could use some encouragement once in a while. I worked so hard to get here and I don't want to give up, but coming home and crying every night this week is not working either. Thoughts? Comments?

Specializes in ED, ICU, PSYCH, PP, CEN.

Sounds like a good idea. Certainly can't hurt.

Up Vote Up Vote ×
Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr.
what do you all think about this idea: i am off today and tomorrow. i thought about asking her on wednesday if i could shadow her instead of taking the team. that way i could see how she does things and get an idea of how she organizes her day. i am organizing myself based on how my previous preceptor did it and my new preceptor is (sort of) trying to fix something that may not be broken. i am thinking that if i observe her "way." i might find some useful practices to incorporate into what i am already doing and open up some positive interaction.

yes, also document your efforts to get along with her and your efforts in letting her know of her behaviors. you may need them if she tries to berate you to your manager and make it seem like you are a waste of time to train. some nurses report being fired due to a poor preceptors. do not allow that to happen to you. gl!

Up Vote Up Vote ×
Specializes in Trauma Surgery, Nursing Management.
My first thought was, "Didn't you think they teach that in nursing school anymore?" but I didn't think attitude was the right way to go. Earlier, she wanted me to start my day "her way." and I had to be assertive and tell her that I had already developed a good rhythm for checking meds and doing a quick review of my patient's orders would like to do that before pulling meds and starting assessments (we do beside report). She didn't seem happy, but her statement was "If that's what you want...."

You nailed on the head RIGHT HERE. She obviously does not want you to deviate from HER plan, so now she will be looking for every "mistake" that you make as punishment from deviating from her perfect plan. Preceptors like this think that there is only one way to skin a cat, and can't accept change, especially when you as a new grad come up with a better/different plan. Her ego... Just. Can't. Take. It. (Insert swooning a la Scarlett O'Hara here)

I totally get where you are coming from. I would ask for a meeting with your educator. Ask her to keep your convo on the DL and tell her that the reason why you want to keep it just between the two of you is because you don't want to seem like a complainer. Getting through nursing orientation is HARD. Doing it without any sort of encouragement is HELL.

Adults tend to perform better with positive reinforcement, not negative. Your educator no doubt understands this. I think you should get your encouragement from your educator, because the preceptor would likely prefer to have 5 enemas in a row rather than give you the smallest hint of encouragement. Sad, yes. Reality, yes. Fair? No way.

Keep your head up. You are going to get through this!:heartbeat

Up Vote Up Vote ×
I just read one of the previos posts about the behaviour of nurses towards new nurses during their first 2 years. I want to give you some encouragement in that area. When I graduated I received 3 weeks of clinical orientation with 5-6 different preceptors. This was 2 years ago. I cried a lot my first year as a nurse partly because of lack of training and partly because of a lack of confidence. If it was not for the support of my co workers I never would have survived this crazy yet wonderful profession. Not all nurses treat new grads poorly. In fact I hardly see that at all on the unit I am on. I had one nurse be a real b---h to me a couple of times but she no longer works on my unit. I think it depends on the culture of the unit you are on.

When you get off of orientation identify the supportive nurses on your unit and use them as mentors.There are a lot of nurses who like to teach and mentor and will take you under their wing.

I have heard this complaint so many times on this forum, that I would like to encourage ALL new grads to ask for a contract to be drawn up stating that "XYZ will function as the preceptee's SOLE mentor during the orientation process".

No kidding, we USED to take this SERIOUSLY, and in matching; would not allow anyone to precept who was: soon to go on vacaton, deliver a baby, be transferring, etc. It was seen as a serious relationship and not "slot the new grad in wherever you can".

You have the right to competent and supportive mentoring. It was promised when you were hired, and the hospitals foul ups should not impact on your success.

Up Vote Up Vote ×

you know what - i still have a preceptor as a CNA, and although i think i'm a very competent adult with 10+ years in the workforce (i know, not quite 30) and a bachelor's degree (something most CNA's don't have) i have been made to feel rather slow/stupid during my orientation.

i've gotten behind on my routine work such as getting vitals on 20+ patients because i get interrupted by a nurse who can't take a patient ice while they're sitting at the nurse's station texting their friend about what's to eat in the cafeteria - or because half of the patients don't hit their call light, but instead wait til i come in the room to ask me for 5 different things and help to the restroom.

granted, my preceptor has told me that i learn quickly - but when i mess up on something i DON'T know she seems surprised. i guess i should mention that i told her on my first night that i knew how to do vitals and she left me on my own to do them - and has left me alone every night since. i've actually never seen how SHE would do things if i weren't there. in fact, i think she sees me as "help" which is detrimental to me. i think things are overwhelming as it is, and she's there answering call lights when she leaves me to do vitals. what's it gonna be like when she's gone? not to mention, the reason i don't know some things is because i've never seen them! and she's not there to explain them to me!

i was just thinking the other night i maybe should ask her if SHE would do the work while i just observe so i can see how she handles EVERYTHING. i really know how to do my job well with help, and i'm sure she loves having me, but this isn't going to be my reality really soon. i think she'll be mad if i ask to just observe her at this point in my orientation, so i'm still debating it, and i'm considering speaking with my supervisor just incase my preceptor were to give bad feedback about me requesting it at this point.

i think my problem from the beginning was being too eager too soon. i'm not one to stand around and watch someone do ANYTHING if i can help at ALL. at this point, i want to keep my hands in my pockets so to speak and act like i'm not even there as i watch - which i think is what should happen in the first day or so, but didn't happen for me - which was largely my fault.

next time you need to give a patient meds and you're tied up in a room, tell you're preceptor, "i have to go give room 20 their meds if you don't mind finishing up with him/her." OR if you're supposed to be "on your own" at this point - in between caring for the patient you're with (say you just finished starting an IV but still need to place tele) tell the patient, "i will be back in just a few minutes. i need to go get something." and then go give the other patient their medication. OR if possible, see if there's a CNA who can place tele or help a patient to the restroom. trust me, as a CNA, i don't care a bit to help the nurses who are helping themselves. if you're chilling at the nurse's station - that's a different story.

medication is a top priority IMO. just a few nights ago, there was a nurse (NOT in orientation) whose patient had asked me if he could get his meds. i told his nurse - but 30 mins later he called for it again. 30 mins. after he called for it i went back to see if he had gotten it. he waited til 30 mins past the time it was due to ask the first time. by the time he hit the call light it had been an hour. by the time i checked on him (because i new his nurse who is NOT new is slow) it had been an hour and a half. FINALLY, i told another nurse (who happened to be charge, but i didn't even know that cus i'm new) that this poor guy who was very sweet had been waiting almost 2 hours for his pain meds and his nurse still hadn't made it. she went and gave them to him.

moral to the story - EVEN seasoned nurses have time management/priority issues. for the record - this poor guy was young, had chrons, a colostomy, and was the ideal patient. the patient she was with for 2 hours was a patient who was ETOH - no "real" problems being as though she was roaming the halls telling everyone that she was detoxing, being obnoxious, and able to walk around without tears in her eyes unlike the other patient who was lying down (although there was drool coming from her mouth). i'm sorry, but i would've left the obnoxious, stable, drunk lady for a few mins. to give this sweet guy his meds he was crying for.

that was probably more of a rant than help, but i'm dealing with preceptor issues at the same time as seeing nurses with time management issues. it all comes with TIME. i think next time you should think if you have meds that are due and you're caring for a patient who needs x,y,z and z can WAIT or the CNA can help with Y - then tell them you'll be back, or call the CNA. it'll come with time - i'm telling myself that.

Up Vote Up Vote ×
you know what - i still have a preceptor as a CNA, and although i think i'm a very competent adult with 10+ years in the workforce (i know, not quite 30) and a bachelor's degree (something most CNA's don't have) i have been made to feel rather slow/stupid during my orientation.

i've gotten behind on my routine work such as getting vitals on 20+ patients because i get interrupted by a nurse who can't take a patient ice while they're sitting at the nurse's station texting their friend about what's to eat in the cafeteria - or because half of the patients don't hit their call light, but instead wait til i come in the room to ask me for 5 different things and help to the restroom.

granted, my preceptor has told me that i learn quickly - but when i mess up on something i DON'T know she seems surprised. i guess i should mention that i told her on my first night that i knew how to do vitals and she left me on my own to do them - and has left me alone every night since. i've actually never seen how SHE would do things if i weren't there. in fact, i think she sees me as "help" which is detrimental to me. i think things are overwhelming as it is, and she's there answering call lights when she leaves me to do vitals. what's it gonna be like when she's gone? not to mention, the reason i don't know some things is because i've never seen them! and she's not there to explain them to me!

i was just thinking the other night i maybe should ask her if SHE would do the work while i just observe so i can see how she handles EVERYTHING. i really know how to do my job well with help, and i'm sure she loves having me, but this isn't going to be my reality really soon. i think she'll be mad if i ask to just observe her at this point in my orientation, so i'm still debating it, and i'm considering speaking with my supervisor just incase my preceptor were to give bad feedback about me requesting it at this point.

i think my problem from the beginning was being too eager too soon. i'm not one to stand around and watch someone do ANYTHING if i can help at ALL. at this point, i want to keep my hands in my pockets so to speak and act like i'm not even there as i watch - which i think is what should happen in the first day or so, but didn't happen for me - which was largely my fault.

next time you need to give a patient meds and you're tied up in a room, tell you're preceptor, "i have to go give room 20 their meds if you don't mind finishing up with him/her." OR if you're supposed to be "on your own" at this point - in between caring for the patient you're with (say you just finished starting an IV but still need to place tele) tell the patient, "i will be back in just a few minutes. i need to go get something." and then go give the other patient their medication. OR if possible, see if there's a CNA who can place tele or help a patient to the restroom. trust me, as a CNA, i don't care a bit to help the nurses who are helping themselves. if you're chilling at the nurse's station - that's a different story.

medication is a top priority IMO. just a few nights ago, there was a nurse (NOT in orientation) whose patient had asked me if he could get his meds. i told his nurse - but 30 mins later he called for it again. 30 mins. after he called for it i went back to see if he had gotten it. he waited til 30 mins past the time it was due to ask the first time. by the time he hit the call light it had been an hour. by the time i checked on him (because i new his nurse who is NOT new is slow) it had been an hour and a half. FINALLY, i told another nurse (who happened to be charge, but i didn't even know that cus i'm new) that this poor guy who was very sweet had been waiting almost 2 hours for his pain meds and his nurse still hadn't made it. she went and gave them to him.

moral to the story - EVEN seasoned nurses have time management/priority issues. for the record - this poor guy was young, had chrons, a colostomy, and was the ideal patient. the patient she was with for 2 hours was a patient who was ETOH - no "real" problems being as though she was roaming the halls telling everyone that she was detoxing, being obnoxious, and able to walk around without tears in her eyes unlike the other patient who was lying down (although there was drool coming from her mouth). i'm sorry, but i would've left the obnoxious, stable, drunk lady for a few mins. to give this sweet guy his meds he was crying for.

that was probably more of a rant than help, but i'm dealing with preceptor issues at the same time as seeing nurses with time management issues. it all comes with TIME. i think next time you should think if you have meds that are due and you're caring for a patient who needs x,y,z and z can WAIT or the CNA can help with Y - then tell them you'll be back, or call the CNA. it'll come with time - i'm telling myself that.

As a new preceptee CNA, I think you are reaching to try to give advice to a new RN's situation.

I just think it's a little presumptuous.

Up Vote Up Vote ×
As a new preceptee CNA, I think you are reaching to try to give advice to a new RN's situation.

I just think it's a little presumptuous.

i said:

"i'm dealing with preceptor issues at the same time as seeing nurses with time management issues. it all comes with TIME. i think next time you should think if you have meds that are due and you're caring for a patient who needs x,y,z and z can WAIT or the CNA can help with Y - then tell them you'll be back, or call the CNA. it'll come with time - i'm telling myself that."

yes, i'm working as a CNA right now by CHOICE and this isn't my first rodeo. i am a student and not a nurse yet, but i am an educated, experienced adult - and while every job is different - being new to a job and learning time management is the same in every field in the sense that managing your time comes with TIME and experience. it doesn't take a genius to know that if your #1 priority is giving meds and you're spending TIME with a patient doing something that can either wait or you can ask for the help of a CNA to do - it would be silly to spend your time doing that task.

call it presumptuous if you want, but i bet you can't call it wrong.

Up Vote Up Vote ×
Specializes in ER.

Some nurses just do not have the right mindset to precept new grads and unfortunately these are the ones that managers like to use all the time. My last nursing job was a travel assignment but I'd been at the same ER off and one for over 2 years and would precept from time to time, I like to teach so I really didn't mind. Anyway, the manager calls me in to the office and closes the door and its her and the assistant manager and I'm thinking oh, crap, what have I done now?? They proceed to tell me about a new grad that just wasn't getting it and it was coming down to either letting the person go or transfer to floor nursing. They wanted to know if I wanted to see if I could precept the person and turn it around, sure, I'm always up for a challenge. The person was a total wreck of a nurse, having me double check Tylenol and such. The previous preceptor had belittled them so bad that every nursing order they had me double check and give permission to perform. Nightmare, this nurse had been berated like this for 12 weeks and the old preceptor told management to fire them cause they would never make it. 6 weeks later fully functional, confident RN that was taking on sick patients and doing a good job. I would like to take credit and say I'm just so great and wonderful that I can turn anybody around but sadly that is not the case. All I did was let them do their job, support and encourage. "you did a good job on that pedi IV, strong work", simple things like that will make a world of difference with new grads or new employees for that matter.

Up Vote Up Vote ×
Specializes in ER.
As a new preceptee CNA, I think you are reaching to try to give advice to a new RN's situation.

I just think it's a little presumptuous.

I don't think it's presumptuous at all, I think we all can add something to each others practice. I worked with a CNA many years ago that was probably one of the smartest people I'd ever been around. We worked a little community hospital and they let him have old the old medical books whenever a new copy came in, he got the old one. His house was full of medical journals and books. He had pretty much read them all and was content with his job. Several of the attendings offered to supplement his income if he wanted to go to nursing school or med school but he liked what he did, he was fine being a CNA. Don't get so caught up on initials and degrees that you ignore what that person has to say. just saying...... my 2 cents anyway

Up Vote Up Vote ×
+ Add a Comment