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When the Preceptor’s Attitude Is a New Nurse’s Biggest Challenge

March 12, 2014

FirstPreceptorIllustrationHere’s the start of “My First Preceptor,” the Reflections essay in the March issue of AJN.

“Manage your day,” she told me, not for the first time, as if it had been my fault that one patient crashed yesterday just as my second one returned from surgery with a new set of orders. I could not be in two places at once, keeping track of two critical patients, making sure each one received the care she needed at the moment she needed it.

A new critical care nurse has a lot to worry about. It’s easy to feel overwhelmed, even when you’re actually doing a pretty good job. A preceptor can play a crucial role in helping a new nurse find her or his footing. As one might expect, however, some good nurses are not good preceptors. In this essay, the author describes her struggles to deal with the time pressures of her new job, along with her preceptor’s constant admonitions and disapproval.

This fraught nurse–preceptor relationship reaches a crisis point against a backdrop of life and death struggles. I won’t try to summarize what happens in the essay, since different readers may interpret it differently, depending on experience and temperament. But it’s definitely worth a read.—Jacob Molyneux, senior editor

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6 comments

  1. My first day in the Emergency Department was an overwhelming one. Not only did I feel the need to cram as much nursing information prior to arriving in the unit so that their decision to hire me wasn’t a mistake, but I also had anxiety when it came to fitting in with the team. My perception of ER nurses was that they were cold-hearted, had the old-eat-the-young mentality, type A personality, and they were too occupied to even try to help me gain the knowledge needed to be a competent ER nurse. I was not sure why I had that feeling when they knew I was a new graduate in the novice program; but I did. Surprisingly, my preceptors (I was assigned two) were great. I understood later why the charge nurse assigned multiple preceptors. My first preceptor was young, easy-going and focused more on the essential skills needed to complete tasks in the unit (i.e. iv insertions, ekg, blood draw, medication administration, etc). My second preceptor was older and she trained me more stringent and focused on my charting. My relationship with her was more like that of a mother and daughter. Anytime I made a mistake and beat myself up, she would tell me to identify my problem instead of telling what it was, and assured me that I won’t make the same mistake again. From the outside this preceptor would have seem to be problematic, but in hindsight I realize she only wanted to see me succeed. The reason that I was placed with both of these preceptors was to realize the different personalities of the unit and to show that although you may have an easy-going attitude, this department is also very serious and requires critical thinking. Maybe instead of assigning one preceptor initially, most facilities should adopt this method of providing multiple preceptor training. Even though we are in a profession where we are expected to be caring individuals, we also live in the real world where there are multiple personalities, and not all are favorable. In addition, this may give you the experience to deal with patients, which also have different personalities.

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  2. As a new nurse, my preceptor was very popular with everyone on the floor but working closely with her showed me that she underhandedly went out of her way not to help anyone. The most important thing to her was clocking out at 7:08. It gave me a clear example of what I did not want to do when I was on my own. While she was out sick for a few days I worked with another nurse who’s views lined up more closely with mine and my stress levels went down tremendously. It was very hard to do after 6 weeks but I had to ask the director for a permanent change.I believe that making sure a preceptor and the new nurse are compatible should be highly important as it can shape the rest of the new nurses career.

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  3. I appreciate the subtleties in this true story. The author captures the preceptor’s short-comings (OK–her outright nastiness), and at the same time captures the preceptor’s strengths in the moment of crisis. I’d like to think that while these two nurses responded to that crisis both of them may have been learning something? The preceptor probably wouldn’t admit that, and will probably going on “eating the young,” but you never know. . .

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  4. When I was in nursing school, I could believe some of the nurses. They were mean and nasty! But I was blessed to have great preceptors as a new nurse.

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  5. I am horrified by the behavior of the so-called preceptor. I certainly hope that the new nurse scheduled a meeting with her nurse manager to discuss the situation and, perhaps, ask for a new preceptor. The behavior is typical of bullies and we do not need them in nursing. I can not call the preceptor a good nurse – given her attitude with the patient’s husband.

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  6. I have been in nursing 38 years and have seen some utterly horrid “mentors.” Still very much eating our young.

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