Whether you’re starting your very first nursing job or are transferring from one department or facility to another, you’ll probably find yourself working with a nurse preceptor for several weeks.
If you’re faced with a difficult nurse preceptor, follow these tips to know what you should do.
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Before Doing Anything Do These First
If you have never met a difficult nurse preceptor before or have recently graduated from nursing school, you may be surprised to find that your preceptor is not as welcoming, friendly or helpful as you may have imagined.
Before you start to deal with any potential unkindness, bullying, or even abuse, be sure to gather your thoughts and the information you need to make an informed decision about what is happening.
1. Make Sure Your Preceptor is Actually Difficult
First, consider whether your nurse preceptor is truly being difficult. For example, she may only be having a bad day or a bad week.
Perhaps something difficult has happened in her life. By next week, she may be acting normally again.
In addition, consider if you’re blowing the entire event out of proportion. You can view one or two criticisms couched in kindness as an opportunity to learn and grow rather than as a belittlement of your personal character.
2. Figure Out Your Chain of Command
Second, find out more about the chain of command on your nursing unit. On many units, your initial supervisor for any shift may be the charge nurse.
You may also have a unit educator and nurse manager to whom you report. Most health care facilities also have human resources departments in charge of work relations.
By knowing the chain of command and learning who the key leaders are in your facility, you’ll be better prepared to make the right response and go to the right individual for help when necessary.
3. Document Everything
Third, you will also need an inner calm, plenty of documentation of what has happened and backup from others on your unit if you plan to approach anyone in management with your concerns.
If you’re concerned about your relationship with your nurse preceptor or do not feel as if you’re learning what you need to from her during your initial training on the unit, take the following 10 steps to address the situation calmly and to move on with your career.
How to Deal with a Difficult Nurse Preceptor
Step 1: Consider What Is Really Happening
Begin by being honest with the circumstances. Do not make excuses for your nurse preceptor if your mind is telling you that something is wrong.
Although no one is ever perfectly patient at all times, a nurse preceptor should ideally be knowledgeable, kind, enthusiastic, calm and a good role model on the unit.
If you have heard others complaining about your nurse preceptor’s attitude or have even seen patients complain about her brusque attitude or arrogance, this is another sign that your initial concerns were correct.
In addition, remember that a painful preceptorship experience is not a sign that you have followed the wrong career path.
While taking constructive criticism is important during this time, do not be too hard on yourself when you are starting a new job or moving to a new unit.
Step 2: Do Not Accept Bullying or Lateral Violence
There is never a good reason to bully someone else, and you should never accept someone else bullying you even if it is only with words.
Lateral violence can be a real concern on some nursing units when certain nurses lash out at their peers rather than addressing what is really wrong.
As the newest nurse on the unit, your preceptor may see you as the weakest link. However, this is harmful behavior that must be stopped for your own good as well as for the good of the entire unit.
On the other hand, try to use the criticisms that are said to improve your own practice because even mean words can have a kernel of truth to them.
I said this above but I want to stress this again.
Even the harshest criticism from the worst nurse ever may have some truth behind it and maybe opportunities to learn and grow.
I’m not saying that it’s OK for you to be wrongly treated, nor am I saying you shouldn’t do anything about the behavior.
What I am saying is that I’ve been able to learn somethings because of rude nurses that other nurses might not have told me for one reason or another.
My point being is that I think in every aspect of your career you should try to learn and grow from each one.
Step 3: Get Feedback from Others
Next, see if you can gather some information from other nurses on your unit. Most of the time, you can do this without being too obtrusive.
Start by listening to what other nurses say about your preceptor. If they are frequently acknowledging that she is grumpy or impatient, this can be a clue that the difficulties are not on your side alone.
However, if you do have a friend on the unit or a coworker you can trust, you may want to consider asking a few more specific questions to find out if the behaviors coming from your preceptor are typical for her.
Step 4: Document Everything That Happens
If the difficulties with your preceptor continue for more than a few days, it will be wise to keep a running log of what things were said and what happened.
I am sure that you have learned in nursing that if something was not documented, it was not completed. This documentation will serve as your backup if you need to move to one of the following steps.
If nothing else, writing these problems down will help you get them off your mind and may help you process them.
Step 5: Talk Directly to Your Preceptor
If the problems still do not resolve, it may be helpful to approach your nurse preceptor respectfully and carefully. Tell her your concerns, and ask her what you can do to make the situation better.
Remember you cannot make anyone else change. The only person you are responsible for changing is yourself.
However, your preceptor may not realize that these problems even exist, and she may be more than happy to make some changes once she realizes your concerns.
However, if she tells you that you’re way off base or that she does not care about your concerns, you can take this as a sign that it is time to talk to someone else.
Step 6: Talk to Your Unit Educator
Although most health care facilities have large human resources departments, it is not usually in your best interest to talk to someone in HR.
According to Brazen, HR is definitely not on your side. At least, not unless it’s in the company’s interest. In fact, they emphatically claim that “HR works for your company – not you”, and warn employees to never assume that their conversations with HR are confidential.People HR
Instead, it is now time to move up the chain of command to the individual directly in charge of your preceptorship experience.
In large magnet hospitals, unit educators, also called clinical educators, may hold direct control over preceptorship experiences and maybe the ones to choose preceptors from the individuals already working on the floor.
You may also want to ask your unit educator for measurable goals that will help you track your own performance. This person can be an excellent resource to let you know how you are doing and to give you additional feedback.
In some instances, she may even be able to change your preceptor to someone who meshes better with your personality and needs.
Step 7: Talk to Your Nurse Manager
If your unit educator does not hear you out or if there is no educator on your unit, the next person in the chain of command is most likely the nurse manager.
Try to speak with the unit manager directly above you rather than the one over your entire department.
In my case, I found that my direct nurse manager was far more understanding about my concerns and needs because she had actually worked with me on the floor and saw the type of work I was capable of doing.
Step 8: Consider If This Is Enough for You to Quit
Situations that get bad enough may signal that it is time to move on to a different job.
This can be especially difficult if you are a new graduate just getting started in your first job but may not be as problematic if you already have years of nursing experience under your belt.
There are several signs you should watch for that signal that your work environment is toxic.
- Constant bullying
- The pressure to work beyond your educational scope and the scope of your license
- Known patient abuse on the unit
- Incredibly weak leadership
- Constant personal emotional struggles should be major red flags.
In the end, you’ll be glad you left a toxic work environment and will find your work is far more rewarding when you’re surrounded by caring coworkers and a supportive nurse management team.
Related: How to Quit Your Nursing Job
Step 9: Get Professional Help for Dealing with Your Emotions
Nearly constant anxiety, new or worsening insomnia, regular crying episodes, sudden problems with your appetite, overeating, substance abuse and a sense of hopelessness are not only signals your job may be toxic but also signs you need professional help to get through this time in your life.
When I have been faced with difficult situations, I have often pushed back, feeling it was a sign of weakness to talk to a professional counselor.
However, these individuals have a great deal of wisdom and can help you process difficult circumstances and get your life back on track.
A counselor can also teach you coping techniques that can help you get through your last few days of preceptorship if you choose to stay in your workplace.
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Step 10: Find a Way to Learn New Procedures Despite Your Preceptor
Difficult preceptors not only may talk down to you but also may not take the time to teach you what you need to know to succeed on your unit.
Not only can this make you feel personally unfulfilled, but it can also be dangerous for your patients when it happens in the field of health care.
You should never put your license or the lives of others in jeopardy just because your preceptor refuses to help you.
Use continuing education modules and textbooks to learn about equipment that you may not have had the chance to experience while in nursing school.
Reach out to coworkers who may be more willing to let you shadow them for certain treatments or procedures.
If there is no way for you to learn what you need to, you may need to look for a different work environment.
Other Tips to Make the Process As Smooth As Possible
Above all, do not blame yourself for everything that happens during your preceptorship. This is a learning experience, and you should expect some constructive criticism.
However, caustic remarks and surly brush-offs from your preceptor are not your fault.
It is vital to remain calm no matter what you choose to do. You will only regret your choices if you end up yelling at your preceptor or nurse manager.
On the other hand, you may be surprised to discover that your preceptor is willing to change when presented with your concerns.
Finally, although it may be tempting to go right to the human resources department, try to stay away from that avenue if at all possible.
The HR representative may simply turn the problem back over to your nurse manager who may feel as if you have gone behind her back.
This whole situation can backfire if the manager then chooses to side with the more experienced nurse rather than with you.
While most nurse preceptors are kind, compassionate and happy to help nurses new to their units, some come across as uninterested, cross or even mean.
If you have ever experienced this, comment below with what you have done to get through this difficult time.
Experiencing it right now. Cried all the way home alone in my car wondering if I have made the worst career move of my life. I’m not sure I can continue.
I’m so sorry to hear that, Deb.
I can say from having had a terrible preceptor experience that my outlook on my nursing career as a whole changed after I solved my preceptor issue. In the case I’m thinking about, I ended up getting a new job.
I’m not saying changing jobs is necessarily what you need to do in your situation. I am trying to say that you do have options, and if crying home at the end of a shift becomes a pattern, it might be worth reassessing.
If you need further help, feel free to comment back on here or reach out through the contact form.
I’m currently training with a preceptor who is very impatient and throws several tasks at me all at once. She is not willing to take the time to answer my questions or allow me to process through one task before throwing 3 more tasks at me. I’ve literally had moments where I feel I’m losing my mind. I recently heard from other co-workers that they’ve had a similar experience while training with her. I’ve been a nurse for 12 years and have never questioned my decision to move into a new role until now. I’m lucky to have a supportive supervisor who has offered to let me follow a different nurse for the next week so I can hopefully get a better understanding of my new role.
I’m currently a 1st year nursing student and we’re going into week 4 of hospital clinical rotation. I tried introducing myself to my assigned preceptor and she walked away without saying a word. She then went to the end of the hall away from my patient’s room and whispered the morning report to another nurse. She wouldn’t allow me to assist or go into the patient’s room with her. When trying to obtain clarification of a statement that she’d made pertaining to the patient’s care, she stopped and loudly stated “that was a stupid question, did that answer your question? Laughed and walked away. She refused to provide any guidance or instruction for the patient’s care. She and the tech whispered and giggled the entire day. The tech also refused to allow me to perform, assist or even shadow during vitals and rudely told me to close the door because she wasn’t giving me any of her answers and she literally turned off the machine and light to patient’s room, while displaying this behavior in front of the patient. I went through my rotation doing everything within my scope and even made attempts to ask the preceptor if she needed me to take care of any other tasks. She would giggle and decline. I made sure to document my entire day, informed my instructor and was told to just be the bigger person and stay out of her way because she just isn’t a nice person. I found the excuses to accept her behavior were a complete joke and disgusting to say the least. At end of shift during my report, the preceptor had the audacity to “share a piece of advice” and said that in the future I needed to remember that all patient’s scheduled for procedure should already be in their gown and that I failed to have my patient ready for transport. I made sure to inform everyone during report that I had no idea and that I hadn’t been properly advised on the proper protocols for surgical patient’s and that all attempts made to obtain any last minute preop information was declined and documented. That concludes my rotation, but the real kicker would have to be my instructor deducting points from my care plan stating it was due to my inability to receive report from the nurse. Interesting.
I’m so sorry you had to go through all of that. It’s unfortunate the nurse you followed behaved in that manner, and from the look of it, your instructor was not very helpful in dealing with that situation.
Hang in there. It looks like you’re doing everything you can to manage and “be the bigger person.” Unfortunately, stuff like this does happen. Do what you can to manage, and if things get really bad, you’ll have to follow it up your chain of command if your immediate instructor is not helping.
P.S. Keep in mind this might mean that particular facility/department might be one you might want to avoid when you’re looking for your first nursing job after nursing school.
Currently in a position with a preceptor. I am a new grad RN. My preceptor is an agency LPN where I am staff. She constanly takes calls on the floor, disappears, starts drama with residents and staff, doesnt follow proper procedure for many treatments/meds, and is now talking about me and telling my DON things that aren’t accurate. Her and my DON are friends and I don’t feel I am getting the training I need from her, but am not sure how to approach the conversation with my DON as she is the one responsible for picking or setting me up with a preceptor. I was so excited about this job and nursing but now I’m questioning if I should even be a nurse. The residents do not like this nurse because she treats them very poorly and were very excited to learn I would be staff and a constant for them. I need advice. How do I tell my DaoN I need a different preceptor? It’s either that or find a different job. I really don’t want to do that because I like this place a lot aside from my preceptor. Any advice???? I’d like to approach this professionally with as little backlash from my agency preceptor as possible.
I’m a little surprised you’re being precepted by an agency nurse instead of one of the regular staff nurses. I typically have not seen agency nurses precepting new grads partially because agency nurses are not as invested in the facility as a regular nurse would (not always the case).
Because the agency nurse knows your director of nursing, the conversation needs to be taken very delicately. Depending on the relationship, the DON could become very defensive of her friend.
With that said, I would approach your DON. Make sure it’s in a private place, and there’s nobody else around.
Mention how much you like the agency nurse and how good of a nurse they are (I know you said the agency nurse is not very good, but we’re focused on you at the moment). Still, you don’t feel like you’re clicking with her (or you could say I don’t feel like our learning styles are the same). Would it be possible for me to be precepted by another nurse?
See what she says and how well that conversation goes. There’s a good chance the agency nurse will find out anyway if they’re really good friends. Honestly, if they’re good friends and have worked together for a while, in all likelihood, the DON already knows about the poor qualities of the agency nurse.
Something else to keep in mind is that you need to ask yourself why do I really like this place, especially with a DON like this. You might need to consider going to another job so you can be trained and then come back a year or two later after you’ve been better trained.
Having a good preceptor those first couple of years matters, and there’s no guarantee even if you come at it as professional as possible that things will go well. You need to get a feel for the different personalities at play.
Lastly, I would not recommend going above your DON unless you’ve tried to talk to her first, and it didn’t work. Breaking the chain of command can be a big deal in some places. You didn’t mention you would do this, but just in case, I thought I would add that part.
Let me know how it goes.