to preceptors/nm's...what's your opinion?

SmilingBluEyes · Oct 3, 2004

I am not a NM or regular preceptor, but it sounds as if you are getting shafted here. I would look for an opportunity at a larger facility. You sound as if you are in a small one to me, not much good going on there for you. To get experience, you need much more than you are getting. They do not sound committed to teaching you much of anything but filling spaces with warm bodies. Just my opinion, of course, from a 7-year L and D staff nurse.

bruinsrbest · Oct 3, 2004

Thank you for validating this,my husband would have me believe it's all me,and is extremely upset that I want to quit.

I'm having trouble adjusting to working nights,and the previously mentioned eval is doing a real number on my self confidence.

You've helped me feel better!

fergus51 · Oct 3, 2004

I agree. I have never understood why nurse managers put new nurses with so many preceptors. You are also being asked to learn a lot at once (pp, nursery, l&D, etc), which makes it even more important to have some continuity. If I were you, I would make a list of things you could do to make the orientation successful and present it to your manager. Some things you could request are:

-Having one or 2 preceptors max

-Being on call for deliveries even on your days off

-Making some good cheat sheets and a learning plan so you know what you need to work on

wooh, BSN, RN · Oct 3, 2004

I don't think going to med/surg is going to help you out here. Med/surg is completely different from what you're doing and what you want to be doing. It's a totally different skill set. I'll echo what was said above, you're getting shafted. Most places will give you the chance to orient during the day, if you choose. I didn't when I graduated, because I absolutely hate days. But it would be good for you, as most scheduled things will be during the day, and it sounds like there's a lot more going on during the day where you're at. If they won't let you do that, they want a license on the shift, not to give you a good orientation. You're going to either have to demand what you need, or find someplace that's more new grad friendly. If you choose to stay there, I'd get really proactive. Let everyone know you want experience. Jump in to do the caths and the iv's. Jump in on the more complicated deliveries. Jump in on whatever it is that's going on. Let everyone, not just your preceptor of the night know you want experience. Don't be afraid to say, "what's going on" when you hear something happening in the next room. In every precepting case, the preceptorship is a two way street. And while it sounds like you're definitely getting shafted on the preceptor side of it, if you choose to continue working there, you can do your best to try to be the best preceptee you can be, and just go after what you need. Good luck.

bruinsrbest · Oct 3, 2004

I've made a point of mentioning to charge nurses that I want to be "in" on opportunities,etc...to gain experience,but I'm never called upon when something comes up.

Thanks for responding;your support is appreciated.

SmilingBluEyes · Oct 3, 2004

Be very assertive in what you want. Try telling them clearly and concisely what you expect and how it will benefit them. And this pairing you harem-skarum with so many preceptors IS NOT HELPFUL....try and get that stopped somehow. If nothing else, try and find a "mentor" who can show you the RIGHT way to do things and is patient enough to help you along the way. Also some reassurance: I made it learning OB without ANY preceptors at all. Where I worked, there was NO internship/residency; you just were on orientation with "whoever" for 3 months, and then shooed on your own. It was a rural facility and you were made a charge nurse, if you were an RN, period. It was stressful, a virtual baptism by fire, if you will. But I made it, choosing and following mentors and emulating them. I tossed garbage and discarded bad examples quickly and efficiently. Yes, I learned early on who to follow, who to ask what and how to do things RIGHT the FIRST time, of my own accord. If I can do it, so can YOU!!!! Best wishes!

kmrmom42 · Oct 3, 2004

Reading the previous posts I have to say that you have gotten some very good advice here. My suggestion would be for you to choose one nurse that you have had a good rapport with and who has been supportive of your orientation efforts. Schedule yourself for the same nights as this nurse and then give it all you've got to gain experience using her as your support system. Don't wait for the charge nurse to call you in on things. Just jump up and go when a second nurse is needed for a delivery or be the first one to take that incoming patient. Listen for opportunities....when you hear a nurse say that their patient is having decels you could ask if you could place a scalp electrode for them for example. It is not fair that you have not been given a better orientation. But if you want to stay at this facility you will need to try to take matters into your own hands. If you don't want to stay then at least you know what kinds of questions you need to ask before accepting new employment! Good luck and let us know how it goes if you can.

bruinsrbest · Oct 3, 2004

Your points are well taken,and I will use your suggestions.I'll know exactly what to ask for the next time around.

SmilingBluEyes · Oct 3, 2004

Also remember Policies and Procedures as well as AWHONN standards are your guidelines. I suggest you become VERY familiar with both; they will guide you as to what proper practice is where you work. Best wishes and hang in there; you can do it!

USA987, MSN, RN, NP · Oct 4, 2004

I'm fairly new to L&D myself and part of the reason I chose the hospital that I did was because of their orientation.

Learning postpartum, nursery, L&D, and the OR all at once seems a little overwhelming. I oriented for 6 wks. on postpartum, then worked PP strictly for 4 months. Then I oriented to L&D for 6 weeks, then worked L&D strictly for 3 months. Now I rotate between the PP & L&D. I have ACLS so I just finished orienting in the main hospital Recovery Room for a 3 days..and I can now recover c-sections & BTL's. My director said I probably won't learn how to circulate sections for another year...just to give me time to get comfortable with the skills that I've acquired over the last year. I really don't have to orient to the nursery as the SCN nurses cover the well-baby nursery. As a side note, I work PM shift but most of my orientation has occured on the day shift just to have a great opportunity to see things.

I do wish you much luck. I can only imagine your frustration.

All the best :)

Nurse_Educator · Oct 4, 2004

As someone who is responsible for coordinating orientation on the unit I do have a few thoughts on this.

1. Is there something like a skills checklist or a list of skills that you need to complete prior to your orientation being over? If so, I would request one, then request assisngments with my preceptor to help me accomplish what is on this list.

2. Goal setting, goal setting, goal setting! What are their goals for you? Do you know? Have they been layed out clearly so you know what is expected of you week by week? You should be given opportunity to meet your goals! I would request weekly goals and weekly meetings with my preceptor, and my nurse manager to review these goals. If they haven't been met, why not?

Is it for lack of exposure? Or other reasons?

An example: Successful IV start per (blank) hospital policy

Circulate vagianl delivery with minimal assistance

Accurate lady partsl exams

Recover vagianl delivery

Perform accurate newborn assessment

A goal always starts with an action word, and is measurable. Meaning either you did it successfully or you did not do it successfully.

Keep a journal in a notebook of who your preceptor is each day and what you did each day, with ancedotal notes. This is important as well.

Hopefully this will help you to start planning an OBJECTIVE orientation.

Marilyn