Preceptor Issues -CVOR

[nocturnallife, ASN, RN]

Hello All nurse family,

I am currently a new graduate RN working in the OR on a general team. However, I'm interested in learning CV because I find the cardiovascular system interesting and I think I would like it. I was allowed to be in the CVOR with a preceptor for a day and I liked it. The other team members such as the perfusionist, anesthesia and even the surgeon was welcoming but the CVOR nurses in the room were not receptive. They did not explain anything they were doing. It's not like they were too busy to explain things either so I'm not sure what to think. I asked questions but I would only receive one word answers. So now I'm hesitant to switch teams.

Any advice is appreciated. Thanks :)

[meanmaryjean, DNP, RN]

Asking questions during a procedure is a good way to cause an error to happen. Ask your questions afterwards. That's probably why you got the one-word responses, they were focused on the patient.

[nocturnallife, ASN, RN]

The surgical techs and the crnas teach colleagues during procedures. Crnas talk to their students through out intubations. Surg techs talk to their preceptees through out cases. So why can't the circulator nurse explain what she is charting? Other preceptors usually explains things as they are doing it. If they feel I'm asking questions at inappropriate times then just say so.

[Rose_Queen, BSN, MSN, RN]

Not everyone is cut out to be a preceptor. You spent one day with one person. Take it as a learning experience that precepting is not for everyone. However, I also looked at your other thread about your orientation. It seems you feel like this with almost everyone- perhaps you need to take a look at what you are bringing to the table as well.

[nocturnallife, ASN, RN]

I have assessed myself as well. I like the OR. I try to prepare for cases by taking home preference cards and also I purchased a few textbooks. I also study at home independently because I like the role of a circulator. I want to be successful. I also study the surgeons operative notes. Some of the preceptors on general team are great. But there is also a few preceptors that just use you to make the day go by faster. I just need someone to explain things when they do it. That's it.

[Rose_Queen, BSN, MSN, RN]

I just need someone to explain things when they do it. That's it.

Have you communicated that need to the preceptor you're with? It's human nature for one to try to teach in the way that one best learns, so if your learning style isn't a match for your preceptor's, they need to know what you need ahead of time to prepare. Even so, it's not always feasible to explain what's happening as the circulator is doing what they're doing.

[nocturnallife, ASN, RN]

I hear you.

[offlabel]

People that are uncomfortable in what they do are uncomfortable trying to explain it to others. Are there staffing/morale problems among the RNs there?

[Nurse SMS, MSN, RN]

It sounds like you were there to observe, not to be specifically trained. That some were willing and able to be more involved with you is a boon for you. To state because some did it, everyone should is pretty unfair. You were an extra variable to deal with that day. You were not entitled to training in that scenario and it is unfair of you to have that expectation. You were there with an assigned preceptor for observation purposes for one day. If you become formally assigned to the CVOR then I suspect you will be given a structured timeframe and process for getting up to speed in that environment, at which time your questions will have answers readily provided.

[nocturnallife, ASN, RN]

I'm excited about being in the OR. Yes it was kind of an observation thing but if I were the preceptor I would explain things as it is happening. I'm would be more eager to share my knowledge with someone that was interested in learning. I'm at a teaching hospital and the surgeons teach residents during surgeries all the time. If the surgeon can do it why can't preceptors? My preceptor did talk to me during the surgery. I was informed that the cv team was not easy and that it was harder than general. It almost felt like I was being discouraged from trying.

[nocturnallife, ASN, RN]

@offlabel yes the hospital does have staffing issues and people are overworked because of it

[ggoodman]

From my perspective, if you are new to the OR and are not in your heart rotation is is not worth my time to really get into every aspect of an open heart case, you wont remember it. Hearts can be very busy and for the most part I am acutely attentive to the needs of the field and the status of the patient. The OH room is not the place to learn the basics of circulating. I always start my OH orientees when they are in their OH rotation watching the first day at the head of the bed. I exspect them to watching every part of the procedure from the intiall intubation to the transfer of the patient to ICU. IMO a good or nurse is two steps ahead of the field and can see things coming. When the **** hits the fan I have serve not only the surgical team but also perfusion, and anesthesia team. our basic OH rotation is 3 weeks and by the end I expect my orientees to not only be able to run the room but be able to tell me about the soft goods and instrumentation as well. When I am in the charge role I keep tabs on the heart and I am always available to those rooms when it gets bad as in this room it is truly life and death.

Sorry for ranting.