Thursday, December 03, 2009

I feel kind of sorry for my preceptor.

Preceptor The First, that is. Because it's obvious our personalities don't mesh. At all.

Not that we don't get along; we do. She's a very good, very competent nurse. She's excellent with the patients, she never misses a trick, she can be relied upon in a crisis. It's just...well, she's from Venus and I'm from Mars. Or she's from Dubuque and I'm from Dubai. Or she's from Van Alsteen and I'm from the Van Allen Belt (holla!). You get the idea: both of us are pleasant, rational people, but we simply don't click.

Which means that in addition to those long, uncomfortable silences after which both of you turn to somebody else with a small-talk remark, there's a total lack of telepathy.

Those of you who've been nurses (or students, actually) for more than a week know how important telepathy is. It's the thing that keeps you from running into somebody who's helping you set up a monitor; it's that indefinable *something* that lets your coworkers know that you are totally in the weeds and good Frog could you use a hand. That is missing.

So, after I took on a third patient (sometimes they get tripled in the CCU, if one or more of the existing patients isn't complex), I was completely swamped. And the usual wild-eyed looks toward my preceptor as I was tied up on the phone or chasing down a doctor weren't working.

Finally, I went to her with a couple of requests: could she please take X, Y, and Z into room 4 for that patient, and please please pretty please could she do A and B for the patient in 6?

(For the nonce, Patient Number Four was uncomplicated but liked to chat. And Patient Number Six was stable, but had one of those oh-God-please-don't-let-the-pump-fail drips that you have nightmares about, with the extra added bonus of side effects like orthostatic hypotension combined with explosive diarrhea.)

She looked at me for a moment, her forehead wrinkling. "You want me to do *what*?" she asked.

"Take XYZ into 4 and help 6 to the commode. Please."

Another long moment's silence as she studied my face.

"You know, it would've taken you the same time to do that as it took you to ask me to. I thought you wanted some real help."

The new, snark-free Jo did not point out that the fifteen seconds PtF had just wasted in contemplation and in pointing out the obvious made the first part of her statement indeed true. Nor did the new, snark-free Jo retort that this *was* real help; that getting a hard-to-move patient with a tendency to crump while vertical was about the most important thing on my to-do list, lest I spend the next 45 minutes cleaning up one of the side effects of that drug.

Thankfully, another nurse had overheard that conversation and rushed into 6, managed to get the patient up and steady, and worked it so that I only had to scrub down part of one wall when that poor guy's bowels cut loose. (Note to self: explore side effects of any potentially life-saving drug before deciding to take it.) PtF then, to give her credit, hustled away to take care of Miz Chatty in 4, but yeah, that was thirty seconds wasted and another layer of stress I didn't need.

In short, I am not in the mood for philosophical discussions of time management when I ask for help. I *know* I'm snowed; if I weren't I wouldn't be begging.

At the same time, pity the poor preceptor who has to deal with me. I get scatterbrained and stressed easily, and my tone of voice at those times makes some people think I'm dealing calmly with a crisis. I tend to forget obvious stuff at weird times. I'm easily distracted by shiny objects and minor problems. I have a very, very short temper. And, worst of all, I get frustrated--quickly and seriously--by the fact that I don't know as much as I want to and can't do as much as I'd like to as well as I think I should.

So basically, what we have here is a failure to communicate. It's not anybody's fault; it's just the way PtF and I are wired. I'm sure she'll be as happy as I'll be to have the precepting part of our working relationship over and done with; things will be much easier once we don't have to be joined at the hip for twenty-four hours in forty-eight.

Meanwhile, back at Casa del Gato, I just spilled a half-cup of coffee everywhere and have to keep the gatos from drinking it. There's a crisis I can handle.


Crabby McSlacker said...

It sounds like you are being VERY diplomatic in how you describe this! But I'm sure that diplomacy helps you deal with what sounds like a very frustrating person!

Glad the preceptor part of the deal is temporary.

StorytellERdoc said...

Great site. Great writing style. In our ER, lots of preceptoring going on. We only have the most experience clinical nurses in that position, and most of them are very kind and hardworking.

I'll keep reading.

An Open Heart said...

You sound like a saint to me.


Crazed Nitwit said...

Hmmm, you're almost scaring me about real world nursing(assuming I ever get a job...). I know how important time management will be and how easily it can get messed up by unexpected issues and events. I am concerned about coworker relations as well. I will try the non snarky other words I'll keep my yap closed as much as possible.

Your skill is amazing.

Elizabeth Munroz said...

From the patient's end of the bed, I thank you on behalf of those too busy recovering to thank you!

danielle said...

"I get scatterbrained and stressed easily, and my tone of voice at those times makes some people think I'm dealing calmly with a crisis. I tend to forget obvious stuff at weird times. I'm easily distracted by shiny objects and minor problems."

I know exactly how you feel....during a stabilization one time I completely blanked out on how to goalpost an umbilical line. The neo was a wonderfully patient man - he just looked at me and said "I know you know how to do it....but take a deep breath, relax, and let me help you". Seconds after he said that - the mind clicked back on...thank goodness we blank on the minor stuff!
People that work with me for awhile also know that the more stress there is in my situation, the calmer I sound...cause I am trying to calm myself and everything around me down!

RehabNurse said...

Oh, aren't those the moments when, inside your head you really just want to say, "Maybe if you write that time management book, you'd help other nurses." retiring or just quitting.

I would have been bleeding from the cut in my lip. We have an "Efficient Ellie" on our unit, who's supposed to have so much experience.

She uses her experience as a cushion to sit and do crosswords or take any of her 12 phone calls a night, in between those pesky patients.

Example my arse!

Elizabeth said...

Hmmm, sounds like the preceptor issues I have had. My PtF and I didn't gel to well. PtS was awesome but she took a position at a different hospital before I was done. PtT was awesome too!

woolywoman said...

I'd a holla'd on that one. She sounds neither rational nor pleasant, to me.

Anonymous said...

I'm in nursing school working on a BSN degree... I've been so lucky that every clinical situation so far, there has been someone there to guide me through it all. I know that eventually I will go on to pursue a higher degree, and that scenario that you described scares me!! I enjoy reading your blogs, it's so inspirational. I bet you're an incredible nurse.