New Nurse feeling very down

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Hello,

I am a new nurse into the PICU one month into my internship. I have gone between 3 preceptors in this time and have just met my "main" preceptor after about 10 shifts, while everyone else has been with their "main" since the get go. After taking report, she said that she did not like how I jotted the body systems and began making remarks that she did not know that I would be so "unadvanced" at this point in time and that she would have to start me from the beginning. That's fine, because I want to learn and do the way that works for her. By the end of the shift I felt I was getting the hang of things and ended the shift on a positive note. In the morning I jotted the way that she wanted and while charting on the same stable pair from the day prior, I was getting behind and had not finished charting on the first patient. She told me that this is the most stable patients that we have and if I was getting overwhelmed with this that I don't belong in the ICU. When I went to flush the IV, I did not see that it was clamped and she sarcastically asked me where I went to school and if I have ever worked with IVs. I feel that at this point in time I felt overwhelmed because she was breathing down my neck. When I administered the meds through NG tube, it backed up and some of it spilled on the sheets. I re-sent for another from pharmacy, but she made a big deal out that because the sheets had just been changed and I was scared of her seeing it before coming in the room because of the fit she had made over the IV a few minutes prior that I was literally shaking. I understand the ICU is a no-nonsense kind of place, but 1 shift into meeting her I am beginning to believe that I am incompetent. When I went home that night, I cried, because I feel that I made a mistake going into the ICU as a new grad, that I'm not going to ever get better, not last and that they will fire me and wind up homeless. I don't really know what to do. I had never felt like this with my other preceptors. I feel like I am giving 100% and that I will never be able to live up to her standards. I am not trying to put her down, she is an amazing nurse loved by everyone on the unit, which is why I feel so poorly about myself at this point in time. I feel as if I am dreading going back to work and even worse.. this hospital comes with a 2 year contract.

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Hello,

I am a new nurse into the PICU one month into my internship. I have gone between 3 preceptors in this time and have just met my "main" preceptor after about 10 shifts, while everyone else has been with their "main" since the get go. After taking report, she said that she did not like how I jotted the body systems and began making remarks that she did not know that I would be so "unadvanced" at this point in time and that she would have to start me from the beginning. That's fine, because I want to learn and do the way that works for her. By the end of the shift I felt I was getting the hang of things and ended the shift on a positive note. In the morning I jotted the way that she wanted and while charting on the same stable pair from the day prior, I was getting behind and had not finished charting on the first patient. She told me that this is the most stable patients that we have and if I was getting overwhelmed with this that I don't belong in the ICU. When I went to flush the IV, I did not see that it was clamped and she sarcastically asked me where I went to school and if I have ever worked with IVs. I feel that at this point in time I felt overwhelmed because she was breathing down my neck. When I administered the meds through NG tube, it backed up and some of it spilled on the sheets. I re-sent for another from pharmacy, but she made a big deal out that because the sheets had just been changed and I was scared of her seeing it before coming in the room because of the fit she had made over the IV a few minutes prior that I was literally shaking. I understand the ICU is a no-nonsense kind of place, but 1 shift into meeting her I am beginning to believe that I am incompetent. When I went home that night, I cried, because I feel that I made a mistake going into the ICU as a new grad, that I'm not going to ever get better, not last and that they will fire me and wind up homeless. I don't really know what to do. I had never felt like this with my other preceptors. I feel like I am giving 100% and that I will never be able to live up to her standards. I am not trying to put her down, she is an amazing nurse loved by everyone on the unit, which is why I feel so poorly about myself at this point in time. I feel as if I am dreading going back to work and even worse.. this hospital comes with a 2 year contract.

"She told me that this is the most stable patients that we have and if I was getting overwhelmed with this that I don't belong in the ICU."

This is unacceptable from a preceptor. Preceptors are there to guide you and teach you.

Report this to your manager and nursing education. You deserve a Preceptor that understands their role.

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I'm a (very) seasoned RN, and even I sometimes forget to unclamp the the stupid clamp before pushing a med. It's not a big deal, you just then unclamp the stupid clamp and push the med.

Right now, you are new enough where equipment is still "scary." Lines are scary, tubes are scary, monitors are scary, alarms are scary, machines are scary, and the patients are scary.

If your preceptor is scary, this can make for a very unpleasant learning experience. You are doubting yourself now, and this will snowball into even more doubt, fear, and anxiety, and the cycle repeats.

You are not stupid, but you will need to find a way to pump up your confidence and relax in this challenging learning situation. My suggestion is to make a habit of going the gym or yoga before work. Get the mind cleared, and the energy, blood, and endorphines flowing. Not kidding here. Take care of yourself first.

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"She told me that this is the most stable patients that we have and if I was getting overwhelmed with this that I don't belong in the ICU."

This is unacceptable from a preceptor. Preceptors are there to guide you and teach you.

Report this to your manager and nursing education. You deserve a Preceptor that understands their role.

I'd "like" your post, but there is no little "like" icon to click on on your post. Weird.

I agree, it sounds as if this preceptor is less than encouraging.

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I'm a (very) seasoned RN, and even I sometimes forget to unclamp the the stupid clamp before pushing a med. It's not a big deal, you just then unclamp the stupid clamp and push the med.

Right now, you are new enough where equipment is still "scary." Lines are scary, tubes are scary, monitors are scary, alarms are scary, machines are scary, and the patients are scary.

If your preceptor is scary, this can make for a very unpleasant learning experience. You are doubting yourself now, and this will snowball into even more doubt, fear, and anxiety, and the cycle repeats.

You are not stupid, but you will need to find a way to pump up your confidence and relax in this challenging learning situation. My suggestion is to make a habit of going the gym or yoga before work. Get the mind cleared, and the energy, blood, and endorphines flowing. Not kidding here. Take care of yourself first.

In a probably extremely unrelated note: I have dealt with difficult preceptors in the past (in nursing school) and you mentioned yoga/gym before work. HOW DO PEOPLE DO THIS PLEASE TELL ME. Like I've tried the gym thing before class/after class and I'm exhausted and miserable. And that's without 12 hour shifts. Please enlighten me.

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In a probably extremely unrelated note: I have dealt with difficult preceptors in the past (in nursing school) and you mentioned yoga/gym before work. HOW DO PEOPLE DO THIS PLEASE TELL ME. Like I've tried the gym thing before class/after class and I'm exhausted and miserable. And that's without 12 hour shifts. Please enlighten me.

Really? Gee whiz. I don't have an answer for that.

I suppose I keep the workouts fun, short (less than 30 minutes) and moderately intense. A thirty minute workout shouldn't exhaust a person. Did you eat after the workouts?

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Really? Gee whiz. I don't have an answer for that.

I suppose I keep the workouts fun, short (less than 30 minutes) and moderately intense. A thirty minute workout shouldn't exhaust a person. Did you eat after the workouts?

Lol sorry I should clarify. I'm not exhausted right away, just towards the late afternoon. Which I guess is normal but maybe it just takes some getting used to. Maybe I can compromise with yoga in my days off!

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OP - your preceptor sounds outright demoralizing.

As I see it there are 3 options:

one is to ask for a different preceptor - you could say that you did not click with her and a different approach to precepting works better for you.

The other one is to suck it up and try to fly under the radar - but that could go the wrong way.

And the last one is to try to please the preceptor - and do it all her way , ask her for advice and so on - but there is no guarantee things will get better. Some are just crazy.

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I'd ask to switch to a different preceptor if the situation doesn't start to turn around. This is not conducive to learning your role.

Just a note, I'm a senior nursing student precepting in the ICU. I have my main preceptor but I've floated with other nurses. Maybe I've been lucky but I have never been torn down like that. It's stressful enough trying to get a handle on everything that's going on without feeling like your preceptor is going to rip you a new one over sheets. Sheesh!

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At this point you should be doing foolish things like pushing meds in a clamped line. Good god! You are human...give it a chance and find another teacher if it does not work. Trust me - this is nothing new for a unit manager. You will learn. You will finish your training. You will not be homeless.

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Girl, cheer up. You're not incompetent. We all sometimes forget about the stoopit clampy-do and try to push a med through it and then have a duh moment. I've had NGs not just spill on the sheets, but explode all over myself and the room....and sometimes visitors. And you're a new grad. These are the times when you can be, "Hey, I'm new. I kinda get a pass for things like the stupid clamp." I milked that excuse (within reason) for as long as I could.

With regards to the preceptor, I'd give it another shift to see if things shake out, but if not, go

to the manager or unit educator and ask to be assigned to another preceptor. It's impossible to learn from someone who is constantly tearing you down, even if they are a great nurse. Sometimes personalities just don't mesh, and that's okay.

There are gonna be times in your first year that even with an awesome preceptor you're just gonna be down and have the blues. It's part of being a new grad and it's one of the sucky parts. You gotta be good at taking care of yourself, too.

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Specializes in Psychiatry, Oncology.

Sounds like your preceptor does not want to be a preceptor. It happens. One of my preceptors was exactly as the one you describe. Luckily, there were others and I am forever thankful to them. If I spent all my orientation with that horrible preceptor, I don't think I would have succeeded - that's how important a preceptor's encouragement and compassion is for a new nurse (I mean, I can always beat myself up, I needed someone to do the opposite).

Long story short, please speak with your educator about getting a different preceptor, Good luck! You can do it!

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