Nursing School Incivility

[amw79]

Hello all,

I am a recent BSN grad currently studying for the NCLEX. I wanted to express some frustrating and rather disturbing experiences I had in my last semester in hopes of some objective insights and personal catharsis. After reading up on it, I am well aware of the frequent accounts of incivility in nursing, in and out of school. I do however want some fresh perceptions as to whether my experience was in fact unfair or just the nature of some less than desirable circumstances.

Either way, I know there is really nothing that can be done now, but advise on how to handle similar situations would be helpful. Also It would be nice to know if I'm being overly sensitive or deluded. I am not complaining and I have moved on for the most part. I do, however feel slightly shell shocked and insecure after my experience and hope to regain my confidence and not become cynical. I have always been a very optimistic, open and genuinely caring person. I am however a bit bitter and angry I hate to admit.

In my final 5th semester preceptorship I worked on a cardiac/med-surge unit with a rather new (1.5yrs) male nurse. Initially he seemed friendly and easy going enough. He made me feel very secure and supported in my experience. I admitted to him that I was uneasy about some skills and hadn't had as much hands on as I'd like. Initially he showed no criticism and emphasized that I could ask any question, etc. This atmosphere relieved a great deal of pressure and I looked forward to my first few days.

In the hustle and bustle of this busy unit he did not give me much hands on the first 3 days of an 8 day clinical. He was constantly behind (we're talking hours) and would chat with patients for extended periods of time while other pressing demands fell behind. Needless to say he did not let me do much, but I shadowed and assisted with med passes periodically these first few days. (granted I'm supposed to be doing MUCH more if not everything independently) on 2 of these days he came in late and tired admitting to playing video all night with 2-3 hours of sleep.

On the 5th day he expressed that he had made an insulin error as a witness and was concerned about a write up...(this was the second time)...this nurse was also in an online BSN program so it is clear he was busy and had some stress in his life. On the 5th day, my preceptor threw me into hands on a bit more than usual and as I was withdrawing meds from the med cart I accidently pulled an extra blister packet....he caught it before we left the med room and counted that as a med error, saying he didn't know whether I would have seen it. Now I do practice the 6 checks and know I would have seen it. I can't imagine even seasoned nurses never have these kind of oversights. We are human.

Secondly, that day I was having difficulty hearing an apical pulse on a man who was overweight and had CHF. It was very faint and my preceptor was chatting while I was listening. I politely tried to hint that I couldn't hear and managed to catch atleast 60 beats. I then indicated to my preceptor that I had difficulty hearing it, captured atleast 60 but he may want to give it a listen. He interpreted this as me being nonchalant and not understanding the gravity of nursing. At the end of our 5th day he preceded to criticize me and express that he was very concerned and not sure I was ready to graduate. I was shocked to hear this and found it absurd. I said I would work harder and prove I was ready.

On our final 3 days I busted by rump going over and above to please him and be able to graduate. needless to say I was a nervous wreck but managed to keep my composure. I truly felt I was excelling and had great patient interactions. He seemed hesitant to give me much positive feedback. He did share that he had tried to apply to my school's BSN program and had been turned away. I wonder if there may be some ax to grind or point to prove here. In the end, after a few more "fumbles" on my part, but nothing serious he wrote me a mixed evaluation indicating that I had potential to be a great nurse, but was not ready or safe enough yet. Of course I was not fully ready yet! I still need to pass the NCLEX and get through my new grad orientation. I felt his expectations were unrealistic and unfounded.

Up to this point I had very high grades and good evaluations from other clinical instructors. I was not perfect but in comparison to other students I was honestly at the same if not in some cases higher level. Several of my peers expressed they had preceptors that rarely let them do much and preferred to stay in control. These students received passing evals. This system seemed arbitrary and unbalanced.

Anyway due to my preceptors eval I was forced to receive an incomplete and could not graduate until completing 80 more hours with an instructor. I did attend my pinning though. I have now resolved my clinical requirement but still am flustered that this happened at all. When I expressed my concerns to my director (the one who gave me an incomplete) she said, well we are not evaluating your preceptor, that is between him and his manager.

I'd appreciate any feedback or similar experiences. I don't wanna become a ***** cynical nurse but the fact that someone on a powertrip can have such an impact on a student's life is ridiculous.

[Ruas61, BSN, RN]

Is this US based?

[Ruas61, BSN, RN]

I see it is by the tags.

Your prospector's evaluation determined if you passed the class?

Or just this segment?

[Nola009]

Maybe there's more to this than you are saying, but it sounds like the "real world". Not everyone's nice and not everyone's your idea of fair. I don't think hospital nurses get PAID to precept you, which might have added to the problem, especially since he is a newer nurse himself. At least you passed and can move ahead as you please.

[amw79]

my preceptorship determined the whole program...

[Ruas61, BSN, RN]

Wow, I guess I need to get up to date on how programs are doing this stuff now a days.

[applewhitern, BSN, RN]

I was paid to precept students who were doing their practicum years ago, but apparently most hospitals no longer pay for this. It sounds to me like he was not a very good preceptor, and maybe he should not have been one. Since students pay tuition, and have to do a practicum to graduate, I think the school itself should provide decent preceptors who have been educated in this role; not just any nurse they can find to do it. When I was a preceptor, my student did everything, and I just watched and followed them. My role was to help teach them, not just find fault. I would be ticked.

[jadelpn, LPN, EMT-B]

I am glad that you are done with your clinical hours. I am very curious if you had to pay more for an instuctor led practicum. Sometimes this is what schools will do to glean more tuition money. However, to base an entire semester on one 8 day clinical rotation is bizzare. What did the instuctor in the instructor led practicum have to say about your performance?

So lesson learned, and what I would get from this is that your work will be your work, and personal life, your personal life. Period. There is absolutely no reason for you to know that your mentor has been up all night playing video games, and all the rest of the nonsense that should never had been shared to begin with. But that is all water under the bridge. Thankfully, you are in a place where you realize this is inappropriate professional behavior, and what kind of a nurse you would prefer not to be.

Chalk it up to an experience among many. Be mindful of it, so that when you do get a job and an orientation preceptor, you will be ready to be professional, friendly but not BFFs, work work and personal personal.

Best of luck in your future endevours.

[caliotter3]

At least you were able to recover. Imagine going through this situation with that preceptor and then failing out with no recourse, because of his biased and predetermined (it seems) evaluation. Then imagine that you find out that you were never going to pass the clinical rotation because the instructor determined you would not, before you even started, and they colluded with the preceptor to see that you received a negative evaluation. They tell you this is what they did! They're proud of it and say so! Yes, it happens more often than we would like to admit. Be thankful that it turned out positive for you in the end. Best wishes as you start your new career.

[jadelpn, LPN, EMT-B]

caliotter3 is absolutely correct.

Interestingly, it is those students who seemingly have the means to pay for an "extra semester" for continuing to have extra clinicals/classes. Most can easily be able to get private student loans (which BTW can be difficult unless one has excellent credit) or have paid with cash, scholarships and the like.

I swear when you give a school your full financials, they can and do use that information to decide if this is going to be the easy or the difficult route.

OP, from what you said out of your entire clinical career, it was the very final clinical that lasted no more than 2 weeks that sealed an extra bit of schooling for you. That is ridiculous. And I am sure costly.

[ceebeejay]

There was no rubric? Even in practicums there should have been a rubric, which helps to weed out a lot of the "opinion". At any rate, no it didn't seem fair, but this will happen always and anywhere. When you establish your confidence you will be able to deal with this better. I also find it's better not to discuss your fears with strangers. If you need more time with a skill, then just say I would like more opportunity to apply this skill or that. I got reamed (rightly so) in my last semester. They judge harshly because you go out into the world without backup after that. Technically, they are looking for you to perform like an RN on the floor. I didn't catch something, but neither did the two actual RNs that the patient belonged to, nor the three other student RNs in the room. I just walked in to observe, but I caught the flames. You did the right thing by moving forward. Just let it go, take the learning experiences and let the bad feelings go.

[Ruas61, BSN, RN]

This is now the educational model of nursing school?