is this what its really like? 2 wks in...

Hi everyone, I just started my new job in the ER almost 2 weeks ago! I have to say I am excited to be there! I was in day surgery for 3 yrs b4 this, so this is a huge change from what Im used to.

I had the worst day today = ( Its not the pts, its my preceptor. Everyone tells me how good she is, how shes been doing this for 25 yrs and how I will learn so much from her. Fact is, yes shes so smart, and yes I can learn so much from her...but...shes a chaotic unorganized mess! We got pretty busy..well truthfully even when were not slammed, shes running around, barking orders at me, telling me to do this...do that, and Im like on who? what room? wheres the chart, wheres that at? I feel SOO LOST. Then she gets really frustrated with me because Im lost.

Ive always wanted to be in the ER, and now here I am, and I love the diversity of it, and the constant change and lovin the faster pace...but I am havin a hard time. I cant even think straight when shes my preceptor. Sounds easy, change preceptors right? Well...everyone tells me I should be with her because shes so smart..etc etc. I feel like an outsider coming into a huge family and Im not sure where I belong. I know it will take some time...but nevertheless thats how I feel. I feel like I am in the way, not doing anything but moving out of the way so she can tell me everything Ive ever wanted to know in 2 hours at top speed.

We had a code today, and I wanted to be part of it so bad, it wouldve been my 2nd code ever!!!! and she basically told me to move, and go give meds to our patient in 3 who was there for ankle pain X's 1 year. Guess its growing pains. I refuse to quit, Im in it and I want it and I will learn it and get it, just not gonna happen overnight.

Is it gonna get any better? Has anyone felt like this before? Should I just expect to teach myself? Funny thing is I cant even take vitals without her breathing down my neck making sure Im doing it right. Just wish she'd give me some credit, afterall I am a nurse.

This too shall pass! My motto is put up with it now, so you won't have to in the future. AND never do this to a student or someone I precept in the future. ALSO, though, in the meantime, learn as much as you can from this person while treating her nicely, NO MATTER HOW HARD IT IS.

Drysolong~

Thank you! I am trying to absorb everything she does and says and ask as many questions as I can. She truely is so smart, and I have so much to learn, I just wish she was a little more receptive to my needs. Ive memorized most of our standing orders, and feel ok starting some of them on my own, but wish there was a little more recognition for the things I do right, and help from her and her words of wisdom when I ask questions. I can switch preceptors, maybe I will, but she is just so knowledgable I hate to bypass her and learn less.

And yes, I treat her with tons of respect and Im nice to her...all I want is to learn..learn..learn! It was just the first day I went home n tears and had to vent.

it was just a long day...:tbsk:

Hi everyone, I just started my new job in the ER almost 2 weeks ago! I have to say I am excited to be there! I was in day surgery for 3 yrs b4 this, so this is a huge change from what Im used to.

I had the worst day today = ( Its not the pts, its my preceptor. Everyone tells me how good she is, how shes been doing this for 25 yrs and how I will learn so much from her. Fact is, yes shes so smart, and yes I can learn so much from her...but...shes a chaotic unorganized mess! We got pretty busy..well truthfully even when were not slammed, shes running around, barking orders at me, telling me to do this...do that, and Im like on who? what room? wheres the chart, wheres that at? I feel SOO LOST. Then she gets really frustrated with me because Im lost.

Ive always wanted to be in the ER, and now here I am, and I love the diversity of it, and the constant change and lovin the faster pace...but I am havin a hard time. I cant even think straight when shes my preceptor. Sounds easy, change preceptors right? Well...everyone tells me I should be with her because shes so smart..etc etc. I feel like an outsider coming into a huge family and Im not sure where I belong. I know it will take some time...but nevertheless thats how I feel. I feel like I am in the way, not doing anything but moving out of the way so she can tell me everything Ive ever wanted to know in 2 hours at top speed.

We had a code today, and I wanted to be part of it so bad, it wouldve been my 2nd code ever!!!! and she basically told me to move, and go give meds to our patient in 3 who was there for ankle pain X's 1 year. Guess its growing pains. I refuse to quit, Im in it and I want it and I will learn it and get it, just not gonna happen overnight.

Is it gonna get any better? Has anyone felt like this before? Should I just expect to teach myself? Funny thing is I cant even take vitals without her breathing down my neck making sure Im doing it right. Just wish she'd give me some credit, afterall I am a nurse.

Do I feel your pain! I started out in my last job that way in 2004, coming from the floor. The preceptors (I had a few because I worked different shifts) were terrible to me. I would listen, learn each of their ways (most needed improvement, but god forbid I ever say that!) I tried to focus on the techniques and specifics of the job. I tried and tried and really attempted to ignore the egos. It's hard, I know! It will get better. Once you're off orientation, you will be able to take a deep breath and go and ask another (perhaps less experienced), but nicer nurse where something might be - or to help in a code. It is definitely a tough environment, but it sounds like you have the determination to cope. It's like some unwritten code that you have to endure being tormented by some nasty people. Hopefully there are at least a few good apples that you can lean on for some support - be careful to keep your opinions to yourself of those not helpful ones, as you know how hospitals are with gossip. Just stay away from the bad and keep close the ones that can really help. I'm glad you found your niche and don't let them push you out!!!

Chicagobsn.....:loveya:

Oh, honey. You are gonna be okay. Really, you probably need another preceptor. Not everyone makes a good teacher, and "expert" nurses have a really hard time teaching new nurses. Let me elaborate.

Several years ago I was responsible for precepting new nurses(they came into the ED at multiple levels) and got the ENA orientation program for them (and for me!) I read about adult learning techniques and about the various levels of nursing experience. Expert nurses have internalized their information and really have a difficult time explaining why they do what the do. Check with your manager first, and tell him/her your concerns. If you get no support, you should contact your staff development department and talk with a clinical educator about your situation. They should be able to help. Everyone wants you to succeed.:redpinkhe

This editorial about precepting focuses on ICU, but the ideas are for any part of nursing:

http://http://ajcc.aacnjournals.org/cgi/content/full/13/6/448

Read it to get a feel for what is happening. Take control of your learning process.

Listen to me...

Do not let this one person discourage you one bit. Remember, every person has their own method of madness, especially in chaotic settings, like ED or ICU. This lady, although she may be an experienced, excellent nurse, she may be a terrible teacher. She may be on her period. She may have a toothache. Who knows? Just because a person has a reputation for being excellent does not mean she is necessarily cut out to be precepting.

Before your next shift, review the skills your have covered so far on your orientation list. Highlight the skills you need to acquire before your orientation ends. Talk with your preceptor about the things you need to cover, for example, be present at a code and then actually participate in a code. Ask her plainly, what are your expectations for me today? What goals do I need to accomplish- today? What can I do to improve? Be very specific in your needs as well. If you don't work well without specific instructions, tell her so.

Also remind her you are not a new grad, but an experienced nurse. Recognize the fact she probably does not value your experience outside of the ED as much as she should.

Finally, I hope you will have the opportunity to evaluate your experiences with this nurse with a written evaluation. Make sure you give specific examples, both good and bad, not generalizations. If all else fails, talk with your educator about your conflicts. Maybe there is another preceptor that will fit better with your learning style.

Don't Give Up!!!

Godspeed

What she said!!

Hang in there. The ER is a great place to work. Just because she's smart doesn't mean she knows how to teach. Learn what you can from her and learn what you can from others when you are off precepting. It can take 1-2 years before you will feel competent to take care of a "crashing" patient on your own, but the feeling that you can do it is wonderful.

northshore08:

I have a comment and a question for you. First, I love your CS Lewis- one of my favorite reads, hands down. Two, your quote from Dorothy Sayers- do you know much about her and classical childhood education?

THANK YOU to all of you! Im not about to give up, and yes you are all right, Im going in tomorrow morning with some ideas and see if that helps~ if not, then I will look for another preceptor, and have my current one as a back up resource. There are so many nurses who seem to not be running around and so stressed out in the same situations. Maybe one of them will be a better preceptor for me to learn from. I truely want to succeed and master a good method to handle the chaos gracefully.

:tku:

your quote from Dorothy Sayers- do you know much about her and classical childhood education?

No, but now you've got me interested!! (I just thought it was a great quote!) But CSLewis I am very familiar with.

Make it seem like her idea. Compliment how smart she is, and how you have learned a lot from her, but that you noticed that she appears frustrated with you. Ask her if she thinks you and her would benefit from you switching to another preceptor, and if she does, who she would recommend. It could be she is frustrated because you are an experienced nurse, she is expecting more of you than if you were a fresh faced new grad. It does sound as if most of your issues are where things are, which will come with time, no matter who your preceptor is. Good luck!

I feel your pain..with our preceptor program, the preceptor and the preceptee meet weekly with the manager to just check in and see how things are going- are you learning what you need to, how are the two of your getting along etc. to help catch mismatches early on. If you feel lost, look around the ER after work. Find out where everything is etc. I agree with the others. Maybe she is an excellent nurse but just isn't a great teacher. I know you will do great because you really WANT to learn. Best of luck!