Preceptor Problems - Advice needed

[dragonfire123]

I know having problems with one's nursing preceptor is common, but I just thought I'd fish for some advice here. I graduated from nursing school a few years ago with a BSN, at the top of my class and fairly confident. Alas, it took me a while to find my first nursing job, in semi-acute care at a rehab facility. I worked there for over a year, and now I just started a new job at an acute care facility. The entire situation is very different from my first job -- patients are sicker (so some of the interventions are very new to me), the charting system is different, the nurse/patient ratio is different -- essentially, it is starting over for me.

I was assigned a preceptor who is well-respected, well-liked, and very experienced. Alas, she is very impatient with me, even though I have only been on the floor for a few days. She feels I am too slow, gets annoyed if I do not understand how to use the equipment or know how to do some of the skills (some of which I haven't done since nursing school), tells me I talk too much to the patients (I talk while working to keep myself calm and centered, as well as to get to know the patients better), and gets irritated if the computer system isn't very intuitive to me (my previous facility had NO computers).

I have been very respectful to my preceptor and openly admitted that I feel a bit new and lacking in confidence. I feel I 'am' progressing slowly (I have half an assignment after only a week, even though the intention was to give me one patient a week -- I now have 4, and a full assignment is 6). But my preceptor is only focusing on what I'm doing wrong. Adding to this, she always takes breaks with me but will not talk to me at all (my attempts to make small talk fall flat). When asked if she was upset with me or something, she harped that I was 'half-baked' and 'not ready' (and will not be in the allotted 4 week orientation) and that 'new nurses have it easy today and not like when she became a nurse years ago.' She gets particularly irritated if I 'don't write things down' like where supplies are (though I have indicated that I remember by doing and seeing, not by writing things down -- I am a very visual person).

Bear in mind that I am in my 40s and though I am new as a nurse, I am not a child and have done many other things in my life. I never asked to be treated as an experienced nurse, but I just don't feel she sees me as a human being or is very compassionate. Very weird when she is nice to everyone. Even when I mentioned I had a migraine at work the other day (I get them bad), she was unsympathetic and just asked if I had finished my charting.

I apologize for sounding dramatic, but my orientation experience is really turning me off to the facility -- a very nice facility, and one that could afford me a great learning experience. Not sure what to do -- I just can't afford to come home and go to work feeling so low about myself when I feel I am trying so hard (and feel I am progressing, though not to my preceptor's expectations). I hate feeling so stupid and being made to feel so. I would appreciate your candid advice and feedback (please be kind).

[dragonfire123]

I should add that this person will be my charge nurse when I am officially off orientation, which is perhaps my greater concern. I won't be able to avoid this person when I start 'working.'

[Libby1987]

Sounds like a pretty negative experience but from the other side, besides how she's saying it, much of her feedback might be reasonable. You might be slower than average. You might be too chatty. You might have been better familiar with the tasks that were taught in school or at least something to build on. I'm not there and can't make an objective opinion.

I do a lot of orientation. I've had one brilliant new employee, a nurse of 2 years, who picked up everything quickly and performed well. I've those that struggle to learn every aspect, whether they were new nurses or not. I'm paid the same training compensation, have the same caseload, the same liability and allotted the same amount of time. Being a preceptor or trainer can be exhausting but we're asked to do it because it's necessary to bring on new staff.

Some of the things she's said and way she's said them are inexcusable, but before you do anything re making a complaint, make sure you are doing your part. Study/view everything you can that you will encounter in this job. Be at least familiar and ready to practice/demonstrate your skill. Reduce the talking, this is a hard one because everyone has a different measure of appropriate during training, or even when you're on your own, but you've gotten feedback and I'd reduce it probably by half.

if you can stand it, and you think she's teaching you correctly, get everything you can out of this experience. You will have better options after successfully getting through. And make sure youre completely focused and prioritizing your energy for this period. Take care of yourself on personal time and remember this is temporary.

[dragonfire123]

I appreciate your honest and helpful reply, Libby1987. I have made a conscious effort to cut down the chattiness and focus on reviewing my skills. I'm not sure what else she expects me to do, given my situation. I am new but I am by no means 'slow' -- I never have to stay overtime to finish my charting and my interventions are never late, and I have not made any errors (I ask questions when I'm not sure about something), so I am a bit bewildered by the feedback I am getting. I'll hang in there but it's hard.

[classicdame, MSN, EdD]

I think you should request a meeting with her and your manager together to discuss your progress. Without making it personal, tell them you feel you are expected to already know what an experienced person knows and that is causing stress which is interfering with your learning. Ask them for input. Ask if you can be placed with another preceptor to get a different perspective. Hope this helps.

[dragonfire123]

Thanks, Classicdame :)

[Libby1987]

Honestly I'd probably be in tears everyday, I can't stand not to feel confident. I empathize. But since you said she's well respected, well liked and very experienced, there must be substantiated reasons for that.

Try not to take it personally, it's your greenness not you as a person that is the source of the criticism (hopefully constructive). Put on some emotional armor and try to keep the perspective that she's teaching you correctly (by your description) and you will gain from this experience.

Some mentors have what seems a rough exterior with exceedingly high expectations without it having any reflection on their integrity or motivation. Worse would be a lazy non-invested mentor.

[dragonfire123]

Thanks -- sound advice.

[dragonfire123]

It will be hard cutting down on the talking -- explaining my interventions and why I'm doing what I'm doing in the patient's room was a habit I picked up (encouraged by my mentors) in nursing school to help me focus, as well as to make my patients feel more comfortable and informed. But I will continue to try cutting it down . . . sigh.

[VANurse2010]

I think you should have a meeting with your manager and preceptor, together, then individually with your manager. It's really kind of irrelevant if she's a good nurse and respected on the unit - her precepting is not working for you, and this is one instance where it is about you, and they need to try to accommodate to match your learning style so that you can be successful on the unit.

[dragonfire123]

Thanks, VANurse2010!

[NurseQT]

I would definitely request a meeting with your nurse manager and preceptor as well as a meeting with just your manager and ask to be paired up with a different preceptor. Your current preceptor obviously has an issue with you and neither of you will have a positive experience because of it. I don't care how slow you may be or how chatty, she's treating you poorly both on the floor and off (ie break times) and that's wrong.

I have done my fair share of training newly hired nurses and have just recently been asked to become a nurse mentor/certified trainer by my director. One of the very first things I ask the person I'm orientating is "how do you learn best?" And will suggest that the person spend the first day shadowing me. Everyone has different learning styles and no trainer should expect their trainees to all learn the things the same way..

good luck to you, I hope things get better for you.