Please advise. I am one month away from being off ER orientation (no prior experience) and feel good about my performance so far--altho I am by no means an expert and have MUCH more to see. I have been told by ER staff, including docs and even chief of ER, that I am welcomed and doing well (altho I still go home and doubt myself somtimes!) Patients and family members tell me they hate our ER, have horror stories about the care they've gotten in the past and have even stated our ER would do well to hire more "caring and compassionate"nurses like me http://www.nurse-forum.com/images/smiles/icon_smile.gif The response I'm getting for the most part is positive.
I love the job, and still have a long way to go tho,like I said earlier. Here's my problem:
My preceptor ( a veteran with excellent skills) is not the easiest person to get along with. Fights with staff, challenges the docs, ALL the time,creates drama and tension.. I felt sorry for her, tried to be friends and stay on her good side since all this is new to me. Today, to my utter amazement, she tells my manager she does not think I am "where I should be in," my orientation, giving no real concrete reasons to justify her statements and actually going so far as to make things up to make me look bad!!!. I felt sabotaged and blindsided. I think she resents me b/c I am a nice person!! I know it sounds crazy..! So, I am disputing this and asking for another preceptor ( I truly believe this woman is unstable) which my (fairly new and overwwhelmed) manager agrees to do. I have worked so hard to do well here and now I have to ask myself if I really want to work in this ER, or whether or not my manager will keep me!
Does anyone have an opinion please? Is there a preceptor out there who can guide me?
Hmmm. My gut was right about extensions (not really beneficial). Thanks for the input, everyone. I agree that the real learning comes from when u have to do it yourself.
I am rethinking this whole ER thing after the sh** day I had today, paranoia setting in I guess, imagining my ex-preceptor is talking trash about me. Why are the day shift RN's the biggest b*****? (NOT all of them :)
I am losing enthusiasm by the gallons as I type this. I just want my life again! All I do is study, or work on orientation learning modules. All the studying in the world is not going to give me experience. Why the hell was I hired w/o experience in the first place? My manager keeps forgetting I haven't done "real" nursing for 3 yrs. I was awesome in my former RN positions, now I feel like I don't know anything...Anyway, I'm pathetic (I know) not like me to feel sorry for myself..I feel this is a safe outlet anyway.
Noelle!!! Girlfriend!!! What happened to drag your spirits down through the mud again? Something new? Or same ol' s...t??
I could have written your post, just about word for word! Except as a "brand new ER nurse" I was REALLY TRULY brand new...meaning, straight out of nursing school! I knew nothing, I cried about 80% of the time in the car on my way home from work! I got this tight, sick, upset feeling in my stomach on the way to work, every day. I spent all my waking hours, while not at work, reading through the orientation manual I'd been given, as well as the ER Nursing textbook I had, and the ACLS and TNCC books. All the time. Any free time that I wasn't reading, I spent going over scenarios in my head, over and over and over again...what would I do if I walked into my pt's room and he wasn't breathing? Would I even realize it, or would I be an idiot and think he was sleeping? What if I hadn't put his cardiac monitor on him? Other than feeling stupid because of the way my preceptor talked to me, yelled at me, I had this fear of feeling stupid anyway, this fear of me running out into the hallway and yelling "hey, I NEED SOME HELP IN HERE...MY PT HAS CODED!!" only to find out he'd been asleep! Would I react properly when I needed to, but NOT react when the pt was really only asleep and breathing shallowly? I can't tell you how many times I took a pt from triage, and looked at their triage sheet and couldn't for the life of me figure out what to do with this guy! Should I start a line and order labs? Why do these pt's never have the "textbook" symptoms? I felt awkward all the time, not knowing what the doc would expect me to do...but feeling like I SHOULD know. And my preceptor was awful, yelling that I SHOULD KNOW what to do for each patient.
And drawing blood & starting IVs. Oh my god, it's not brain surgery, why couldn't I do it? How can I have missed that IV? And the next one and the next one and the next one? How can it have taken me AN HOUR to finally get blood on a patient??? Well that was because I'd looked and looked and looked, hesitantly stuck the guy a couple times, wandered around looking for a sympathetic soul who would come in and do it for me....of course, that was after my orientation was over, because my preceptor would never have left me that long...he'd have just rolled his eyes and acted exasperated at my stupidity, and then done it himself.
What finally helped, was finally being OFF of orientation. Yes I still felt stupid...yes I still stopped other friendly nurses in the hallway and showed them my triage sheet and asked what they thought I should order...but it's has slowly come together. I don't cry anymore after work, because I've felt so stupid. And I feel SO MUCH more comfortable iwth the docs now...that just takes time to develop that relationship...I can very easily walk up to a doc and tell him my pt's symptoms, say left abd pain and left shoulder pain, but she's got a hx of cardiac issues...so do I order the normal abdominal pain workup, or a cardiac workup or both? What I like to do is suggest what I THINK we should do, rather than going up to the doc and saying "what should I do?", I say "do you want xyz, or abc, or both?" The headache people...it's hard to tell, some docs want blood work, some will want head CTs, others will want nothing done until they see the person...so it's NOT stupid that you don't know exactly what to do for every pt, it often depends on the doc that is going to see them.
Anyway, my point is, it's a painful process that we all go through, to some extent. Some of us wallow in the misery for longer...I graduated school in May, started classroom orientation in June, and working with my preceptor in July. I have been out on my own, without my preceptor, since October, and I'm just now, honestly just in the last few weeks, starting to feel fairly comfortable with things. I still don't like having to work the same shift with my preceptor, because he still judges me, still pulls me aside and berates me if I'm doing something slower than he thinks I should be...but I just let that slide.
Sorry to write a book girl, but just wanted you to know that it's not you, it's your preceptor, and the fact that you're new, and the fact that it's ER, and basically, we all had to go through it, and you WILL get through it too! Every painful event that passes, is one less painful, or humiliating or embarrassing or confidence draining event that you have to endure, before you're through, to the other side, and you finally find that you're a damn good nurse!
Oh, and by the way...my preceptor did the same damn thing to me in a review with my educator. It came out of the blue, that I wasn't where I should be by now, as far as the knowledge I had, and that I'd done something the other day that INFURIATED him SO MUCH, that he knew he couldn't even talk to me because he'd have lost it, he was so angry with me. This was NEWS TO ME!! He hadn't told me this at all, just decided to bring it up in my performance review!
VS!!! You ROCK! I am so down right now, and I actually did start crying on my way home from class just THINKING about going back in there tomorrow. So unlike me!! I am the one everyone ELSE cries to! I read your post, you made me smile and LOL :roll THANK YOU!!!!!!!!!!!
You know exactly where I am coming from, and I'm certain you are an awesome nurse. That ER is lucky to have you!
I was trying so hard to let this bs go, start clean w a new preceptor and do my best. But then when I went in yesterday, I got the feeling my former preceptor had turned some of the staff against me. THEN...I made the mistake of asking some of the RN"s ( that have been telling me to my face what a great job I've been doing) if they were telling my preceptor the opposite (like she claimed). Of course they denied it, and I believe them (I think). I then asked that if in the future I wasn't doing something right, they would please be honest with me and tell me. I guess one of them went to my manager and that started a whole thing-apparently I "cornered" this RN and made her uncomfortable by asking her this. You see, VS, I am ssoooooo above this crap--truly! Now I feel like I am the one looked at as the troublemaker--EVEN THO this former preceptor LIED about me (in front of me), and started this whole mess!!! So, now it's hard for me to trust anyone there..I'm not sure what to do. I feel like I might be wasting my time trying to finish out orientation. Almost as tho I've done myself in asking for a new preceptor. My skills are not that good yet but I know the director wants me there b/c he is getting good feedback from the patients--and this particular ER is notorius for the "mean ER nurses." So. This is my quandry.
I can't even believe I am actually thinking of going somewhere else. I never imagined I would have a problem. I should have taken the community hospital ER position, but I said no b/c I did not want to lose 4 yrs. where I'm at.
Anyway,
you helped me ALOT. Thanks so much for taking time to post that msg. It's a great feeling to love what you do and do it well, isn't it??
Hey girl! One last thing about your situation. Well, let's be honest here, that friggin' preceptor of yours may be an unbalanced loon, BUT she also may have some friends out there that believe her. Oh well, nothing you can do.
If I were you, I wouldn't ask people anything about how you're doing, don't ask them to evalute you, don't ask them to contradict your preceptor's crazed rantings. That sort of smacks of taking sides, if you see what I mean, and nobody wants to get involved in that kind of thing, regardless of how they feel about either of you.
You CAN get their opinions, but do it IN THE NOW, during a situation, not later, asking about your overall performance. When I walk into a trauma where there's another nurse or two, I just flat out tell them, "hey, it's been a while since I"ve done one of these & I'm still not real sure of myself...so can I help you out?" (that's assuming there's ALREADY a nurse in there that was planning to handle the trauma). "PLEASE let me know if I'm not doing the things I'm supposed to be doing. Feel free to yell, and tell me to do something, if I'm not doing it. Heck, tell me to get the hell out of the way if you need to. I won't be offended, I just want to learn. Sometimes I get a little panicked when everybody and their dog starts running in on these big traumas, it gets so loud in here, just yell at me to do something if you need to. Believe me, you won't offend me".
By phrasing it that way, it tells them that I am NOT above receiving criticism, I am not above the yelling that simply HAS to happen during a chaotic situation just because the overall noise level gets so high, and it tells them that you WANT to learn. See, if they've heard anything bad from your preceptor, it will be stuff like "she thinks she knows everything already" "she can't take constructive criticism", "she gets upset if I try to tell her she's doing something wrong". Anyway, that's my view on it. And I've NEVER had a nurse turn me down and tell me she doesn't want me in there helping out. We usually have 1 primary nurse, who does all the writing/charting, and 1 secondary who does all the "doing", but you really can use an extra secondary to get the lines in, the meds given, etc. So I try to be that extra secondary.
Hi VS. I just lost a long msg I tried to send u--I'll make this one shorter. Thanks for the advice. You and I think so alike, it's kinda scary :)
I had a great day w my new preceptor today. She is a nurse educator as well. It was a little awkward at first, I asked her to please not be afraid to yell at me or correct me or anything. She watched me for awhile, then I literally saw her RELAX after she told me I was doing well and my charting was "very good." She then told me my expreceptor left a "note" telling her to make sure I was given the toughest assmt (the "corner"). She said that was odd and didn't think it was cool. I somehow was not surprised.
Anyway, I had a great day--handled the "corner" better than I ever have. I think I impressed her! We agreed I would be with her for the next 2 wks, the remainder of my orientation.
On my way out I stopped by my manager as she wanted to know how it went with the new preceptor. I told her what a good day I had. Then, it hit me. Something in the look on her face told me what I already knew. I realized right then that no matter HOW well I did, no matter how many patients/other staff told her how well I did--it doesn't matter. So, I beat her to it, telling her that I decided if ER didn't work out for me, I was going to be ok. That I was not going to kill myself anymore. She asked me to have a seat, and proceeded to tell me she "was glad I said it first." (!!!) I asked her if that meant she had already decided not to keep me, and why was she letting me finish orientation? Her answer? She had none. She told me she just didn't think I would be able to learn everything I needed to know in the 2 wks I had left.
I knew right then I could not be happy working for a woman like that. A woman who let my expreceptor lie about me to my face. A preceptor who is out to destroy me for some psychotic reason!! I knew something was odd about her when on our 2nd day together she almost made me cry talking about her abusive sociopathic (seriously) mother who she has nothing to do with.
So, it's over for me, and I am relieved! You're right, VS. This women has friends there that may resent me. They "ate me alive," just like the dir of the ER warned me about. Should I let him know why I'm leaving? He actually thanked me for coming to his ER, I think he deserves to know the truth--but who really cares, right? The ER will go on and do fine w/o me.
So, I will finish my critical care and ACLS, hopefully. And then my next step? NO IDEA. Maybe go beg that community hospital ER manager who I said no to before this fiasco? All I know is I am so grateful to be who I am, and no matter what, I will NEVER be a b++++ like that to a fellow nurse. We'll see what lies in store..I'm gonna walk my dog now!
OK I have to ask. Where is the manager in all this? I made my living as an ED manager for many years. Why is he or she not informed about these types of preceptors? Are your managers involved in your orientation? I routinely was on the unit without preceptor or new orientee knowing it watching the interactions between the two. I called the new hire into the office every week to ask SPECIFIC questions about orientation and the preceptor. I also spoke with the preceptor weekly and met at the end of every week with both at the same time. Sometimes we needed to switch preceptors. I inherited a bunch of veteran nurses who were nasty and terrible preceptors. I sat them down and explained the role of a preceptor and my vision and goal for a new hire and it certainly wasn't going home crying! The second meeting with some of them was their last as a preceptor. And the third meeting with some of them was their last in my unit. Speak up and don't be afraid. The days of having to put up with these old crass unstable nurses have long past. My goal is to have you competent and happy and to translate that into your patient care and hopefully like working in my unit and stay with us awhile. If you need an extension then so be it. And when you come off orientation you should always have a "go to" staff member to bounce things off or just talk to if needed. I also would continue to meet with you weekly just to make sure things are working.Just another side to this story.
Hi Qanik! Thanks for the info. If I had a manager like you, I'd still want to work ER. She is new to my teaching hospital (5 mos maybe). I know some of the old timers are giving her a hard time, so I tried to be a perfect little trouble-free orientee, since she gave me a chance by hiring me on. So, I kept my mouth shut until last week, when I felt my position was in jeopardy b/c my preceptor turned on me!!!
I've been there almost 10 wks. Didn't meet with my manager until my 4th week, and then only once after that, which was last week when all sh++ hit the fan, and then today.
I guess I commited the unforgiveable sin of asking for a new preceptor, when this woman was supposed to be one of her best RN's. Too much scandal for her ER. See, by my leaving, it sort of saves face for this manager and her psycho preceptor, huh? Too much BS for me! Life is too short! In the short time i was there i discovered i will never like anything as much as the ER, so i am sad about that. But not even I am strong enough to deal with mean women like this! Women that would put an acute patient's care in jeopardy (if it was my patient), rather than help me if i asked them!
Hopefully some good will come from this--we'll see
Hey girl. Sorry it's not turning out well. But before you say adios to this ER, make sure you know your financial responsibility. If they let you go, you should have NO financial responsibility, right? Get that in writing. I know if I left my ER, I'd have to pay back for all the training I'd received, but I'm pretty sure it would only be if it had been MY decision to leave. So suck it up, if you have to, and make sure you make it very obvious that it's NOT your decision to leave, it's theirs...otherwise you may get stuck having to pay some $ back for the "training" they gave you!
Also, DON"T give up on ER!! Just find another ER that will work for you. And don't bad mouth the ER you're at. I don't know why, I really don't, but no matter how psycho, no matter what freak of nature it is that you're finally getting away from, calling them out and "saying it like it is" to a new manager just never goes well. It always comes across as sour grapes. So practice your gracious explanations..."it wasn't a good fit", or heck, I don't know, but just don't say it was the psycho ***** from hell and her devil spawn of a manager that ran you out of there. Try to figure out what you're going to say in your next job interview, that can leave you looking gracious and professional, and "hint" at the situation without ever coming right out and saying it. Maybe someone else here can help you with that. Just don't come across as bitter & hateful, that will make you appear, however unjustly, as a "difficult to get along with" person.
Hey VS--I appreciate what u say here and I took your advice--I went back in there and told my manager it is not my decision to leave the ER. I DO love the ER--just maybe not this one so much anymore, if I am to deal w BS like this. And please--I know there is BS EVERYWHERE..and I can handle a fair amount thrown my way. I have to say that I am REALLY disillusioned and disheartened--honestly trying to get past this whole thing! Tell me, on what grounds can my manager say "it's not working out" for me if my new preceptor gives positive perfomance evals., I'm passing all the courses, and the patients are commending me? I am on time, never absent either, BTW.
I have 2 weeks left on orientation and I am supposed to meet with her tomorrow.
Any suggestions? Oh and what kind of ER do u work in? How would u handle working with a nurse like this that is out to get you?
Thanks again--you have REALLY kept me sane the past wk!
Well, for your meeting tomorrow, I guess that depends on your goals. Do you still think you'd be willing to stay, if you had the opportunity? If you DO want to stay, or you're at least willing to try to stick it out if given the chance, then you'll manage that meeting differently than if you are happy to sit back and let them dismiss you. If it were me, I guess I'd ask if there are certain specific things they could list for you, that you could study up on during your off hours, and certain skills you could look to gain during your shifts in the 2 weeks you have left. Find out your "deficits" and tell them you'd like the chance to correct them, even though you know the time you have to do so is short. How can they let you go, without telling you what it is that you're not doing up to their standards, anyway?
As far as handling that awful preceptor...I hate to admit this, but if it was a woman (mine was a man, and it didn't seem to work quite as well as I think it would have if it was a woman), I'd swallow my pride, and say things like, "how long did it take YOU to learn this?" in an expression of "awe" at her skill at whatever particular thing she's criticizing you for. Ok, cut to the chase, kiss up, that's what I'm saying. I'd do it subtly, of course, admit to my own deficits, comparing my lack of skill to her "great & awesome" skill, and show her how desperately I want to try to "achieve" that level, some day. Now be careful there, that's a really tricky issue, about "admitting your own incompetencies"...dont' highlight them, don't bring them up, just don't argue about them if SHE brings them up. I did that poorly with my preceptor, I think (and with my teacher in nursing school too, now that I think about it). I have this habit of saying "gosh, I'm terrible at this, why can't I do this? I should have gotten so much better by now", and I think what I'm trying to do is get her to say "oh, no your NOT terrible, you just need a little more experience". But these people, that's not how they think. She just AGREE with you, and possibly your negative self-comments actually cement their OWN negative opinions! So fishing for compliments that way is NOT going to work...I've done it!
There was a preceptor at my hospital who sounds a lot like yours, her orientee ended up asking for a new preceptor because she was so awful and treated her so rudely. I knew, as a friend with her orientee, I'd be "guilty by association" and be treated badly by this preceptor too...and at first I was. But then, I asked for her help when I needed it. It's a really fine line but I tried to do it without appearing incompetent, just a little overwhelmed, and as though I knew she was the one I knew who could help. (her overall problem with my friend, her orientee, had been that the orientee had argued with her when being criticized...my friend felt she was trying to explain WHY she did something a certain way, but the preceptor took it as trying to debate the issue of what she was being criticized for, as though she knew more than her preceptor). I even allowed her to overhear me telling someone else to go ask her for help (it was about starting IVs on "hard stick" patients, the woman truly is phenomenal at it, & I told someone that, KNOWING that she was near enough to hear me.) Yes it's a game, yes it's all smarmy, and yes it may not work. Kissing up doesn't always work, and some people just can't bring themselves to do it. And some of those tough, really mean people end up being the type that don't respond to it, it just makes you appear weaker, they're the type that respond better to someone who stands up for herself. But the unstable ones...hmmm, I don't think those are the ones that would respect you more for sticking up for yourself.
So, sorry if you're above the butt kissing...ignore the advice if you want. I hate to admit that I do it, but then again, didn't everyone's mom & grandpa ALWAYS say "you catch more flies with honey than with vinegar"? Now, I know you started out saying you tried to be really nice & agreeable, and it obviously didn't help...but maybe just changing directions a tad, and complimenting her skills & knowledge, subtly, will help.
I went back later, to my friend's preceptor who'd started an IV for me a week earlier, and told her that after she'd shown me where she'd gotten that line (I ALWAYS follow the nurse in who's getting a line for me, so I can see where they find a vein that I hadn't been able to find myself), I'd later had another patient who happend to have NO veins in the ac or in the hand, but had GREAT ones in the forearm, right where she'd gotten that one for me the week before. It was a way to thank her for "imparting her wisdom" on me, and that I was willing to learn from her. And it was actually sincere, too, it's not all about being manipulative, it's about acknowledging someone's skills and knowledge, they appreciate it.
I quit my Agency job just last week and only 4 days into orientation due to the lack of orientation and hours I was receiving at the facility. They only had one nurse available to orient me, and she was out 50% of the time due to illness and Dr's appointments. When she was available to orient me, she sent me home every day after only five hours. I told the recruiter this, but they docked half of the 15 hours I had worked, for breaking my contract, anyway.
Who cares? I stayed home and prepared for my moving sale and made over $500 on Saturday...without having to go ANYWHERE! :angryfire
noelle4
43 Posts
Hmmm. My gut was right about extensions (not really beneficial). Thanks for the input, everyone. I agree that the real learning comes from when u have to do it yourself.
I am rethinking this whole ER thing after the sh** day I had today, paranoia setting in I guess, imagining my ex-preceptor is talking trash about me. Why are the day shift RN's the biggest b*****? (NOT all of them :)
I am losing enthusiasm by the gallons as I type this. I just want my life again! All I do is study, or work on orientation learning modules. All the studying in the world is not going to give me experience. Why the hell was I hired w/o experience in the first place? My manager keeps forgetting I haven't done "real" nursing for 3 yrs. I was awesome in my former RN positions, now I feel like I don't know anything...Anyway, I'm pathetic (I know) not like me to feel sorry for myself..I feel this is a safe outlet anyway.
have a good nite all.
noelle