precepting assignment- need advice

[Iliauna]

Hi everyone,

I am in my last semester for my BSN, the class I am in has been weeded down by 50%, those of us precepting at this time did not get any acknowledgement of our 1st, 2nd, or 3rd picks. However given our small class size, most of my peers were placed in critical units. I was set to precept at a magnet status institution, last minute this fell through and as a result I got switched onto a basic medical/surgical floor at our local, rural hospital. One that I did clinical on in my 1st year. This is the lowest level of acuity available in this area and in many ways is not what you think when you hear medsurg floor. I am the only person working this level of my class, yet I'm top of my class.

Beyond how devastated,I am trying to come to terms with it. What I'm wondering is how much will this effect my future career opportunities? I want to work in a critical care unit eventually and am concerned this will come across as a red flag on a résumé if I did a clinical there, then clinical on critical care units, now precepting back to a basic floor that doesn't even have a name... (Please know I am not downing medical surgical floors, as in this case I don't even know what to categorize this floor as....) any advice is much appreciated!

[VANurse2010]

Thank you for your reply. I know that in any setting there is a great deal to be learned for me as a student. I am simply disappointed in the lack of planning that put me in a situation which could have been prevented. I believe that those that work hard should be acknowledged for their efforts vs. those that put in minimal effort, in a "fair" world that would be ideal. That being said I know that isn't always the case. I would never speak so candidly to a potential employer as I have here and know better than to do that. I just came here to speak honestly and get informed about the potential implications this would or would not have on job opportunities. I have approached the situation with positivity and expressed my gratitude in all professional settings and plan to make the best of it.

I should have clarified. I don't think it will hurt your career at all because your classmates that *do* have ICU preceptorships will be no more prepared or competent to function as independent RNs than you will be. The *only* thing that *might* hurt you is that you won't have the opportunity to make connections on the unit the way you may have with a preceptorship. However, as you've seen on these boards that can cut both ways

[Iliauna]

Thank you so much! I really appreciate that.

[lilbitgeeky]

I know that this is disappointing. Your preceptorship seems like it's an accomplishment, and something you've been working toward the entire time you've been in school. However, it's really just another step toward the bigger accomplishment of being a fully oriented nurse taking a patient load of your own.

My suggestions for making the most of your experience no matter what size the floor or the acuity of the patients. Try to get report on as many patients on the floor as possible. You'll hear diagnosis and situations that you've never heard of you and you'll get to ask questions and research these. Make yourself open to assessing as many patients as you can. Even if you're just getting someone up to the commode. When you get them back to bed, if you haven't already listened to their heart and lungs DO IT!! You'll learn to recognize abnormal assessments the more you do. Similarly ask your preceptor to keep an ear out for patients who have weird assessment findings (ie. listen to someone in a. fib, someone with crackles, rales, wheezes, etc.)

If you want to be a critical care nurse some day your assessment skills need to be phenomenal. The best way to do it is to assess as many people as possible and you can do that in any floor. And most importantly if you don't know what you're hearing, your preceptorship is the perfect place to ask someone to take and listen and talk it over with you.