New RN on a cardiac floor

[82Angie]

I am a new nurse who is working on a cardiac step down unit. My preceptor is nice but doesn't explain much. I do ask her lots of questions but am told that we will get to it later and it never happens, and I do remind her. She doesn't let me do much either. I wouldn't mind observing her if she would take the time to explain things. I have worked a few weeks with her and have not so much as started an IV, put in a catheter, or given IV meds. I feel like I don't have a chance. I come prepared, look up meds, and let her know that I have verified the doses and pull up the IV meds for her. Then she says thanks and gives them herself. She will tell me that I can have my own patient but it never happens, even when I take the initiative. I don't know what to do. I have SO much that I need to learn but it's not happening. Does anyone have any advice? I don't want to go to my manager. We all know that will only make things worse. My preceptor is nice and a good nurse but I wish she had a little faith in me..... I don't want to step on her toes either.

[dura_mater]

Good luck 82Angie, I hope things work out for you!

Could you possibly talk to your preceptor & let her know that you have goals in mind for your workday? IE: IV meds, total care on 1 pt, etc.... and see what she has to say?

Don't let her to allow you to feel useless, you sound like a wonderful nurse

keep us posted

[vincejojo]

So.... let me get this straight. You are recommending that instead of her talking to anyone for fear of seeming "impatient" or "backstabbing" that she should let her manager know that her schedule is not convenient, which is not at all the issue. No, it is not easy having difficult conversations, but sometimes these are the ones that really need to occur. I don't know of to many new nurses that can ask for a different schedule and end up with a new preceptor.

I think the original poster needs feasible suggestions....

No smart one! its a clue for the manager and preceptor. Have you ever been in a situation like that? it is not that easy. if her preceptor is changed, any preceptor assigned to her would think she is a problem besides that new preceptor would probably speak to her former preceptor to know what the problem is. Also if the manager tells the preceptor to change, this might be another problem.

Whats your advice?

[Ruby Vee, BSN]

being a preceptor is a really, really difficult job, and not everyone is good at it or even interested in it. some very nice people who are excellent nurses are abysmal preceptors. not everyone can teach. it's entirely possible that your preceptor is one of those nurses who has a really hard time keeping her hands in her pockets and letting you learn. it is so much easier, speaking from a preceptor's perspective, to just go ahead and do it myself rather than watch my orientee struggle with it. whatever "it" is. unfortunately, the orientee doesn't learn as much from that.

talk to the preceptor. it could be she really doesn't realize how much she is doing for you. she intends to let you do it yourself, maybe she even believes she is letting you do it yourself. you may have to remind her again and again that you learn by doing. so remind her.

one of my personal failings as a preceptor is that i do too much for my orientees and i find that i have to tell them up front "i have difficulty keeping my hands in my pockets. i know you need to learn to do things yourself, and i want to help you do that, so if you catch me doing too much for you and not letting you do things yourself, tell me. you might have to tell me every hour on the hour, but please do remind me." most of my orientees learn to remind me to step back and let them do it themselves.

if you talk to the preceptor and that isn't the issue, see if you can find out what is the issue. maybe she believes you learn better by watching -- probably not a realistic belief, but some people aren't good teachers. maybe she doesn't want to precept and just doesn't care, but it doesn't sound like that's the case. it sounds to me like a new or a reluctant preceptor who hasn't learned to stand back and let you do it yourself. so this orientation is going to be a learning process for both of you.

when your preceptor isn't explaining or showing you things, it could be that it's been so long since she was new that she takes things for granted. i'm guilty of doing that sometimes. i take things so much for granted that i don't think to explain it to my new grad and she has to ask me. and then i feel like a big fat dummy for not explaining it. just tonight i looked at a dinner tray, said "she drank 500cc" and dumped the (disposable) tray while my orientee was saying "hey, wait a minute. how do you know that?" it didn't occur to me that she didn't know the big cup was 360cc unless it's full of ice and then it's 180cc and the little cup is . . . . never even crossed my mind. another possibility is that she doesn't understand things herself well enough to explain them. some people just aren't able to break things down into simple parts and explain them. if you're consistently having that issue, discreetly ask someone else to explain it to you. someone else may put just a little bit different spin on it, but it's different enough that it suddenly clicks for you and you have an "aha!" moment. i'm never insulted when my orientees ask someone else to explain something differently, but your preceptor may be defensive. so be discreet.

going to the manager or asking for a different preceptor is usually not the answer because you're right . . . it will be seen as you not being able to deal with your preceptor. many managers believe that part of the orientation process is learning to deal with personalities, and one of those personalities is your preceptor. so talk to her. i know it isn't easy to do, especially when you're new and not that confident. but it is the best thing to do. good luck!