New hospital~~>not a new grad.

Sorry soooo long, mini vents included


Today I started my unit orientation to CCU in a New hospital, in a New state. I've been in CCU and ICU for roughly 3.5 years, have my CCRN. I was very concerned last night about how I should display a "humble, please teach me the ropes, in's and outs" attitude during orientation. But I still don't understand how to convey the "teach me please, but oh I understand this already, but you can still tell me what you gotta say, because I might learn something new and don't want to miss a learning opportunity, and DO NOT want to come across as rude, or even act like I think that I know everything". I have the utmost respect for the experienced nurse and love learning from them as well as recycling the teaching to others because learning is fun.

This nurse I was paired with was an extremely knowledgeable nurse, 30 plus years in nursing. Personality wise, she was firm with patients, kinda militant, and dry humored. Im a little softer and very sensitive to the emotions in the air, still firm when I have to be but definitely not a stickler, I like my patients to be in control of what they can be when they can be for themselves. Hippocrates said, "Cure sometimes, treat often, comfort always".

I was proactive (just jumped right into pt care, charting, paperwork etc), asked questions as they came along, discussed aspects of patient care, shared knowledge and experiences so she could add teaching moments.

Eventually, I felt there were lots of differences in what I thought I knew to what she was teaching me. It was frustrating because she wasn't receptive to the differences and would just shut me down by saying "No" to this and "I've never" to that followed by correction. I wanted to learn from her perspective and her experiences in accordance with how this hospital does things, so I found myself nodding along with understanding, only spoke for clarification, and continued listening. It gets worse.

She converted my orientation to the unit, to orientation to basic nursing. I asked where we got rid of medical wastes for tubings and bottles/bags etc, no blue bins, "oh, just put it in the trash, BTW tear off the HIPPA info and place in the shredder bin." I said a big "OK" in my mind. Another instance, I asked her to run through the Crash cart monitor and organization of supplies meds etc. At one point, I suggested perhaps I should recert for ACLS since it was an entirely new machine, tons of fancy buttons, and its up for renewal in 2 months anyway. She said, no, and said this is all ACLS, kept honing in on placing the patient on the pads and leads first. Basically, going through ACLS protocol. Talking about PEA, AFIB vs Aflutter, sync cardioversion etc. I kept listening, she kept insisting it would come along with experience, stating it will get better as I see more codes. I almost lost it.

At that point, I thought. Maybe since I was more of a listener and had less of a discussion and asking questions, I think I may have made myself out to be clueless. Yet I don't know what else I could have done.

I wish I had just sat in front of the computer and just informed myself of policy and procedure. Every hospital, different formats of orientation, never felt like this before. Not even given the opportunity to actually validate skills. She had trouble starting an IV, needed to start Bicarb and DDVAP, she didn't even give me the opportunity. I asked, she said no, pt is already stressed out. The pt was calm but she exceeded her attempts, Hmmm, okay. It was her show.

Suggestions please.
Orientation won't last forever... You can always talk to the nm to change preceptors, pull her aside and talk with her or just bite your tongue and get thru it. Either way you'll get through it. I went through the exact same thing- (see the article "dear preceptor") I thought I was going to explode everyday hang in there and remember what you cited here- new employee, not new grad. Take all those amazing qualities and experience you have to shine and take great care of your patients. Good luck Ivanna

You don't only have to ask your preceptor things. Ask other nurses. Ask you NM if you have P&P concerns.