Preceptor Made Me Feel Like I Should Leave Nursing

Wuzzie · Sep 12, 2021

3 hours ago, Closed Account 12345 said:

I can't speak to your performance to give feedback, but I can say this as a parent. If I were ever in the horrible situation of my newborn child being critically ill and heading towards a code, I would choose for the experienced NICU nurse to step in and take over care every single time. The best orientee is still an orientee, and from a parental standpoint, I wouldn't care what an orientee learned during that shift. I'd care that my baby had the best nurse possible and survived. Maybe try to think of it from that perspective.

Yes but you don’t tell your preceptee that if they had let her take care of the baby it would have died. You. Just. Don’t. Do. That.

I’m about to make myself very unpopular with some of the members here but the NICU is a vile place to work. Most are staffed with nasty, insecure nurses who bully and abuse new people while the really nice ones cower in the background hoping to fly under the radar and not be made a target. God help the nurse who stands up for herself. She’ll be lucky to escape with her license intact but her reputation will be trashed. My first death on transport I came back with an empty isolette to be met by Heather (her real name and I hope she sees this) an old cow of a nurse who said to me “if we had sent a real nurse that kid would still be alive”. Never mind the fact that this was in the 80s and it was a 27 weeker with a Grade III CAMS who was being bagged by the local MD with a CPAP bag with the valve completely CLOSED! What lung the kid had was shredded before we even got there but somehow it was my fault. This kind of behavior is rampant in NICUs because it is tolerated. I left that job but made the mistake of going back like 20 years later and it was still the same and Heather was still there ruining people’s lives.

To the OP. Get out while you still have any self-esteem left. Trust me on this.

LovingLife123 · Sep 12, 2021

It’s difficult for me to precept because I have a very difficult time not controlling everything. Any type of ICU nurse by nature is a control freak. We are all very aware that our patients could code at any minute.

I’m not at all saying it is right. I realize that I might be a good ICU nurse, I’m not a good preceptor. Unfortunately I don’t get a choice to precept and usually find out when I come in that I am.

You are going to have to either find away to get through your orientation or quit.

And I will also say depending at what point my orientee is in orientation, depends on what I allow them to do if a patient is really sick. But, you don’t know what you don’t know. I know you have to learn and I’m not at all saying you shouldn’t be given some independence, but I would also stop trying to prove your competence. You aren’t a competent nicu nurse yet. That takes lots of time.

Wuzzie · Sep 12, 2021

I’m going to say it again louder for the people in the back…

You don’t tell a new nurse that they are so incompetent they are going to kill a patient!

At least not until they do something egregiously stupid and have demonstrated they are unteach able. Then all bets are off.

The OP’s mistake is being overconfident. I get that, it’s annoying and needs to be addressed but jeebus people, I’m as uptight and obsessive as the next ICU nurse, but you don’t have to be mean. You just don’t.

JKL33 · Sep 12, 2021

30 minutes ago, Wuzzie said:

I’m as uptight and obsessive as the next ICU nurse, but you don’t have to be mean.

??

Yeah, with regard to what the OP's preceptor said, a prudent and concerned preceptor would have handled it differently if they truly didn't think their orientee was ready for a challenge. "The baby would've stayed dead if you were in charge..." is not in any way productive. It mostly sounds like a toxically insecure and miserable person just taking a potshot and looking for a reaction.

Nurse12390, BSN · Sep 12, 2021

1 hour ago, Wuzzie said:

I’m going to say it again louder for the people in the back…

You don’t tell a new nurse that they are so incompetent they are going to kill a patient!

At least not until they do something egregiously stupid and have demonstrated they are unteach able. Then all bets are off.

The OP’s mistake is being overconfident. I get that, it’s annoying and needs to be addressed but jeebus people, I’m as uptight and obsessive as the next ICU nurse, but you don’t have to be mean. You just don’t.

Thank you! I just want to address this. I am definitely not overly confident at all on the unit. I know I don’t know anything. I own that. I apologize that I don’t know things and that I need help because I can tell she’s annoyed when I do ask for help. Nicu is a different beast then the other floor I came from so I am a new grad all over again. I’m open to learning and feedback because I don’t know anything! I just feel discouraged when my preceptor talks to me and treats me like I’m incompetent of anything. I know I wasn’t ready to handle a kid that was really sick. my issue was that she wouldn’t let me help at all. I wasn’t expecting to be independent with the assignment at all. I’m not ready. But she wouldn’t let me hang an antibiotic or assist her with anything. And I only wanted to help because I could feel her stress and I wanted to help her and do whatever I could to lighten her load even though I can’t offer much right now.
I was really hurt when she told me that I would have killed the kid if I had been in charge. I know I don’t know anything and I wasn’t expecting to be in charge but to hear her say that just really broke me. My patients are everything to me and to receive a comment like that completely devastated me. I just want to learn and be the best nurse I can be but I feel like I’m constantly being treated like I’m an incompetent person and that’s what really gets to me.

renatanada · Sep 12, 2021

I started out as a new grad NICU nurse. I had a great preceptor. But quickly discovered that this is not the place for me. I found that, on the whole, NICU nurses don't really want to be nurses. They will freely admit that they cringe at the thought of "big people" blood or (God forbid) POOP. But they do loooooove reigning over their little helpless patients (and preceptees) and the almost invariably clueless and terrified parents. Sure, there are a few good eggs (mostly from older generations), but the majority are cliquey and in it for the money. Next shift look around, how many are preening their hair extensions and making appointments to get their tarantula eyelashes stuck on? Just saying.

FolksBtrippin, BSN, RN · Sep 12, 2021

On 9/10/2021 at 9:32 PM, Ashywlms1290 said:

Thank you for the feed back. I have now been training in the nicu now for a little over two months and it hasn’t gotten any better. I was really hopeful that it was going to be a better environment for me to work in.

My preceptor is really nice but she can be very controlling. She never lets me go into rooms by myself and she will critique everything I do. Yesterday I was changing out an infant’s nasal cannula and redressing it and she was criticizing the way I cut my tegaderm because it was 1cm shorter than it needed to be. I always listen to her input and will redo things if she is unhappy with how I am preforming tasks. I am always open to feedback and constructive criticism but it’s gotten to the point where it feels like she critiques everything I do and that everything I’m doing is wrong.

A lot of times she will take over things I’m doing or take medication out of my hand to do it. It’s very discouraging and I feel like I’m having a hard time accomplishing anything because she is always upsets about something I am doing. I’m new to the nicu but I was a nurse on a renal transplant floor for 2 years prior so I do have some skills that translate over.

Last night we had a kid that was very sick and vented and she told me that she would be doing everything and that I could watch her. I was very discouraged and disappointed because I wanted to be apart of this kids care and it felt like she was indicating that she didn’t think I was competent enough to do so. The kid ended up coding and I tried to get involved in the code as much as I could by getting supplied/suctioning/decompressing the stomach. I was pretty upset after the code because it was my first one and it’s horrible to see your patient that way and she never debriefed with me.

We were able to get the kid back and started a blood transfusion. I pointed out to her that it looks like the IV is infiltrated and she told me it looked fine. I was concerned so I was checking the site every 30 minutes. The IV ended up infiltrating pretty badly and when we went in together to asses she asked me if it looked like this 30 minutes ago which I responded no. She then asked me if I was sure which I was very insulted by and told her I would never keep something infusing through an infiltrated IV.

My patients are everything to me and I work really hard to learn as much as I can to be the best nurse I can be for my patients. When I was in the nursery training I received very positive feedback and was told that they could tell I was a good nurse on my other unit and that I was doing really well. I even got thank you cards from families I had while over there. I was with a different preceptor the other week and she told me that I did an amazing job and gave a very detailed report. My other preceptor often talks over me while I’m giving report and makes me practice with her before giving report.

I’m more than happy for any opportunity to learn but other preceptors have never had a problem with how I give report on this unit and when I’ve ask for feedback they always tell me that my reports are good.

I decided to talk to my preceptor about why she wouldn’t let me help with the sicker kid because it was really bothering me. This week she has been especially critical of everything I have been doing and won’t let me do anything on my own so I wanted to clear the air. I was hoping to get feedback on how I can improve and if I am where I should be at this point in my orientation. She basically told me I’m lacking critical thinking skills and time management/prioritization. She told me that if she had let me have more control in the assignment last night that the kid wouldn’t have been recovered. Which really made me sad when she said that. I really want to improve and do better but it seems like my preceptor has no faith in me and thinks I’m a bad nurse who shouldn’t be there.

Her response broke my heart and it made me feel like I’m a terrible nurse. It even made me consider transferring to a different floor. The nicu has always been my dream job and I’ve worked really hard to get a job on this unit. I’m devastated that this has been my experience on this floor so far. I know the turn over rate on the floor is very high due to bullying and the senior nurses make it very clear that newer nurses are not welcome there. I’m looking for advise of any kind. I’m just completely devastated and questioning if I should even be a nurse at this point. Thank you for reading and sorry this post is so long!

How much longer do you have to endure this woman before you’re allowed to fly solo? Can you ask not to be paired with her anymore? I wouldn’t quit over this just yet.

LovingLife123 · Sep 12, 2021

11 hours ago, Wuzzie said:

I’m going to say it again louder for the people in the back…

You don’t tell a new nurse that they are so incompetent they are going to kill a patient!

At least not until they do something egregiously stupid and have demonstrated they are unteach able. Then all bets are off.

The OP’s mistake is being overconfident. I get that, it’s annoying and needs to be addressed but jeebus people, I’m as uptight and obsessive as the next ICU nurse, but you don’t have to be mean. You just don’t.

I didn’t see anyone that said that was appropriate to say. I think a lot of people were just stating why it can be hard to precept in the ICU. I acknowledged that precepting is not my strong area because of my control issues and it’s a weakness that I recognize.

Wuzzie · Sep 12, 2021

1 hour ago, LovingLife123 said:

I didn’t see anyone that said that was appropriate to say. I think a lot of people were just stating why it can be hard to precept in the ICU. I acknowledged that precepting is not my strong area because of my control issues and it’s a weakness that I recognize.

I saw people making excuses for really bad behavior and not addressing the critical statement that has absolutely destroyed the OP. You can have control issues, you can be a weak preceptor, you can hate doing it but you cannot be a bully while you are assigned the role. I don’t use that term very often and despise when people use it to describe random incivility but the term is accurate in this situation.

sleepwalker, MSN, NP · Sep 12, 2021

13 hours ago, Wuzzie said:

you don’t tell your preceptee that if they had let her take care of the baby it would have died. You. Just. Don’t. Do. That.

I would be hot-footing over to the manager and letting her/him know what was said, how it was said, the context of when it was said, and how it impacted you mentally. Pay careful attention to how your manager reacts...this well tell you what you need to know about your units culture and whether or not you want to stay in such an environment.

This type statement is outrageous, egregious, and demonstrates extremely poor judgment and character ! It should not be treated lightly.

subee, MSN, CRNA · Sep 12, 2021

6 minutes ago, sleepwalker said:

I would be hot-footing over to the manager and letting her/him know what was said, how it was said, the context of when it was said, and how it impacted you mentally. Pay careful attention to how your manager reacts...this well tell you what you need to know about your units culture and whether or not you want to stay in such an environment.

This type statement is outrageous, egregious, and demonstrates extremely poor judgment and character ! It should not be treated lightly.

It sounds like the manager is very happy with the culture of the unit now. IMHO, it would have been better to get some peds experience before going to NICU.

Zapi791, BSN, LVN, RN · Sep 12, 2021

19 hours ago, subee said:

IMHO, NICU is a terrible place to put a new grad. When the patient is someone else's kid, the anxiety stakes are much higher and that puts most people on edge taking care of the tiny people. This probably has nothing to do with you. You are the one more mistake the hospital made by putting a new grad in that unit. If the turnover is so high, they haven't learned from their mistakes and you know what that diagnosis it:) Why start out on ice when you can start out on snow?

Hospitals are hiring new grads directly into specialties now so that they can meet the criteria for magnet recognition. However, it takes a strong nursing education department to execute the transition of RN’s to practice safely. The hospital may not be failing by hiring new nurses but instead may be failing on training preceptors and providing excellent nursing education in each department.