Precepting New Grad in CVICU

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Hey AllNurses-

I'm a second-career RN who started my nursing career in a small CVICU/CVRU two years ago. As such, my learning curve has been very steep (including 90+ hours of intensive classroom and simlab orientation at hiring), but I can finally function independently and have much more realistic expectations of myself, the job, etc. Dare I say- I even like my job some days. :)

A couple of months ago, I was asked to be a preceptor for another New Grad RN to our unit. While she is technically a new grad, she has also been in the healthcare field for decades and has an ease about assessment and patient care that comes with lots of clinical experience. Rewind to add that MY initial orientation to nursing was very harsh, very difficult, and not well managed. I survived, let it go, and met this opportunity to be a preceptor with the idea that I would not let this new grad sink or feel hazed instead of supported.

To the issue: My role as a preceptor is not going well. We have developed a dynamic that includes her not knowing what nursing actions to take- and she is hostile when I prompt or attempt to help her prioritize. So I'll confront this and let her move on to another preceptor, but it's disappointing. I wonder if it's me... or if healthcare education teaches to expect a harsh teaching style....

Any resources or ideas how to become a better preceptor? Would love any insights.

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Is this new grad older than you? Probably was intimidated by you. If new grads were really open minded about learning, they wouldn't be so hostile.

By the way, which medical center did you get your ICU training experience? Would love to be a nurse like you! :)

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I am new grad.. I like my preceptor. However I wish she challenge me further versus letting me do what I think it's right.

No you are doing the right approach.. I would talk to her and ask if anything is bothering her. Sometime personality clash and will not help neither of you. Specially her and the safety of the patients.

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I would love to have you as a preceptor! I'm a new grad and have experienced those preceptors, who obviously hated teaching and let that trickle over into their behaviors, as a preceptor. ..not good experiences. You sound perfect!

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Apply the nursing process and begin with an assessment of the new nurse and their learning style. One of the first things I do is sit down with the person and discuss where they are coming from, what they expect to get out of the experience, etc... Once you have a mutual understanding, then you can proceed. I don't often "give" the answers, but I make the person reason it out. Of course, I don't expect them to have all the answers and I sometimes feel like a "guide". Precepting is difficult and it's not for everyone. Also, you're not always going to mesh with every single person you come into contact with, either.

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Thanks for all of your insights- my role as a preceptor has actually been another opportunity to learn about myself as a nurse. Since my last post, I spoke with our nursing educator and my orientee using our weekly progress worksheets, keeping my comments very factual and observation focused. The new nurse was immediately forthcoming about some personal and professional issues that, she felt, were hindering her progress with me. She apologized, insisted we stick with it, and she's done a great job since. It's nice to know that we can help each other progress in a mature fashion!

Thanks for all your ideas- much appreciated.

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I think you went into the precepting position with the right attitude, you would not let her sink! Being a new grad myself, I was just precepted to a CCU. I had three different preceptors who were all great, but I think that it takes two for the experiece to be all that it should be! They were all very knowledgable being seasoned nurses in this field for many years, and I was very receptive and appreciative of their teaching. I liked that they didnt let me feel stupid, even when I asked a million questions. They were all very supportive, I really liked how they took the time to introduce me to all of the doctors! That way when I am on my own I will know who is who.

I think you sound like a great preceptor, sometimes personalities just clash. Dont take it personal :up:

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Apply the nursing process and begin with an assessment of the new nurse and their learning style. One of the first things I do is sit down with the person and discuss where they are coming from, what they expect to get out of the experience, etc... Once you have a mutual understanding, then you can proceed. I don't often "give" the answers, but I make the person reason it out. Of course, I don't expect them to have all the answers and I sometimes feel like a "guide". Precepting is difficult and it's not for everyone. Also, you're not always going to mesh with every single person you come into contact with, either.

This sounds like me! It's taken me a decade of trial & error precepting new grads to figure out my teaching style & sometimes it doesn't jive with the new grad's learning style. Talk it out & try to work it out. If it really can't work, then switch it up. Usually I try to adapt to their needs & learning style so it works out. I always keep them informed about expectations, progress, things they did well, & things to work on. I always ask how they think they did prior to giving my feedback. I ask questions to figure out how they think & if they are on the right track. They know up front that I don't expect the right answers all the time...just a decent attempt & more questions usually means to keep trying...it just takes awhile for them to trust that I won't flunk them for wrong answers but they eventually do learn that. But once they do, I can see them blossom as an ICU nurse.

To the OP: I know what you are experiencing because I started precepting with just shy of 2 years ICU experience. I thought my manager was nuts because there were tons of nurses with much more experience then me. But it's taken me awhile to realize that experience doesn't always equate a good preceptor. What precepting has taught me is patience as well as expanded my knowledge base because you can't teach well what you don't know! Good Luck! It looks like you are on the right track.

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