Questions about preceptorship

clee1 · Sep 23, 2007

You need a new preceptor. Period.

Do whatever it takes to get one.

mountainnurse · Sep 23, 2007

How should I go about this without stepping on her toes? She has ALOT of pull around there and I was hopeful to work in this department when I graduate.

clee1 · Sep 23, 2007

Ah! THERE'S the rub.....

Influence or not, future job or not, you are not getting what you need in a preceptor. At this point, what you NEED is a good preceptor.

Your whole career, from this point forward will be marked by the influence of your preceptor. You deserve a great one.

Practically speaking, go to your instructor with your concerns - you are not being precepted appropriately and that needs to change. As to future employment on this unit, the management thereof undoubtedly know ALL about this nurse; if they allow him/her to "rule the roost" and get away with such behavior, trust me, you don't want to work there anyway.

Think about it, if this "nurse" is badmouthing patients and coworkers to you now, what is she going to say about you and to whom if you wind up working there?

mountainnurse · Sep 23, 2007

Thank you for the advice. I will speak with my instructor on Monday, she is really great so hopefully she can give me some guidance. I agree that I need a good preceptor. This is soooo disappointing to me because I have been looking forward to this experience for months!!! Can you give me an idea of what I should expect out of a preceptor?

clee1 · Sep 23, 2007

Yes, I can. I was fortunate enough to have a GREAT preceptor (she was also my "new hire" preceptor after school). I was not your "average" student, however. I am a former paramedic, and as such, came into nursing school unafraid of pt contact, routine skills (in fact, from day one I was the designated "tough stick" IV man) and rapid, yet thorough, assessments. What I did not know was, of course, the unit routines, policies, charting methods/requirements, and specific equipment used therein. My point is that your preceptor should meet you where you are and then bring you up to the expected level for a new nurse.

My preceptor started off with a short interview of sorts, to assess my current skill and knowledge level. The she asked the question "What do you expect me to teach you, and how best do you think you can learn these things?"

First off, you and your preceptor will need to form a symbiotic type of relationship: he/she will teach you things, you will then relieve him/her of the necessity of doing those tasks in the future. This allows him/her to get on with the jobs that will inevitably fall behind d/t the time it takes to teach you something new. A preceptor should expect and graciously answer the multitude of questions a student/new grad will have. You should know where your preceptor is at all times, and they should know where you are and what you are doing at all times. Remember, you are a student (or new grad) and NOTHING you do should be done without the knowledge and approval of your preceptor!

Personalities should match, or at least be complimentary to, the student and the preceptor. A preceptor should not only teach you skills, but should also impart knowledge of the intangibles: those things a nurse should know, but are never taught it in school. Things like time-management, priorities of the shift, unwritten rules and best practices. Necessary correction should be gentle and in an attitude of teaching, rather than "keeping you in your place". A preceptor that won't answer your questions, allow you to perform interventions, or disappears on you for extended periods is worse that useless: he/she is actually detrimental to your career!

Also, there should be a "shift debrief". After you report off to the next shift, you and your preceptor should spend a few minutes discussing the shift, what you learned, and what you should spend some more time perfecting. Also, your preceptor should give some suggestions for your independent study - homework, in other words.

You mentioned in your first post that "I think she is just precepting for the extra money". Also that she runs down patients/coworkers to you. Her "job" now includes providing a quality education for you. Be VERY CAREFUL of the lessons you learn from this sorry individual - if she is skimping on the job she has with you, how much is she skimping on patient care? I can tell you from personal experience that such types DO NOT have nearly the "pull" they think they do. Quite often, they are highly disliked by their coworkers, and their managers would fire them in a second if a qualified replacement could be found. You cannot fool an experienced nurse for very long - we have ALL seen these types come and go.

Lastly, you MUST learn to trust, and more importantly to act on, your best judgment. In essence, thats what nursing really is - it's NOT tasks and medications - it is JUDGMENT. Your first post indicated that your preceptor is not right for you. Now, act on that knowledge: your school instructor will help you.

Best of luck to you! :)

mountainnurse · Sep 23, 2007

I can't thank you enough for your thoughtful advice. I will most certainly discuss the best course of action with my instructor. We have been taught to voice concerns with the individual with whom we have a problem, should I let her know how I am feeling that we are not a good fit and see if she is willing to change her tune? Or should I tell her I plan on finding another nurse to work with? I would appreciate any opinions anyone has on how to handle this situation with dignity. I know that conflict resolution is something I will need to learn and I guess I am getting an early lesson.

clee1 · Sep 23, 2007

IMHO, you need a new preceptor. A "talking to" most likely won't help, and at worst may have her try to sabotage you in the future.

Good luck!

Chloe'sinNYNow · Sep 23, 2007

FutureMtnNurse,

this sounds sooooooooo much like my own preceptorship in NS. I am so sorry to hear you are having this prob. Def speak about getting a new preceptor b/c no matter how many times you go home feeling defeated and return to try harder, this preceptor will not change her spots. So see if you can work alongside someone else. And document why!!

Good luck!!

Chloe :nurse:

triagethis · Sep 23, 2007

:idea:

Hi everyone, I am in my last semester of nursing school currently doing my preceptorship the emergency room which I was REALLY excited about starting. My first couple days with my preceptor have been really disappointing and I am trying to make the best of the situation but could use some advice. I am a fast learner and a hard worker and am passionate and positive about nursing. My preceptor has been working in the ED for about 15 years and while she is very knowledgeable and a great technical nurse she is less than enthusiastic about her patients or teaching me. The first day she had something negative to say about each and every patient we cared for and instead of taking the time to talk to me about what she was doing she said just to watch her and ignored me most of the day. Now I am not a very sensitive person and I thought that maybe this was not to overwhelm me, but the second day got worse. She doesn't communicate with me at all, she disappeared for an hour and half first thing in the morning and I finally tracked her down in another area. She had taken over for another nurse and stayed there while her collegues were left to care for her patients and I had no idea where she was. She ignores direct questions I ask her about tasks necessary for care of our patients, and instead of taking the time to explain procedures to me she does them. I have asked her multiple times if I can do any one of the many tasks we have and she brushes me off. I understand that working in a busy ED that we need to move fast but she has not even taken the time to explain their charting system and it is my first time in this hospital. She gossips constantly about the patients and her co-workers and is out drinking many nights of the week (a fact which she is proud of). I am getting more guidance and experience with other nurses than with her and I have the sneaking suspicion that she is only doing this because it gives her extra money. I am really sad about this because I LOVE nursing and I want to keep a positive attitude about my profession and about our patients. I don't expect her to give me 100% of her time and attention, but 10% would be nice. I would love some advice on how to change this rocky start because I want to learn!!

mountainnurse · Sep 23, 2007

Thanks for everyone's input.

Triagethis, I don't see your response, did you mean to write something else?

triagethis · Sep 23, 2007

Sorry to hear that. Believe it or not you are still learning. Use this as an example of what not to do. Try to concentrate on the input from the nurses who are willing to help you. Remember your objective is to get as much out of this experience as you possibly can. When one door is closed another maybe open. There are still good nurses out there . Don't let this experience determine your view of this profession. Always kepp this in mind. "We are not born nurses".