Preceptor Refusal

[LJOHRrn]

Nearing the end of my 12 week orientation as a circulating nurse in the OR for general surgery, and currently my preceptor sits outside the room to let me fly pseudo solo. Today was my first vascular case, a bilateral fem-pop bypass, which I read about the night before but had never done. Didn't have time to look at the pick sheet before hand (during turnover) and felt uncomfortable going this alone. Because of that, I asked my preceptor to stay in the room with me to which she replied "No, I didn't have anyone with me for my first fem-pop." I explained that I felt uncomfortable being alone to which she replied "no, you'll be fine."

A few minutes later, I called my lead nurse and asked her to meet me outside the OR to explain the situation.

Sidenote: Last week my lead and I had a heart to heart about me asking for help when I feel uncomfortable, overwhelmed, etc. while in orientation, and repeatedly stressed to me that I should call her at any time, which I did today.

I explained to my lead nurse what the situation was, what my preceptor said, and she sent my preceptor back in the room. My preceptor stayed with me until she dismissed me for lunch break. The procedure hadn't even begun by that point as IVs, ART lines, and Foley's were still being placed, so I feel like asking for help was futile and defeated the purpose.

These are my questions:

Was contacting my lead the right thing to do?

Was my preceptor's refusal appropriate?

Do I just need to suck it up and embrace baptism by fire?

Is there something I should have done differently?

Are my expectations of my preceptor unrealistic?

[WhoDatWhoDare, BSN, RN]

I believe if you think it was appropriate to call your lead, then it was. You're a student/orientee and still learning but.... I don't necessarily believe your preceptor was in the wrong either... It all depends on a relationship you've built while under this preceptor and your exposure to increasingly more complex cases during your training.

You mention that you're nearing the end of your 12 week orientation, but how near? 8 out of 12 in the books, or 11 out of 12? This could make a difference in my perception of the events as you've told it. Further, has this been your preceptor for some time or was this the first time they've seen you in action? Based on their response to you voicing concern, it seems they were confident you could critically think through any obstacles and knew they'd be there if you needed more.

From experience, I'll tell you that you'll be competent before you feel confident.

You would've wanted to see the positioning, the prep (abdomen down to toes, circumferentially around the legs, the position the bed to the back table for your rooms setup, the placement of lines to know what timing before the actual incision can be expected, perform the timeout so you address items like blood products in the room, what is the expected length of the case, etc. The timing of going to lunch when these were occurring is a missed opportunity for you.

Lastly, you stated that your preceptor was going to let you go pseudo solo... that they'd be outside the room. Hopefully that meant they were literally outside the room, and not out of the OR on a coffee break. This makes some difference too.

In the end, there needs to be a debrief between you and your preceptor... A way for you two to address your concerns and for them to give you feedback (good, bad, or otherwise).

Good luck.

[MSNMPHPhdNMD]

You did the best thing trust me. I have been working in the OR for many years but i have no neuro experience. I was asked to circulate a neuro case and never have i scrubbed or circulated a neuro case.

I was pressed by the Surgical tech manager who was leaving for an appointment to her doctor. I explained im not comfortable scrubbing and circulating these cases. She kept pressing me and then i had to go to the main surgery center manager. They were very happy to accomodate me.

Keep in mind you have a license and its your license and your responsibility.Never allow anyone to put you in a position you are uncomfortable with.

Now , when she tried to send you to lunch I would have asked to stay so you could learn and watch.

[RNOTODAY, BSN, RN]

Before going to the lead- essentially over your preceptors Head- You should have been more stern with your preceptor that you needed her in the room and didn’t feel comfortable... surely if you INSISTED, she would stay? That’s what I would have done differently...