Picking preceptorship + indecisive (insights from PHN and med-surg nurses?)

TriciaJ, RN · Feb 27, 2017

It might actually be worth taking the plunge and picking med-surg. It would give you a different experience from the one you had (assuming it's a different unit) and hopefully erase some of the unpleasant associations. If your critical thinking skills are weak, this would be a good place to shore them up, especially with a dedicated preceptor.

I totally get wanting to avoid risking a repeat experience, but it might be worth it. I don't know what your other choices are, but there are pros to choosing this one. Good luck.

jennylee321 · Feb 27, 2017

If you didn't do well in med-surg and you cried every day definitely don't put it down as a preference. Just because you will gain skills and the majority of new grad jobs are in hospitals doesn't mean you should set yourself up for failure.

I enjoyed my surgical placement in school and wouldn't have minded doing my preceptorship there. Would of been a lot of job opportunities for me if I had gone this route.

But my passion was NICU, its what I had wanted for as long as I could remember. Yes there would be less NICU jobs available then med surg when I graduated but I decided I would do everything I could to make myself a competitive applicant.

Look at the job market in your area, are there any public health postings. It is still an important thing to consider. What other areas do you think you might like. Just because you didn't like surgical doesn't mean you would hate every area in the hospital. I loved cardiology and surgical but I don't think I would of enjoyed a medicine floor.

hesitantstudentnurse · Feb 27, 2017

Thanks for responding.

I was also debating whether to just take throw caution to the wind and choose a med/surg unit, but I find that I'm hesitating (either way i'm hesitating even if i pick public health) because I'm scared to "challenge" myself because I feel that picking med-surg would guarantee me a failure... and I'm scared that i'll cause harm to my patient since my critical thinking is on the low end of the spectrum (since I almost harmed my patient in my surgical rotation last time when I gave morphine to her, when she had signs that she was getting too much opioids - very drowsy, pinpoint pupils, and my buddy nurse had to order nalaxone stat). But I also feel that i'm passing up the opportunity to gain more skills/knowledge, but i'm still absoultely and irrevocably terrified.

I'm a highly anxious person, so the idea of picking my preceptorship options scare me.

hesitantstudentnurse · Feb 27, 2017

If you didn't do well in med-surg and you cried every day definitely don't put it down as a preference. Just because you will gain skills and the majority of new grad jobs are in hospitals doesn't mean you should set yourself up for failure.
I enjoyed my surgical placement in school and wouldn't have minded doing my preceptorship there. Would of been a lot of job opportunities for me if I had gone this route.
But my passion was NICU, its what I had wanted for as long as I could remember. Yes there would be less NICU jobs available then med surg when I graduated but I decided I would do everything I could to make myself a competitive applicant.
Look at the job market in your area, are there any public health postings. It is still an important thing to consider. What other areas do you think you might like. Just because you didn't like surgical doesn't mean you would hate every area in the hospital. I loved cardiology and surgical but I don't think I would of enjoyed a medicine floor.

Yeah, I feel like i'm in a false sense of positivity that I can handle the challenges whenever I dabble with the idea of choosing med/surg for my preceptorship. But at the same time, I feel like i'm passing up the opportunity to grow. However, I also don't want to set myself up for failure since I'm not the sharpest tool in the toolbox when it comes to critical thinking, and I really don't want to endanger my patients' lives just because I didn't critically think..

I'm thinking of picking public health nursing as my first option, and doing med/surg for my second option, but i'm scared that if i pick public health for my preceptorship, I might screw myself over if I don't get a job in the field and can't find any other areas of nursing since I am limited to only public health. And what whole "WHAT IF" comes into play. what if I decide I want to try working in the hospital? What if I end up hating public health?

Do you know if preceptorship placement affects job prospects?

Libby1987 · Feb 27, 2017

All nursing areas require critical thinking, you can't avoid it.

Have you worked in the community setting before? Or volunteered?

jennylee321 · Feb 27, 2017

Graduating nursing school without any critical thinking skills is concerning, you need these skills for any nursing job. If you want a job without critical thinking, you will have to look outside of nursing.

HOWEVER, I have a hunch that you are being really hard on yourself and you probably do have the capacity for critical thinking. Remember that you've made it this far in nursing school which requires critical thinking. If your not the sharpest tool in the shed as you say, I doubt you would of gotten into nursing school so give yourself some credit.

You mentioned you made a patient error during your clinical. I think you really need to take some time to sit and reflect on this error (even right a reflection on it). Once you've reflected, write everything you learned from the incident, what factors contributed and what you would do next time. Once you have done this you will have used this mistake to inform your future practice and there will be no point in dwelling on it any further. When you've done this you can forgive yourself and move on from it.

Keep in mind also that even though your school gives you a preference to list, it's a lottery and you may get your last choice anyway. It's really out of your hands in the end so you will have to make the best of it.