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Precepting new BSN grad/having trouble

Posted

Specializes in Certified Diabetes Educator. Has 20 years experience.

I am an older nurse and a designated preceptor. I had a new BSN RN grad yesterday and for the first time ever, I had problems. Mostly I'm looking for feedback so that I can correct anything I did that made the situation worse and maybe some feedback from new grads so that I will do better at handling the situation in the future.

This RN is starting her 3rd week of orientation. She only wanted to take one patient and she wanted to handle that patient by herself------which after much "discussion" came down to the fact that since I'm an RN, but don't have a BSN, she did not need any assistance from me. She simply needed me to direct her to our procedure manual on the floor and leave her alone. I was nice, but had to be firm about the fact that she would be taking 2 patients, I would be there to help and check her off as required by the hospital on certain skills she performed and that no one gets to "be alone" during orientation. The entire day was a struggle. She only did something for the second patient when I absolutely made her do it. She went into the break room and told the nurses in there that she just might not even come back the next day and that she did not like me at all and I need not think for one minute that she was going to do my job for me while I told her what to do. She went on to say that she did not need all this orientation, and I was just trying to punish her. She wants to go to nights, but all the night positions have been filled at this time and she made the comment at the front desk in front of everyone that she thinks the hospital is doing it on purpose just to keep from paying her what she is worth.

So, I never want to lose a nurse and I think she has really good skills. I think she is a good nurse. I just have to get her to understand that this is now the real world that no book in the world could teach her. This is about time management, surviving in a hospital culture, and all the little hospital policies that can be learned faster and easier than reading a policy and procedure manual.

Help.

Uh, she sounds a little like a nut job to me. I'd take her straight to the manager and let them set her straight. She sounds like she's got some hang-ups about the whole BSN thing.

Doesn't sound like you did anything wrong at all -- it's her.

Lovely_RN, MSN

Has 11 years experience.

I don't think that you did anything wrong. That new nurse has a horrible attitude and she was very disrespectful to you.

Also she sounds like she is going to be a problem employee. It's usually a bad sign when a new employee has the guts or gall to cop an attitude so quickly.

I will be surprised if she last six months.

NotReady4PrimeTime, RN

Specializes in NICU, PICU, PCVICU and peds oncology. Has 25 years experience.

omigosh!! i can so relate!!!! we've had a few of those lately and nothing seems to shake them out of their belief that there is nothing they can be taught because they have a degree! if only they were given the real story in university... that you do 99% of your learning on the job and university doesn't even really prepare you for that. (i know, i dream in technicolor...) we had one such gn in our picu, off orientation about 2 weeks, give a baby captopril via his central line... her first code! then our management apologized to her and said she should never have been saddled with that assignment: a baby post cardiac surgery ready for the ward and the most stable patient in the unit. another one at about the same juncture in her career gave me report on a burn patient who had been extremely unstable hemodynamically just the day before. she was so proud of the fact that she was able to read nine chapters of the newest harry potter that had been released the day before, because this child was so stable all night. yeah, because her transducer was leveled with the bottom of the mattress... and i'm pushing fluids and ramping up the epi!

so what's the answer? it would be irresponsible of anyone to give in to that sort of behavior. take it to your nurse manager and your nurse educator and make it their problem. that's what they get paid for. and if she leaves, well, i guess you'll have a much healthier work environment!

ukstudent

Specializes in SICU.

It's not you, it's her lousy attitude. DON"T give in to her. She probably believes that "she didn't go to school for 4 year to clean up **** either.

If she comes back, give clear directions about what is expected from her during the day (2 patients etc) and what the consequenses of not doing the assignement is (such as going to management - that she is failing orientation). Put it in writing and both of you sign it at the begining of the day.

Then sit back and see what she does. Do NOT keep reminding her about the second pt. If she does not do anything for that second pt, YOU do it. At the end of the day make copies of the charting, med records that show what she either did or did not do.

As in all things in nursing, you need a paper trail. If she again doesn't want to follow the steps of orientation you now have a document either signed (or not) about your expectations for the day and the results of her work for that day.

She is either going to have to bend to fit into hospital nursing or she will break. You can't make that decision, only she can. Good luck in your futher orientation of this new grad.

I just went to a preceptor class and the number one thing stressed in the class is clear comunication, about expectations and consequesces of not even trying to meet those expectations.

UM Review RN, ASN, RN

Specializes in Utilization Management.

Our hospital policy is clear on this, and yours probably is too. She's not apt to believe you at this point, judging from how she's acting already, so maybe your manager should step in and outline the policy and the expectations.

This would be the perfect example of someone I would not want to precept, because doing things "her way" is going to land her in dangerous waters. Things are done a certain way for a reason....usually the reason is patient safety.

Best wishes on this mission, Mudwoman. I think you have your work cut out for you.:twocents:

nursemike, ASN, RN

Specializes in Rodeo Nursing (Neuro). Has 12 years experience.

I suppose your facility has some policy against smacking orientees upside the head. Too bad. It might do her some good. Maybe she won't come back...

The really sad part is, there are first year nurses on this forum who would probably weep with joy to have a preceptor as patient as you evidently must be, assuming you've been able to adhere to that pesky no-smacking policy.

Chloe'sinNYNow

Specializes in Did the job hop, now in MS. Not Bad!!!!!.

So, I never want to lose a nurse and I think she has really good skills. I think she is a good nurse. I just have to get her to understand that this is now the real world that no book in the world could teach her. This is about time management, surviving in a hospital culture, and all the little hospital policies that can be learned faster and easier than reading a policy and procedure manual.

Help.

Mudwoman, where were you when I still stood a chance in hospital acute bedside care? I had the worst of the worst preceptors. And the last 3 weeks WAS with the banshee who was stern, ridiculing, never smiled, demanded, and warned of my impending emancipation from orientation in 3 weeks minus, 2 weeks minus...But when I really was sinking, she would just tell me that our facility has all the protocols on the Intranet, and I should never do anything on my [8 pts!!!~ it was couplet care] without researching beforehand.

I suffered with time management and all she did was throw me in the deep end while she sat back and played online or helped other nurses w/ their babies in the nurseries. But she never jumped in to help me, or show me how something should be done, or try to correct my time issues. And yet she wrote me up constantly in confidential correspondence to management about how she did all my pt care making me a risk?!?!?!?! (Gosh, what was I running my tush off for in those 12-14 hours?????)

I lost this battle Mudwoman and I have all the necessary degrees. WHOOPEE! Paperwork and classroom do NOT prepare a new grad nurse for the real world. All new grads should be so lucky as to start w/ a preceptor like you. Definitely go to management and nip this gossipy trouble maker in her bud!!

NurseMike, I'm with you on the slap upside her thick arrogant skull. She sounds awfully like a "trustfund baby" to me and I'll bet she wears the really expensive scrubs that she's afraid to get dirty too!

"for G-d so loved stupid people, he made so many of them"

Chloe

RN-BSN, BA

BlueEyedRN

Specializes in ICU.

I started with a girl who had a BSN and was always telling everyone that. She was the most frustrating person to work with ever. You couldn't tell her anything and giving report was like getting your teeth pulled. One of the doctors banned her from his patients forever after she refused to follow an order he wrote. "I went to school for four years to be here, graduated summa cum laude, I'm not stupid and I know what I'm doing." His reply, "I don't give a bleep what letters come after your name, you don't know bleep." Everyone had big grins on their faces. (I also started with a BSN, btw, and also graduated top of my class--we aren't all like that. I know my degree doesn't trump 10 years experience. In fact, it doesn't trump 3 months experience. It just means I took extra leadership and art history classes :bugeyes:).

Mudwoman

Specializes in Certified Diabetes Educator. Has 20 years experience.

Mudwoman' date=' where were you when I still stood a chance in hospital acute bedside care? I had the worst of the worst preceptors. And the last 3 weeks WAS with the banshee who was stern, ridiculing, never smiled, demanded, and warned of my impending emancipation from orientation in 3 weeks minus, 2 weeks minus...But when I really was sinking, she would just tell me that our facility has all the protocols on the Intranet, and I should never do anything on my [8 pts!!!~ it was couplet care'] without researching beforehand.

I suffered with time management and all she did was throw me in the deep end while she sat back and played online or helped other nurses w/ their babies in the nurseries. But she never jumped in to help me, or show me how something should be done, or try to correct my time issues. And yet she wrote me up constantly in confidential correspondence to management about how she did all my pt care making me a risk?!?!?!?! (Gosh, what was I running my tush off for in those 12-14 hours?????)

I lost this battle Mudwoman and I have all the necessary degrees. WHOOPEE! Paperwork and classroom do NOT prepare a new grad nurse for the real world. All new grads should be so lucky as to start w/ a preceptor like you. Definitely go to management and nip this gossipy trouble maker in her bud!!

NurseMike, I'm with you on the slap upside her thick arrogant skull. She sounds awfully like a "trustfund baby" to me and I'll bet she wears the really expensive scrubs that she's afraid to get dirty too!

"for G-d so loved stupid people, he made so many of them"

Chloe

RN-BSN, BA

Chloe,

I have tears in my eyes that this was done to you. I am so devastated when I hear that new grads have these kind of experiences. I hope that you will try again. Believe me when I say that all preceptors are not like this.

Charlee

Mudwoman

Specializes in Certified Diabetes Educator. Has 20 years experience.

Thank you all for your replies!

I ended up with this nurse because the person that was supposed to be orienting her had a death in the family. I was already orienting someone that day ( a jewel of a nurse btw). We are doing total care on our floor (neuro/step-down) and my other orientee was taking 3 patients and so I still had 2 and there was no one else on the floor to take this nurse.

I didn't smack her. I always want new nurses to have a chance. Some don't work out and this one may end up leaving. Maybe she didn't come back the next day. All this happened on the weekend when we don't have a unit manager there. Our charge nurse is aware of everything and she was going to talk with our unit manager about it. I will just leave it in their hands. However, if I end up with her again, I'm still going to do everything I can to help her succeed.

I hope the personality I dealt with was just a defense mechanism, and that under all that blatant defiance is a new nurse with great skills that is just scared. I would like to be able to show her she doesn't have to be. I just don't know how to do that at this point. I'm clueless.

Charlee

PS I'm in Hot Springs AR if any of you newbies want to come. Beautiful area!

suzy253, RN

Specializes in Telemetry/Med Surg.

I think you're a great preceptor!

Her attitude is totally wrong and unacceptable and hope that the manager straightens her out!

whodatnurse

Specializes in Psych.

You have the heart and soul of a teacher! :yeah::yeah::yeah:

Sounds as if she has a long way to go towards learning to adapt to the culture of whatever workplace she finds herself working in.

Something within your own control you can work on developing is comfort with being in a role of authority. Personally, I would be thrilled if someone said to me "these are my expectations and this is the criteria by which you'll be evaluated". The onus is upon HER to make sure she's doing what you want her to do, not upon YOU to accommodate her personal preferences.

Here's an example of something you could say in such a situation:

"You'll be expected, under close supervision, to handle all responsibilities for two patients. As you develop a track record of demonstrated proficiencies with XYZ, you'll be granted additional autonomy."

Chloe'sinNYNow

Specializes in Did the job hop, now in MS. Not Bad!!!!!.

Chloe,

I have tears in my eyes that this was done to you. I am so devastated when I hear that new grads have these kind of experiences. I hope that you will try again. Believe me when I say that all preceptors are not like this.

Charlee

Charlee,

you are sweet to say so. You make me want to hop a plane now and find you!! I'm afraid my experiences that so wracked my physical health have also mentally scarred me. Next week I'm starting in a lovely nursing home here, but taking a $10k/yr pay cut to do so.

Just keep doing what you are already doing. It reminds me that there are still good nurses out there.

Chloe

:nurse:

RN-BSN, BA

Irishgirl

Specializes in ER, Research. Has 6 years experience.

Wow, I can't believe the immaturity in this person. She sounds like she'll be a terrible nurse with such a know it all attitude. Being cocky gets you nowhere in nursing, in fact, it may land your patient in trouble when you can't admit you don't know something. As for the "BSN is holier-than-thou" attitude, that just sucks. I think if you're an intelligent, caring person, the degree doesn't matter. A lot of nursing skills are "on the job" training anyway. Good luck with this student. Let's all hope that her first humbling experience doesn't cost a patient anything.

I recently graduated with a BSN, and you know what? I feel like I didn't learn diddly. I can give posterboard teachings, powerpoint presentations, and make concept maps (ugh!), but when it comes to clinical skills, the local community college is cranking out way better unit nurses...I've spoken to a few members of my graduating class, and they concur. I've also spoken to a few local nurses who precept new grads, and they concur as well!

Chloe'sinNYNow

Specializes in Did the job hop, now in MS. Not Bad!!!!!.

I recently graduated with a BSN, and you know what? I feel like I didn't learn diddly. I can give posterboard teachings, powerpoint presentations, and make concept maps (ugh!), but when it comes to clinical skills, the local community college is cranking out way better unit nurses...I've spoken to a few members of my graduating class, and they concur. I've also spoken to a few local nurses who precept new grads, and they concur as well!

:yeahthat:

I CONCUR!!

Chloe

RN-BSN, BA

1MOM2RN

Specializes in Med/Surg.

i am a brand new nurse, in week 4 of my preceptorship and i would never dream of doing or saying the things she did. it is 100% her,and you have done nothing wrong! if she starts out this arrogant as a newbee, can you imagine what she's going to be like when she's on her own? :eek:

i made the decision to put off continuing towards my bsn until january, because "i will be learning 10 times in the next year what i learned in school". she'd better figure that out fast! i commend you for putting up with it. i'm afraid i would have had some equally snotty things to reply to her.:saint:

when i leave my shift every night, i thank my preceptor. i am well aware that i will go nowhere without her guidance and patience with me. you deserve respect, not this treatment.:o

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