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.
When I was working on a M/S floor, one nursing school had its students passing meds with the nurses while the instructor sat at a computer the whole afternoon looking at pinterest. I didnt think it was fair that she got paid to do nothing while we had even more added to our workload. I also had a student nurse with me for 3 weeks and even though she may not have been ready to take on a 5 pt load, I realized she had the foundation necessary to do fine in a normal orientation whenever she gets hired. You learn a lot in your work orientation which is much longer than 3 weeks so I wasnt too hard on her in my eval.
Holy cow - I would be beyond livid. I'm sure this was an eye opener, and not the last injustice you will face in life, etc. However, you were a student, and this was your learning experience and your grade. You deserved a willing, capable, trained, professional preceptor, a rubric or some other indication of goals and expectations for the preceptorship, a reasonably ojective evaluation, and a school that gave a darn about providing those things to its students. I'm sorry that happened to you, and really glad that you came out okay in the end.
This is now the educational model of nursing school?
Unfortunately, for a percentage of students.
I continue to be amazed at schools with an arbitrary model; most schools have rubrics and models to follow by; but even then, it could possibly be skewed by subjectivity instead of objectivity.
The sufferer raises his eyes to the heavens and cries, "God, why me?"
And God looks down and says, "Why not you?"
OK, you got a lousy preceptor, or, to be charitable, one who wasn't having his best week. It's done now. Pass NCLEX, and go on with your life, and I promise you in a few years you won't even remember this fool's name, and the extra few hours will be forgotten (and maybe you even learned a little more during them...and if that was time c a faculty member and s/he found you were fine, perhaps the feedback will make it back to the hospital who assigned the fool to provide a learning experience to a student...)
Let it go. And in a good while, when you have your confidence back (and your license), write a letter to the dean.
The point now is what will you do if the situation happens again? I vote for asking for another preceptor assignment and keeping great notes to turn in to instructor. I also would talk to the Dean to see how they could possibly take the preceptor's word as pass/fail since he was not an employee of the school. How do they qualify him as preceptor? What training did he receive? Geez, Louise. Also, when you get your license, remember this story and try to help out the next student. GOOD LUCK
Did you not get a chance to evaluate your preceptor? When I was a preceptor for the local college I filled out an evaluation on the student but they also filled out one on me.
iluvgusgus
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When I was working on a M/S floor, one nursing school had its students passing meds with the nurses while the instructor sat at a computer the whole afternoon looking at pinterest. I didnt think it was fair that she got paid to do nothing while we had even more added to our workload. I also had a student nurse with me for 3 weeks and even though she may not have been ready to take on a 5 pt load, I realized she had the foundation necessary to do fine in a normal orientation whenever she gets hired. You learn a lot in your work orientation which is much longer than 3 weeks so I wasnt too hard on her in my eval.