Why do I get yelled at for doing the correct thing??

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Ok so I'm a new grad two weeks into training. I administer a lot of BP meds so I also do a lot of manual BP checks,every time I'm trying to take a blood pressure the correct way like they taught us in school (feel the radial pulse first then inflate the cuff,wait 30 seconds and then go 30mmHg more of what was the radial pulse cut off number) I get yelled at by my preceptor and then she questioned me if I also listen to the pulse with the stethoscope? Duh,of course I do,you kidding me,just because I want to get the feeling of the radial pulse doesnt mean I dont know the rest of the steps on how to measure blood pressure,then another time she asked my why am asculating the breath sounds in eight places (that the max I should asculate would be 4) Ok but this is what I was taught in nursing school,and I'm sure that a good reason behind this rationale,then she said that it takes me too long to assess the lungs (hello I'm new I'm not an expert in crackles,wheezes,so I want to make sure that what I'm hearing is right,after all I will be charting on this patient)Also my preceptor told me I shouldnt be carrying a drug book with me and took it away from me. I dont know,I'm surprised I'm getting yelled for doing the right assesments!:crying2::crying2: I cant afford to take shortcuts,I dont have experience yet

Specializes in Peds Critical Care, Dialysis, General.

Most of us in our unit look up meds, especially if its one we don't give often. That is always better safe than sorry. If if it's something I give often, sometimes I just have a brain fart and must look it up!

Our kiddos are all on automatic cuff or have art lines, so we don't do too many manuals (just on the renal kids).

Do what you learned. Know that YOU know you're doing the right thing for your patients. Never let anyone make you feel bad about being diligent.

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Specializes in RN, BSN, CHDN.
dang, we were taught (in school) to palpate the brachial pulse, place steth over pulse and inflate 20-30mm higher.

they're teaching radial pulse now?

as for your preceptor, i too would have to ask, if she was literally yelling?

if so, yes, tell her you can't hear anything when yelling.

if she wasn't yelling, merely smile and tell her you'll consider her criticisms when you get more comfortable.

and thank her.;)

leslie

Yep I was told brachial too

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Okay, my radial pulse is 60. SO I'd inflate to 90? What am I missing?

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Specializes in OB/GYN, Peds, School Nurse, DD.
dang, we were taught (in school) to palpate the brachial pulse, place steth over pulse and inflate 20-30mm higher.

they're teaching radial pulse now?

leslie

This is how I was taught, too. AND we were taught to manually palpate a BP--handy when your patient is crashing and his BP is falling faster than your sphyg can count. 'Course, that was back when the earth was flat, so maybe something has changed.:confused: Most hospitals around here check BPs with a machine. How does that work with the magic 30-seconds?

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Okay, my radial pulse is 60. SO I'd inflate to 90? What am I missing?

im thinking the op must have meant she inflates until the radial pulse is obliterated and then inflates 30mm more?

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Hang in there, we all develop our own styles and it takes time to become proficient in all of the skills that we use. In 6 months to a year from now this will probably not matter to you. Be kind to yourself, eat healthy, get enough sleep, and seek out good friends that will support you outside of work :)

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Was she really yelling at you?

Yes, you should be thorough. Yes, you should look things up when you are uncertain. But the reality is, you also need to get faster. Those two things are not mutually exclusive.

And criticism does not necessarily equal yelling. Maybe your preceptor isn't the best communicator. But she's trying to teach you something....

Hang in there!

No she wasnt literally "yelling" at me..I just used this expression but yes she was definitely "DISPLEASED" and used a displeased tone of voice and did question my abilities to measure BP,asked me why am wasting time inflating the cuff twice and listening for the radial pulse...also she when I ask her questions (like about diluting meds or something else) she gives me an attitude look like I'm asking stupid questions or I should arleady have a freaking answer to everything,like the other day she asked me to give a pt a pneumo shot and I told her that I never gave an IM shot in the arm and if she could do it this time so I can watch her demostrating it...she got totally furious,she made this comment "I cant not believe you guys never did IM shots in the arm in school.." Then she proceed to tell me "that I came out of a bad school":crying2::crying2: Also on couple of occasions when I was trying to avoid shortcuts she told me I waste my time by following my school way of doing things...I have a feelings she talks,and laugh behind my back...She never praises me for anything good like the fact that I was able to graps the computer charting system in a very short period of time and other stuff.She just focuses on my shortcomings,how discouraging is that.

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im thinking the op must have meant she inflates until the radial pulse is obliterated and then inflates 30mm more?

yep,that is what i meant,when you stop feeling the pulse,you inflate it 30mmhg more

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Specializes in Legal, Ortho, Rehab.

You just have a crappy preceptor that's all. Maybe you can get someone else?

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You just have a crappy preceptor that's all. Maybe you can get someone else?

I was thinking about that and there is one really cool nurse who is also a new nurse (been there for 1.5 year) and she seems so much more understanding,but I dont know if she does full time,I think she only does part time;she even took time make me a copy the brain sheet she uses,I also like her style,she writes down a lot of stuff,while my preceptor has a really good memory and is able to memorize many things and is very fast going,I'm not saying she is bad but maybe our styles doesnt match,anyway she still continues to work with me (I guess that is a good sign) I'm just praying to make it through with her for another couple of weeks,I think she holds against me the fact that I have no hospital experience whatsover (just my lowly clinicals)

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You are not in school anymore, you are at a job. That means your instructors are no longer the last word on nursing procedure like they were during nursing school.

It seems you are getting yelled at for being a little dense. If you have a baseline BP, you can go 20-30mm hg above that while doing a manual BP. (You should know this.)

If your preceptor wants you to change how you auscultate for lung sounds while she is watching you, then you should try to learn her way. If you hear any adventitious sounds while using her faster method, you can slow down and expand your technique.

As for your drug book, she is right. You don't carry it on your person. You squirrel it away in a place you can get to it when you need it. And you will need it often. You are a working nurse now, not a student so start acting like it. I've seen drug books shoved in carts, in the med rooms, by the pyxis, or at the nursing station and nurses of all backgrounds have their noses in them. But NO ONE carries it with them - she was right to take it away from you.

After your preceptorship (which you were lucky to get and maybe luckier to get through) is over and you are on your own, you can practice however you want.

If I was you, I would start trying to work with my preceptor instead of trying to show her how things should be done according to your instructors.

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You are not in school anymore, you are at a job. That means your instructors are no longer the last word on nursing procedure like they were during nursing school.

It seems you are getting yelled at for being a little dense. If you have a baseline BP, you can go 20-30mm hg above that while doing a manual BP. (You should know this.)

If your preceptor wants you to change how you auscultate for lung sounds while she is watching you, then you should try to learn her way. If you hear any adventitious sounds while using her faster method, you can slow down and expand your technique.

As for your drug book, she is right. You don't carry it on your person. You squirrel it away in a place you can get to it when you need it. And you will need it often. You are a working nurse now, not a student so start acting like it. I've seen drug books shoved in carts, in the med rooms, by the pyxis, or at the nursing station and nurses of all backgrounds have their noses in them. But NO ONE carries it with them - she was right to take it away from you.

After your preceptorship (which you were lucky to get and maybe luckier to get through) is over and you are on your own, you can practice however you want.

If I was you, I would start trying to work with my preceptor instead of trying to show her how things should be done according to your instructors.

The OP stated that they were a new nurse, just 2 weeks into training. A little slack is warranted, and there is every indication that Blackheartednurse is trying their best to learn AND be safe. That's nothing to scoff at.

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