Struggling new grad - tell me it gets better

[NJRNtobe]

I'm a recent new grad who accepted a position on a very busy tele/med surg floor. I am happy to have a job given the current job market in NJ, and am pleased that I'm getting that initial year in med surg as a foundation to my nursing career, but I'm struggling in a way I couldn't foresee.

I am by no means stupid, having a previous bachelor's degree in biochemistry before pursuing my BSN through an accelerated program. And I'll be the first to say my clinical time could have been more educational but the nature of an accelerated program doesn't leave much time for clinicals. Even still, I attained perfect grades in my program and feel very comfortable in the knowledge I bring to the job.

BUT...and that's a big but...I am completely stressed out and frustrated about work. My preceptor is an excellent nurse, but she expects me to know things only a seasoned nurse would know. She consistently talks to me like I'm a child, and the tone she uses with me is inappropriate. So much so that patients ask me if I'm a nurse at all. When I tell them I am, they've responded "ok...but who's the RN?" I again tell them that's me, but at that point they have lost all confidence in me because of her attitude and request to see HER for even the most basic of things. In addition, she's constantly barking orders at me, enough that I can't complete a thought of my own. If I'm in the process of giving a patient meds, she'll tell me to stop what I'm doing because that's "not a priority". I would see no problem with that if there was something urgent that needed attention, but most of the time it's because I'm not doing things in the order she would like.

Example: one of my patients was due for meds. Lasix was on his MAR. I gave the med. I later learned from the cardiologist (the hard way) that I should have held the med because his BUN and creatinine were elevated. It wasn't a huge deal, but it taught me a lesson. Check ALL labs before giving meds. So that is my plan for the day - get report, check patients, check labs, start meds. Yesterday, while I was checking labs after report, she asked me why I hadn't started my meds. I explained that I wanted to check labs before administering meds, and I received a thorough reaming about how I wasn't prioritizing my day correctly.

I feel like I'm in a no win situation with her. I had a BP med to give, and the PCA had just taken the patient's vitals and left the room. I asked her what they were. Since they were within the parameters to give the med, I gave it. I later got a "talking to" about how I was cutting corners and being lazy and I should have taken the pressure myself again. Am I wrong in thinking that's extreme? Especially when I see her use the vitals record to give out meds, even when they were taken an hour ago? When I brought this up to her, she told me I wasn't an experienced enough nurse to make those decisions. Even though she's right, I explained to her that no amount of experience would justify "cutting corners". You can imagine how much she liked that and what the rest of the day was like for me.

I'm just so frustrated with her and the way she's making the job for me. I know things will be different once I'm off orientation, but it's so bad most days I'm on the verge of tears - and I have a pretty thick skin so this is different for me.

Does anyone have advice?????

[**All Heart RN**]

WOW! I am a new grad and went through the same thing you are going through. My preceptor was someone who loves to "micromanage" and wanted to "do everything" and have me watch while she explained how to work an IV pump. I am a hands on learner and I learn by actually doing things, rather than to be "told" what to do.

On top of that, this preceptor would stand at the door while I did my assessments on pts with her arms crossed in front of her chest like she is attempting to "intimidate" me. I said nothing for 4 weeks while she talked down to me in front of other people and treated me like a 3 year old. I even heard her complaining about me to others in the breakroom because I asked too many questions.

So, I attempted to talk to her and let her know that I don't do well with micromanging. I also told her I need to try to develop my own nursing judgement and I don't need her to remind me to do certain things that are routine that I already know. She continued to do these things, despite me talking to her about it.

The final straw was when she talked to me in a condesending tone of voice in front of all my co-workers and then went in the breakroom and laughed about it. I still said nothing, although I was angry. I didnt let her see me sweat. So the next day I went to the educator and requested a change in preceptors. I told nobody my plans. The preceptor, myself and the manager all had a "come to Jesus" meeting and I voiced my concerns and told my preceptor how I really felt about the way she was treating me and that I have requested a new preceptor. I brought up all the times she would talk about me in the breakroom. I also told her how I thought her behavior was unprofessional and I didnt feel comfortable being trained by someone who found it ok to down others behind their backs.

And you know what happened? She sat there and cried. She didnt even try to defend herself or her actions because I'm quite sure she knew she was wrong. Besides, I don't think nobody has ever pulled her to the carpet on her behavior.

I still see her from time to time and I walk right past her like she's glass. Nobody in her "clique" says nothing to me either, which is fine with me. I don't have to work with them, so they are not important.

To the OP, I say have a meeting with her and the manager. Request a new preceptor. I feel there is a way to talk to people and also teach them at the same time without making them feel like an idiot.

Wow, it's so nice to read about a new nurse standing up for herself!

[Bessie22]

Trust me time changes everything. One day you will look back and remember these day. I'm a nursing student at the momment and I get those meany nurses who are ignorant and non-considerate. You have made it thru and it shouldn't be much harder anymore. but please remember when you come across student nurses or new grad treat them the way you like to be treat it. and never forget this experiance :). time will change everything...you will be ok. hang on there.

[NewAggieGrad09]

Man I am terrified :-( I'm a new grad, set to start on a medical care unit at a peds hospital.

[NJRNtobe]

Thanks everyone for your responses. I know this story is all too common, but I can't help shake the feeling that I'm being genuinely mistreated. It clearly does nothing for my personal confidence, but aside from that - I'm missing the education I will require 3 weeks from now when I'm thrown out on my own.

And while I'd love to switch floors because of the atmosphere, I genuinely like the patients and take a real interest in cardiac anything. As far as switching preceptors, I'd love to do that as well but to be completely honest...I can't think of anyone on this floor that I'd rather work with. As much as I can't stand the way she's treating me, she really does know her stuff. And while it's great that SHE knows it, she needs to TEACH it to me.

Which brings me to my next question...at my hospital you don't just get picked to be a preceptor. There's a special class you have to take and essentially YOU choose to be someone who teaches. If you're not interested in teaching me anything, is the extra $1/hour really worth it??? Why are you a ******* preceptor???

[Dreamer-RN]

NJRNtobe,

One of my primary preceptors is similar to your preceptor's personality. I also question why such RN's choose to precept as well.

With regards to the micromanagement, I believe this stems from the RN being control freak and likes to be in control of his/her environment. I think the control comes even moreso into play given the fact he/she is ultimately responsible for the patient outcomes as well as training you properly.

Insecurity may play a role with the undermining and poor treatment. I believe a person who is secure with themselves will not put down, belittle, and/or gossip about another individual in such ways, especially a new grad RN.

Do not inherit their problems. Something lead to the individual to become what he/she is today. Your main goal is to get the most you can during this orientation period. Continue to do your best and keep in mind this orientation period will pass. You cannot change your preceptor's personality. However, you have control on how much you'll allow this individual to influence you and your future nursing practice. Learn the good and do away with the bad. Set professional boundaries when needed.

One step I took to address this issue was speaking to the nurse educator directly. Prior to this, I tried communicating some of my thoughts to my preceptor to no avail. While meeting with the educator, I did not point fingers but rather clarify what I'm suppose to learn during my orientation and the steps that should be taken to ensure that I'm getting the most I can while I'm on orientation. The educator communicated the goals directly to my preceptor. After this, things have significantly improved. I'm operating moreso as the primary nurse while my preceptor is assisting me where/when needed (in addition teaching when opportunities arise). I also ensure to maintain open communication with my preceptor by communicating procedures, medication administrations, etc. prior to doing them despite I may know how to do them (just to keep the individual in the loop).

The day usually ends with getting constructive feedback from my preceptor. This has been very beneficial as well. It's not to say all is perfect. However, it has significantly improved than before and I'm learning a lot each day.

The suggestion I want to most emphasize is to not allow this preceptor's negative behaviors get the best of you and/or distract you from your goals. Find ways to work around it. Perhaps, it may involve changing what he/she perceives about you, speaking to a nurse educator/manager, etc.

Finally, maintain your confidence that you'll have that knowledge one day. You may be precepting a new RN in the future. Having this kind of experience under your belt teaches you what not do or say to a new RN who is learning the ropes, already stressed from the typical emotional roller-coaster new grad period.

Best wishes getting through orientation! You're not alone with this!

[FroEJ25]

Usually it gets better, but some floors are just hostile / evil. I know where I did clinicals, we dreaded some assignments; the staff was just flat-out unpleasant and generally didn't seem to want to be there. Suffer for now, be glad you have a job, then get out when the economy turns around...

[careerchg09]

I can relate as well. As a new grad, second career RN who has recently gotten off orientation (not by my choosing) I'm having a tough time feeling grounded on the floor. Its interesting that people note that the BSN new grads are more textbook competent and less clinically competent. I hesitate to, but have to agree. At least that is how I feel as a BSN grad as well. I feel like most of my days my sense of self (my former, non RN self) is the only thing that keeps me going. I'm grateful to hear from coworkers on my floor, mostly seasoned RNs, that I'm doing well and I'm asking the right questions, but I feel like I'm ALWAYS asking questions. And here too, having been a successful professional in a previous life, feeling so dependent is practically debilitating. Ironically, I've struggled with the meds vs lab values myself. Someone recently suggested to me that I start my morning meds and stop somewhere between 8-8:30 to get lab values. (For us, the lab usually doesn't have things reported until after 8am). Then restart from where you left off. I liked the idea and have been trying to restructure my routine (again) to add that in. I'm drawing support from the replies that you have received because I am finding myself not looking forward to going to work, which is something I rarely experienced in any of my careers or school. But here I am. Wondering along with you when this will begin to feel better. It feels lonely out here. I guess that's why this site is so successful and helpful. Hang in there. I keep telling myself, "this too shall pass".

[JLynMiles]

It will get better. Can you go to your supervisor, explain the situation, and request a new preceptor? I lasted all of half a day with my first preceptor before we were both asking that I be reassigned to someone else. I was reassigned and it was a much better personality fit. However, my preceptor was very easily stressed out and not very organized so, I learned a lot by being the one to keep up with what needed to be done. It really helped me with my organization and prioritizing skills. I was also very comfortable with being able to ask her questions and admit when I didn't know how to do something. I would suggest asking if you could precept with someone else. If you can't, try to hang in there. It eventually does get better. However, you may not realize this until you observe another new nurse during his/her orientation and then you will realize just how far you have come and how much you have learned. Good luck!

[shoegalRN, RN]

Thanks everyone for your responses. I know this story is all too common, but I can't help shake the feeling that I'm being genuinely mistreated. It clearly does nothing for my personal confidence, but aside from that - I'm missing the education I will require 3 weeks from now when I'm thrown out on my own.

And while I'd love to switch floors because of the atmosphere, I genuinely like the patients and take a real interest in cardiac anything. As far as switching preceptors, I'd love to do that as well but to be completely honest...I can't think of anyone on this floor that I'd rather work with. As much as I can't stand the way she's treating me, she really does know her stuff. And while it's great that SHE knows it, she needs to TEACH it to me.

Which brings me to my next question...at my hospital you don't just get picked to be a preceptor. There's a special class you have to take and essentially YOU choose to be someone who teaches. If you're not interested in teaching me anything, is the extra $1/hour really worth it??? Why are you a ******* preceptor???

I understand what you mean about your confidence being shaken. My confidence is still shaky from that experience with my first preceptor. My current preceptor is tough on me, but that's because she knows I can handle it (her words). She tells me all the time she's "kicking the training wheels off", meaning she is allowing me to try to develop my nursing judgment. She also asks me my plan after my pt assignment and I tell her my plan and why I came up with said plan. If she agrees, she says so. If not, she tells me why and we come up with another plan all together.

My current preceptor is there to help me when I need assistance. However, she makes sure I ask for help and allow me to delegate things to her. She don't offer assistance, she waits for me to ask her. I learned this lesson the hard way when I thought I could "do it all" (residual left over from previous preceptor who NEVER asked for help) and I got my azz handled to me on a plate. I had to go through that lesson to learn that it's ok to ask for help and to delegate. It was quite a lesson learned!

My current preceptor is tough for a reason, because she's preparing me to be out on my own and making me a better nurse in the process. And I appreciate it. And she's not condesending either.

[Dreamer-RN]

And here too, having been a successful professional in a previous life, feeling so dependent is practically debilitating.

I had a successful past professional life as well. Having such a background brings its own unique challenges too with having to start all over with proving oneself in a new career, adjusting to new expectations, and being dependent again. It also offers advantages in that you can utilize previous skills gained to get through the new grad period. I find myself doing this often. Another advantage is once you are settled into the RN role and feel confident in your abilities, you'll have another set of skills under your belt (in addition to the skills learned in your past career).

[sunnycalifRN]

So sorry that you're having such a miserable preceptorship. As other posters have said, this happens sometimes . . . doesn't have to, I had a great orientation. It's just another example of "nurses eating their own". You will get through it and then you can develop your own excellent nursing style!

[HeartsOpenWide, RN]

Your not along. I feel like an idiot daily, and terrified I am going to do something wrong. Not saying misery likes company, but sometimes its nice to hear I am not the only new grad that is having a hard time.