Preceptor Ping Pong

[KnitWitch, ASN, RN]

Earlier this year I landed my dream job in a very busy ED -- no mean feat for a new grad! After a few weeks of classroom orientation we've hit the floor to get down to the hands-on business of nursing. By and large I love what I do and I am fortunate to be working with a lot of great people.

However, due to the size of our orientation group and the weird staffing in our ED, it's pretty much a given that I have a different preceptor every day I'm out on the floor. In some ways this is good because I get to see a lot of different ways in which people organize, prioritize, give care and chart in the ED. On the other hand, it's sometimes really difficult because one preceptor will show me her way of doing things, only to have another preceptor a day later tell me, "Oh no, NEVER do it that way!" The constant bouncing from preceptor to preceptor every day always leaves me feeling a little uncertain of myself because I never know if what was right yesterday will be good enough today. And I certainly don't want to start pitting people against each other by saying, "Well yesterday X told me to do it like this."

Does anyone have any advice on how to cope with this? Should I address it with my educator? She's the one that makes up the schedule but she has it tough finding enough places to put us all every day -- there are almost as many orientees as nurses out there on the floor!

[CrufflerJJ, BSN, RN, EMT-P]

Been there, done that as a preceptee. Now, as a preceptor, I sympathize with the my preceptees.

My advice to them is generally along the lines of...."Working with different preceptors, you'll be told many different ways to do things. You'll be told no, don't do it that way, do it this way. My way may very well NOT be the best way. As a preceptee, it's probably best to nod your head and say "OK, thanks." and do it that certain preceptor's way when you're working with them. This is the case, UNLESS you feel that it poses a risk to the patient, then raise concerns with upper levels (including the educator)."

My advice is that you shouldn't make waves. You will bounce from preceptor to preceptor. Learn what you can from each one, until you can develop your own "style" of doing things once you're on your own. Only if you get pulled into a meeting with your educator (regarding your pitiful dangerous incompetence as a newbie who should OBVIOUSLY know better) should you broach the subject of preceptor ping-pong.

No, it's not perfect, but it is what it is.

Good luck!

[elprup, BSN, RN]

Definitely do not make waves. If you can deal with it, deal with it and learn all you can. Otherwise, if you start questioning how it would be better "your way", they will see you as annoying, even though evidence based practice states a different preceptor all the time does not create condusive learning. They do not care. Sad but true. Been there. Keep your job and learn all you can.

[Ruby Vee, BSN]

Definitely do not make waves. If you can deal with it, deal with it and learn all you can. Otherwise, if you start questioning how it would be better "your way", they will see you as annoying, even though evidence based practice states a different preceptor all the time does not create condusive learning. They do not care. Sad but true. Been there. Keep your job and learn all you can.

I agree that you should try to deal with it and learn all you can. We (preceptors and educators) realize that a different preceptor all the time is not condusive to learning, but while we DO very much care about it, there's little we can do. When there are many orientees and not enough preceptors to go around, we all do the best that we can.

If you decide to discuss the situation with your educator, don't expect that anything will change. If they had more preceptors or better choices, they'd do it that way. Instead, ask for advice in making the most of your orientation despite the preceptor ping pong. It could be that Ray is the best wound care nurse, so the days you're with him, soak up all of his wound care expertise and don't get too worked up over how he draws blood. And maybe Sue is an expert at venipuncture, but wounds are not her best event. A good educator will know these things and help you to make the most of it.

[One1, BSN, RN]

My experience was very similar to yours regarding having a lot of different preceptors. It is not ideal by any means, but like everybody said, stick it out and learn as much as you can. On the upside, it gives you a chance to get to know different nurses better and to decide whose work style, skills, knowledge, and ethic you respect. Once you are on your own, you will know who to ask if you have questions or need help.

[HouTx, BSN, MSN, EdD]

Ugh! Education nightmare. As an educator, I would urge the OP to:

1. Make sure s/he is absolutely clear on all of the orientation objectives - including any "checkoff" lists for competencies. In this case, it is best that the orientee maintain control of these important documents & ensure that they are up to date.

2. Whenever a competency is met, make the "preceptor du jour" sign off on it. Same goes for any other objectives that have been met.

3. Refer to documentation as needed. Ex: when preceptor X says "do it this way", OP can say "I already checked off on that with preceptor D last Tuesday - see, right here is where they signed"

This will help avoid any nasty surprises similar to the "sorry, you're just not getting it" stuff that many orientees are faced with - at a point that is too late to make a difference.

Best of Luck!