Preceptor is SO BAD!

[Guest606]

Hi All,

I'm a new graduate nurse who just started in the ICU and on my third shift tomorrow with my preceptor. She's been there for 7 years and everyone was telling me how lucky I am to be precepted by her before I even met her so I was excited.

Come to find out, I feel more disoriented with her than actually oriented. She took her ADDERALL right in the middle of my first shift around noon in front of me, doesn't follow policy or procedures and does things the way she wants, leaves me out of almost everything and doesn't explain anything unless I ask and even when I do ask she just says and I *** you not "this is what the government says to do", tells me I can do whatever I want, didn't introduce me to anyone on the unit, dumped urine down the sink instead of the toilet, didn't sterile glove when changing a central line dressing, doesn't tell me why or what she's doing and is doing everything HERSELF instead of having me lift a finger. When I asked her when I can do medications, assessments, or anything she just said "Yeah I guess you can do this" I just looked at her in disbelief and just went to the bathroom and cried. She is very OCD and needs things done her way and I did notice she is very thorough and does go above and beyond for the patients we had but she's a lunatic! When SHE was giving report to the night nurse during the end of our shift, I just stood there. The night nurse coming on even said "who is this" because I was just standing there like a lost puppy. She gave report, she could tell I was hypertensive and angry with her for leaving me out once again and apologized and promised we will go through everything.

I told my peers/previous classmates about this and they thought I was joking. They said to stick it out since it'll only be the third day and she has a good reputation for a reason. My thought process is I only get one orientation and I'm eager to learn and be the best nurse so I don't want to waste another second with this joke of a preceptor. I'm not amused. I'm not impressed. Should I ask the manager for a new preceptor? Good grief all I wanted was structure, to be included, more focus, just anything at this point!!!

[fauxbadnurse, ASN, BSN]

Leave the Adderall out of this! ?

[pebblebeach, BSN, RN]

When I worked nights I had an alarm set on my phone to take my birth control pill, Lexapro, etc. Now wondering how many new nurses I've traumatized with "She took her Lexapro right IN FRONT OF ME!" ? Sorry not sorry, barely have time to eat a full lunch let alone whisk away to privacy when I need to take my pills.

OP, I've also been the lost puppy, but it's been two shifts. It's great to be eager to learn but the learning curve (especially in ICU) is steep and slow vs. nursing school cramming and regurgitating. Be patient.

[Hani, BSN, RN, EMT-I]

That part cracked me up too ?

[emmjayy, BSN, RN]

On 10/31/2019 at 7:01 AM, Citygirl606 said:

Hi All

Wow. You're two shifts into your ICU orientation as a new grad and are upset that you aren't doing a lot? I think you need to understand that it is very normal for ICU nurses to have trouble trusting new grads with their patients. These patients are UBER sick. What you should be doing right now is a lot of watch, learn, and ask questions. That's pretty much it. I didn't start giving handoff report until about three weeks (12 shifts) into my ICU orientation. I wasn't allowed to touch drips and meds until I'd studied them and understood what they did, what to look for when administering them, and why my patient was on them. Meds we use in the ICU are very different from the ones used on the floors and it can be difficult to understand what they do or why one med vs. another is being used.

If your preceptor isn't telling you things, YOU need to take responsibility and initiative and ASK her why she is doing things. Ask her about the drips, the vent settings, the interventions, what she is observing/hearing on her assessment, then ask if you can see/listen for what she's hearing, etc. Even better, look up the drips you see commonly and tell her what you've learned and ask her to help you fill in the knowledge gaps. Ask her how to zero an arterial line, draw off a CVAD, etc. It sounds like you need to express interest to her. And, it's not really her job to introduce you to people. Yes, it's nice to be introduced, but you are just as capable of introducing yourself as she is of introducing you.

To your final point of calling her "OCD" and "has to have things her way" and characterizing her as a lunatic - you bet your butt that we are OCD and want things a certain way and behave a little crazy about our patients. We are often the only ones standing between our patients and death - this is not an exaggeration. These patients are the sickest of the sick and so fragile that the slightest mistake could cause them to die. About six months ago, we had a patient on the unit whose nurse (who was a new grad fresh off orientation) didn't pay attention, she pulled off her oxygen, desaturated, carted, and DIED. Because her nurse didn't respond to the alarm saying she was desaturating. This is why we are so OCD, because if we slip our patients could literally be dead. It's a lot of responsibility and it is very tough to pass that responsibility off to someone who we KNOW is inexperienced and doesn't have the knowledge base to handle things.

You need to communicate with your preceptor about what you need, your learning goals, and make a plan together about how to get you there. If people are saying she is a good nurse, good preceptor, and she is well-respected on the unit, it is a little crazy of YOU to be characterizing her as a joke of a preceptor after two shifts with her.

[DeeAngel]

Ask to have other preceptors to provide you with the best variety of experiences. This way it’s an education choice instead of not wanting to work with a nitwit.

[TwoLayi, ADN, BSN, RN]

Playing the Devil's Advocate...

Hi All,

ICU nurse here with several years of experience. Recently I have been precepting a new grad to our unit. I let her observe at first because I don't really know how much she learned in school and what she feels comfortable with. But I am starting to get worried because she has taken no initiative. She just follows me around, asks zero questions, looks distressed when I do explain things to her and has failed to even introduce herself to our coworkers. And then when I gave her permission do very basic nursing stuff, she went to the bathroom and cried.

[sevensonnets]

And then calls you a lunatic.

[DextersDisciple, BSN, RN]

6 hours ago, TwoLayi said:

Playing the Devil's Advocate...

Hi All,

ICU nurse here with several years of experience. Recently I have been precepting a new grad to our unit. I let her observe at first because I don't really know how much she learned in school and what she feels comfortable with. But I am starting to get worried because she has taken no initiative. She just follows me around, asks zero questions, looks distressed when I do explain things to her and has failed to even introduce herself to our coworkers. And then when I gave her permission do very basic nursing stuff, she went to the bathroom and cried.

Wait Are you the preceptor ..?

[historylady, MSN, RN]

This is how we are losing new grad nurses.

New grad nurse - you have three courses of action. One you can do nothing and wait the day when you are on your own and something you should have been taught happens needs to be done and you do it wrong and then get into trouble and maybe even risk your license. 2) you go and talk to the unit manager and ask for a different preceptor. Don't tell them all the stuff you wrote, just tell them that you and your preceptor are not clicking and that you really want to become a kick *** ICU nurse but you just don;t feel that this preceptor is the best for you. 3) You can stay with this preceptor and be alert for others on the floor that are more open to teaching you. They are around. It is your career, you must decide how and what you want it to be. Personally, I would ask for different preceptor on my personal grounds. I would tell them that although she is considered a great preceptor, I do not feel that we are clicking and I seem to missing a lot and that maybe a different preceptor could better help you learn the unit. Don't attack her, put the blame on you. As a nurse educator, I see this a lot, not all great nurses are great preceptors They miss steps and don;t understand the teaching relationship.

[historylady, MSN, RN]

15 hours ago, TwoLayi said:

Playing the Devil's Advocate...

Hi All,

ICU nurse here with several years of experience. Recently I have been precepting a new grad to our unit. I let her observe at first because I don't really know how much she learned in school and what she feels comfortable with. But I am starting to get worried because she has taken no initiative. She just follows me around, asks zero questions, looks distressed when I do explain things to her and has failed to even introduce herself to our coworkers. And then when I gave her permission do very basic nursing stuff, she went to the bathroom and cried.

Have you asked her how she is doing? She sounds very overwhelmed by it all. Some new grad nurses come in brimming with self-confidence, other don't. IF she is going in the bathroom and crying, you need to find out the reason. Ever person has a different learning style. You as the preceptor needs to find out this new grads learning style. Maybe she is overwhelmed, maybe she is scared of you. Maybe her education was not as she had hoped, talk with her, ask her what she needs, have her tell you what she needs, build her confidence. The nursing profession needs to nurture new grads not scare them away. ICU is a tough place to learn as new grad.

[NurseKristen82, BSN]

1 minute ago, historylady said:

This is how we are losing new grad nurses.

Exactly!!! ?

OP- I'm so sorry that you came here for help and instead found Nurses that are making excuses for a Nurse that is clearly not doing the right things and made it YOUR problem- IT IS NOT!!! I agree with the Educator above that you have a couple options. As a Nurse Manager, I disagree about not providing details. If you don't let the Manager know what's going on, how can he or she fix it? What about the next new grad they stick her with? I really hope you have a good Manager that can help make the transition smoother for you but it's worth whatever you have to go through to get a really good foundation with a Nurse that is competent in both Pt care and in precepting. You're right- you only get one orientation.

Hang in there- it does get better! You worked hard to get here and YOU MADE IT so you can get through this too. The first year it the hardest for so many reasons, but it will be worth it once you get through this hard part.

Please keep us updated.

[AlwaysLearning247, BSN]

I’m not a new nurse but am new to an ICU setting. When I started I wasn’t expecting to do much in my first couple shifts but to observe, although I took initiative. As a new grad it is important for you to take initiative and show you want to learn. In reality, you still do not know the basics (time management in the real nursing world, explaining disease processes with patients and families, communicating with doctors, etc) - that’s okay, it comes with TIME.

However, when you see your preceptor not using sterile technique doing dressing changes, make sure you use sterile technique when you do it. Maybe she was in a rush and far behind and for whatever reason didn’t use sterile technique but it doesn’t make her a bad preceptor over that. You’ll come to see many nurses do things differently.

My advice for you is to assess your patients, she is still going to assess her patients but that doesn’t mean you don’t. Whenever something is going on be there and jump in to help. Show your coworkers that you’re there to help. Offer to help turn patients, answer call lights that aren’t yours if you have time. That is how you’ll start getting close to your coworkers, showing them that you’re a TEAM. You are a professional and can introduce yourself to them.

I have oriented many nurses and I feel more inclined to help when they take initiate and don’t try to make me look like I’m a bad nurse! If you hold a grudge on your preceptor you won’t have a good orientation. If you still feel like you’re not clicking then you can ask to switch preceptors but I would use your words very carefully. Don’t make this nurse look bad, your manager had the confidence in this nurse to precept you. Good luck!