Think I've Done All I Can for This Person?

[Marie_LPN, RN]

I've been precepting a new OR tech for close to 6 months now. Every 3 months for the first year, everyone gets an evaluation. The first week of March, is the new tech's turn. She's had 3 preceptors, who are also involved in the evaluation, by talking to the supervisor first, which means i'll have to do that too.

Why i'm dreading it is that i'm not going to have much positive to say. While she can set up a table and tray ok, she forgets a lot of things for cases, and someone has to run out at the last minute and get whatever she forgot (part of her training is for her to get stuff herself before she scrubs, and by now she should have a better grasp on this).

BUT, the biggest issue is this. She's very emotional. While i'm not saying she should be a hard***, she is sniffling and crying (quietly) over practically every case, and it's been like this since the first week. We get pts. for cancer removal, PEGs, trachs, central lines, etc. who don't look very good, and yes this is sad, but she's bawling over every single case. Why this is a problem is that she's so distracted by being this upset, that any surgeon is asking 3 and 4 times for something, and she's not paying attention to what he's saying, or what's even going on. Which makes it really hard for them to do their job, which is not good for the pt.

I've explained this to her, i've asked a million questions to her, thinking, ok, this stuff is hard for anyone starting out, maybe this is reminding her of someone, wondering if there was other reasons aside from the pt.'s condition that this is going on (boy, have i tried, sheesh). She says "no i just think it's so sad that people are in this shape". I recommended the in-house employee counselor, but she refuses to go.

I'll have to tell the supervisor that this girl just isn't focused, and it's an issue. Some things get to people more than others, but if it's affecting how someone does their job, i can't really lie and say she's doing a good job. The 3 month evaluation addressed all of this, and nothing's changed in 3 more months.

I've tried talking, till i've sounded like a broken record, and i feel like i've helped as much as i can. The other 2 preceptors are dealing with the same issues with her, and we're probably going to wind up saying the same things.

[BittyBabyGrower, MSN, RN]

We always get at least one like that a year in NICU. They love the babies, hey great, but you have to be able to do everything else too, like think in a critical line. I always feel bad for those people...we do offer them a job in NBN.

Do you guys have a simple outpatient surgical center?

Good Luck!

[Marie_LPN, RN, LPN, RN]

We have Outpatient, staffing wise, everyone works everywhere, but the goal for every new trainee is for them to be able to scrub on any cases from lumps and bumps, to ortho.

[ICRN2008, BSN, RN]

Marie, it sounds like you've been very understanding, and you've even encouraged her to get help. If she is unwilling to accept that help, then you would not be doing her any favors by trying to pretty things up on her evaluation. If she hears from enough people (and especially a supervisor) that her emotional state is interfering with her job, she might be willing to deal with the problem.

For my part, I don't really understand why she would want to continue to do a job that makes her so sad. Not everyone is cut out to work in health care, and there are jobs (such as medical coding, unit secretary, etc.) where you are not directly involved with sick people.

For the sake of the patients, she needs to learn to get a hold of herself. It sounds like if there were ever an emergency, she might not be able to set aside her feelings long enough to do her job properly.

She is lucky to have you as her preceptor, because not everyone would be so caring.

[traumaRUs, MSN, APRN]

Marie - I think you have been very fair. The fact that two other preceptors feel the same tells me that its not a personality issue or anything you are or aren't doing. Its hard, but I have to agree that perhaps this person isn't in the right job. I know in the ER we have had nurses and techs that just couldn't handle things. In the end, pt safety and pt care has to come first and it sounds as though she is not safe. Sorry. However, I think we have all confirmed what you already knew.

[LHJ_RN]

You said she is still in training? Why not have a meeting with all involved- her instructors, nurse manager, preceptors, etc. It sounds like she is unable to put aside her sadness over these cases enough to actually do the job. It has been 6 months, maybe it's time for some tough love?

[Gompers, BSN, RN]

She's not the one with the stinky feet, is she? :chuckle

I think you've done all you can. It's obviously not a good fit for her. Maybe the hospital can find her a better placement? Maybe an outpatient surgical center that does "nicer" surgeries? They have no obligation to her though - she's gotten more than enough orientation and if she still isn't up to snuff, it's now her problem.

[Marie_LPN, RN, LPN, RN]

Why not have a meeting with all involved- her instructors, nurse manager, preceptors, etc.

Well, that's what what's going to happen, since that's part of the evaluation. The meeting's scheduled, just hasn't happened yet.

[Marie_LPN, RN, LPN, RN]

She's not the one with the stinky feet, is she? :chuckle

Nope lol.

[prmenrs, RN]

I used to cry @ the drop of a hat, too. Then I found Paxil.

Any further orientation/employment needs to be contingent upon some sort of eval for depression/ADD which might explain forgetting stuff and the weepies.

[SFCardiacRN]

We always get at least one like that a year in NICU. They love the babies, hey great, but you have to be able to do everything else too,

I love the little babies and wanted to work in NICU after school. I soon realized I was not cut out for it. I loved the nurturing but could not handle the other aspects of this heart wrenching specialty. I have found my home in the OR.

[purplemania, BSN, RN]

There are so many wasys to be a nurse. You are better off dealing with these people honestly so they can move on and find their niche. Also, you need dependable help in your area. Better for all concerned if they move on.

[Marie_LPN, RN, LPN, RN]

Clarification, she is not a nurse.