I have two preceptors. I worked with one on Wednesday and the other on Thursday of this week.
Preceptor the First is....difficult to approach. She's a fantastic nurse, a very nice person; I like her a lot. I'm nervous about working with her, though, because she combines OCD-ness with such a huge amount of personal reserve that it's difficult to approach her with problems or questions. We're in the middle of testing a new computer system in the CCU, so a lot of the questions I had for her were computer-charting-related. Instead of having me fly the box and learn by doing, she would simply take over and chart *for* me as I watched, then expect me to be able to replicate the motions when it was time to do so.
I don't learn that way, sadly. I *used* to, but seven years of hands-on learning has ruined my brain for anything else, and it's probably too late to get a brain transplant and still pass my classroom final exam.
Wednesday ended with an emergent intubation to which I was invited (like Queen Victoria "invited" people to show up in the throne room) by the charge. Rudely. As in, I was in the middle of something else that was just a little bit important, there were already eight people in the room (two docs, three RTs, three nurses), and I got snarled at to come in and start an IV.
Which is fine. I can start IVs all day, with my hands behind my back, in my sleep, you name it. The particular IV I had to start was in the hand, and the dude I was starting it on was elderly, very fragile, and had extremely large veins. In a situation like that, I use the technique I learned years ago of putting the hand way below the heart and starting the IV without a tourniquet, as filling the vein tends to make it easier to blow.
I had gotten a nice, fat, 18-gauge IV into a hand vein when the CN rushed over, grabbed the dude's hand, and said sharply, "What the hell are you doing?" The vein, of course, blew. She then reminded me how to start an IV properly (ie, her way) and gave me a lecture on not losing my head in stressful situations. I looked at her levelly and said, "I have led a code before, you know."
Then I went away after the dude was intubated, started two impossible IVs for another nurse, and was told I needed to apologize to the CN by my preceptor.
It was a bad day. It was such a bad day that I vented to both my Brother In BFE and Sister Rat about it, then went to bed in tears. It was one of those days when you feel you're trying to run up a staircase coated with pig fat while somebody yanks on the scruff of your neck at odd times, making you lose your footing.
Thursday was different. Preceptor the Second is a total goofball. I am a total goofball. Neither one of us have any filters to speak of, so we'll talk about farting over lunch (note: I thought the nurses on my old floor were filterless. I was wrong), do yoga poses in the nurses' station, and eat cake when it presents itself, then be sugar-rushed all day. Besides that, she's detail-oriented in the same way I am, without being totally OCD about small things.
It was still a day when I felt like I was completely behind. I would've drowned had it not been for her help entering orders and turning patients and dealing with the second-largest bowel explosion I've ever seen, but it was a *good* day. A patient who'd been heavily sedated and intubated the day before got better, and I admitted-then-discharged one patient and admitted another (and actually got the swing of getting somebody into an ICU bed, wahoo!).
The charge nurse from the day before was mercifully absent, so I got to send her an apologetic email, doing the last ten meters on my belly.
It is hard to learn new things when you're a new nurse. It's harder--*much* harder--to go from being an expert to being a newbie at something. Your pride takes a hit, your ego gets involved, and you end up trying to prove things when you really don't have to. That much I learned from Wednesday. I learned from Thursday that a preceptor who's just as loony as her intern can make a hell of a difference in terms of that intern setting her (massive) ego aside and actually learning stuff and being humble enough not to freak out about it.
It's amazing what a difference personality makes. With Preceptor the First, I'm a little afraid to ask questions, for fear that she'll swoop in and just plain take over. With Preceptor the Second, nothing's off-limits and I have no fear of looking stupid. Both of them are excellent instructors; there's just the ease of meshing personalities with PtS. I'm learning two different ways of going about things, which is valuable: if one thing doesn't work, I can try the other and it might just make things happen. I certainly don't want to drop PtF as a trainer, but I do find myself a little more tense on those days and a little more wary of what might happen.
Years ago when I was first starting nursing, I got a crazy patient--and I mean *crazy*, as in, I've not had anybody to match her since--and she and I did not get along. This of course caused much hand-wringing with my boss, my preceptor, and the educator for the department. Because I was a new nurse, I couldn't simply say, "This person is a fucking nutjob and I refused to play her game, therefore, she decided to report me." Instead, there was a long meeting with all three of my superiors during which I finally had to come up with some deep psychological reason why I couldn't get along with this person (I said she reminded me of my then, now thankfully dead, mother in law) and listen to a whole bunch of bullshit about how I needed to set personal feelings aside in dealing with people who were nuts.
I had worked for three years at that point in an industry known for being a target for wackjobs, and had actually been a target, personally, for some of those wackjobs. Yet none of that counted. I was PISSED. I was treated as though this job was my first rodeo, and none of my previous experience was taken into account. The ability to call out a nutjob and treat that nutjob as such was taken away from me, and I had to take the fall for somebody else's inability to be a sane human being.
That's kind of what's going on now. It's assumed that I have the technical skill to deal with any number of problems. In terms of the personal angle, though, pretty much everybody assumes that I'm a complete n00b with no clue. It happens more with PtF and the charge nurse than it does with PtS, but that's not their fault; they're trying to make me the best critical-care nurse I can be. It's up to me to lose the ego, gain the patience, and prove that I can do this without completely losing my head and holding somebody's smoking entrails up before their dying eyes.
Which means I will need much more cake.