Preceptor issues

You say she likes getting on your case even though it is legit.... Remember the preceptor is your teacher, she is not getting on your case to be mean. Learn from your mistakes, ask her help for ways to help with remembering what ever your are forgetting. You have been on orientation for only 2 1/2 weeks, you have a while to go. Precepting done correctly is not an easy job, she is on your case because she cares about the unit, the patients and the nurse you are going to turn into. If after some time you still feel this way, then talk to your educator about the problems you are having with her.

You say she likes getting on your case even though it is legit.... Remember the preceptor is your teacher, she is not getting on your case to be mean. Learn from your mistakes, ask her help for ways to help with remembering what ever your are forgetting. You have been on orientation for only 2 1/2 weeks, you have a while to go. Precepting done correctly is not an easy job, she is on your case because she cares about the unit, the patients and the nurse you are going to turn into. If after some time you still feel this way, then talk to your educator about the problems you are having with her.

I understand what youre saying but actually, she's always sitting around, talking with the other nurses, eating, etc. Occassionally she asks if im OK but I'm essentially on my own, just as the other nurse she's precepting is essentially on his own, except he has 20 years experience and is in the final week of orientation. Yes, i do have a while to go, and i dont want a bad experience to start off with. i certainly dont need to be reminded of my "bad short term" memory. she likes mentioning that all the time. you need to build that confidence early on. The orientation is 10 weeks and i dont want this getting worse. it's bad now, in my opinion.

Just read your post and wanted to tell you that I had similar feelings about my preceptor when I started. I have almost been at my position for a year now and am finally getting to the point where I feel confident about my decisions and can relate to my preceptors as peers. I believe it is easy for a new nurse to take things personal when all the preceptor is trying to do is teach. Although we would like to hear "That's ok" and other affimations remember that the preceptor wants to know you will do a great job once you are on your own as it is a direct reflection on them. Try to shake it off... also remember some personalities need to feel superior especially when training a new nurse. I found that reaffirming their status and experience helps them back off a bit. I would make comments to my preceptors about what a good nurse they are and I think that helped them look at me as a new nurse that they once were... Just hang in there.. suck up to them a bit and remember they are your teacher.. I will rely on my preceptors and coworkers for much more learning as there is always new stuff to learn and have ofund they will come to me at times. It's hard to start fresh and green but time will pass and you will be do great!!

I have more questions after reading about your situation. Do you think that your preceptor knows that she makes you uncomfortable? Are there other people on the unit who detect that things are unpleasant? If so, have they said anything to you?

It's a little alarming to me that she's critical of your memory yet she's hardly checking on you at times.

Grugan,

I can relate. I went through it. But my experience was very bad, I was on a bad unit, and I ended up getting physically ill. I left somewhere around my 8th week. Now I'm not sure where my next paycheck is coming from.

If your preceptor is getting on you for legitimate reasons, take the lesson and use it to show her you are learning. This will show her you are, and how wonderful she is. You won't have to suck up for long. I found that using index cards w/ step by step instructions helped me on things that I was getting upset and mixed messages on. I went to the policy and procedures and made myself a "cheat sheet" that I kept in my pocket. Came in handy for the many many CVL blood draws I had to do in a short amt of time.

And I completely empathize w/ only getting checked on w/ a "are you ok" fr within a group of nurses that are sitting around in gossip or planning their gift shopping, parties, or whatnot. It's a feeling I got if I happened to be crossing her path, she'd remember to ask, or if she had an audience of her peers, she'd ask. But it seemed like when I really needed her she just wasn't there for me, unless I would hunt her down and "nag". This certainly became a pattern w/ the precptors there. Worst part of this was that her own pt load became mine since we were sharing. And then I found out she was helping nurses on the floor that were here friends! Once she even went to help a friend on another floor!!!

Definitely a clique thing and I was the new kid on the playground.

I've been assigned a preceptor that is very good, very smart, and has a great deal of experience. However, she really seems to like getting on me.

Yeah, some preceptors feel they must turn you into their clone in 6 weeks or whatever, forgetting it took them years to get there. Many preceptors tend to have perfectionistic tendencies anyway, but when you add in an unconscious unrealistic goal, look out.

I have more questions after reading about your situation. Do you think that your preceptor knows that she makes you uncomfortable? Are there other people on the unit who detect that things are unpleasant? If so, have they said anything to you?

It's a little alarming to me that she's critical of your memory yet she's hardly checking on you at times.

hello, thanks for responding. Today, i got the sense that my preceptor knew she made me uncomfortable. She needled me alot today. It's just so disappointing because i really liked this hospital. I dont know how I'll ever explain to my family, who has worked at and used this hospital for years, why i left, should that happen. My preceptor is the type that is just in everyones business. People on the unit sensed that i was having a bad day but didnt know why.

Its a bad situation. Today, right off the bat, at 7:30 in the mornign, i had to remove a PCA pump. My preceptor says, "now for room 422, youll need to remove a pca pump. We have done this numerous times now(twice actually)." It's just her whole talking-down-to-me tone,it's so damn unpleasant and such a rotten miserable way to start the day. Today, i stood in the medication room pondering whether or not to just leave.

Its been almost 3 weeks. Maybe I should be picking up on more, but not everything is going to make sense when im getting report. I dont like the situation I'm in and after only 3 lousy weeks, I dread work. I've already called out for tommorow, if that gives you any idea. I worked so hard for this career.

I work very closely with preceptors and orientees and have had to re-assign orientees to different preceptors many times for many different reasons. Is your supervisor or educator meeting with you frequently to assess your progress? If they are, please be honest with them about your experiences. If not, it seems like it's time to request such a meeting. Some nurses may be excellent nurses, but horrible preceptors. Not all personalities work well together in what should be a very close/intensive working relationship. As you become independent in your orientation, you should expect your preceptor to sit back and serve only as a resource or go-to person, but not this early in your orientation. Right now, she should be watching you like a hawk, following behind everything you do and quizzing you on why you're doing it. Are there any other nurses on the floor that you've observed who are strong and might be a better fit for you? Are you making a lot of mistakes and being overly sensitive? Does this preceptor make you more nervous, causing you to mess up more? It's hard to tell without knowing you. I would suggest that you not give up until you've spoken with someone about your situation and requested a change. You may do great under a preceptor with a different personality.

I work very closely with preceptors and orientees and have had to re-assign orientees to different preceptors many times for many different reasons. Is your supervisor or educator meeting with you frequently to assess your progress? If they are, please be honest with them about your experiences. If not, it seems like it's time to request such a meeting. Some nurses may be excellent nurses, but horrible preceptors. Not all personalities work well together in what should be a very close/intensive working relationship. As you become independent in your orientation, you should expect your preceptor to sit back and serve only as a resource or go-to person, but not this early in your orientation. Right now, she should be watching you like a hawk, following behind everything you do and quizzing you on why you're doing it. Are there any other nurses on the floor that you've observed who are strong and might be a better fit for you? Are you making a lot of mistakes and being overly sensitive? Does this preceptor make you more nervous, causing you to mess up more? It's hard to tell without knowing you. I would suggest that you not give up until you've spoken with someone about your situation and requested a change. You may do great under a preceptor with a different personality.

Thank you for your response. Yes, the preceptor makes me nervous. It's almost a self-fulfilling prophesy kinda thing. For instance, the ritual is to see my patients, chart, and give meds. This morning, I forgot to give the meds. She said, in her usual speaking-down tone, "it's been almost 3 weeks, you know youre supposed to give meds." I know this of course, but I'm frazzled now and my confidence is gone. The "tone" started this morning with the PCA pump, the "we've been through this many times" crap, even BEFORE we see the patient. She was talking as if she was expecting me to not know what I was doing. This is how we started our day at 7:30 in the morning, with this tone. It annoys me to the point where I can't even look at her.

When I get info in report, because I'm new to dialysis patients, fistulas, etc, I can't always remember details such as temporary access,etc. Because of this, I forget them because I'm not at the point where i can tie everything together. So when i was giving report, i forgot to mention why the patient was in dialysis today, and she told me in front of the incoming nurse. "Remember?" she said.

It's been almost 3 weeks and i dont know where a new nurse should be. Im kinda a scatter-brained person but because i genuinly care for these people, i feel that i can overcome this eventually. Things like printing reports, doing paperwork for labs, i do forget this stuff, not always but a good amount of time. I just have to do it a few times and itll start to make sense. I havent spoken to any new nurses to gauge their progress so I dont know.

I think itll be a good idea to look over my texts and just get more familiar with these patients' conditions. But really, I dont know what Im going to do about work. This particular preceptor is well-liked and is ALWAYS in people's business. She seems to be well-respectedso itll be tough asking for a new preceptor.

I dont see things changing. Approaching her isnt the answer, it'll just be more of the same.

Thank you for your response. Yes, the preceptor makes me nervous. It's almost a self-fulfilling prophesy kinda thing. For instance, the ritual is to see my patients, chart, and give meds. This morning, I forgot to give the meds. She said, in her usual speaking-down tone, "it's been almost 3 weeks, you know youre supposed to give meds." I know this of course, but I'm frazzled now and my confidence is gone. The "tone" started this morning with the PCA pump, the "we've been through this many times" crap, even BEFORE we see the patient. She was talking as if she was expecting me to not know what I was doing. This is how we started our day at 7:30 in the morning, with this tone. It annoys me to the point where I can't even look at her.

When I get info in report, because I'm new to dialysis patients, fistulas, etc, I can't always remember details such as temporary access,etc. Because of this, I forget them because I'm not at the point where i can tie everything together. So when i was giving report, i forgot to mention why the patient was in dialysis today, and she told me in front of the incoming nurse. "Remember?" she said.

It's been almost 3 weeks and i dont know where a new nurse should be. Im kinda a scatter-brained person but because i genuinly care for these people, i feel that i can overcome this eventually. Things like printing reports, doing paperwork for labs, i do forget this stuff, not always but a good amount of time. I just have to do it a few times and itll start to make sense. I havent spoken to any new nurses to gauge their progress so I dont know.

I think itll be a good idea to look over my texts and just get more familiar with these patients' conditions. But really, I dont know what Im going to do about work. This particular preceptor is well-liked and is ALWAYS in people's business. She seems to be well-respectedso itll be tough asking for a new preceptor.

I dont see things changing. Approaching her isnt the answer, it'll just be more of the same.

OK, It sounds like this whole thing is turning into a nightmare. How many patients are you taking? If it's your third week on the floor you should be taking no more than 2 patients with strong preceptor support. At this point, I think you are so overwelmed, that you are barely functioning. Are you using any kind of "brain" or worksheet to organize your day? If not, I suggest you get one ASAP. I don't have to tell you that forgetting to give AM meds is not something you forget. Organize your day with check-offs for things in the order that you do them. Assessment/charting, fingerstick/coverage, Labs checked/treated, Meds (times due), AM care, etc. Start educating yourself on your specific patient population. Make list of all lines, and how to maintain them. Is there an IV therapist that could help you with that? Start a collection of note cards on common Medications for your area. Do you have time in the day to look up diagnosis, disease processes, policies, etc? These are things the preceptor should be quizzing you on during the day. I'm afraid that without stepping back and getting things under control, you will not be successful. Things will continue to spiral out of control with her making you nervous, you messing up, and her losing respect for you. Please approach your supervisor to review your progress and needs. I gaurantee the preceptor is talking to the supervisor. If you want to succeed, you've got to do something. and now!

nservice,

you mean to tell me by week 3 she should have no more than 2 pts???? With strong preceptor support and regular feedback?

I want to know where you work and you can be my preceptor anyday! That sounds like the perfect situation, but certainly not the way it is. Or at least not in my case.

I started off w/ assessments, meds, charting and as many procedures as my crazy educator could yank me to do off my own pt assignment in the first week on unit. They were trying to get me up to 5 pts as soon as possible to be able to take on a full pt load (6-7 at night) ASAP. By rushing me, it was counter productive and I backslid. The constant nagging, harassment and ridicule about being too slow and not having confidence broke me.

There was NEVER any time to evaluate and get feedback b/c I was always behind and my only feedback was negativity and criticism. It didn't matter that sometimes the reasons for poor time management didn't always pertain to me (computer log in glitches, nurse calling in sick last moment, code pink, code blue, ...)

For this reason, I can totally relate to our O.P. But I agree with the need to have a brain, and to have some sort of system down at this point. In my case it was also a major issue trying to do so because I had 5 preceptors in 4 weeks. Again, not my fault, poor management BY management. And each one had a different approach to scheduling. But I knew that in the course of my 12+ hours, what/when meds were to be passed, what/who drains and dressings needed tending, etc...

I think it's time to go to the charge nurse and ask for anotehr preceptor. It's just not a good fit hun. And after 3 weeks it's not getting better. Why let it get worse?

Chloe

Chloe,

I'm sorry you had such a poor orientation. Slamming new grads on the floor to sink or swim is one of the reasons we have such high turnover of nurses. I am the clinical educator for 4 very busy Med-Surg units (@ 200 nurses). We have completely over-hauled our orientation process with great results. One week of hospital wide/classroom education. then one week of shadowing a preceptor. After that the orientee starts with one patient, adding a patient each week or when ready. Usually time management is a problem going from 3 patients to 4, so they can have a few weeks with 4 patients to get comfortable. Once the orientee is independent with 5 patients, we give them a couple of weeks for team-leading experience. Finally we have the orientee "float" to the other Med-Surg units for a few shifts for orientation. The Supervisors and I meet regularly with the preceptor and the orientee to see how things are going, if goals are being met, Any problems needing addressed. In the two years that I've been in this position, we've only had one orientee not make it and that was a language barrier issue. We offered to send and pay for english classes, but the orientee refused. Every single orientee is still working with our hospital system, most in the same unit.

I know our system is probably unique, but I think the investment is really worth it. My goal is to make every orientee successful.