I spent 12 hours with the preceptor from hell last week, and I'm dreading going back to work tomorrow.
A little background: I completed my 7th week of orientation at a new facility, having 3 years experience. I will be critical care float pool for a pediatric hospital, and am about halfway done with my orientation. I've had 10 preceptors so far with positive feedback from all of them, and am becoming increasingly confident in my transition from peds med surg to critical care. This patient was an intubated toddler, on propofol, with a planned extubation the next day. I was placed with this new preceptor because mine had a schedule change.
This shift did not start off positively. I approached my patient's room and the nurse at the desk introduced herself, I realized she was going to be my preceptor and introduced myself as well. I then peaked through the window into the room, and said, Well I am ready to start report, but I don't see the day nurse.†My preceptor snaps at me, clearly irritated, I'm the nurse. I came in at 3. You can come in at 3 and still work a night shift. It's called a double.†I'm a little taken aback, but just mumble okay great†and follow her into the room for report. I do tell her that I'm not very familiar with propofol, I had only been exposed to it twice on patients that were extubated quite early in the morning.
The shift continues, but does not go well. My preceptor criticizes my every move. How I put eye drops in, how I reposition the patient, how slow I complete oral cares, that I don't know how to bolus the propofol properly (I wasn't sure how to program the pump), etc. She would even pop her head into the room to chew me out for not charting something, when I was still in the middle of my charting.
She laughed at my questions when I dared ask them. She even gave me the wrong answer when I asked if a certain lab needed to be on ice (the policy said to put it on ice if it would not be run in 30 minutes. Turns out, they run ICU labs immediately and it does not need to be on ice, so I just did useless busy work).
She also let me know she was willing to throw me under the bus. She was describing how I would need to assist the patient during the xray, you need to watch that tube. Because they aren't watching it, and they are gonna say it's fine. But if it comes out, it won't be me that's in trouble. It will be you.†When Xray did come, she did not help me position the patient.
If this was the worst of it, I could handle that. But, she even found a way to criticize me for something that happened on a previous shift, while simultaneously making me paranoid that the whole unit hates me. In the middle of criticizing my charting, she says, people have been talking about you, you know. Last night, you know you shadowed the admit? Well, you said something to the family. You were supposed to be a fly on the wall, not saying or doing anything except maybe asking the nurse questions if they have time. You were way out of line. If that had been me, I would have thrown you out of the room and chewed you out. But (nurse's name)'s a newer nurse. She's not as salty as some of us. Yeah, I thought I'd let you know cause if it were me, and I did something wrong, I'd want to know.†Sadly, I know this means people have been talking about me, because she was not there that night. I also do not know what I may have said to the family, because nobody brought it up to me at the time.
I understand that ICU's are full of nurses with strong personalities†and that there may even be some hazing of new nurses. However, this seemed too aggressive for that. I have a meeting with my educator to discuss what happened, partially because I am nervous this nurse will report me for incompetence, and partially because I feel like I should report her for being so unprofessional.
Any advice would be appreciated!! I am very nervous to say something to management and have it come back to her, especially if people on the floor already have a low opinion of me. I've really liked this job so far, but now I'm dreading going back.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Although this sounds horrible there is no way I'd go to management about a peer at this point.
I agree. Part of nursing is getting along with difficult, unkind and unpleasant people. Going to management isn't going to change the preceptor, management will usually side with the known quantity rather than the new employee and it will put a target on your back.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I did this and my first year was absolutely horrible because of it. I had worked as a CNA prior to becoming a RN and had known this nurse and we were good coworkers prior to her becoming my preceptor.
Once she became my preceptor (which I was initially stoked about) she just went all mean girls on me...
The preceptor made it her life's work to make my life as hard as possible and the other staff that were her friends joined in as well. The worst part about it was that the manager knew she was not ready to be a preceptor as the orientee she had before me had quit the on the last day of their orientation together. Man I wish I had known this piece of information up front!
The manager also did not intervene and just let me drown until I figured out how to swim. This is probably the reason I'm passionate about staff development and leadership.
The fact that a previous orientee quit does not mean the nurse was a poor preceptor. The other orientee may not have been suited to the job. Now the preceptor is concerned about her "failure" as a preceptor and she's going to be extra sure that YOU learn what you need to know. Perhaps that isn't the case, either, but my point is that the other orientee quitting is not necessarily a reflection on the preceptor.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I kind of agree when you said "but that is the reality of some nursing workplaces nowadays."
However, if it's unhealthy, one has to do something about it and not just "to suck it up."
She, I believe, is in a spot where the preceptor can easily tell her manager that she is unfit for the unit. So, I'd rather fix the problem now by asking for a replacement, like soon! I don't and will not tolerate bullies. Unless you let them!
So it's like damn if you do and damn if you don't! If I were the OP, I'd rather do something and that is standing up for what is right, this in turn, may define her future in nursing!
The OP is talking about one bad apple a month the ten preceptors she's had. Hopefully she gets along with the other 90% of her preceptors. Unless most of them share the opinion that the OP is not a good fit for the unit, I doubt the OP is in danger of being deemed a poor fit for the unit. Going to management and complaining about a preceptor is a pretty good way to paint a target on her back. My nurse manager considers teamwork to be especially important and going to her about your preceptors or colleagues is a good way to start making her wonder if you'll be a team player.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I didn't read through your whole post, but if you're discontent with your preceptor, ask for a different one. You are right that orientation in ICUs and ERs is generally not pleasant or enjoyable, but there is only one way to fix it: either live with it or ask for a change. If your preceptor is truly being a difficult/unprofessional person then you should report it. It is just a job and you're entitled to work with pleasant professional people without being harassed or belittled. You could also confront your preceptor directly about your concerns (which would be my first tact) and see if she can accommodate your needs. I don't know what to tell you except nursing can be a weird environment. Just stay professional, learn, be good to yourself, be good to your patients, and everything will work out.
Your critical thinking needs work if you're thinking to offer advice on a post which you admit you haven't even read.
The fact that a previous orientee quit does not mean the nurse was a poor preceptor. The other orientee may not have been suited to the job. Now the preceptor is concerned about her "failure" as a preceptor and she's going to be extra sure that YOU learn what you need to know. Perhaps that isn't the case, either, but my point is that the other orientee quitting is not necessarily a reflection on the preceptor.
And in my experience the supervisors know who is a good preceptor and who isn't anyway. Perhaps there was a last minute call out or emergency which resulted in OP being assigned this less than stellar preceptor or there was no one else who could do it patient load wise? In my experience the ability to be flexible and suck it up on occasion actually reflects positively on the new staff member. Now is not the time to be assertive and attempt to establish boundaries there will be plenty of time for that when you become a contributing member of the team. Again I am in no way supporting the despicable behavior if as the OP posted however going to management because of one shift with a sourpuss preceptor #1 is never confidential and #2 will be interpreted as someone who can't work well with others, jmo.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I just don't understand why some of you feel that anyone who is "new" should put up with foul treatment from older staff members. Nursing as a profession is stressful enough for all sorts of other reasons. No one has time to deal with toxic, bullying behavior from coworkers. Being rotten and disgusting towards fellow staff is not cute nor should it be tolerated. We're all supposed to be grown people here.
As a preceptor, they are there to teach and/or lead by example and if not, get out. Some of these folks act like someone forced them to take on this role. If that was the case, please don't take it out on the preceptee. They've got problems at home, with their job or with life in general? Please don't take it out on the preceptee. They're not there to be their personal punching bag. They are there to earn a living just like them.
No, the OP should not have to suck it up and just take it. And so what if she's not liked by others for standing up for herself? This is a job not a popularity contest. That preceptor was unprofessional and unhelpful. The OP will never learn this way...period.
No one should put up with continued foul treatment from another. But the OP is new, and she doesn't know if this is simply a good nurse, employee and preceptor going through a very bad time or someone with a perpetually sour outlook. The reality is that many preceptors ARE forced to take on the role. THIS particular situation looks like one in which there is such a dearth of qualified preceptors that they cannot even offer the OP a regular preceptor or three.
I wish all the orientees out there who are expecting to be taught/mentored/led by example and if the preceptor isn't up to snuff they'll just go away would be as considerate of the preceptor's feelings as they expect the preceptor to be of theirs. Sometimes preceptors are living through truly awful life circumstances and they don't get a choice to NOT precept. Precepting makes a shift three times as difficult as just going in there and taking care of your own patients, and some preceptors just don't have the extra energy for that right now.
The nurse who was back to work within two weeks of her son's suicide because she was the sole breadwinner for her family and she needed to keep up the health insurance because her husband was in ICU waiting for a transplant. The nurse who just moved her mother into her home with her because Mother has Alzheimer's and can no longer be trusted to live on her own -- but Mother wanders all day and all night and the nurse cannot get any sleep because mother will (has already proven she will) wander into danger. (I tried taking care of Mother at home -- trust me, Mother can get into life-threatening situations of her own making quicker than you can fall back to sleep after rescuing her from the last one.)
Give every preceptor the benefit of the doubt; especially if you've only been with them once. You would want the preceptor to give YOU the benefit of the doubt.
I have read your post with interest and here is what I find:
1. stop being a people pleaser. It is easy to say you do not want to be labeled by the other members of the staff but I need you to pair that with a date in court.
2. stand up for yourself. Nurses have the tendency to look at the more experienced nurse in awe. Come down from the clouds we all started on day one and we all put our nursing caps on one pin and a time.
3. go to management. Getting reprimanded for something and allowing someone to set you up for failure is not good. Report, report and report. This is not the first time this nurse has preformed in this fashion. There has been more than one nurse who has experienced her raft. Now she gets to experience yours. Remember pts lives are a stake. Not your feelings and not the feeling of the other staff members.
I could go one and on but you get the point.
Report, stand up for you and stand up for your patients.
Well I've gotten along great with the day shift nurses on my units. Several nurses on the night crew seem to have it out for me.
As a float nurse myself, trust and believe that management already knows which nurses have which personalities. They'll surely insert your name under the 'can't handle constructive criticism' tab.
I simply give them the look that I'd probably be tempted to be as mean as them, too, if I had to do this job everyday. But as a float nurse, I don't. So I smile and keep it moving. Your orientation won't last forever. When it's done, you'll be calling the shots with your patients. Just remember not to be mean like the preceptor when you reach that point where you may know a little bit more than the next nurse.
On a side note, I've wondered sometimes (because most times, I don't give a crap), why it seems that nurses who primarily deal with patients who don't, or rarely, utter a sound seem to be on the most vicious power trips. Perhaps it's because they are not subjected to the abuses that the conscious patients hand out so freely.
I didn't read through your whole post, but if you're discontent with your preceptor, ask for a different one. You are right that orientation in ICUs and ERs is generally not pleasant or enjoyable, but there is only one way to fix it: either live with it or ask for a change. If your preceptor is truly being a difficult/unprofessional person then you should report it. It is just a job and you're entitled to work with pleasant professional people without being harassed or belittled. You could also confront your preceptor directly about your concerns (which would be my first tact) and see if she can accommodate your needs. I don't know what to tell you except nursing can be a weird environment. Just stay professional, learn, be good to yourself, be good to your patients, and everything will work out.
What, really? I find this the complete opposite. At least on my unit all of our preceptors are awesome and experienced nurses. Probably a little bit OCD about how they like things...but i had a great orientation. Although i was mostly with 1 preceptor i sometimes changed days and was placed with other nurses...all who were great.
Well thanks for the feedback everyone! I spoke with my clinical educator off the record, and went into everything that happened. With my permission, she will speak with this nurse's educators asking if she normally precepts and anonymously mentioning that her staff had a negative experience with her, and that she maybe isn't the best choice for precepting.
Oh...it is not going to be anonymous. Especially if you are the only one she precepted recently.
"Anonymous" reporting.... Nothing in this world is anonymous!
Well thanks for the feedback everyone! I spoke with my clinical educator off the record, and went into everything that happened. With my permission, she will speak with this nurse's educators asking if she normally precepts and anonymously mentioning that her staff had a negative experience with her, and that she maybe isn't the best choice for precepting. My educator voiced sympathy for my experience, and did say she remembered this nurse from when she used to float to the unit, and recalled her being fairly rude on a regular basis. Luckily, I should not have her as a preceptor again. If I do get assigned to her, I plan to ask the charge nurse for a reassignment prior to the shift start. There's also a good chance I will not work very closely with her as float pool tends to be assigned down the less intense hallway.
By chance, my neighbor tonight was the nurse I would have shadowed for the admission last week, and she seemed appropriate throughout the shift. Whether that means she will only talk behind my back vs. to my face, I can't say.
I'm glad something was done!
Re: people talking behind your back that's should be the least of your worries at this time. Just learn right and do things right and take a whole lot of advantage while you still have a preceptor!
Honestly I would just keep my head down and move it forward. How often do you have to work with this preceptor? Just try to get through it. If all of your other preceptor experiences have been positive, I wouldn't focus on this one. I know it's awful when you're in it but just try to get past it.
Nothing in this world is anonymous! 
Ruby Vee, BSN
17 Articles; 14,051 Posts
I agree. Part of nursing is getting along with difficult, unkind and unpleasant people. Going to management isn't going to change the preceptor, management will usually side with the known quantity rather than the new employee and it will put a target on your back.