Precepting new BSN grad/having trouble

[Mudwoman]

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.

[whodatnurse]

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

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

RN-BSN, BA

[Irishgirl]

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.

[mrpickle]

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]

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]

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?

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.

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.

[Fun2, BSN, RN]

I hope she's reading this and her behavior being ridiculed world-wide embarrasses her.

Her career will be short with that attitude, and unfortunately, it could be at the expense of a patient's life.

[lorabel]

Shame on the BSN! Coming from a horrible experience as a new RN, I would have LOVED to have had a preceptor that cared enough to encourage and guide me as you are trying to do. What goes around comes around as they say. I am thinking that her over-the-top confidence will be shattered one day soon. I didn't have enough confidence in my skills and that was MY fault. This new BSN has too much and I was told in an interview that they would rather have new RNs that feel scared than walk in thinking they know it all because those type are the most dangerous! I was told they wouldnt even hire nurses like that. You do what your gut tells you and it will be the right thing. Ultimately, you are protecting your patients! At the end of the day, the preceptor is responsible for what the orientee does....I think? You hang in there and let management have a little sit-down with her. I have a feeling you are a wonderful preceptor and one that cares!

[rashan1053]

I have been a RN for 6months now and have belonged to this site for awhile. I have read so many posts about "know it all" new grads. I still feel like I could be in orientation because there is so much to learn. School can't possibly teach you all the different skills you need to be a nurse. This particular person truly upsets me. Many new grads are truly scared-to-death about starting their first job and how they will get along with their preceptor. When good---I mean excellent preceptors (like this one) come along they need to be respected. They offer so many years of experience and wisdon that new grads need to take advantage of. I hope to someday be one of those nurses new grads can count on. Until then I am going to take all the advice and knowledge I can from my more experienced colleagues.

[lilywater]

The first thing I see in everything you have written, is that this orientee is not putting patient safety first. Someone who is not allowing a designated preceptor who knows the unit and the patients to help her is not thinking in terms of what is best for the patients. For her to actually think that her BSN gives her any type of one up on a seasoned nurse is audacious. What really matters in floor nursing is your license, not your degree. Without that license, you can have your BSN from the very best and would not be designated as safe per the state boards to practice. This nurse needs to be re mediated. I think as soon as she made the comment about her not needing your help because she has her BSN should have been documented and taken to management. That is out of line professionally, and is not a safe attitude to have when you are a nurse with lives in your hands. In my honest opinion she sounds a little bit like someone who has borderline or narcissistic personality disorder, and those types of personalities are not compatible with the real world of nursing. I honestly believe that this needs to go to management because it sounds as though this orientee to your unit has stepped out of her boundaries multiple times.

[justme1972]

This is what I would do if I were you:

You need to take her into a private office and have an "off the record" conversation with her.

Start of positive, tell her everything that you like about her, but inform her that hospitals are some of the most gossipy places on earth, tell her right to her face that you know what you said about her...however...everyone, even new grads, has to start somewhere, and a degree isn't a short-cut to learning the day-to-day care and management of patients.

You won't be chastizing her, you'll be doing her a favor. Tell her that, "I have been a nurse a long time, I want to see you succeed, this profession needs good nurses, and I would rather have this conversation so you can vent and we can discuss anything you want tol...before someone in management or HR does...because if you keep this up, it will eventually happen."

She is probably too ignorant to understand that she is committing career suicide.

[NurseBrittney]

One of the first things I said to the nurses on my first day of orientation is "I know that I've graduated nursing school, but I am well aware that I don't know a thing and would appreciate all the help I could get" They all had huge grins on their face.

Personally, I would much rather teach someone to do something start to finish than have to try to 'retrain' an arrogant know-it-all.

Sorry you have to deal with foolishness.