New nurse needs advice. Might be let go at end of orientation

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I thought I was doing well in my orientation until around week 9 when my preceptor starting telling my manager a bunch of things I was doing wrong. This was the first time I was aware of these problems. My manager called me in for a meeting and my confidence went down a lot. She said she was extending my orientation by 2 weeks. Since then I’ve made a few mistakes. None of my patients were harmed and I don’t see them as major but my manager does see them as big problems and was concerned. In our last meeting she said that she’s not completely sure if I will have a job at the end of orientation if she doesn’t see improvement. I’m not really sure what to do at this point. I will try really hard to do well in these last 2 weeks. If I don’t make it though should I still include the 3 months of experience on my resume? If I have to provide contact information I’m not sure if she will say anything good about me. This was my first job so I don’t have any other experience. I’m just really scared right now and need some advice.

Specializes in CTICU.

What were the "few mistakes" that you don't see as a big deal since the discussion? What types of errors? I do not agree that it's "not a big deal" to be making repeated errors while orienting - is your preceptor working with you? Supervising? Available for questions? Are they errors where you weren't taught what to do properly? 

I need so much more info.

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19 hours ago, ghillbert said:

What were the "few mistakes" that you don't see as a big deal since the discussion? What types of errors? I do not agree that it's "not a big deal" to be making repeated errors while orienting - is your preceptor working with you? Supervising? Available for questions? Are they errors where you weren't taught what to do properly? 

I need so much more info.

I understand why you ask but it's irrelevant if they aren't going to either let this orientee go or else help him/her to make a real plan for improvement. The bottom line that was posted here is that this individual has been lead to believe that they are doing well (or maybe at least on par) for 9 weeks. Now it's getting down to the wire and the preceptor/employer suddenly wishes to air their concerns and opinions about everything s/he has been doing wrong that they haven't previously disclosed/critiqued--which is a situation we read about here not infrequently unfortunately. It's baloney.

It's quite possible this is someone who needs significant improvement. But people need to give a little clue and then probably a lot of direction. That's why there's (the pretense of an) orientation.

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Specializes in CTICU.

Perhaps irrelevant to YOU, but that's your opinion. It's very relevant to me. It's a separate issue than the quality or lack thereof of the orientation process. It will most certainly be relevant to the OP when he or she tries to get another job, and progress in his or her career.

 

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10 minutes ago, ghillbert said:

Perhaps irrelevant to YOU, but that's your opinion.

What the heck. The entire post is about what happened before the errors of unknown significance that you are referring to.

 

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I'm not saying this isn't a growth opportunity one way or another or that there's no use discussing the OP's part in this.

Yet the topic is about the fact that someone believed they were on par for 9 weeks and then got trashed. Again, not an unheard of story around here. The only way the OP is completely responsible for this is if they had been meeting regularly and telling him/her that there were significant deficits that needed to be corrected pronto. Doesn't sound like that was the situation though.

Secondly, have you seen some of the things new nurses consider significant mistakes? We have a very recent thread about devastation related to not putting an isolation sign on a door during a busy night shift.

I will admit that I'm completely biased because I am **over** nurses always having to be the party, out of whomever all was involved in something, to be the ones who have to display massive penitence for their failings no matter how meager or insignificant, which are often equated to either moral or ethical failures.

 

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Specializes in CTICU.

I think you're taking this a little too personally, or imbuing things into my post that I did not say or think. I just asked for more information. 

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Probably. And I don't mean my comments personally against you.

I do think it is very important for people to always take stock of what has happened after something like this and focus on the self-reflection and honest self-critique that will make them improve and perhaps have more success the next time around.

But, come on....the person said s/he received a big surprise blow from these posers and made a few mistakes after taking the hit to his/her confidence...

ETA: They told OP of problems at the very tail end of his/her orientation. The orientation was extended because of what they chose to enlighten OP about, well past the 11th hour.

Sorry but it's BS.

 

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OP, how is your relationship with your preceptor?  I agree with several other people here that there seems to be lack of communication, both in terms of timely feedback in the moment and specific, measurable goals for improvement.

If they are not giving you specific feedback on their own, would they give it if you ask for it?  Can you take the initiative to ask for the feedback upfront, and then check in periodically throughout the shift?  I realize that not every new nurse is comfortable asking for this, and not every preceptor is comfortable being forthcoming about weakness directly to the orientee. But if there's a way to shift the relationship to coaching rather than judging, that would be of invaluable help.

I was in a similar position regarding feedback. My preceptor was (and is) an awesome nurse, and I learned a lot.  He is also someone who can't sit still, and he would often jump in and do things without discussing them with me first.  Like I'd be finishing my med pass, and start to do a discharge, and he'd have already done it.  Near the end of orientation, my manager approached me to say that the floor manager came to her and said I didn't have good time management, based on what my preceptor told her.  Nothing was ever discussed directly with me, and there had never been any formal meetings or feedback in any area.  So, since my preceptor had a couple weeks of PTO anyway, I went around and lined up several other nurses to precept me for a few days each.  I told them my specific focus was on time management, I was open to any suggestions or feedback, but please not to jump in to "rescue" me without discussing it first.  I enjoyed getting some new tips and strategies, and got up to speed pretty quickly.  It only worked because I had a specific area to improve, and was very proactive in soliciting coaching for it.

OP, is there any pattern to the "things" you're "doing wrong" or was it just a litany of mistakes?  Are the problems with skills you don't have a firm grasp on or related to something else like med errors when you rush?  Because if the issue is that you, say, broke sterile technique inserting a foley, then maybe you need more practice with catheter insertion or need to watch videos to review the steps.  If the issue is related to something in your clinical judgment, then it would help to see if there's an underlying issue that's preventing you from making the right call when something is off with a patient.  

See if you can get your preceptor or manager to be more specific.  I think if your manager really wanted you gone, you would not be getting the additional two weeks to improve.  But now it's up to you to make sure those two weeks are used differently, and are not just a continuation of the past nine.

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I know this is an old thread (thankfully for you, op!) - Medapop, I truly hope things have gone better since this. I just wanted to chime in and say that reading this advice has been incredibly helpful to me in my current situation, so thank you all for sharing your experience and wisdom.

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

I know this happened a while back, and I hope things worked out for the OP. I had a similar situation in my first acute care position. The hospital started a transition program for nurses coming from long term care with an orientation not geared for brand new nurses, but nurses new to acute care care. I was a few weeks in and also thought that all was going well when I sent the manager an email asking when I would be switched into my regular position. I was incredibly shocked when the email response came that my orientation was, in fact, not going well. I was off for three days when that came in and I spent the next three days in a near panic that my new career was not what I thought it was. When I returned, my preceptor and manager sat me down and pointed out my "many" mistakes that had never been brought up until then. They told me I would be given two more weeks, but four shifts later I was called into HR and let go. The manager said she had concerns about my ability to think critically in the acute care environment and I should probably plan to return to my long term care facility. I thought the mistakes were small, obviously they didn't agree. I'll admit I spent the next two days pretty upset and wondering how I was going to support my family with a new career after losing my first full time job. Fast forward three years and I'm in critical care and almost finished with my NP Program. I've considered "stopping by" that manager's office to share my success, but she's not worth the effort.  I've worked with many people since then that know that same manager and all of them report that her behavior and professionalism is a well, known nightmare in that hospital. Sometimes things just don't work out, and it may be a blessing in disguise. I know it was for me. Good luck!

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43 minutes ago, JBMmom said:

I know this happened a while back, and I hope things worked out for the OP. I had a similar situation in my first acute care position. The hospital started a transition program for nurses coming from long term care with an orientation not geared for brand new nurses, but nurses new to acute care care. I was a few weeks in and also thought that all was going well when I sent the manager an email asking when I would be switched into my regular position. I was incredibly shocked when the email response came that my orientation was, in fact, not going well. I was off for three days when that came in and I spent the next three days in a near panic that my new career was not what I thought it was. When I returned, my preceptor and manager sat me down and pointed out my "many" mistakes that had never been brought up until then. They told me I would be given two more weeks, but four shifts later I was called into HR and let go. The manager said she had concerns about my ability to think critically in the acute care environment and I should probably plan to return to my long term care facility. I thought the mistakes were small, obviously they didn't agree. I'll admit I spent the next two days pretty upset and wondering how I was going to support my family with a new career after losing my first full time job. Fast forward three years and I'm in critical care and almost finished with my NP Program. I've considered "stopping by" that manager's office to share my success, but she's not worth the effort.  I've worked with many people since then that know that same manager and all of them report that her behavior and professionalism is a well, known nightmare in that hospital. Sometimes things just don't work out, and it may be a blessing in disguise. I know it was for me. Good luck!

^^ And thank YOU, JBMmom, for sharing your success story. It gives me hope and some reassurance.

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I am so glad you posted this query.  I experienced similarly, but just a few weeks into a 6-week preceptorship on a different unit. My confidence is low.  What is helping me is having had a prior positive experience working on another unit as a tech.  I loved working on that prior unit, never uttering a complaint and so proud to be a part of that team.  That prior unit had an amazing staff of nurses, therapist (PT/OT) and techs with exceptional leadership. Unfortunately, the unit leadership just recently changed and I was not offered a position to return. I had to leave the hospital. 

The good news is the market for RNs is strong right now. Every hospital in my area that I have applied has reached out to me and scheduled an interview. I never have had poor reviews in 30+ years of professional experiences, so having to confront this unfortunate experience is uncomfortable, to say the least. I am a very honest and transparent person.  I do agree with a prior post to acknowledge your experience orienting, as you continue to look forward to finding a unit where you are properly supported by qualified preceptors and leadership, taking time to find ways to improve in recognizable weak areas. 

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