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).
Thanks, NurseQT. I appreciate all your advice, folks. I suppose my main concern is that this person will eventually be my charge nurse, so the relationship is only beginning. I am hoping she ease up a bit as I acquire more experience, become more efficient and effective, and feel more comfortable and confident in my role. As it is, I will heed your advice and suggestions, as well as building my skills and confidence and buttressing myself with the necessary emotional armor to endure.
Keep in mind that even though your relationship with your preceptor may not have started out on the right foot, it doesn't necessarily mean that your relationship won't get better and/or change over time. Relationships at work, I find, are so dynamic; sometimes you have to work just as hard, if not harder, on them as you do on a marriage at home. Regarding you talking out your procedures to patients, I think that is just fine. Once you are off orientation you can be free to practice the way you are comfortable. I like when nurses explain things to patients instead of just going and doing something. For one, it keeps patients in the loop and makes them an active part of their healthcare. Best wishes.
I just finished being precepted. I had three different preceptors and all three were very different. Nursing does not = teaching. I was a teacher in my previous career and so I had to take charge of my learning. It is not your preceptor's responsibility to teach you in your learning style. That is your responsibility. You can do this!!! You sound smart and caring. If you learn best by hands on, tell her to talk you through a task. Let her know that you have seen her do such and such and she is an expert, you would like her to watch you and give you pointers. It also doesn't hurt to walk in her shoes. It is a tough job to precept. Tell her that you appreciate her precepting you, as you know it's not easy. Bring her a coffee or a treat. This is not kissing up, this is showing that you appreciate the time and responsibility. Also, study at home. Ask her if she has any study suggestions. You can take ownership of this period of time and absolutely turn this around. Don't give up!
Specializes in Peds Urology,primary care, hem/onc.
Sometimes we have aspects of our personality that others do not like. For better or worse, it will effect a work enviroment and you can get labeled a problem, even when you aren't. I have a very outgoing, talkative personality that I have found over the years, can grate on people. My first preceptor out of nursing school DID. NOT. LIKE. ME and made my first job a living hell. That being said, I learned A LOT from her. I am not excusing how I was treated but she, like your preceptor, was very well liked, and excellent nurse and all of her other preceptees loved her. I was not going to get anywhere if I complained.
One thing I learned is to NOT immediately have an answer when you are getting feedback. Pick your "battles". She wants you to write down helpful things- just do it for now (it is not going to harm anything and you may find it helpful if you do it for awhile). If she does not want you doing a verbal dialogue of a procedure in a room- fine, don't do it for now and if you can always do it later when you are on your own. If she is giving you feedback on how you do something (even if it feels unreasonable/unfounded) instead of immediately coming back with "WHY" you are doing it that way (which was what I used to do), ask her how SHE wants you to do it. If it is appropriate, try it that way (even if your brain is screaming at you that you do not want to do it that way) and see how it goes. You can always file it away in your brain of how you are NOT going to do something when you are on your own. I found out that when I wanted to discuss my rationale behind my choosing to do something a certain way when I was getting feedback, it was interpreted as I was getting defensive and not listening. That was not the case at all in my head but that was how I was coming across. We all know in nursing that there are many different and acceptable ways of doing things. I think the key is being willing to try different ways of doing things (as long as they are medically acceptable of course). If you are chatty like I am, your preceptor may be wanting you to just listen and try her way instead of having a long discussion about it. If she is not chatty on her break time (yes it is rude) bring something educational to review during that time (procedure book/information on the computer systems etc) that shows you are using your time wisely to try to optimize the areas she has concerns with. You are not going to be stuck taking all of your break times with her once you are on your own.
I am not saying be a doormat and it reasonable to request a meeting to discuss your progress but keep it objective.
In an ideal world, you would have a preceptor that works with you and your learning style. Unfortunately, that does not always happen and sometimes you can do an honest self assessment to see if there are things you can change in yourself that can get you through a preceptorship that will enable you to work at a place that is good for you in the long run. Sometimes, the preceptors are flat out not good and you are not able to work with them at all and if they are well liked on your floor, you are going to be the one that loses, not them.
Everyone else has great advice so I am going to hit something a bit different. You are saying you are starting all over again, this is incorrect. I have changed jobs a couple times until I found my niche, and each time there were new procedures and charting styles to learn but I brought my nursing experience and knowledge with me. You are better than you think and you need to take responsibility for that (saying this in a nice way!) I had AWESOME preceptors and EVIL ones lol, so I found that just buckling down, putting on the big girl panties (one of my more evil preceptor's favorite saying) and learning the job. I think you will be fine, own what you know and learn what you don't.
Everyone else has great advice so I am going to hit something a bit different. You are saying you are starting all over again this is incorrect. I have changed jobs a couple times until I found my niche, and each time there were new procedures and charting styles to learn but I brought my nursing experience and knowledge with me. You are better than you think and you need to take responsibility for that (saying this in a nice way!) I had AWESOME preceptors and EVIL ones lol, so I found that just buckling down, putting on the big girl panties (one of my more evil preceptor's favorite saying) and learning the job. I think you will be fine, own what you know and learn what you don't.[/quote']
This.
I have the 3 C method: competence, consistency, confidence.
You are competent; meaning, you have nursing experience that is fundamental enough to transcend your setting; you also state you have not made any errors and have been plugging along, which is consistent; in turn, be confident enough in what you know, and what you don't know-don't sell yourself short in what you do know.
Be confident enough to take the advice of your preceptor, the message, not the delivery; advocate for yourself to make sure you are at an understanding of what her expectations she has; and the. In turn, express your expectations; share what your learning style is and be proactive in your orientation; one thing nursing school taught me was to be a self-starter; investigate, process and apply what I know to my practice.
Also, be confident enough to self-study and review what you DON'T know...studying did not end once nursing school ended; this is an ever learning career; be proactive to gain knowledge in what you don't know, whether you change preceptors or not.
I agree with ClassicDame. Talk with you Manager and preceptor together, if possible. If not, go talk to your Manager alone and give very specific examples of what your Preceptor has said or done (exact words, when possible). I had a very similar experience with my first preceptor, and she almost destroyed my confidence. (I gave my Manager feedback and she assigned me to a new Preceptor). Preceptors should not criticize or de-grade you. Preceptors should be experts at teaching and giving positive feedback. You should be able to feel "safe" with your Preceptor: able to ask questions, able to practice your style of Nursing, able to give your Preceptor feedback, and able to learn at your speed.
I definitely would not request a meeting with a supervisor but I would continue to try and work with your preceptor. My thought is that if you aren't able to work with her in this capacity you probably won't be happy with her as your nurse manager but going to the boss at this point, imo, will definitely not make for a pleasant working environment if you decide to stay at this facility.
If she doesn't want you to be chatty, cut back, as others mentioned when you are off orientation you can run your beside your way. It does seem as if you are a bit sensitive as noted in several of your posts, "be kind" etc. I'm not saying your preceptor isn't being harsh but perhaps you need thicker skin. Do what she says, if that means writing something down that you won't ever use, who cares? She obviously isn't extending any friendly vibes so don't complain about personal things like a headache. It is telling that she is well liked and respected by peers so hopefully you will eventually have that relationship with her also.
Just my two cents. Good luck I hope things get better and this facility is a good fit for you.
Thanks, NurseQT. I appreciate all your advice, folks. I suppose my main concern is that this person will eventually be my charge nurse, so the relationship is only beginning. I am hoping she ease up a bit as I acquire more experience, become more efficient and effective, and feel more comfortable and confident in my role. As it is, I will heed your advice and suggestions, as well as building my skills and confidence and buttressing myself with the necessary emotional armor to endure.
This might be a bit tricky . . . but could you maneuver a meeting with the nurse manager and this preceptor under the auspices of 'her concerns' that you are 'half baked' (fer gawd's sake what a thing to say!). I mean get together with the manager and her to discuss exactly how you are failing to meet 'developmental milestones' -- I mean heck, you want to be as good a nurse as you can be, and all the feedback you get (mumble mumble about the negative and USELESS feedback she's tossing in amongst the good).
Does that make sense? It will expose your preceptor's um less than helpful inability to shut HER mouth and keep her unhelpful quips to herself. At the same time, it shows much respect to your preceptor by taking her SO SERIOUSLY you want a meeting with the manager to gain further feedback and direction.
I have a sense that bringing this idea up with your preceptor will poke some holes in her bluffery. Either that or she genuinely believes you are THAT lacking in whatever and a meeting with the manager will only be helpful, even if you realize the very, very, very unlikely possibility that this new job is 'too much for you'.
Like I said, tricky, but it preserves your relationship (hopefully) with this person who will be your future charge nurse if you stay -- and it calls her bluff.
In my experience, people who behave this way will continue to do so until they are stopped -- and often they stop themselves as they come to respect your assertiveness and seriousness. I wish they'd behave themselves from the git-go but we do live on Planet Earth, home of the imperfect :)
Stop ! This nurse is clearly not ready to be a preceptor. You need to be trained but so does she. Do what you do best, continue to talk with the patients. Be professional, but stand up to the preceptor. Formulate questions for her that will give her the opportunity to reflect on her behavior. Being new and 40 does not constitute abuse of any kind. You have a right to practice in that facility. Remember the HR department has policies in place for such behavior. Best of Luck !
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
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.
Don't cut down on the explanations to patients, just the "chattiness". People who like to chat often don't realize how much time is really being eaten. You don't know how many people this nurse has precepted that didn't pan out. I don't think she's trying to run you out on a rail; I think she's trying to cultivate the kind of coworker she'd like to have.
As far as trying to make small talk with her, it might be prudent to let her initiate any social interaction. I wonder if she doesn't want to worry about a personal relationship with you until you've proved yourself professionally. And if she says to write down where things are, then just write it down. It might prove more helpful than you know.
I think being 40 and competent in other things actually makes it harder for you. When we're young, we expect to feel stupid and not very competent and take that in stride. Now that I'm older, I really hate that feeling. I think the reason a lot of nurses don't change jobs when they're dissatisfied is because they don't want to feel new and stupid again.
Try to go with the flow if you can. She might end up being your best friend and the one you keep in touch with after one of you leaves. (This has happened to me more than once.)
dragonfire123
16 Posts
Thanks, NurseQT. I appreciate all your advice, folks. I suppose my main concern is that this person will eventually be my charge nurse, so the relationship is only beginning. I am hoping she ease up a bit as I acquire more experience, become more efficient and effective, and feel more comfortable and confident in my role. As it is, I will heed your advice and suggestions, as well as building my skills and confidence and buttressing myself with the necessary emotional armor to endure.