A good preceptor can make all the difference between a good day and a bad day while training on a new unit. Frankly, I’m long past the days in which a preceptor could have an effect on my sense of self-worth, or make me question my decision to pursue nursing. Instead, I’m finding that I have time to really sit back and notice the strengths and weaknesses of different styles of nursing and precepting.
I thought I would highlight some of the different preceptors I have had so far during my ICU orientation, and discuss how their personalities have effected my experience. I think we’ll all recognize these folks in those that we work with in any setting.
My very first preceptor was young, beautiful, and hip. She was dry, sarcastic, and witty. She was absolutely fantastic and thorough at her job, but wasn’t shy about explaining her goal to do as little work as possible. She didn’t cut corners or skip tasks, she simply didn’t make work for herself. She wanted her patients to be stable, sedated, paralyzed, and orphaned.
Her personality was fine with me! I laughed hysterically all day–which was a welcome experience considering it was my first shift. I was completely in a state of fear/shock/anxiety/panic, but she was very warm, and welcoming–not afraid to talk to me about the unit, look for interesting things for me to see, and get me involved with hands-on care.
“Have you ever drawn an ABG from an art. line?” Was one of the first things she said to me.
“No, actually, I’m not certified yet. I haven’t done the classroom theory or the exam.” I meekly responded.
“Pfffffft!!” she laughed. “Here’s the syringe. You’re going to do it.”
My second preceptor was completely different. He was just finishing up the last few days of his Master’s degree. He had just defended his thesis and was waiting the results. He was also doing some last shifts in his final Nurse Practitioner practicum.
He was a nurse that was extremely controlling of his environment. Every last moment of the shift was filled with checking, rechecking, adjusting, and readjusting. I don’t think I will ever again see a CVP/ICP/Art. line zeroed so many times in one shift! Lines were checked (all twelve of them) several times during the day–carefully followed from the patient to the label to the machine to the bag. IV labels were torn off and replaced with his nicer looking writing. Dressings were changed if he didn’t like the way the tape was positioned.
Every time he did anything at all, he would turn to me, explain exactly what he was doing, why he was doing it, and (not joking) list several research papers and their list of authors that backed up exactly why it was the best practice.
I remember how he listed all the things he would tell the team on rounds, and how they would respond. He explained what he expected the new goals for the day to be. He was spot on! Rounds went almost word-for-word how he predicted.
I loved the shift I spent with him. It proved to me how research and intellectualism play an integral part in the ICU. Every little move we make is because somebody spent years researching the practice. Often this research had been done by nurses and doctors within our very own ICU.
I also learned just how NOT controlling and detail-oriented my nursing practice is. In my mind, the jury is still out on whether I am OK with that.
My third preceptor was a delight! She was very warm, friendly, and encouraging. She wanted me to dive in and do absolutely everything I could. She helped me work toward being a bit more independent.
“So, Sean. This is your third shift. Are you ready to present a patient at rounds?” She said with a sickeningly sweet smile. I had been dreading the day someone suggested this very thing.
“ACK! NO! But the way I see it, I will never feel ready unless I just do it a few times and get a feel for it.” I responded. I’m sure, by the way she looked at me, that I had turned white as a ghost.
There were many “first times” that day, and each and every time, she told me how great a job I was doing. At the end of the day, she said I was doing great and let me go early.
I left that day on cloud nine! I was loving myself, my job, and the ICU.
My fourth preceptor was again completely different. She had twenty years of experience in the ICU. She was a very quiet and silent person. She rarely said anything unless it was to tell me I had done something wrong.
She didn’t let me dive in and try anything unless I specifically asked, “Would it be OK if I did that while you watch me?”
She always seemed surprised, and responded with an, “oh…OK…I guess.” And if I didn’t ask her in time, (which happened a few times)and I found her mid procedure, I would have to ask her what she was doing, and what her rationale was.
I tend to be a very shy person and struggle with starting conversation. Generally I find that I am on the receiving end of someone trying to make conversation (note to self: work on that!). However, by the end of the day I found myself desperately asking her questions, trying anything possible to break her out of her silence.
Now, she was a very nice person. She was never mean to me. It was just that she didn’t make a great teacher. However, she was a HUGE source of knowledge, and whenever I did prompt her for information or explanations, she was able to provide it with depth and little effort.
At the end of the day, she said, “Wow, I feel so useless today! You’ve been doing everything!” I took that as progress for myself.
I don’t necessarily think there is a perfect preceptor when learning a new job. In fact, I think every single nurse has something very important to give to new staff–whether they’ve been there six months or thirty years.
This is why I don’t personally believe in having one single preceptor during orientation or a practicum. Every single nurse I have had has shown me the ICU from a slightly different angle. Just like in nursing school, I am poaching my favorite practices of each nurse that teaches me. Picking and choosing my own style.
Seven more preceptor shifts to go. Then the REAL test begins!
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