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.
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!
Specializes in Medsurg/ICU, Mental Health, Home Health.
she truely is so smart, and i have so much to learn, i just wish she was a little more receptive to my needs.
i want to point out that very smart does not equal a great preceptor. some people may have a great knowledge base, but aren't able to teach others. often, the "smartest," "best," or "most experienced" staff are chosen to precept, rather than the "best educator." your preceptor doesn't have to know all the answers, although he or she should know where to find them!
Also, as far as participating in a code, you may want to find out how long it was before your preceptor participated in a code. I know my girlfriend first was on the urgent care part of the unit, before she trained in the actual ER. You probably weren't needed at the time and it wasn't a smart use of resources (You!)
Specializes in peds critical care, peds GI, peds ED.
I am humiliated to say I worked in the PICU for nearly 2 years before I was actually involved, from start to finish, in a full code. Chalk it up to timing or excellent patient care on my part (ha ha!). I remember when I brought this up at a staff meeting and no one could believe me. And I am not one to shy away from drama either- it just happened that way.
Believe me, I wish I was a code virgin these days sometimes. Although experiencing and participating in these events are critical in ED and ICU, they are not the entirety of what we do.
Well, my preceptor was sick today, so I was with another nurse. I thought to myself, ok...good...lets see what happens! Oh-my-goodness...what a difference that made!!!! We talked about where I want to focus in on b4 we began and her and I went through the entire ER so I can find everything I need, and before ya know it, we were slammed and it went pretty smoothly I must say! Half way into my shift today, we were so busy and short ppl, that I just started taking on room 1, then room 2, then helping out the other nurses with their meds, nebs, IVs, labs etc etc.
Man..today was the first day I actually felt like I can do this! I went home with a smile on my face, no lunch, exhausted, feet achin... but...happy!
Gotta say thanks for your support and great advice!
~withasmilelpn~you are so right! I asked about going in on codes and getting to know the routine and found out that my normal preceptor doesnt like codes and will bow out quickly and gracefully when not needed. Plus she feels that is not the time or the place to teach.
I asked, and this nurse has agreed to be my preceptor..so Im with her tomorrow too. What a difference she made for me..with just one shift.
Well, my preceptor was sick today, so I was with another nurse. I thought to myself, ok...good...lets see what happens! Oh-my-goodness...what a difference that made!!!! We talked about where I want to focus in on b4 we began and her and I went through the entire ER so I can find everything I need, and before ya know it, we were slammed and it went pretty smoothly I must say! Half way into my shift today, we were so busy and short ppl, that I just started taking on room 1, then room 2, then helping out the other nurses with their meds, nebs, IVs, labs etc etc.
Man..today was the first day I actually felt like I can do this! I went home with a smile on my face, no lunch, exhausted, feet achin... but...happy!
Gotta say thanks for your support and great advice!
~withasmilelpn~you are so right! I asked about going in on codes and getting to know the routine and found out that my normal preceptor doesnt like codes and will bow out quickly and gracefully when not needed. Plus she feels that is not the time or the place to teach.
I asked, and this nurse has agreed to be my preceptor..so Im with her tomorrow too. What a difference she made for me..with just one shift.
That's so great, I'm sure you feel so much better.
Well, my preceptor was sick today, so I was with another nurse. I thought to myself, ok...good...lets see what happens! Oh-my-goodness...what a difference that made!!!! We talked about where I want to focus in on b4 we began and her and I went through the entire ER so I can find everything I need, and before ya know it, we were slammed and it went pretty smoothly I must say! Half way into my shift today, we were so busy and short ppl, that I just started taking on room 1, then room 2, then helping out the other nurses with their meds, nebs, IVs, labs etc etc.
Man..today was the first day I actually felt like I can do this! I went home with a smile on my face, no lunch, exhausted, feet achin... but...happy!
Gotta say thanks for your support and great advice!
~withasmilelpn~you are so right! I asked about going in on codes and getting to know the routine and found out that my normal preceptor doesnt like codes and will bow out quickly and gracefully when not needed. Plus she feels that is not the time or the place to teach.
I asked, and this nurse has agreed to be my preceptor..so Im with her tomorrow too. What a difference she made for me..with just one shift.
The ER is very chaotic.... the best way for me to describe what we do in the ER is controlled chaos. If you're not happy with your preceptor, ask the charge nurse to change you. Everyone has their own style, what works best for them. Coming from surgery, you're pretty used to being in a controlled setting. The team does one patient at a time, in the ER, you've got no time to do that. You perhaps need someone closer to your own age, someone you can relate to. I agree with others, just because someone is smart, it doesn't make them a great preceptor. You need someone with patience and kindness, not everyone has that. Ask your charge nurse to pick someone to help you be what you know you can be to your new unit. :)
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.
Hang in there chicagobsn. I'm willing to bet that ALL nurses have had the feeling of being "lost" at one time or another when they were just starting out in the ER. Heck, I've been working in an ER setting for years now, and still get this feeling every now and then!
As to what happened to you during the code, I'm sure your preceptor was just trying to keep a bad situation from getting any more chaotic than it was at the time. Don't feel bad, or left out because she asked you to give out meds, instead of doing something at the bedside, because I believe that everyones roll in a code is important, that includes helping the other nurses give out their meds or watching their patients for them.
Hang in there chicagobsn, it really does get better.
chicagobsn, i feel your pain! i went home MANY times in tears! in fact, i recall actually crying in the bathroom on break a few times as well. my preceptor was ex-military, an EXCELLENT nurse and he taught me well, but at the time, it was hell. i kept thinking "i'm too old to feel this stupid".
although a different preceptor might help, please try to hold off on that for a few more shifts. i can tell you from experience, i had a friend who was precepted by a really good, but REALLY....harsh, i guess is the word i'm looking for, nurse. my friend ended up requesting a new preceptor, and even if it's not right and it's not fair, the word got around that my friend was a "know it all", was "whiny" etc. she would question her preceptor, and it came across NOT as "ok, help me understand why we're doing this" it was more "i disagree with what you're telling me we should do". make sure you're questions are very obvious attempts to learn, not to disagree.
also, sometimes now when i precept, i can get the same way...we have SO MANY things we need to do, and it's easier when things get critical with patients to have the orientee go do the things i know they can do, while i make sure our crashing patient doesn't "go to the light". it is more helpful for the orientee to be right there in the thick of things, of course, and you should have been allowed to stay in that code, but in the end, we still have to make sure all our patients get the care they need. i'm not defending her actions, but i've been there as a preceptor myself and it's hard when you have a dozen things you know that need to be done, not to take the "easy way out" with your orientee, just to get caught up...with the intention that once you get caught up you can slow down and explain things.
i don't know if this happens at your ED, but sometimes with us, when we have an orientee with us, we end up getting more patients, or more of the higher acuity ones, because the triage nurse or person who assigns the EMS stretchers knows there's 2 of you...you're SUPPOSED to be treated as one nurse, while you're working together, but when things get tight and there are patients who NEED A BED NOW, the preceptor/orientee team gets more than their fair share. that's not the way it's supposed to be, but it happens. i remember my preceptor taking another pt, then another, then another, until we were carrying twice as many patients as anyone else, and he'd have me running all over doing things on all of them...he pushed me HARD, but after orientation, i learned how to push myself when i needed to, because of the way he'd taught me. it was really awful at the time, but now i am grateful for what i went through with him. he was mean sometimes, and hard on me a lot, and i may have learned just as well with someone more gentle and supportive, but i do think in the end i learned a lot from him.
good luck!! this too shall pass.
VS
Editing to add: didn't realize there were 3 pages to this post, and i missed your post about getting a new preceptor when i typed mine. i'm glad things are better for you!
Thank you for all your words of encouragement. Vampireslayer..you are right. Even though my preceptor is tough and harsh...seriously, I have come to the conclusion she is right there for me and pushes me hard so I can "fly" on my own when Im done with orientation. I actually didnt request a new preceptor, I changed shifts where I got more opportunities to be with other nurses. Low n behold, the other nurses left me on my own and treated me as part of the team I became overloaded with my own patients..taking on one..two..three.. next time I look up I have 7 rooms and no preceptor and everyones to busy and were slammed.
So...back to my original preceptor..I changed my shift back..and she doesnt leave me on my own..but is always looking out for me and controlling situations where I have 4 rooms thats it. Goes to show that the ol saying.."the grass isnt greener on the other side" still exists in everything we do. Im with her..and Ive learned a hard lesson...but a lesson learned well. I went home in tears over being overloaded and felt like I didnt know what the heck I was doing in the ER.
Oh-and lilgirlRN you are SOO right about me coming from a very controlled environment in surgery. The controlled chaos is taking me for a wild ride...but I will get used to it. I am getting the hang of their method to the madness.
looking back at my previous posts...rereading it sounds rather silly now that Ive been in the ER for over 2 months now...Ive been in quite a few codes, and completely understand using the orientee to help with the other pts, explain later and do it next time deal. As I had some blinders on before...I do not have them on now.
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.
:D:D
KimRN41514
37 Posts
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!