Contrary to nursing legend, preceptors aren’t villains. They want you to succeed, and, if given the chance, could be your best advocate. After all, most of them have volunteered for the job or have been identified by their manager as the type of person who would be able to help you best. When preceptor-new nurse relationships get to the point of intervention, it’s not always the preceptor’s fault . . . really. Sometimes, new nurses shut out their preceptor, saying things that demonstrate they don’t want help, don’t need help, or don’t want to work at all.
Kim Rapper, RN, a preceptor for many years, tells you what not to say to your preceptor so that your relationship stays healthy and beneficial to you:
1. “I already know how to do that.”
The know-it-all attitude—and cutting off your preceptor in the midst of instruction—will keep you from learning all you can. You don’t know it all, not even the most seasoned nurse does. Even if you’ve seen a procedure done 102 times, you can benefit from the reiteration. Every preceptor, even if his/her personality drives you crazy, has insights from which you can benefit. And if you listen and watch closely, you may pick up some simple strategy to master the skills you already possess. So, don’t shut your preceptor out, and be open to new ways of doing things.
2. “I can’t do this!”
Most preceptors appreciate when a new nurse admits they don’t know how to do something. But don’t say, “I can’t.” It’s not the right word, because you will be doing it by the end of the orientation. Saying “I can’t” suggests you don’t care to learn.
Instead, say, “I don’t know how to do this yet. I need your help.” This demonstrates a willingness to learn. And it is completely appropriate; your preceptor needs to be in the room watching, helping, and coaching. No one should be doing something they feel they can’t do or have never done before. It’s in those instances that a good preceptor will be able to push you—so, ultimately, you will be able to fly on your own.
3. “Did you hear what so-and-so said?”
Cattiness and gossip are never appropriate. It’s okay for a nurse to say to a preceptor, “I don’t feel comfortable with so-and-so nurse.” But to come out and say things like, “Did you hear what so-and-so did?” chips away at your professional demeanor. Don’t get me wrong, it’s okay for there to be differences. However, when your priority shifts from quality patient care to the “Who’s Who” network, there is a problem. New nurses need to be socialized appropriately, and many preceptors take on that responsibility by inviting new nurses out to lunch and introducing them to the physicians. This needs to happen more frequently. If preceptors don’t socialize new nurses into their peer group in a professional manner, then cattiness takes over.
4. “If you don’t put me on the day shift, I’m going to quit!”
We had a new graduate make this demand. And, as you know, it’s an unrealistic one. New nurses are low on the totem pole, so expect to work the hard shifts. Most new grads start on the night shift; day shifts come with seniority. When you sign a contract, you’re agreeing to work any shift. So it’s shocking to me that new grads start making demands when this is what they’ve signed up for. However, if you are struggling with the night shift, seek support and advice from your preceptor on how to make nights work for the short-term; she’s been there. Also remember that if you want to pick and choose your shifts, you have to stick with your hospital. At many hospitals, seniority is rewarded. That’s why I’ve stayed with the hospital I started with; now, more often than not, I get the shifts I request.
5. “I’d rather be doing…”
Once I heard a new grad frequently and freely talk about changing her career—because nursing was “beneath” her aspirations. If nursing isn’t what you expected, you’ve got to discuss that with your preceptor. But don’t waste your time, or your preceptor’s time, if you know you’re not going to stick with it. Nursing demands passion and a stick-with-it attitude.
6. “I’m doing it just for the money.”
These types are called appliance nurses. I made a commitment to myself when I was in nursing school that I would never keep doing this if it became just a job. That may not be something that everyone can do. But if you find you are seeing your job just as a paycheck, then maybe you need to take a step back. That may mean dumping some of your expectations of yourself. Or maybe you need to pursue activities that recharge you. For instance, I dabble in graphic arts, which rejuvenates me. When I go back to work, I do my nursing job much better because I want to, not because I’m locked in. I’ve learned you need to be able to do this job for the right reasons: to give the best possible patient care and make a difference in people’s lives.
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June 6th, 2008 at 2:46 pm
These are all such true and resounding words. I am not yet a graduate, but just thinking about what you have written inspires me to be a better nurse, and even at this point student nurse. Thank you.
June 6th, 2008 at 9:03 pm
Thanks for the article! I am a student nurse about ready to start my first clinical rotation and have no idea what to expect, so this gives me a better idea on things to keep in mind so that I can be sure I am doing the best job possible! -Thanks!
June 11th, 2008 at 8:52 am
Great article! I am a graduate, and this article came just in time to get my career started the right way!
June 13th, 2008 at 2:51 pm
this is great advice for anyone in the field. i’ve seen veteran nurses say things similar to these to the dr’s face (no no!). i can’t imagine even saying this to a clinical instructor, a co-worker, or a CNA. these statements just show a lack of professionalism and (as stated above) a know-it-all attitude (which is the worst–and dangerous in nursing). thank you for writing this!!!
June 16th, 2008 at 10:16 pm
I think this advice is great. I wish all students, myself included had a heads up on what could be termed nursing etiquette. We are all professionals and we should think about what we say before we say it. We are more respected and credible to each other and to those we care for. Awesome job!
June 18th, 2008 at 5:59 pm
Great advice!
June 23rd, 2008 at 10:19 am
Nice
There needs to be a list for preceptors of what not to say as well!
June 24th, 2008 at 5:25 pm
As a new graduate and orientee, I really appreciate this list. But, I do agree that there should be a list of things for the preceptor not to do.
July 5th, 2008 at 6:33 pm
thanks so much this was really helpful.. But i still wanna work lol
July 10th, 2008 at 8:26 pm
I just started precepting- for my first time!- this past month! I really like this article- I’m only a year out of school and hardly a year into being an RN- so being new is still fresh on my mind. There definitely needs to be a list for what-not-to-do for preceptors too
July 24th, 2008 at 6:29 am
I figured in this list would be:
“He was alive just a minute ago…”
“I’m so drunk…”
“Where do they hide the good stuff?”
“I could only fit so many supplies in my pocket…”
“Where’s the smoking section?”
“It’s okay to put crushed tylenol in an IV bag, right? I mean…Only for pain, right?”
“I left the meds in his room so he could take them later…”
“I let him give his own shots…”
“I kept calling for a nurse but pump kept pumping…”
“My English is what?”
“Was that 1,000 units or 10?”
“Patch Adams wouldn’t stand for this…”
“I’m allergic to all the food I just ate off her tray…ugh…”
“Sorry I’m late…I caused a car accident outside so can you not send me to ER?”
“I found a hot traveling nurse and an empty closet…”
“Apical pulse is found below the floating ribs, right?”
“You put the cuff around their neck if they’re an amputee, right?”
You’d never believe it, but I’ve actually heard some of these…Bet you’ll never guess which ones are real…
October 6th, 2008 at 7:29 pm
I’m orienting with a preceptor in the ER and i agree that some things should never be said.
October 6th, 2008 at 11:47 pm
I totally agree with this article – and I agree there could be a comparable article for preceptors as well. There is nothing more discouraging then being a new nurse and hearing certain things. These would include:
“I’m not a preceptor – I don’t teach. I’ve told our boss that before but she assigned you to me anyway tonight.”
“The boss is such an idiot, she can’t ever schedule anyone right”
“I saw such and such hospital is hiring. If it wasn’t such a far drive I’d be there in a heartbeat.”
Ugh – it is definitely discouraging – I’ve been experiencing this off and on during my past 8 weeks of orientation. Not to mention the “eating your young” syndrome. But, I try and keep my head up and learn as much as I can… what else can I do but make the best of it? It is a saturated nursing market in my area – so I’m lucky I was able to find a job as a new grad at all.
October 12th, 2008 at 8:53 pm
You should also leave a list of what a preceptor doesnot say/ shouldnot do. I was a new nurse couple of years back.Later i precepted many new nurses also.But still i cannot forget the bad experiences i had from my initial preceptor that made me to cry several times and i felt like leaving that job. A preceptor can encourage as well as discourage you completly.
October 13th, 2008 at 3:47 pm
WOW!!! This nurse must have been precepting with me over the years. I have heard every single one of those comments.
October 14th, 2008 at 9:33 am
The list is very true. I am a clinical instruct for a nursing school as well as work full time as a staff nurse. I precept and my primary expectations of my preceptees are to enjoy and embrace nursing. One cannot enjoy nursing when he/she is cocky and negative. Nurses don’t “eat their young” as many did years ago, but egos still persist and when new grads or nursing students tell experienced nurses that they already know everything they are opt to get a “negative” response.
November 7th, 2008 at 6:59 pm
Please new nurses, take these tips to heart! They are so….true! Unfortunately, I made all of those mistakes and have paid the price by being terminated. I have really been humbled!
November 30th, 2008 at 10:07 pm
I am so glad to read all these comments. This will prepare a new nurse for the challenges ahead, especially when you are waned all the time about how quickly your license could be taken away from you. To be a new nurse could be very frightening. Nursing profession is like surviving in an empty wilderness. Sometimes it feels like every one is out to get you. 23 years ago I started this journey as a brand new nurse, with language barrier. I was born and raised in a foreign country hence I was faced with both cultural and professional shock. Mixing and getting along with co-workers was a big challenge. My preceptors were not patient at all. I wish I had these hints at that time. I do not know if it could have helped me, but at least it would have encouraged me, knowing that I was not alone in my struggle
December 11th, 2008 at 9:32 am
Most of it are true but based from my experience there is always a wicked preceptor who does preceptorship for money. I had one…and i hate the experience…good thing i survived.
December 19th, 2008 at 10:31 am
I had a preceptor nurse who treated me like an unwanted stepchild. I couldn’t do anything right no matter how hard I tried. I was very uncomfortable with her and dreaded coming to work. I learned 2 things in that experience. 1 – to be nice and helpful to anyone I might be a preceptor to and 2- we have to learn to work with all different personalities in our field no matter how hard it may be.
January 3rd, 2009 at 1:22 am
This article was great! Like many of the others I agree the preceptors need to be carefully picked and trained! They are the face of the facility to a newly hired or newly graduated Nurse. I had a horrible experience with my preceptor at my previous job. She had been in the field for 30 years, and was horrible. She was the most negative, argumentative person I have ever met. She was the type that wanted to find something you did wrong, and seemed angry when she couldn’t find anything. She constantly tried to trip you up, nothing you did was right.
We worked at a Detention Center, and the Nurses there literally said “they are all dogs, and you have to treat them like dogs”. I know that our patients were in there for breaking the law, but I don’t agree that they should be treated differently than any other patient. It turned my stomach the way they treated and spoke to the patients. I was orientated by 4 different nurses that all told me how to do things differently….. so depending on who was working I got reamed for not doing things “their” way. I loved the job, but it was not worth the anxiety of constantly being picked at, and dreading just going to work!
January 21st, 2009 at 7:04 pm
I have been a R.N. for over a decade. I teach prenatal classes, do floor nursing, charge nursing and precepting. Since nursing is such a dynamic career and technology and protocol changes so rapidly, I still learn something new every shift. I will admit, the “Know It Alls” scare me the most. I always watch them very closely and their patients even closer. I have learned a lot precepting and always try to be encouraging and patient with new grads…seems like I was just there. I’m so thankful for the “reinforcements”. they bring a lot of enthusiasm and enery to the floor!
February 1st, 2009 at 2:19 am
Unfortunately some nurses carry this attitude and phrases all throughout their careers. It’s dissapointing to work with people that just dont’ care.
February 3rd, 2009 at 12:26 am
I had many different preceptors and one question I hated being asked was “were you a tech” as if I wouldn’t be a good nurse otherwise!!!
February 3rd, 2009 at 5:56 pm
I’ve been an OB/NSY nurse since 1973; I just wanted to say that I still learn something new every time I go to work. You can also learn a lot from your preceptees; if you’ll only listen!
February 11th, 2009 at 9:46 pm
I am not yet graduated, but wanted to thank you for posting these. I have met several nurses over my small nursing-school-clinical experience who definitely “eat their young.” I was starting to get a little depressed with careplans, class, tons of things to do, etc, and a good preceptor-student relationship was just the thing to turn it around! It has helped to reconfirm my love of nursing and the belief that I really can do this!
As a preceptee, be open to constructive criticism (as a preceptor, please let this is the only kind of criticism you give us). Even if the day has gone well and your preceptor says you did great, it’s a good idea to ask “is there anything I could have done better?” This shows that you are really open constructive critisicm and want to be the best nurse you can be.
February 13th, 2009 at 3:18 pm
as an RN with only 12 months of experience under my belt, i was told i would be precepting. and i did… thankfully it turned out beautifully and my preceptee is and extremely promising talent on our unit. thank god i never ran into any of those six issues… not sure how i would’ve handled them.
March 20th, 2009 at 7:29 am
I havent been put on night shift and im a new nurse. Though this week i had the whole week of earlies. and then next wk got late, late early then day off and then 3 nights….
Though i did since last thursday have the same patient load..so annoying when you want to learn
March 24th, 2009 at 11:14 pm
Luv Bug brings up a point…as a nursing student, I would like to know, is it easier to make the transition to RN from tech.? I was hoping to not do tech work, focus on getting my RN, and then go from there. I was a tech many years ago, and it’s not something I care to repeat.
April 2nd, 2009 at 6:26 pm
Bonnie,
I am also a nursing student and can’t tell you if it is easier to transfer from Tech to RN I can tell you that the students who have been Tech’s are much more prepaired, and much more comfortable as nursing students, than those who have jobs in other fields.
May 2nd, 2009 at 12:38 am
As a preceptor all I want is for you to want to be there and want to participate. I am not going to task you with wiping a butt if you are past that stage and something better is available.
Please do not disappear. I view you to a degree as my responsibility regardless of how you see the situation. I have plenty to do and having you with me is fine- wondering where you are is stressful.
If you are a brittle diabetic or have some other chronic condition please consider what you are getting into. I respect you desire to share your personal experience with other patients but nursing school is a challenge and the first couple of years should be mentally and physically challenging- take care of yourself and when you are stable then rethink nursing.
September 19th, 2009 at 10:09 pm
How about a list of preceptors?
For starters, make criticism CONSTRUCTIVE!
Don’t assume your way is necessarily the only way.
Remember, your students/new grads might not be experienced nurses just yet, but yes, we notice YOUR mistakes too.
November 8th, 2009 at 12:52 am
I have the worst preceptor ever. She always has a head ache expects me to know things before I do them. Quizes me on everything. Makes me call pharmacy 100 bizzilion times a day, tells me things that aren’t even right. Gets upset when I don’t have questions. It’s driving me crazy!!’n