My preceptor is everything they taught us NOT to be... - page 3
I was hired on a med-surge floor, and have been working with a preceptor for several weeks. After questioning some of the things she is "teaching" me, I've been given a "final warning" and am facing... Read More
Dec 11, '15Joined: May '03; Posts: 1,390; Likes: 4,930I get it. You're a new nurse and you want to be perfect and "make a difference". All I can say is welcome to nursing...in the REAL world. One hard lesson I had to learn (and it took me over 20 years to learn it) is that it doesn't matter how good a nurse you are, and it doesn't matter how much you know. It's all about if people like you and how you are perceived. If you don't learn that hard lesson early on you're in for a very rough ride. Does it make it right? Does it make it ok? Absolutely not, but it's what really happens on a nursing floor. It's about making things work for you AND doing your best for the patient AND for you AND still complete all the requirements of management AND keep the patient's family happy, AND get all your charting done on time AND manage to not pi$$ anybody off AND still be smiling at the end of it. Don't sweat the small stuff. None of this is a competition. The only competition you have to worry about is making people like you and keeping your job. Really, it's the truth. As long as you're the preceptee and she's the preceptor, you have no say. Keep your head down, your mouth closed and get through the day unscathed. I've learned that I will NEVER complain about anybody again. As soon as you do, the spotlight's on you and it burns.
Dec 11, '15Specialty: 14 year(s) of experience ; From: US ; Joined: Dec '06; Posts: 4,123; Likes: 8,859How badly do you want to keep your job? Getting terminated will have lasting consequences for you. If you have one foot out the door already, maybe this job is not salvageable.
As a new grad, your chances of landing a better job are much greater if you have experience. Even if the experience is in an imperfect workplace.
Dec 11, '15Occupation: RN Specialty: 7 year(s) of experience ; Joined: May '10; Posts: 1,750; Likes: 1,570Unless there is more to the story then you have told us, I don't see why you would be fired. You haven't done anything to jeopardize your patients, or impair customer service. You've only annoyed your preceptor.
And, yes you have been stuck with a crummy one. It seems he/she has missed some teaching opportunities. A discussion should have taken place as to why you didn't need another BP, or why the low urine output was accecptable, etc.
That being said, while on orientation you need to "go with the flow". If she wants certain charting done by 10, get it done by 10. I've gone through a few new employee orientations, and I've figured out I need to just do things the way my preceptor wants them done while taking what learning opportunities I can from them. Sometimes I have to bite my tongue, but sometimes I gain a new perspective on something I've come across a hundred times.
Dec 11, '15Joined: Mar '15; Posts: 2,450; Likes: 8,549Quote from Live..&..LearnHere's the thing - some of what you describe does come across as nit-picking but still honest in you quest to understand. I keep coming back to the wound dressing change you describe. Even our wound care doc does not do sterile dressing changes on these wounds. It is considered a clean procedure not a sterile one. I have preceptored several new grads and I always asks as I going along - do you have any questions.Sorry, I was not trying to be sarcastic in my comment, not at all. I'm brand new to nursing, and really don't know anything. I put my head down and didn't say a word for several weeks until she started hammering me with bad feedback, even then I only asked her a couple of times why she does things the way she does. I'm lacking in nursing experience, but have plenty of life experience, and am not out to be an arrogant b####. I didn't "tattle" on her, I didn't talk to anyone else in that department or the manager about any of this. Seriously, if an orientee asks why you do things a certain way, especially when all of your clinical experience was at a different hospital, than why take offense? I really did not try to come off that way, maybe I did, who knows, and apparently I'm coming off that way here.
Dec 11, '15Joined: Oct '10; Posts: 2,886; Likes: 8,713Quote from RocknurseThere is so much truth to this. If you are well-liked by patients, peers, and supervisors, often you will be given many opportunities for remediation, as opposed to someone who makes the same mistakes that is not well-liked.One hard lesson I had to learn (and it took me over 20 years to learn it) is that it doesn't matter how good a nurse you are, and it doesn't matter how much you know. It's all about if people like you and how you are perceived.
I've seen some really shoddy care, but the patients had no idea- they just thought that nurse was "so nice". And you absolutely shouldn't try and correct their misperception, as this undermines the patient's confidence in the care they are receiving. Talking about the nurse behind their back is also a very bad idea, because you never know who they are best friends with or related to- for all you know, they could be besties with your unit manager, or the sister in law of the CEO.
Of course we should intervene if we see something dangerous or unsafe- but as a new grad, you don't know what you don't know. Unless something is blatantly dangerous, you need to keep your head down and get through your orientation. If something makes you uncomfortable or you don't understand, ask questions before judging. Keep an open mind that there is more than one way to get something done.Last edit by Anna Flaxis on Dec 11, '15
Dec 11, '15Joined: Sep '13; Posts: 633; Likes: 1,912My primary preceptor, a 30-year nurse, was clueless. Almost no clinical skills, no computer skills, no time management skills (other than taking her breaks), zero ability to plan, react, or adjust to situations. No interest in taking initiative. Completely clueless on the use of the EMR system. Not able to use any electronic tools or resources. Not able to and no interest in figuring out multiple IVs or compatibility. No interest in patient progress or planning. Never tried to figure out a thing for herself, always called and blamed the doctor or pharmacist and even refused verbal orders when she got responses (she didn't know how to use Epic to implement the orders). The only thing she ever did was double-check my medications.
Every time. Even on our last day. That's all she did. "I'm making sure we keep our licenses."
I pretended to pay rapt attention to everything she said or did, got through preceptorship with glowing reviews and began doing nothing the way she did when I got on my own. (I did have other very good preceptors and some other excellent mentors.)
I worked on that unit four years, gained excellent experience, and moved on. She is still there giving nurses a really bad name. Every day I hope she retires.
Dec 11, '15Joined: Jun '05; Posts: 1,745; Likes: 2,511All of the previous posters have given you excellent advice. I just want to chime in and say that charting is soooo important. If it wasn't charted "it wasn't done" and if your patient has a problem and a baseline assessment hasn't been charted it will be interpreted that you have done nothing for your patient yet. That looks bad at 1300.
Dec 11, '15Specialty: 6 year(s) of experience ; Joined: Sep '10; Posts: 1,549; Likes: 5,469Quote from gonzo1All of the previous posters have given you excellent advice. I just want to chime in and say that charting is soooo important. If it wasn't charted "it wasn't done" and if your patient has a problem and a baseline assessment hasn't been charted it will be interpreted that you have done nothing for your patient yet. That looks bad at 1300.
That depends on the hospital policy of how quickly/by what time assessments are expected to be charted. I agree that it may "look bad" if an assessment isn't charted by late morning, but I had times back when I was a floor nurse that I couldn't get to charting until late in the afternoon - and that was considered acceptable where I worked at the time.
Dec 11, '15Joined: Nov '12; Posts: 1,254; Likes: 3,571Quote from RocknurseSuch words to the wise, regardless, you've got to learn how to play nicely together in the sandbox!Keep your head down, your mouth closed and get through the day unscathed. I've learned that I will NEVER complain about anybody again. As soon as you do, the spotlight's on you and it burns.
Dec 11, '15Occupation: LPN and a LPN-RN student Specialty: 5 year(s) of experience in Allergy/ENT, Occ Health, LTC/Skilled ; From: US ; Joined: Aug '15; Posts: 542; Likes: 830Isn't it something that how well you do in nursing comes down to how well your liked and not how well you work?! Maybe it is because I am a nurse, but the one time I did have somewhat of an emergency condition (UTI that went systemic, had no I idea I even had one, just puking/confused as all get out), my nurse was rough around the edges, but she figured out what I had quicker than the intern could even think and she pretty much told him what to order LOL. I do see importance in being pleasant, and I try myself to be, but for me personally, as long as your good, I don't care how chit chatty or cheery you are.
Dec 11, '15Occupation: RN Specialty: Medical Surgical ; From: US ; Joined: May '12; Posts: 390; Likes: 719I can't even read all your examples. If you know all this then do it in your own practice. What is wrong with saying let me grab a manual BP before I give this norvasc. We routinely give 0700 insulin at 1030 when the pt gets their breakfast. If the last BG is old I get the meter myself and recheck it. Telling a nurse who has been there longer than you how to do her job is bad practice. You are new. Instead of worrying about what other people do you need to work on figuring things out for your own practice.
Dec 11, '15Specialty: geriatrics ; From: US ; Joined: Jul '10; Posts: 5,489; Likes: 11,536Quote from Been there,done thatNo that's not what I'm saying. I replied based on the information that the OP has posted here, and the fact that she is soon to be terminated. It's all in the approach.So.. what I hear you saying is... while one is orientation... one has no say in the delivery of care?
At this point, considering the lousy job market, she is better off to try and "make nice", keep her opinions to herself, and do things differently when she is on her own.
Dec 11, '15Occupation: Critical Care Nurse Specialty: 20 year(s) of experience in ICU ; From: US ; Joined: Aug '11; Posts: 1,078; Likes: 2,652The OP is a critical thinker and the preceptor is just a tasker and a vindictive little witch.
The OP should not be vilified here or at work just for trying to protect her patients.