My preceptor is everything they taught us NOT to be... - page 7
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 13, '15I have a different opinion than those posted. I work as a clinical instructor and bedside nurse. A person scanning all medications then hanging them at a different time, it's considered fraudulent documentation. Had a friend fired for that. Start a new IV line or get the medications retimed if possible . The one thing I see at the bedside is the inability of nurses to critically think. She is aware of what's being done wrong by her preceptor. What happens to the next person she trains who adopts her bad habits? These habits can cost you professionally. I've seen joint commission come in and people practice their bad habits. It's not pretty! Plus, who lets a nurse of a year experience train a new grad. She is still a novice nurse herself. I would have given my manger feedback on her and requested a new nurse . Delegation is important I agree but charting can be done later. On a good day, I may not sit down until 10 am to start charting. Please note: I see a lot of nurses copy- charting and they are done earlier.
Dec 13, '15Take this as an opportunity to learn. Preceptors usually have more than one year of experience, but that is beside the point. New nurses are an investment so unless you have really messed up they will not fire you. Normally, you will be assigned a different preceptor and if that preceptor has issues with you then they will let you go.
I have some questions for you to consider....
Before or after the dressing change did you ask why the procedure wasn't sterile? That was an opportunity for you to understand why a sterile procedure wasn't done. As far as the BP and glucose go, did you ask the reasoning behind her decisions? The IV med timing, another opportunity to find out why she does things the way she does. The timely charting issue, did she tell you why charting needs to be completed by that time? Did you explain to her why you were having trouble getting it completed by 10:00? This was an opportunity for you to understand why delegation is so important.
Orientation is very different than nursing school clinicals. In clinicals, you learn skills and it is important that you learn the correct way to do these skills but when you start working as a nurse, the skills are a small part of the overall picture. There are so many tasks that need to be completed and prioritization is key.
Be open and honest with your preceptor. Ask questions. You don't know everything and a nurse that does not ask questions, is a dangerous nurse (new grad and experienced nurses included). Negative feedback is not a bad thing. It is an opportunity to become better and stronger in your nursing practice. Listen, really listen to the feedback you are given and don't be so defensive.
Don't take it personally, it isn't meant to make you feel inferior but to increase your proficiency.
Take a step back, and look at it from an outsiders view. Go into the meeting with the manager and be humbled not defensive.
Hang in there, I hope everything works out for you.
Dec 13, '15Don't quit. Did you end up getting fired? She should have changed her gloves after removing the old dressing. It may not require sterile gloves, but clean gloves are always nice... and if you felt like checking the bp again that's your call, you're the nurse. it shouldn't have been a big deal and she should have appreciated your concern for patient safety. Even if she KNEW you would still get a high enough reading for the meds and that you were wasting your time. I mean really, who cares if you wanted to take it again. That's how you get a feel for things and learn your own lessons.
Don't feel bad, she didn't sound like a good preceptor because the moment she sensed you didn't like or understand her way she should have communicated with you why and let you share your thoughts and questions. This is no biggie, just keep working and doing what you think is best. Quitting is the worst thing but if you already did then, you'll get another job and things will be ok too. Either way, you'll be fine.
Dec 13, '15First you need a new preceptor, i work in california so we had ratios. I practice nursing as if the patients where my family members, you cannot make bad habits common practices. I know you are new, but nursing school is the foundation of what nursing should be. do the right thing when no one is watching, do it once do it right, and advocate for your patients needs. All nurses do their job different, just get a new preceptor, get experience and get a job where you feel more comfortable. med
Dec 14, '15If you would use critical thinking skills I don't think you would be nit picking as much. As for using a blood glucose from 2 hours prior...was that BG 150? If so the patient is receiving cont tube feed and 2 little units of insulin will not cause the pt to bottom out. It may cause the next BG to be higher but you can give additional units per SS if indicated. On my computer system I can scan the med and change the time (up to an hour) in advance. As long as you give the med within an hour it should be fine. If the med was given outside that range you can modify your charting. Remember, you can always change anything you've charted. As for administering BP meds, I agree with you. I personally like to know what a BP is before I gave 3+ BP/diuretics. Again, use critical thinking. If pt has been hypertensive throughout hospitalization a small dose of one BP med will more than likely not cause them to became hypotensive. USE CRITICAL THINKING SKILLS!
Dec 14, '15New nurses should never be precepting new grads! I see it all the time, good never comes of it. And very very very rarely will a bedside dressing be a "sterile" procedure, they are "clean" procedures.
Dec 14, '15The "I know it all" attitude needs to come to a halt and the "I am brand new at this and need to really watch and learn from everyone this first year especially" attitude needs to take hold or you will never get along with the nurses you work with. You need to learn to pick your battles too, most of these aren't worth your time and just make you look bad.
Dec 14, '151. Being precepted by someone with one years' experience is a big red flag. This should never happen.
2. As previously stated, there is school and there is real world. Do you have friends who have been nurses for a while? If so, discuss these issues with them. You will see that real world practice is very different from school practice.
3. It takes a great deal of time to figure out how to prioritize when you are new to nursing. In clinicals your tasks were mostly CNA type tasks. You now need to learn that the CNA does for you most of what you did in school. This is not to say that it is never your job to help someone to the bathroom or clean them up. You definitely do or assist with these when you can. But nursing priorities are different, and you need to figure that out.
4. Everyone develops their own style of practicing nursing, once your basic skills are in place. Until then, never judge another nurses practice unless she is being flagrantly negligent or breaking the law. You are in no position to judge.
5. The best thing you can bring with you every day to work is a positive, helpful attitude. Without this, your day will be long and difficult, and you will end up hating your job.
Dec 14, '15I definitely feel your pain. My first nursing job, my preceptor was the worst. She was showing me bad nursing habits then throwing me under the bus because I was a new grad. I got chewed out for it, only to resign my position because I felt that my orientation wasn't fair to me. Trust me, you're not alone. But if you feel that your preceptor is teaching you bad habits, ask if you can be reassigned. That might remedy the situation a lot.
Dec 14, '15Your attitude towards her, especially speaking to her that way, is completely appalling. its not wonder new nurses are scared of veteran nurses.
Dec 14, '15The standard process for orientees in virtually all hospitals is to have regular meetings with your preceptor & a representative from your units leadership. At these meetings issues in practice may be discussed, and you will always know where you stand. Management shouldn't be able to terminate you unless they have consistent documentation of poor performance being a pattern. Management is also responsible for providing remedial education to help you perform your job competently at the new grad level. this also needs to be well documented, and it must include your success after education.
If I were you, I would request a new preceptor, watch & learn, have regular meetings with her & leadership, and frame your questions so that your preceptor doesn't get offended, but rather regards you as someone willing to learn from her. Everybody has a different practice. delegating tasks to the appropriate ancillary personnel avoids micromanagement and allows for you to complete your RN responsibilities.
Dec 15, '15Quote from germinariojennIn all fairness, they're both "new" nurses.Your attitude towards her, especially speaking to her that way, is completely appalling. its not wonder new nurses are scared of veteran nurses.
I want to believe that this could have been avoided by having the OP paired with a more experienced preceptor, but the way the OP spoke of some things (particularly delegation) makes me think that this was more of a personality clash.