What type of role do you take as a preceptor with non GN nurses?

[Codeblue1982]

I am just wondering what type of role you take as a preceptor with nurses that have some nursing experience? Everyone seems to have a different style and level of involvement. I work ICU at a large teaching hospital and when new nurses transfer in I like to get a feel for what their overall practice, knowledge level and work ethic is like, so I feel like I have more than a responsibility that simply teaching them about Vents, gtts and ICU interventions; I want to know that they are competent at baseline before we go jumping into taking patients on hypothermia with 10 gtts running. Some of my coworkers choose to take a more passive approach and go over just the ICU pieces and leave it at that. My issue is recently I have oriented a nurse who is very flip about everything, will surf the internet instead of seeking out learning opportunities, misses key pieces of basic assessments, becomes defensive with constructive criticism about incorrect practice issues and document interventions that were not done. My concern is that the previous preceptor passed on to me that this person was doing wonderful . I am not an eat your young type of person and try to promote learning in a non threatening way by talking through scenarios. I was told by my orientee that this makes them feel put on the spot and is stressful. I explained that it will be more stressful when an emergency is actually happening to a patient as opposed to just talking about it and that I am not doing it to make them feel dumb but as a learning exercise. I learned early on that this person does not like to be wrong or made to look like they don't know something which to me sends up red flags as being dangerous since none of us know everything.

So any input from other preceptors would be much appreciated!

[Codeblue1982]

Thanks for the feedback....I did use the straight forward approach and made the discussion about the behaviors and not the person asked the orientee how she thought things were going and had a frank discussion with management. Unfortunately I don't think it made much of a difference behaviors have not changed and she was released from orientation shortly after my post. There have been a few issues right off the bat, some minor and some serious such as high risk gtts running at incorrect rates. My approach is now to try to mentor this person and document issues as they happen, I am really not sure what else I can do.

[icuRNmaggie, BSN, RN]

When this person causes a sentinel event, the first thing that risk management will do is pull her entire education file to verify who signed her off as competent and to absolve the hospital from liability. If you do not have copies of your progress evaluations, at least make a note somewhere that on 04/00/2015 that you informed your manager and other management officials that the nurse was not competent to come off of orientation. You will most definitely be asked that question in a root cause analysis, should you be working with her at the time of the incident.

As someone outside of the situation, I think that your management is not invested in patient safety and safe nursing practice. A culture like this will not improve and you can not change it by yourself. I would do my best to protect the patients while planning to part ways with this hospital on a positive note.

[Codeblue1982]

Thanks for your feedback, i have documented email correspondence and I have also filled out our midas occurrence forms which go to risk management. I am praying a sentinel event does not occur but I am also concerned that she does not have the integrity to self report when a mistake is made. I have encountered "scary" coworkers before but this is the worst I have seen so far.

[icuRNmaggie, BSN, RN]

Forward those emails to your personal email account.