I was recently asked “Steph… I’m struggling with my preceptor. I feel like my preceptor is very hard on me and they’re the best at what they do. I feel like sometimes they leave me feeling really frazzled and put on the spot. I know this job is really high stakes and I’m new–should I expect to feel like this and suck it up; just take the intense criticism? Should I talk to them? Am I really cut out for this job?”
It’s Not Always You– Recognizing the Learning/Teaching Mismatch
First, I want to confirm that this culture is one that attracts the alpha-type provider. You can expect high-energy, assertive-types in this wolf-pack. That is the nature of this business. I would learn that it isn’t personal nor a reflection of your shortcomings. We all came here because we’re similar personality typologies. It doesn’t mean that people are “mean” or “aggressive.” That means they may be overly driven and as such, may have a tendency towards being perfectionists and having high-expectations. These individuals may have been trained under high-stakes conditions and simply believe that they must in turn train you that way for you to thrive.
By now, you’re no longer seen as a newly-hatched duckling, fresh out of school, but rather a grown-ass bird who should be ready to hold their own (“fly, buddy! *as you’re yeeted out the nest*).
Some may have been in the business so long, they have lost touch with what it is like to have to begin again. Either way, don’t take it as a personal affront. It isn’t personal. It may be that person’s unique teaching style.
Confidence/Competence and Asserting Your Needs
That being said: you wouldn’t have gotten hired, nor would you still be here if you didn’t deserve to be here.
Further, the fact you care reasserts your place. I discussed this at length in my post about imposter phenomenon (you can refer to it here). It is not unusual to feel those feelings you felt the first time you came off orientation all those years ago: unsure, shakey, and nervous. The combination of alpha-teammates and your uneasiness is a lethal dyad for confidence. I want you to know–you’re fine. The feelings are normal and doesn’t mean you aren’t cut out for this job. There is a difference between your learning style and your provider style.
If you’re coming into flight, you’ve probably worked a little while by now. Recall when you first entered your job: you were probably a very different person than when you left it for this flight job. At your old job, very likely you were probably training the new hires or at least working with fairly new people. I imagine you were confident, competent, and known to be reliable at your position. Now you’ve moved into a completely new field.
It takes a full-year to really get competent in anything new and when you switch, reset the game clock. It can take up to 2-3 years to become truly confident enough to handle anything thrown at you. However, even the most senior staff member has doubts, sometimes–they have just learned how to play it cool and use their resources. Don’t let the air of “nothing phases them” make you question your own abilities.
Coming full circle… if you feel like you aren’t getting what you need from a preceptor, it is probably time to have a talk about your goals, your learning style, and what you need with your preceptor. If your preceptor is as good of a flight nurse (or paramedic) as you say they are, they will understand that maybe you two need to change your approach to the learning process. Your learning is ultimately your responsibility as an adult–you need to take the reins and articulate if you aren’t getting what you need rather than wait until it is too late to bring up that you didn’t get what you needed. Speak up early and ask for what you need.
Plan of Attack: The S%$T Sandwich Method
Generally, what I recommend is this (from some personal experiences throughout my entire nursing career and as a preceptor myself): use the “s%$t sandwich”.
First: articulate what you respect and want to emulate in your preceptor. I don’t mean blow smoke up their gluteus maximuses (maximi?)–be sincere. Take what qualities you want from them and verbalize that you want to adopt from them. Discuss what you think is going well with your preceptorship: what you like that they do or how they do it with you.
Then the s%$t: be honest about what you feel needs to be done differently (and why). If you are a person who needs to learn by doing (a kinesthetic learner), then you need to explain how just reading about procedures isn’t helping you. If you feel like working in a team of 3 people is not helping you learn to function in a team of 2, you need to verbalize the need for one of the teammates to stand back over your shoulder more as a coach to allow you to learn (this is something I myself have struggled with–asking teammates to stand back and allow me to function as a crew member and they watch instead… it is a hard conversation, I know). If you need more simulation time, ask for it. If you need more time with a specialty, ask for it. Articulate exactly what you need in a polite manner that utilizes “I/me” statements than “you” statements (these often come off abrasive).
Finish with a high note: conclude with positivity for how things will continue to go. I like to end things optimistically. This is your chance to express gratitude for your preceptor listening and how you look forward to continuing to work with them. I can’t stress enough: don’t apologize for what you need! THANK THEM for listening but DO NOT apologize for expressing what you need to succeed. Remember… ALPHA-types. Unless you truly have something to apologize for, do not apologize for advocating for yourself. Assertiveness is a respectable quality and one the best providers have.
Not Every Preceptor is for You and That is Ok
Most great preceptors will listen and try to help you however, that is not guaranteed. If after your discussion, you are still finding you are struggling with your preceptor don’t be ashamed of asking for someone else. Thank your previous preceptor and if asked, be honest about your learning style differing from their teaching style. It never has to be a personal affront. Your success hinges on your ability to be able to learn and your team relies on you to learn what you need to function. If someone’s feelings do happen to get hurt, they will heal in time (their egos are their responsibilities, not yours). The alternative is your lack of competence could have worse consequences for your patients, your teammates, and your career’s potential as a flight crew member.
A lot of dealing with preceptors comes down to communication. Sometimes, you and a preceptor will just not click. It is not always learning and teaching styles but rather just a clash of personalities. If you are on the receiving end of hazing or harassment: do not tolerate it. This is not a culture that should be tolerated in flight and I encourage you NOT to put up with it because you feel it is your due. Bullying is not acceptable nor should it be normalized in the flight industry. If you cannot resolve things with your preceptor, I encourage you to bring it to the attention to the next-in-command. No crew member should ever have to work in a hostile work environment when they are expected to be of clear mind to care for human beings. You are worth more than being treated poorly–please do not ever forget your worth and that you earned your place here.
Dealing with preceptors is an issue that plagues both new and experienced providers. Flight is a tricky beast because of the typology of the humans it attracts. While we run as a pack, sometimes we like to partake in the soft flesh of our young. It is getting better but it is not a perfect industry. This is why it is of upmost importance that the new flight provider advocates for themself early and learns to traverse the culture with tact and grace. You worked hard to get here and you will still have mountains to climb to stay here, however, understand that you ARE wanted here and there are many of us who want to truly see you succeed.
-Clear Skies and Tail Winds
Do you have suggestions for dealing with difficult preceptors? Please drop them in the comments below!
Patients will burn you despite you breaking your back for them. The pay will never equal the work some days. Lunches won’t come some days and your bladder will harden to that comparable to those weird frogs that hibernate for years in Australia (I pulled out that metaphor from somewhere…don’t @ me).
should’ve told ya! The acronyms (WHO, CDC, NIH, etc etc) all pressing for social distancing and hand washing (which by the way, I am perturbed by the fact so many people apparently WERE NOT already doing this….) to help mitigate the spread of the virus. Meanwhile, the general population is torn between “the end is near–panic!” and “we’re over-reacting; it’s a media induced frenzy; the flu kills more; it’s a political plot…. *insert more bullshit*” You do have the warm and creamy center that doesn’t really know what to think or just follows advice calmly. (Shoot for the warm/creamy center–its the best part of the Twinkie, guys… and Twinkies survive. Consult every zombie movie, ever. They’re the cockroach of the snack food industry).
go on critical care divert. Do we have an abundance of nursing staff? Again, no. They’re leaving the bedside in masses from retirement of our boomer population (thank you folks for your service), burnout from unsafe/unfavorable working conditions and general malcontent, better work/life balances, and for advancement in careers. Ok, so maybe we have enough doctors? No. That is why medical schools are beginning to offer medical schooling free to certain specialties. It is expensive AF to be a doctor.
Scrubs n' Sirens 