The role of the nurse preceptor?

[BerthaRN]

I have a question...ofcourse a statement too. I'm a new grad (and RN), and I started a job in the beginning of Sept. Since that time I have been orienting on different critical care units so I can learn things from these various areas, which I really do need to learn and be taught. The area I am going to work in doesn't open for another month. During this time with various preceptors, I have had some good, but mostly not so good preceptors. I was talking with one of my future co-workers and she has had the same experience. What we are finding is that these preceptors are treating us like we are their workers who they can order to just go perform undesirable tasks, as opposed to teaching us and fostering our growth. It's really starting to wear on me. Yesterday it was my first day on a unit and they have a completely different routine and charting method from where I was...I was obviously a bit on the slow side because I was trying to learn the area and routine, plus I am paranoid about making a mistake. From the start my preceptor acted like I was an annoyance, and had no problem ripping on me and speaking to me condescendingly.

My issue is.....well, I just can't stand it. I'm already disliking this chosen career because it is so unenjoyable to go to work. I'm going to stick with it, and hope that it gets better. But you know....I am witnessing the nurses eat their young thing and it irks me. I have no problem standing up for myself....but sometimes it's not worth it. I am really hoping it will get easier and better when I am on my own. I just think these preceptors need to realize their role is to teach us, not to be condescending and negative. it's really irritating.

Has anyone had these experiences? What did you do? I have 13 more shifts of this....ugh......

[pattymac]

Unfortunately there are many nurses out there that don't particularly like to orient new people, but either they have to or they get money for it or something. I'm sorry you are going through this, but my thought is that it always worth it to stick up for yourself. You never know how someone might react and you might be pleasantly surprised. If it doesn't help at least you have the satisfaction that you did it. A nice, "I feel I may be a burden on you and I don't want to be. What can I do to help you to help me?" might be in order, or if they are truly mean and/or rude you might just call them on it. I know that most people being confronted by someone about having been rude tend to be surprised. It's like they kind of know they are, but have fooled themselves into thinking it doesn't show. We have all been in similar situations with people in general and sometimes you just have to work through it. Don't give up now. Get through this and go on and find a terrific place to work (they really are out there) and be the best nurse you can be. for you....

[alkaleidi]

1: A preceptor should be a position that is APPLIED for. It should be a position that a staff nurse CHOSES to do because they enjoy teaching. It should NOT be a position that someone is ASSIGNED to. That would be nursing's first mistake.

2: The transition of a new grad in any field should start with a 1-on-1 preceptor. You should start at a point where your preceptor is doing ALL the care, explaining everything and answering questions, while you as a new grad are asking questions, observing, and absorbing everything. You should transition from there to you taking half, your preceptor taking half, you relying less and less but your preceptor ALWAYS being available to help. The end point being where you are doing EVERYTHING and needing NO help whatsoever.

In the ED that I started in, for example, the preceptor I had would be assigned usually 2 patients to start. We would go through the entire process, etc, and eventually I was taking 2. The max patient/nurse ratio was 4:1, so even as I was taking 3-4 patients, my preceptor was not assigned any so that in the event I needed her, she was available. The preceptors in the ED were chosen after expressing interest IN precepting, and we also had 2 mentors that were our go-to people to voice concerns, etc. If you and your preceptor didn't get along, you could discuss that with your mentor. Anything you said was in confidence and in a very non-threatening manner, you could be reassigned to a different preceptor.

Does that help? I think a preceptor should also be a mentor. Deal with the actual role you are learning as well as be able to discuss personal issues, stress, etc. Just my opinion and my positive experience being able to have that.

[CHATSDALE]

preceptor is very important exp for a new grad as they are the bridge from school to nursing

if you feel like your issues are insurmountable then request a new preceptor, before you discuss this with the preceptor that you have now..a few days might make a world of difference

go in the next few days with an open mind i hope that you can learn from this person and be ready for your new unit to open

learn also because down the road you will be the preceptor and i know that this will make you a better person for that job when the time comes

[classicdame, MSN, EdD]

Precepting should be a privilege. We tie it to clinical ladder. If I hear about a preceptor behaving as you stated I will talk to their supervisor and possibly restrict them from service. That will interfere with their ability to get clinical ladder points ($). The last thing we need is to lose a potentially good nurse.

[Turtle in scrubs]

Sorry to hear this is your experience. Not at all the way it should be. I too was hired into a unit that had not yet opened, and oriented on another unit. Most of my preceptors made it pretty clear they did not appreciate having to orient new grads that were not even going to stay there. They weren't as bad as what you are experiencing, so I just stuck it out. On the other hand when I was in school I had some real winners. I had one who was so rude I said "it is obvious you don't want me around. Is there anything I can do to make this better for both of us"? She did a complete about face and it turns out she was just irritated b/c she was forced to do it and was swamped with work, etc. No excuse to treat someone that way, but we worked through it. I'm sure that wouldn't work in a lot of cases.

Now when I have students or new nurses on the unit I try so hard to make it a good experience for them. Starting up a new unit, you will be in a unique position to really shape the attitude and culture on the unit, and break the cycle of nurses eating their young. Until then I wish you the best in making the most out of a bad situation. I agree with the other posters that you must speak up for yourself (since it doesn't sound like anyone else will).

Best of luck.

[BerthaRN]

Thank you all for your replies, I do appreciate it. Actually, the past couple of days I have been with one individual who really has been quite nice, and I love that. And yes, a good thing out of this is that I will be sensitive to students and orientees when they join me on my unit. I definitely believe in "paying it forward"....good instruction and a good attitude can really make a difference. Thank you all for your feedback and encouragement:).

[pagandeva2000, LPN]

What I have noticed is that while my facility does have a preceptorship program, few apply because they only get an additional three dollars a day to do this. Because there are so few of them, the facility usually winds up 'dumping' (sorry to use this word for you, as a new nurse) the new grad on those whether they agreed or not, and are not even being compensated the three dollars that a preceptor should be paid. Also, in my facility, LPNs cannot enter the preceptorship programs, but, I have trained many RNs (even BSNs), because no one wanted to do it, and I am getting paid less than all of them.

I am not defending their behavior, because I do believe that if you leave a new employee (particularly a new grad) in the dark, you are not obtaining the help so desperately needed. Sometimes, nurses shoot themselves in the foot behind their behaviors. I am just trying to introduce another perspective.

A preceptor should be a willing person who is patient, fosters learning and is observant of the talents and weaknesses of their charges and should also be creative, because each individual has their own working style. The preceptor should also be realistic, by allowing the newbie to see what is really involved in nursing (such as telling them they can obtain as many as 10 really sick patients with various important needs), how to balance their time and politely remind the person of habits that may hinder them from good prioritizing and time management.

I'm sorry to hear you are not pleased and also sorry to say that more people than I care to read about or admit experience these things you mentioned. Maybe going to the new unit will allow you to be able to create your own style because you will all be new to it and can each put in a contribution to make things easier while giving patient care.