Preceptor Made Me Feel Like I Should Leave Nursing

[Nurse12390]

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!

[Orion81RN]

17 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.

Your preceptor might have realized how dire the situation was and realized what was coming. While operating at that stress level, her communication and teaching skills probably weren't ideal. She may not have mentally been in a place to debrief you appropriately or discuss your performance after she'd just had a newborn baby die on her and gone through the adrenaline rush and trauma of trying to reverse that death. Could she voice her concerns in a more kind, clear, and tactful manner? Of course!  But I'd give her grace for that night because she had just experienced the same trauma you had.

Hang in there. Remind yourself of the positive feedback you've received along the way, and remind yourself that a micromanaging preceptor isn't necessarily a reflection of your performance or abilities. It might just be her style. If you have down time on your next shift, ask her to walk you through her thought processes and actions from the critically ill/coding baby so that you'll be better prepared for similar situations in the future.

I can’t speak to OPs performance either but look at these two statements.

“She didn’t believe me and ended up verifying with someone else and when they told her that the drager was correct she said that’s what She thought and completely dismissed me”

“There are alot of times I definitely need her to intervene or her feedback and I am very appreciative of that”

One person unwilling to admit to something they didn’t know & instead denied it & directed it at someone else. The other statement shows insight, an understanding of needing to learn, and that this person will ask for help when needed. 

You also stated to give this other nurse “grace.” A nurse allowing herself to be bullied and accepting very subpar education is not what is best for your baby. 

 

I’m crappy at training in certain ways. So I outright state that to the people I’m training. I tell them if they feel they need more training, to demand it and state that they did not get all the training they needed from me. I don’t take my stress out on them. 

[Nurse12390, BSN]

13 hours ago, Ashywlms1290 said:

@WuzzieThank you! I just want to address this. Sorry if I came across this way in my post! 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 assist her with anything even simple tasks. I wanted to help the patient and her in anyway I could. I wanted to do anything 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. 

 

[Wuzzie]

1 hour ago, subee said:

IMHO,  it would have been better to get some peds experience before going to NICU.

Maybe but that still doesn’t make how she’s being treated right. I know that’s not what you’re saying but in my opinion this preceptor does not get a pass. I’m pretty sure they are going to continue torturing the OP just for funsies. 

[Nurse12390, BSN]

15 hours ago, Wuzzie said:

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. 

Thank you so much for your feedback! I really appreciate it. If you don’t mind me asking what area of nursing did you end up going to after the NICU?? 

[Wuzzie]

PICU (not as bad but still backstabby), CCT/flight, ED (awesome group) and now oncology (also awesome). 

[Nurse12390, BSN]

My preceptorship in nursing school was hem/onc and I loved it. Maybe I will look into that. Thank you so much for all your feedback and help! I really appreciate it! 

[caffeinatednurse, BSN, RN]

5 hours ago, Wuzzie said:

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. 

I'm not making excuses for anyone's bad behavior. In fact, if you go back and read through my reply, you'll see where I freely state exactly that. I've also been bullied as an orientee in a setting that was not nearly as stressful as ICU, so I know where the OP is coming from as well. But I also know how hard it is to precept someone when you're under considerable stress, you have a very sick patient, and an orientee. I can understand where her preceptor is coming from, even if I don't agree with the statements she made to the OP. 

Also, to be clear, there are A LOT of new grads who feel like they're being bullied, when in reality, their preceptor is being blunt and less-than-tactful with their criticism, but not necessarily bullying them. There are PLENTY of nurses who will give you the shirt off their back in a bad situation where the patient is crashing but if they feel like you're about to do something that could make the situation worse, they're going to tell you about it...how you interpret it, is up to you. It might hurt your feelings, but it also might be truthful. And sometimes our feelings get wrapped up in the situation as well, so it can be hard to differentiate between what is happening. None of us are there and we can't judge the situation. From what she's describing, it does sound like her preceptor has made some hurtful comments but also that there may be some things that she's doing that require correction.

[Wuzzie]

1 minute ago, caffeinatednurse said:

I'm not making excuses for anyone's bad behavior. In fact, if you go back and read through my reply, you'll see where I freely state exactly that. I've also been bullied as an orientee in a setting that was not nearly as stressful as ICU, so I know where the OP is coming from as well. But I also know how hard it is to precept someone when you're under considerable stress, you have a very sick patient, and an orientee. I can understand where her preceptor is coming from, even if I don't agree with the statements she made to the OP. 

Also, to be clear, there are A LOT of new grads who feel like they're being bullied, when in reality, their preceptor is being blunt and less-than-tactful with their criticism, but not necessarily bullying them. There are PLENTY of nurses who will give you the shirt off their back in a bad situation where the patient is crashing but if they feel like you're about to do something dumb, they're going to tell you about it...how you interpret it, is up to you. It might hurt your feelings, but it also might be truthful. And sometimes our feelings get wrapped up in the situation as well, so it can be hard to differentiate between what is happening. None of us are there and we can't judge the situation. From what she's describing, it does sound like her preceptor has made some hurtful comments but also that there may be some things that she's doing that require correction.

I wasn’t directing my comments to any specific person. I was highlighting the inexcusable behavior of a preceptor. Telling her she would have killed the baby is beyond a hurtful comment and the OP has been very open about what she needs to work on. If you read back on my comment you will see that I do not lump run of the mill incivility in with bullying but a person with any sort of real or perceived power who systematically and repeatedly cuts a person down and makes them fear for their job, which is the very definition of bullying,  is exactly what this person is doing. I have precepted hundreds of students and new grads and have had plenty of times that I had to stop them from doing something stupid and dealt with a plethora of bad attitudes  but you do not cut them down…ever. If you have not ever been a new person in a NICU I promise you cannot possibly understand the level of evil behavior that happens if they decide they don’t like you. It’s mind blowing. 

[LovingLife123]

5 hours ago, Wuzzie said:

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. 

Again, not one person said that behavior was OK.  I said in my post, what happened doesn’t make it OK.  I watched one of my new grads get absolutely bullied by other preceptors in her last phase of orientation.  I was livid about it and had many conversations with my unit manager.  But I also told the orientee this, put your head down and get through this orientation.  I told her I believed in her.  She did and is now precepting on her own on night shift.  She’s ended up being a great nurse and im so proud of her.  
 

So no, I don’t condone bullying.  But if this is the specialty that the OP wants, she’s gotta make it through orientation.  

[Wuzzie]

2 hours ago, LovingLife123 said:

Again, not one person said that behavior was OK.

Again, until I pointed it out the horrible thing she said it was completely overlooked. The preceptor was being described as “crunchy”, lacking “tact”, concerned about her patients, that she should be given “grace”. The OP has been told to develop a thicker skin, to examine what she’s doing to see where her weaknesses are and to understand where the preceptor is coming from. Telling somebody that they would have killed someone else’s baby is not constructive criticism, it’s not designed to help new people realize their weaknesses and is sure as hell isn’t meant to help them grow. My BSometer is pretty highly tuned and I’m not getting from the OP that she’s some snowflake whining because someone didn’t say hi to her in the breakroom. I’ve worked with those kind of people and I’ve worked with new people who don’t know what they don’t know. I’m not getting that vibe at all. 

[Nurse12390, BSN]

Thank you for all the great feedback and advice. I really appreciate it. I just want to do everything in my power to be the best nurse I can be for my patients and coworkers. I can usually brush off the occasional rude comment. My nurse educator told me before my first shift that the nurses on the floor can be tough and to come to her if I ever feel like I’m being bullied.
 

I previously worked for a little over a year as a CNA in a nicu while in school so I thought I was somewhat prepared to face a difficult environment. The nurses on this floor make it very clear that new nurses are not welcome. I’ve had preceptors complain that they have to precept while I was sitting right next to her. One threw a tantrum when he found out I was following him for the day. I have felt very unwelcome from the beginning and it made learning very uncomfortable. Most of the nurses spend their free time gossiping about the other nurses or critiquing the new grads. I’ve heard them make comments saying they aren’t impressed by a new nurse or that they think that person is dumb. It’s very discouraging to hear your peers break down someone who is new and trying their best. I hate when other people tear other people down. Nursing is hard and we should be building eachother up not tearing eachother down. 
 

I feel for both sides. I can’t even imagine how hard it is to be a preceptor in this kind of environment. Most of the preceptor don’t get a say and are stuck teaching when they don’t want to or have been stuck training orientee after orientee without a break. They are burnt out and I feel for them.  It’s also hard being new and knowing you are not welcome and that your preceptor doesn’t want anything to do with you. 

My preceptor does go out of her way to teach me things and she is very knowledgeable and a good teacher/nurse. I’ve slowly become very self conscious and feel constantly stressed when I’m with her or on the unit. I’ve had panic attacks before my shifts which is something that never happened to me on my other floor. I remember my first shift with her I was trying to place my first IV on an infant and I was taking my time to find the right spot since I didn’t want to hurt the baby by attempting multiple times. She turns to the baby and goes “she better hurry up and stop being so wishy washy.” After we left the room I apologized to her for taking so long and asked for feedback. But she makes little comments like multiple times through out every shift. She also critiques things I’m doing right and will ask other nurses the right way to do it. When she finds out I did it the right way she just dismisses me. She micromanages me to the point that it’s hard for me to complete any task independently. I definitely need her to intervene if I’m doing something wrong but sometimes it over small things that I know how to do. I definitely don’t know anything and I own that and always seek out advise and feedback so that I can improve. I never complete a task I don’t know how to do without someone else walking me though it or showing me first. And I’m very appreciative for the help. I just feel like I can’t do anything right in her eyes.

 

I’ve had times where a baby was desating and I was giving stim and forgot to turn the alarm off and a nurse will come in and angrily turn the alarm off and tell me that my alarm is annoying everyone and walk out. when I was setting up to take a baby down for my first MRI I was asking for help and everyone just sat and watched me struggle. Eventually someone helped me after I basically begged and she told me that now I can’t tell the manager that nobody helped me. I’ve never gone to management or talked to anyone about how I am feeling on the unit so I’m not sure why she made that comment.

I don’t know what I’m doing wrong. Im trying really hard. I’m always open to feedback, try to help other to the best of my ability and try to kill everyone with kindness but it doesn’t seem to be working. I’ve never has a job where I can’t make friends or feel hated by everyone. I’m working tomorrow and I’m dreading going in and facing everyone after the comment my preceptor made to me. 

[caffeinatednurse, BSN, RN]

54 minutes ago, Wuzzie said:

Again, until I pointed it out the horrible thing she said it was completely overlooked. The preceptor was being described as “crunchy”, lacking “tact”, concerned about her patients, that she should be given “grace”. The OP has been told to develop a thicker skin, to examine what she’s doing to see where her weaknesses are and to understand where the preceptor is coming from. Telling somebody that they would have killed someone else’s baby is not constructive criticism, it’s not designed to help new people realize their weaknesses and is sure as hell isn’t meant to help them grow. My BSometer is pretty highly tuned and I’m not getting from the OP that she’s some snowflake whining because someone didn’t say hi to her in the breakroom. I’ve worked with those kind of people and I’ve worked with new people who don’t know what they don’t know. I’m not getting that vibe at all. 

You're not directing your comments at anyone in particular, but you just (poorly) summarized my initial reply to her, which was thoughtfully constructed because yet again, I. don't. blame. her. for. her. preceptors'. words. Let me say again for the one person not listening to what anyone is saying: no one is defending her preceptor. We are just adding some perspective to the conversation because that's what discussion boards are for. 

You're welcome to share your perspective, but you can't invalidate others just because you've met a few people in your past that remind you of her preceptor. Everyone's input is valuable as far as I'm concerned, like it or not. ?‍♀️