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!

[FashionablyL8, CNA, LPN]

I don't have any really original input- I think you've gotten a lot of great advice already. I just want to say that I'm sorry that you're going through this. That type of treatment is exactly what I fear when I think of my first nursing job (haven't taken the NCLEX yet). I have seen posts from people who seem very entitled and overly sensitive, but you do NOT seem to be like that at all. You sound humble and willing to learn- IMO your preceptor has an attitude problem. She may be smart and competent, but it seems like she's unable to give you any credit, possibly because putting you down makes her feel superior. Group mentality can be a toxic thing and it sounds like the general consensus in that unit is that new nurses are a nuisance and need to be kept in their place, rather than treated as an asset to be welcomed and taught. My only advice is that you try to remember that the behavior of these people is not due to anything being wrong with you- it may simply be impossible to gain their approval. There's nothing wrong with cutting your losses and moving on. That is not the only NICU in the world and I think you will achieve your dream of being a NICU nurse- this just may not be the place for it. 

Best of luck whatever you decide to do. 

[Zapi791, BSN, LVN, RN]

13 minutes ago, Ashywlms1290 said:

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.

It sounds like you are not doing anything wrong Ashywlms.  The culture on the nursing unit is just very negative and they lack interest in creating positive learning experiences for new nurses.  Since you now know that your preceptor lacks integrity and spews defamatory comments during stressful situations you may want to practice becoming more assertive and reminding her that defamatory comments are not a professional behavior of a preceptor.  In the meantime try your best to "focus on learning and your passion" for NICU.

 

[Wuzzie]

2 hours ago, caffeinatednurse said:

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. ?‍♀️ 

I picked single words out of multiple post not yours. How the hell did I invalidate anybody’s perspective? I pointed out ONE thing that she did that nobody else was addressing and you’ve gotten all butt hurt over it because I’m not giving the preceptor any slack for her atrocious behavior. I’d wager I’ve precepted significantly more people than you have and there is no excuse for what she has done and said. You’re making a huge assumption about my motivation and I don’t appreciate it at all. If it was you in the OP’s shoes I’m willing to bet you’d appreciate the support which in this instance I believe is deserved. 
Also, I don’t need schooled on how forums work nor do I need your permission to share my opinion. If you don’t like what I’m saying please put me on ignore. 

[caffeinatednurse, BSN, RN]

32 minutes ago, Wuzzie said:

I picked single words out of multiple post not yours. How the hell did I invalidate anybody’s perspective? I pointed out ONE thing that she did that nobody else was addressing and you’ve gotten all butt hurt over it because I’m not giving the preceptor any slack for her atrocious behavior. I’d wager I’ve precepted significantly more people than you have and there is no excuse for what she has done and said. You’re making a huge assumption about my motivation and I don’t appreciate it at all. If it was you in the OP’s shoes I’m willing to bet you’d appreciate the support which in this instance I believe is deserved. 
Also, I don’t need schooled on how forums work nor do I need your permission to share my opinion. If you don’t like what I’m saying please put me on ignore. 

You probably have oriented a lot more people than me, but that doesn't mean that you're better at precepting...I think we've thoroughly covered that topic in this discussion. Experience does not always = better.

I have already stated before that I was bullied as a new grad, so I know what bullying feels like. I don't think I need to cover that ground again. 

To get back on topic here. The preceptor is wrong for her comment after the code. But patient safety is 100%. As a preceptor, I would not have let my new ICU orientee take care of a patient that was going south. I would absolutely change her assignment if I felt she wasn't ready for that. And if I feel like they're doing something wrong, I would absolutely interrupt what they're doing, with the end goal being that I would explain to them later why I interrupted them and did it a certain way. Obviously, she and her preceptor are not a great match and if she chooses to stay in NICU, she should ask for a different preceptor. But ICU (and I do mean any ICU) is tough for a variety of reasons, and at my hospital ICU, we had a lot of strong personalities. So she's going to have to try to find a buddy on this unit to have her back if she plans on staying.

Just be aware that not all units are the same...some aren't friendly and you'll never find that buddy...sometimes you're just staying because you love the specialty or the patients, etc. It really depends on the reason why you want to work NICU.

There are my 2 cents, take it or leave it. 

[Wuzzie]

51 minutes ago, caffeinatednurse said:

You probably have oriented a lot more people than me, but that doesn't mean that you're better at precepting...I think we've thoroughly covered that topic in this discussion. Experience does not always = better.

There you go, putting words in my mouth…again. I never said I was better just said I’ve experienced many, many orientee personalities and even the ones I’ve greatly disliked deserved to be treated with kindness. I’m mystified how you can find an issue with that but whatever. 

[NursLitt, BSN]

Oof. That sounds like a very difficult situation for all. Based on what you've said, IMO, your preceptor is being too hard on you or at least not communicating with you effectively. Being a preceptor can be very stressful, and not everyone is cut out for the role. She seems a bit out of line with the comments about how that child would not have recovered etc. Also, some people just don't seem to understand that people who are learning need positive feedback as well as constructive criticism. You seem to be only getting the negative with no encouragement. You may want to take a deep breath and straight up ask her every day something like "I thought I did X well today and the mom seemed more comfortable with our plan of care; how do you think I did?" By asking her about something specific, but for which you've already noted the positive effect on the pt/family, you not only take responsibility for the pt interaction, you also are telling her that you can indeed critically think about pt situations, and that you are putting together your interventions and their results. It also should tell her that you are mature enough to seek criticism. Bonus: if her constant negative eval of you continues, you can then go to your manager and say that you have been seeking input from your preceptor on a regular basis; have shared pt/family feedback with her, but she doesn't seem to take that into consideration.

First time is the hardest. Frame the way I've suggested and unless this preceptor is someone who should not be a preceptor (it happens), things should improve, if only because you are taking control of the bit of this that you can. Hope this helps.

[OHIO OR RN]

Hi,

Just wanted to say don't get discouraged! I've seen a lot of good comments and there are options! Talk to your manager and see if there is another nurse you can follow. From your post, it sounds like there was a missed opportunity for you to have gotten experience with a vented patient. A strong preceptor can usually help you improve skills and improve your critical thinking, while keeping the patient safe. This prepares you to eventually spread your own wings in the unit. I think she missed an opportunity to have you be hands-on with her skill and advice supporting you. Everyone needs practice on new skills. Nurses, residents, doctors, and non-medical staff included. Sometimes preceptors forget this. Also, sometimes more seasoned nurses can be a little rough on new staff. There is an expression "nurses eat their young". It unfortunately happens sometimes. Don't let this experience stop you or hold you back. Don't give up on your NICU dream!

[JKL33]

18 hours ago, Ashywlms1290 said:

I hate when other people tear other people down. Nursing is hard and we should be building eachother up not tearing eachother down. 

So, without making excuses for anything or explaining it or downplaying it:

It comes down to this: You have to decide what you are going to do in the face of basically the world not being pleasant. That is the bottom line here.

We each will have our preferences on how to handle a given situation and we each probably have a tendency or baseline thinking when faced with unpleasantness. Do we prefer to go through it, get around it or turn around and go the other way.

It is up to you. But we can sit here all day long and say what nurses shouldn't do or say that xyz thing isn't right or something should have been done a better way or it didn't need to be as harsh or...on and on. 

Taking into account all you have said in this thread as best I can, I believe this is situation solidly mixed-bag. She isn't the worst and honestly aside from the post-code comment which was totally inappropriate, she mostly sounds like a particular person who is generally trying to take good care of patients but has a struggling self-esteem.

You have to decide if that is enough that you wish to turn around and go in the opposite direction rather than going through or going around (to your original destination/goal).

I am not critiquing your personal make-up, but you do use fairly emotionally-charged words to describe your feelings about all of this. I think it might come down to whether or not you can summon the ability to not take this preceptor so personally. I don't disagree with Wuzzie's feelings about some of the harsh things this preceptor has said, but at the same time I can't imagine my own reaction would have been to feel "heartbroken" unless I knew deep down that she was correct or that I really did have some serious deficiencies and was not cut out for this thing that I believed was my dream. Heartbroken is for losing a loved one, not for some rando nurse saying something (in my book).

Introspection is in order. Do you want to "go through" rather than turn and go the other way? If so then as far as I can tell the solution is to buckle down and don't waste emotional energy. Take what is useful from her and leave the rest.

[pinkdoves, BSN]

20 hours ago, Ashywlms1290 said:

 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.

EXCUSE ME??? They know the staff bullies new hires and choose to do nothing about it? LOL this place is a shitshow please leave now. It's not you. When I was a new grad my preceptor continuously yelled at me in front of everyone and NO ONE every said or did anything...I left that job with no regrets and work somewhere way better now.

[Ohio NP]

On 9/11/2021 at 6:07 PM, CalicoKitty said:

The poster is not a new grad. She said she has 2 years experience in renal transplant.

I worked for a number of years in renal transplant. Does not prepare someone to step in and be the frontline nurse for NICU. These are the most vulnerable, most fragile patients in healthcare. She has been on the unit for 8 weeks and is pushing to get more autonomy. Perhaps this nurse would benefit from backing up, asking questions observing these critical cases, asking questions again afterwards to learn from the experience and slowly build her knowledge base and the trust of her peers. NICU nursing is a very high stress, highly specialized area of nursing and quite frankly, you won’t survive there if you are thin skinned or looking to get your needs for validation met. Pump the brakes and learn slowly and gain the trust and acceptance by the unit through demonstrating that you realize how much you have to learn and respect the difficult nature of this area of medicine.

[cgw5364, ADN]

On 9/11/2021 at 8:05 PM, Wuzzie said:

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.

I had a similar experience working in a Level lll NICU. I was not a new grad and had experience working in L&D and Special Care Nursery. My preceptor was nice and everything seemed to go well on orientation. Then I was placed on night shift after orientation. Whole different type of nurses. I have never felt so alone as a nurse in my entire 30 year nursing career. I got no help from anybody and the nurses and respiratory therapists were very "cliquish" and shut me out entirely. One hellish night I was the only nurse in one of the NICU rooms (the unit was not divided into individual room and had several NICU beds in each room) and I wanted another nurse to listen to a baby's breath sounds. I found the nurses from my room and the respiratory therapists all taking a break in the doctor's chart room adjacent to the NICU. I walked in and asked for help and told them what I needed and was laughed at by the respiratory therapist. One of the nurses begrudgingly got up to help me. I had nights in that NICU where I had patients in 3 separate rooms and my assignment would change multiple times in a night. I lasted 2 months after orientation before leaving. The nurse manager had the nerve to tell me I had "wasted" their time and I would never work at that hospital again. Well, I left there and went to a hospital across town to another NICU and loved it and stayed there 4 years.  You don't have to put up with a toxic environment! 

 

[anewsns]

It sounds like its a bad preceptor. If you really think you would like the unit I would request another preceptor. Otherwise you could just leave. If you did fine in your last job with no concerns from others then your care is probably fine. Your preceptor should definitely let you be more independent. It makes sense that you have only a small role in a code and I am sure you are fine securing a nasal cannula. She sounds controlling.