When Your Preceptee is a Know-it-All

[Nurse Beth, MSN]

2 hours ago, KatieMI said:

Sorry, no. They were not. With all honesty.

Yikes! A little off-topic, but what was their issue?

[KatieMI, BSN, MSN, RN]

1 hour ago, Nurse Beth said:

Yikes! A little off-topic, but what was their issue?

Their issue was that they thought if they were doing bedside for X years and knew what written in some stupid policy, they therefore may stop thinking and just follow the said policy and everything gonna to be all right. They did it despite me being there, analyzing clinical situation and telling them (with my terrible accent) that things are getting out of control and what they need to do to hold them where they belong.

Their problem, in all cases, was total refusal to perform any clinical or critical thinking activity whatsoever and getting aggressive and cruel toward someone below their own perceived rank who was clearly smarter than they were and was able to perform such activity.

In two cases all that had also a thick covering of anti-immigrant and racist attitudes.

[NICU Guy, BSN, RN]

Those who think they know it all ruin it for those of us who truly know it all. ??

[Nurse Beth, MSN]

Just now, NICU Guy said:

Those who think they know it all ruin it for those of us who truly know it all.

I know, right

[Original_pronurse]

How come it’s “Mr.” know-it-all? With the ratio of M-F nurses, certainly it should be Miss-Mrs-Ms know-it-all. Don’t ya think!?

[DextersDisciple, BSN, RN]

1 hour ago, Original_pronurse said:

How come it’s “Mr.” know-it-all? With the ratio of M-F nurses, certainly it should be Miss-Mrs-Ms know-it-all. Don’t ya think!?

Oh Cmon, really??

[WestCoastSunRN, MSN, CNS]

On 6/4/2020 at 8:26 AM, BostonFNP said:

Maybe I am an outlier here, but am I the only one that the "case" isn't a great example of "know-it-allism"? I generally don't have a problem with peceptees being well read about a topic and eager to engage on it; in fact I've always felt it is a good time to engage them on applying their theoretical knowledge to practice.

In my own self-reflection, I can admit that most of the time I have a problem with "know-it-all" comments is when they are on a topic that I don't feel I have a mastery of (and the preceptee may even be better read than I am). I think as preceptors we need to be OK with the fact a student might actually know more than us on a given topic.

As I write this, I keep thinking maybe I am being the know-it-all by posting. I don't mean to be.

You are not the only one. I understand the point of the OP, and have certainly known my share of 'know-it-all' graduate nurses (who really DON'T know what they don't know). However, the example expressed, to me, someone who is excited to learn and engage in interprofessional care. I really dislike it when nurses dumb themselves down by becoming so task focused that the whatever thinking is taking place is how to efficiently get all the tasks done. It's a real danger in our profession - sets a bad example, leads to burnout and overall boredom with bedside nursing. Blech.

I know that's not what the OP was talking about, but actually, I think what the OP is talking about can slide into what I am talking about. Bored/tired nurses who serve as preceptors can certainly tire quickly of the ready-to-learn-it-all-and-keep-challenging-myself mindset. To be sure, there are tasks and standards of care that we must master (and apply critical thinking to) to keep our patients safe - and this is a major objective of orientation. However, preceptors should be model nurses - setting an example of and encouraging life-long professional growth.

[FolksBtrippin, BSN, RN]

As to one of the roles of the preceptor as "Socializer"...

Okay, but we are socializing a nurse to unit culture. As in, this is Harry the CNA. We put our personal items in our lockers. Feel free to use the food items in this cabinet which are community and the ones you don't wish to share are marked with your name and kept here. That kind of stuff.

Teaching someone not to brag is something parents do for children.

[Daisy Joyce]

Yes, I know the preceptor is not supposed to be an armchair psychiatrist, but know-it-all-ism doesn’t always stem from narcissism.

Some people were in environments growing up where to avoid belittlement or dismissal they *had* to give the appearance of confidence and smarts. Or they were constantly compared unflatteringly to another sibling or classmate. Or they couldn’t be the “beauty” or the “athletic one” , so they *had* to be the “smart one”.

Like I said, it’s not the preceptors job to fix the emotional problems of the new employee, but just be aware that some people carry a lot of wounds and baggage.

[egg122 NP, MSN, APRN]

On 6/4/2020 at 11:26 AM, BostonFNP said:

Maybe I am an outlier here, but am I the only one that the "case" isn't a great example of "know-it-allism"? I generally don't have a problem with peceptees being well read about a topic and eager to engage on it; in fact I've always felt it is a good time to engage them on applying their theoretical knowledge to practice.

In my own self-reflection, I can admit that most of the time I have a problem with "know-it-all" comments is when they are on a topic that I don't feel I have a mastery of (and the preceptee may even be better read than I am). I think as preceptors we need to be OK with the fact a student might actually know more than us on a given topic.

As I write this, I keep thinking maybe I am being the know-it-all by posting. I don't mean to be.

I agree with you about the example. Being excited about a topic and engaging in it is different. Being a know it all generally is someone arguing or refusing to be open to knowledge, facts or direction from others because they think they know best (and they don't). The example could be misconstrued as nursing having an anti-intellectual streak.

[Emergent, RN]

I agree on the social skill coaching. Let's take the example of a new nurse who really does know a lot. He or she needs to have some finesse when bringing something to the attention of those in the group. How to tactfully bring up newer data is important, especially when one is a newer nurse.

It's true that sometimes young nurses know some things that the old hands don't know about. But, if you come across as an arrogant know-it-all, people will not be very receptive.