What would you suggest to your preceptor if..

Clovery · Jun 16, 2015

I suppose I'm sensitive to criticism... I prefer to hear criticism coupled with something positive. Like "It was great how you did C but next time remember you need to do A before you do B". Or "you have amazing customer service skills and rapport with the patients, but you need to balance this better with time management."

I'm definitely a hands on learner. I could watch someone do something 10 times but I don't really get it until I do it myself. If I'm being walked through a new procedure I like to verbalize what I'm going to do then get a quick approving nod or "okay" then do it. If a preceptor needs to take over because I'm doing something wrong, realize that I'm going to feel like a complete failure and be really nervous about doing this again in the future. It would be best to talk about what went wrong right away, practice or verbally walk through the procedure again, then make me do it again as soon as possible before I develop a phobia about doing that task.

Libby1987 · Jun 16, 2015

I'm finding that the praise is forgotten when there is correction. If I lay it on any thicker I don't think it will seem genuine but maybe I'm projecting how I would perceive quantity of praise.

Red Kryptonite · Jun 16, 2015

You've hit the "special snowflake" wall. You're probably not doing anything wrong at all. I mean, shaking and crying because of constructive feedback during training? Whatever happened to maturity?

Been there,done that, ASN, RN · Jun 16, 2015

Is this home health care, and are you precepting nurses or assistants?

It' s all about the tone of voice to me.

llg, PhD, RN · Jun 16, 2015

I am a bit hypersensitive to criticism and I have been a nurse educator for many years. Based on that experience on "both sides of the fence," here are the thoughts off the top of my head.

1. Start by creating a "safe environment" with your trainee before you do any actual teaching -- and especially before you give any feedback. They have to trust you to be both fair and kind before they will feel comfortable with having you criticize them. Get to know them as people a little, share some personal stories about your own learning experiences, express that you understand that they may be nervous, self-conscious, and/or insecure about their new job (or whatever.) Arrange times away from the patients and other staff members that are intended for practice and discussion during which it is REALLY OK to ask "stupid questions" and/or practice with equipment and make mistakes. Give "rehearsal" time when it is REALLY OK to mess up and don't limit the experience to "real life" experiences in which the learner can hurt someone or be embarrassed if she makes mistakes. (That's what rehearsal is for -- and that's why musicians, actors, etc. spend so much time in rehearsal. It's a safe place to try out new behaviors/skills.)

2. Earn their trust by always displaying positive regard for them as a person -- even if you have to discuss areas of weak performance with them. Couple criticisms with comments about strengths and expressions that you believe they can succeed. "I think you will do just fine if you can focus a little more attention on ..." or "I see an improvement in ...., but we still need to work on ...."

3. Be careful about you language. Instead of discussing their performance difficulties in terms of "weaknesses" or anything else that sounds linked to their basic abilities or characteristics as a person ("You're to ...") ... try to use less personal terms. Talk about "learning needs" instead of "abilities" ... or talk about the need for "more practice" rather than saying "You're still not very good at ..." etc.

4. Even if things get bad to the point of leading to the loss of the new job, keep re-stating your faith that the trainee can learn from this experience a move forward towards bigger and better things.

Libby1987 · Jun 16, 2015

This is Home Health and I'm precepting RN's.

I've been the main preceptor for several years but this is my first time working with newer nurses without acute care experience.

dudette10, MSN, RN · Jun 16, 2015

You've hit the "special snowflake" wall. You're probably not doing anything wrong at all. I mean, shaking and crying because of constructive feedback during training? Whatever happened to maturity?

Not really. It's anxiety, frustration, fear of failure, fear of hurting a patient....and a little bit of role shock.

One of the floors I work on just hired one of the CNAs as an RN. The preceptor she works with gives both praise and constructive feedback. One particularly tough day, the CNA-to-RN looked like she was on the verge of tears for the last half of the shift. As I left (she was still charting), I noticed her eyes were red. I stopped and told her that it's tough in the beginning, but it gets easier. She looked at me and said, "I had no idea it was this hard!"

Been there,done that, ASN, RN · Jun 16, 2015

This is Home Health and I'm precepting RN's.
I've been the main preceptor for several years but this is my first time working with newer nurses without acute care experience.

Surprised that nurses without acute care experience are accepted to home care.

No wonder they are anxious, and you are wise to anticipate training difficulties.

Again, for me, it's mostly not what was said , but how it's said. Your need to cover a lot of material is probably making you loud / brusque. Not conducive to a first time learning experience. Role play with another nurse and find out how you are coming across.

Farawyn · Jun 16, 2015

Not really. It's anxiety, frustration, fear of failure, fear of hurting a patient....and a little bit of role shock.
One of the floors I work on just hired one of the CNAs as an RN. The preceptor she works with gives both praise and constructive feedback. One particularly tough day, the CNA-to-RN looked like she was on the verge of tears for the last half of the shift. As I left (she was still charting), I noticed her eyes were red. I stopped and told her that it's tough in the beginning, but it gets easier. She looked at me and said, "I had no idea it was this hard!"

But why didn't she? Coming out of nursing school, I did have an idea of "how hard" it was.

Not fully, but enough.

I was lucky to have good preceptors who offered constructive criticism.

One would always tell me "what you have DOWN is this, what you still need some work on is THIS, and here's why..." I can still see her. Yes. I was intimidated, but I guess, more respectful than anything else. She was friendly but not overly so and would make sure I had coffee before we started anything. "You fueled up? Good. Let's go!" and off she would zip.

She wouldn't let me leave at night unless I asked her 3 questions. And if she didn't know the answers, she would help me to find them.

My scariest preceptor wore LOUD HEELS and was super tall.

Farawyn · Jun 16, 2015

Oh, and Libby1987, the fact that you're asking how to be better means you are already better.

AJJKRN · Jun 16, 2015

I have no problem with constructive criticism when I'm given examples on how to fix whatever it is I'm lacking in. I can remember getting a whole lot of "constructive criticism" as a new nurse and even being told by my manager at the time that I needed to be better at receiving it. My problem wasn't getting the feedback, it was getting someone to give me examples on how to change. I was a new nurse without any experience but most of my experienced peers I guess figured that I should just know what to do to change, but then why would I have been having problems in the first place? :sarcastic: This is just something I have kept in mind over the past few years of precepting new grads and experienced nurses to Med-Surg. Could totally be a special snowflake thing going on too!