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.
Have you tried just telling her how you feel about the situation (without sounding like you are accusing her of treating you badly or being a bad preceptor of course)? You could try saying something like "I really appreciate that you are taking the time to precept me and I would like to make the most of the time I have with you before I am on my own. I know each person has a specific way in which they learn best. I learn best by (example: reviewing what I need to do before going into a patient's room and being allowed to perform patient care then discussing privately what could have been done differently/things I need to improve on). I am not trying to say you are doing anything wrong in the way you precept, I just want to see if we can try things a little differently so that I can learn as much as possible from you before I am on my own. I hope I haven't offended you because I think you really know your stuff and I could really learn a lot from you."
I don't know if that would fit your situation but coming up with something like that might be worth a try. If you feel like you can't talk to her, you could always write her a note. Anyway, it's just a suggestion.
I have been off orientation for about 2 months now. I too had a previous career and I am about to leave my current intermediate care unit. It seems that every time I turn around there is something I missed or didn't do that I didn't experience during orientation. On top of that, I had a patient complain to my manager because I didn't stay in the room while she went to the bathroom after telling me to close the door. She told the manager I left her and that I should be behind a desk telling people what to do b/c I don't pay attention to her details! Mind you, this pt was note very mentally stable (won't get into details due to privacy issues). My manager reamed me w/o even asking me what happend. I left thinking everything was fine with the pt, she thanked me for letting her sleep and that she hadn't gotten any sleep etc. Then I get this email from my manager. Anyway, I wrote a lenghy email to my manager with an hour by hour account of the night. I received no response. I have been in management and have had a previous career and I know you don't lambast someone without understanding all sides. In addition I had 3 other patients with labile BP issues and I was on the phone with doctors concerning these more critical patients. We are also expected to treat the patients as if they were staying at a hotel, dropping what we are doing to get them coffee. If we don't do it we are in trouble if we ignore critical patients we are in trouble so you can't win. I was offered another position, part time with a possibility of full time. What concerns me if that the manager doesn't stick up for her nurses or even asks what went wrong. ANY patient can say ANYthing and you are in troubel irregardless of whether you used good nursing skills to take care of other more critical patient issues. I am about to throw in the towel!
Well I want to quit. The nurses on my unit all stick together as if they are against me. They laugh behind my back or get silent when I come around. I dont understand such behavior by so called professionals? When you are a new nurse how can you be labled as a bad nurse already? Or labeled most likely to fail? I dont think I am the one in need of education here I believe my preceptor and my fellow co workers need the education. They need to be educated on how to treat new comers to the profession. Not everyone was born run a tele unit with little to no experience and we dont all learn at the same pace. I hate my job more and more by the day! The thought of going to work makes me sick to my stomach. My preceptor told me today that she is scared for me and she is not going to recommend that I work the day shift???? Why now? I have been with her for almost 12weeks now and she could have slowed me down and took things in a different direction or something? Instead they are going to place me on nights for one week and then on my own I go? They have high expectations with sub par training!
We all have our own way of doing things and prioritizing. She is "set in her ways" and of course feels her way is the "correct" way and is teaching you her way. Once you get thru this, you will find your own way and feel much better. It is hard, I remember how I felt when I was being precepted and it was like I had NO autonomy. She shouldnt correct you unless it is actually necessary. If you do something different, it isnt wrong just because you do it differently than she does. But I would mention to her about her tone of voice in front of the patients because you do need to have trust from your patients. Some preceptors really get a "high" in feeling like the teacher and important and want to look like the queen nurse in front of the patients. That may not be the case here, but I do know alot of nurses who like to look important in front of patients and undermine the new grad and not realize it. Talk to her and tell her how you feel in a professional way. She cant/wont change unless its addressed. You do need space to learn and she needs to give it to you. As long as you arent putting patients in danger and doing your job, she needs to back off and let you learn.
i'm a new grad as well!! i started in mid-september and i work on a step down unit (which really is more like an icu, a lot of our pts really are too sick even for our floor) but i'm going through a similar situation! i think that no matter what, whenever you start a new job it's going to be all new types of stress, but i feel like this is even more so for nurses! i used to be a bartender all the way up to the veryyy end of august.....so anytime i find myself getting particularly overwhelmed or stressed out or feeling like a total ass i have to remind myself, "i'm still new at this, i'm learning new things everyday and doing the very best i can and that's all i can really ask of myself"......
...as for your preceptor...i'm very sorry to hear she is giving you a hard time!! my preceptor has been extremely patient and helpful with me, and i think that makes a huge difference in how you feel about your job in general. is there a way you could try to talk to her or your nurse manager and in a very nice way, just explain that you don't think the way she is teaching is conducive to the way you learn...?? thanks for telling the lasix story, btw, because i didn't know that either! that's the thing about being a new grad..guess what, you gotta learn as you go! but the good news is, you will never make that mistake again!! i guarantee everytime you give lasix, you're going to check that lab value!! it's impossible to expect nurses to never make mistakes, the important thing is that we don't make big ones. i think it's great you check your labs before you give meds....i had a similar situation where one of my patients had a pretty low potassium level and the only reason i knew was because my preceptor caught it (which i needed to pass this info along to the charge nurse) but it's just little things we need to start picking up on that will make us better nurses. as for not being able to use the aide's morning vitals for you're morning meds?? that's a little nit-picky if you ask me. i make sure i always know the heart rate and blood pressure before i give any type of med that has an effect on that, but i was taught that the aide's set of morning vitals is sufficient for your morning med pass. now say the patient is getting lopressor at noon, i would def want you to check the bp yourself before (if for nothing else, just to cover your own ass), but if she is that worried about your priorities being off, she should understand that especially on a busy floor during the day shift, it is not really in the interest of time to do vitals twice within a half hour unless you really really had to!! i could be wrong but that's just what i've been taught!!! keep us updated how you're doing!
I've been through orientation three times. My first time, I had four different preceptors. My second time, I was thankful to only have two. My third time, I had one.
In all of that time, I never once had a preceptor who treated me badly. If anything, they had more confidence in me than I did.
I'm really saddened to hear about all of these horrible precepting experiences. Even though I don't feel qualified to precept, I'd love to take new nurses under my wing and give them a good orientation experience.
All I can say is, just get through it, and you'll be cut loose eventually. Once you're off orientation, it's an opportunity to develop your own practice, integrating your own self and your own style into it.
Good luck to you, and don't be afraid to ask for help. We're here for you!
I feel the same way so you aren't alone. Nights are better because the pace tends to be a bit slower. I need the time to analyze things and look things over so I can completely understand, that is just the way I am. I am on nights with 6 patients and you don't get a chance to go to the bathroom. That is dangerous in my opinion when you barely have time to understand the meds, ask questions etc. I am rushed all the time and then expected to take my time and listen to the patients stories etc. You are damned if you do and damned if you don't!
You shouldn't have to dread work, if you do, it is time to get another job. I have been off orientation for 2 months so I have around 6 months experience so I was able to get a part time and full time employment elsewhere!
JLynMiles
9 Posts
Have you tried just telling her how you feel about the situation (without sounding like you are accusing her of treating you badly or being a bad preceptor of course)? You could try saying something like "I really appreciate that you are taking the time to precept me and I would like to make the most of the time I have with you before I am on my own. I know each person has a specific way in which they learn best. I learn best by (example: reviewing what I need to do before going into a patient's room and being allowed to perform patient care then discussing privately what could have been done differently/things I need to improve on). I am not trying to say you are doing anything wrong in the way you precept, I just want to see if we can try things a little differently so that I can learn as much as possible from you before I am on my own. I hope I haven't offended you because I think you really know your stuff and I could really learn a lot from you."
I don't know if that would fit your situation but coming up with something like that might be worth a try. If you feel like you can't talk to her, you could always write her a note. Anyway, it's just a suggestion.