Overwhelmed International Nurse - Preceptor is Condescending

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Dear Nurse Beth,

I am an international nurse working in the Medical Surgical ICU of a healthcare facility. Being from Jamaica it is taking me awhile to get used to electronic documentation and other aspects such as different medications and equipment.

The preceptor that I am assigned to is helpful in some regards but she has a very condescending tone when speaking to me if I am getting overwhelmed with tasks she does not assist. I realize that she spends most if not all of the twelve hours dictating, pointing out things I should do in not a good tone of voice.

I feel as if I am going to ask to be placed on the medical floor despite my 2 years of ICU experience as working with her I am slowly losing my self-confidence and in essence developing a very low self-esteem. I try my best, I read widely but it seems as if the only thing she notices are things bad, she has never given me a positive feedback on anything.

For instance, I had 2 patients, one requiring a high level of nursing care and an admission. Throughout the shift I did all the nursing care plus the entire admission process, at the end of the very hectic shift she informed me that I should have taken time to read through the admissions complete history, mind you I read his admitting history and the plan of care but while I was literally drowning in tasks for both patients she was sitting down and not helping.

I am asking you for advice on handling this situation because the unit is a good learning environment but if I am overwhelmed each duty I am not going to get much chance to learn anything. I am thinking of asking my unit manager if I can be placed on another floor. The other preceptors that I have had are much better than the one I presently have.

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Specializes in Tele, ICU, Staff Development.

Dear Overwhelmed,

Your preceptor is critical and withholds any positive feedback. This does not create a good learning environment for you, and that is her job. While you can't change her, you can control your responses.

Your options include speaking with her, frankly and respectfully. Tell her what you need from her and how you are feeling. Use "I" statements to avoid provoking her

defenses. "I need to know what I am doing well and what I need to improve on. I really appreciate your feedback and I am feeling that you are dissatisfied with my performance. Can we talk about that?"

During the shift, keep her updated on your activities and ask "Am I on the right track? Is this what you feel I should be doing, or is there another priority?"

This puts more accountability on her to guide you and provide feedback.

Are you receiving regular (weekly) progress evaluations and goals? Goals should be written, measurable and attainable so that it's clear to all

whether or not you met them. Otherwise, it's a no-win for you. You cannot meet expectations that are never expressed.

If speaking with her is not an option for you, you can ask your manager for another preceptor, citing a better fit or personality. Chances are she is this way to other orientees, and it should not come as a surprise.

When you are overwhelmed, do you communicate? "I'm feeling overwhelmed right now with one patient's pressure dropping and a blood transfusion to start on another. What is your advice as far as prioritizing?"

As far as her not helping, without knowing how far along you are in your orientation, it's not possible to comment. Most preceptors will allow you to feel the stress of the assignment by being hands-off, without letting you fail.

I hope this resolves for you, friend.

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