Having a tough time

[uklandrn]

I know I don’t post much and when I do it’s either about my weight loss or a comment regarding the football or basketball team but today I’m asking for a little bit of encouragement.
I have been in grad school for 2.5 years - including summers to obtain my family nurse practitioner degree. I have worked full time up until this semester when I’m required to complete 360 clinical hours along with 3 didactic classes which all require multiple papers and assignments. Throughout my program I have achieved passing grades and high reviews from my preceptors. I have a 3.8 gpa and am in the Sigma Theta Tau National honor society for nurses due to my academic achievement.
This semester I was placed with a preceptor I had never met before. I knew of him through Ron’s family and they only spoke in the highest possible terms about him. I was excited to get an opportunity to learn from him for my final clinical rotation and be able to visit with Ron’s family on a weekly basis at the same time.
I thought things were going well. The patients all like me. I’ve had 3 people in hiring positions for other practices offer me jobs while I was caring for them during their office visit. I’ve had others tell my preceptor how wonderful I am and even a few asked if I was going to stay on so they could transfer their care to me.
Well at midterm my preceptor basically wrote an evaluation stating I’m incompetent and not close to being ready to graduate. He told my professor that I had no clinical foundation and basically do not know what I’m doing. This failed me for my midterm. Since that time I’ve had to jump thru multiple hoops trying to prove my competence. The day after my midterm evaluation 2 providers in the office came to me individually to tell me they feel I’m doing an incredible job and that my preceptor is being nit picky and unreasonable. They contacted my professor (without me even asking them to do so) and told her this. It did not make any difference to her in the least.
So here I sit - 5 weeks from graduation. I have a 3.8 gpa. I’m in their honor society. I’m attending clinical and seeing and treating patients- and my preceptor and professor do not believe I’m capable of being successful.
To say I’m distraught is an understatement. I’m terrified; scared; horrified; and basically feel like I’m being made a scape goat for no reason. I’ve never missed a diagnosis in all my hours at clinical. I’ve never misdiagnosed a person. Their big problem with me is they say I ask too many questions and chart too much. So because I want to be thorough and not miss things I’m incompetent?
Like I said it’s 5 weeks til graduation. On 4/13 my preceptor is going to re-evaluate my progress. Depending on that evaluation is if I graduate or not. I have that pit in my stomach feeling it will not matter what I do - he is not going to pass me. The other 2 providers in the office said if any of the other students in my class were being scrutinized at the level I have been they would be failing too.
I guess I just needed to let it out and tell someone. I’m ashamed and disheartened and a bit bewildered.
So if you have any free time - and don’t care to take a minute or two - I’d like to ask you to say a prayer or two for an old KY girl who knows in her heart she is more than capable of doing a great job if only given the opportunity - even if one person doesn’t think so. Thank you for this forum and all the support you have given me and my family over the past 16 years. You are like family and I hope you never forget that.


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[jazyd]

part of me wants to tell you to tell them to screw themselves but that really doesn't do any good other than giv you satisfaction for a few minutes

See what happens and if bad ask them to explain why they feel that way when so many others feel just the opposite. Why asking questions and being thorough is considered bad in their eyes?

While you are correct, you might have to suck it up and do what they say to graduate and then go back to being a good nurse

My sister was a nurse practitioner and gave it up because of the arrogance of doctors. It happens

I went thru the same thing once as a sales rep. I knew I was right, lost the temporary battle but in the long run I won as the company that gave me grief went bankrupt . Made my day

Hang in, pray about, ask for peace and guidance, it is Easter you know and what a perfect time to pray for Jesus to guide you. Regardless of what happens this semester, don't give up, then he wins. He may just be seeing what you are made of

[ETWNAPPEL]

That was hard to read. I’m so sorry. You have nothing to be ashamed about. I hate that this is happening to you. I will certainly pray for you.

Very often greater good comes from our biggest trials. Hang in there. Do the best you can and put this in God’s hands. You are a strong woman. You can handle this

[CitizenBBN]

That was hard to read. I’m so sorry. You have nothing to be ashamed about. I hate that this is happening to you. I will certainly pray for you.

Yes it was, esp. coming from one of the great people we've had in our group all these years.

I'll have to give this some thought before I have any kind of advice, right now I just want to go have a "chat" with this person. I have a friend in that field, may hit her up for her thoughts.

On a personal note try to keep your head up. Something here isn't right, and it isn't you, but you will overcome this in the end.

[KSRBEvans]

I'm so sorry you're having to go through this. You've been through so much already, it's just not right.

I'll certainly keep you in my prayers. You're a tough person and a real inspiration to all of us who've been able to know you online. Just keep putting one foot in front of the other, like you have all this time.

Some universities have an Ombudsman's office--if yours does, you may want to schedule a meeting and see if they have any thoughts. If you run into a brick wall and have no other recourse, you may want to try meeting with the Dean of your program or the Dean of students. Hang in there.

[suncat05]

Honestly, it sounds to me like you are the person that he is not.
Be who you are. If he can't handle that, it's his loss. I, and many others here have no doubts as to your capabilities.
You will get through this just fine.
Prayers for you and your family. Everything is going to be okay.
And FYI, my daughter is planning to go through the Nurse Practitioner course via the University of South Alabama, and already has sponsorship and a preceptor onboard already.
You will overcome!

[badrose]

My prayer for you is sent and my sentiment mirrors those above. If there is a quantifiable way to support you position, document it the best you can in case you are able to present your argument to a higher authority.

[UKFlounder]

Best wishes. Just keep doing your best. I cannot say how that might work, but that s all you can do, all you control.

I share the sentiments in this thread and wish you good luck and a bright future

Stay strong, friend

[PedroDaGr8]

I'm so sorry you're having to go through this. You've been through so much already, it's just not right.

I'll certainly keep you in my prayers. You're a tough person and a real inspiration to all of us who've been able to know you online. Just keep putting one foot in front of the other, like you have all this time.

Some universities have an Ombudsman's office--if yours does, you may want to schedule a meeting and see if they have any thoughts. If you run into a brick wall and have no other recourse, you may want to try meeting with the Dean of your program or the Dean of students. Hang in there.

I fully agree with this. I would reach out to the Ombudsman ASAP. Additionally, I would reach out to your professor and instead of focusing on what the preceptor is doing wrong, asking what you can do to prove that you ARE competent. Similarly, going to your preceptor and trying this same tactic as well (while unlikely to pay off, it does occasionally work). l Lastly, I would also go to the dean of nursing (and/or medicine) to see what you can do in this scenario. As you don't have a lot of time, fighting this on multiple fronts is going to be necessary to ensure that if any of them can pay off, it does so before the cutoff date. Choose to be action focused instead of afraid, the time for fear comes later after all pathways for action have been exhausted.

While I don't know you like the others, you have seemed like a competent and capable person. From your description, it sounds like most others that deal with you think the same.

[KSRdallen]

Some universities have an Ombudsman's office--if yours does, you may want to schedule a meeting and see if they have any thoughts. If you run into a brick wall and have no other recourse, you may want to try meeting with the Dean of your program or the Dean of students. Hang in there.

It’s best to go with hierarchy first. Start with the professor and document it (and at each point along the way). Then the department chair, then the dean. From there it’s the provosts office or the equivalent. The provost is involved with academic affairs whereas the dean of students is over student issues that are not academically related in most institutions (at least the 4 with which I’ve been affiliated.

Wishing you all the best. Glad to discuss if you want as you move forward. Thoughts and prayers are with you.

[KSRdallen]

I fully agree with this. I would reach out to the Ombudsman ASAP. Additionally, I would reach out to your professor and instead of focusing on what the preceptor is doing wrong, asking what you can do to prove that you ARE competent. Similarly, going to your preceptor and trying this same tactic as well (while unlikely to pay off, it does occasionally work). l Lastly, I would also go to the dean of nursing (and/or medicine) to see what you can do in this scenario. As you don't have a lot of time, fighting this on multiple fronts is going to be necessary to ensure that if any of them can pay off, it does so before the cutoff date. Choose to be action focused instead of afraid, the time for fear comes later after all pathways for action have been exhausted.

While I don't know you like the others, you have seemed like a competent and capable person. From your description, it sounds like most others that deal with you think the same.

Most Ombuds offices deal with interpersonal issues, of which this may be. As a starting point, I’d think this is an academic issue. See below what the Ombuds office does at Ole Miss.

http://ombuds.olemiss.edu/

[Darrell KSR]

Sorry, Niki. I just poked my head in, been on college visits with my son this week, and saw this. I'll ask my wife and daughter if they have any particular advice--I remember my wife telling me about some issues she had with a particular preceptor who was unreasonable, but that has been a gazillion years ago. My daughter is in her last semester of nurse practitioner school as well; she may have some thoughts.

I had one issue with my son and a professor at Auburn University who was basically caught lying in his emails to him, and as a result gave him a "0" on an exam that dropped his grade to a "D" and made him potentially lose his scholarship. Dallen is right, that you need to follow the hierarchy and document everything. By doing so in his case, by the time it reached a certain level of decision-maker, the problem was solved, and if we had skipped some steps, it may never have been.

My thoughts are similar to someone's above--bite the bullet, do it "his" way, and show that you are flexible and competent. My guess is he's coloring this as, "obviously, she doesn't know what she's doing because the patient has already told her what she needs to know to do a proper diagnosis, and she's continuing to ask questions, and write things down." So if you can do it "his" way and get through this, you'll have the rest of your life to do it perfectly in the manner you describe.

But I'll ask this weekend and get back if they have any good suggestions. Thoughts and prayers with you, girl.

[CitizenBBN]

I've thought about it, and my advice, seriously, is to take DAllen's and Darrell's advice. Two of the smartest guys you'll ever know, and they know this stuff. But do NOT give up, and be willing to move up that chain and stand up for yourself. I don't worry about that with you a bit, but just encouraging.

If you can find the way to turn this guy that's the win, and you should try as Darrell suggested, but be willing to take the other steps.

[KeithKSR]

Use the hierarchy and record all in person conversations.

[uklandrn]

I appreciate everyone who responded to me. I am currently completely all my assignments and clinical hours as necessary and then will discuss my situation with the preceptor on 4/13. If he continues to state I’m incompetent with no knowledge base then I am going to contact the ombudsman at the school and go from there. I cannot understand how I’ve never misdiagnosed or missed a pertinent diagnosis on any patient and the reason I’m possibly going to fail is due to my order of questioning the patient- and even though I ask all the pertinent questions they are sometimes not in the order the preceptor thinks they should be in. I am trying to do things his way - but even if I do I’m not sure it will be enough for him. We shall find out soon. Thank you again.


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[Doc]

Ill come from a different prespective......as somebody who took four attempts to get into Vet school while my peers took two. My third attempt I had a veterinarian write a recommendation and he jobbed me as hard as he could. Cost me another year of my life. But I realize my life was in pretty bad shape, I had spent my first 3 years of college drunk yet managed respectable grades. I contempated burning down Dr G's clinic, thats how pissed I was. But two positives arose from that. First is I rededicated myself, kicked the booze and pulled 2 semesters of 4.0 with mostly medical school prep classes (cellular biology, histology, etc) to prove my academic ability. Second, I firmly believe it made me a far better doctor. See, realistically I wasnt ready however I didnt need a letter of recommendation that said I was a POS and the worse employee this guy ever had.

I suspect worse case is you repeat that rotation however I'd not be shocked if the initial evaluation was an attempt to motivate you farther, which it sounds as if it did. Im not a fan of that...sort of the coach who tears down a player then builds them back....to me that is idiotic but some do hold that as a valid method. I'll also add that if it was his concern, the excessive questions, I've had people who work for me that fall in that catagory. Sometimes its taken as questioning what Im doing, and sometimes its just plain annoying and seen as not asking questions to learn but rather to ask so they can show off. I dont know your situation but I hope its he is trying to motivate you to do your best.

[uklandrn]

Doc - I totally understand your point. The only thing is I’m not asking questions to show off or show him up - I ask because I am trying to be thorough with my history so I don’t miss anything. I’m definitely motivated - he doesn’t need to worry about that. (Lol). I guess my issue is I think he is an incredible provider whom I’d send anyone I care about to for care - I’ve learned so much from him and I never cease to tell people this. I want to be him when I grow up. It’s just difficult when I am the person doing the history and physical exam and he is using the information I report to him as his diagnosis and treatment plan yet he tells my professor I have no knowledge base and I’m incompetent. I try to look at it as a learning experience or a trial to overcome- but In my adult life feel I have had plenty of obstacles and trials to overcome so at this stage all I want is a fair chance to succeed without someone playing games or sabotaging my career.


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[Doc]

Doc - I totally understand your point. The only thing is I’m not asking questions to show off or show him up - I ask because I am trying to be thorough with my history so I don’t miss anything. I’m definitely motivated - he doesn’t need to worry about that. (Lol). I guess my issue is I think he is an incredible provider whom I’d send anyone I care about to for care - I’ve learned so much from him and I never cease to tell people this. I want to be him when I grow up. It’s just difficult when I am the person doing the history and physical exam and he is using the information I report to him as his diagnosis and treatment plan yet he tells my professor I have no knowledge base and I’m incompetent. I try to look at it as a learning experience or a trial to overcome- but In my adult life feel I have had plenty of obstacles and trials to overcome so at this stage all I want is a fair chance to succeed without someone playing games or sabotaging my career.


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I don't mean to imply you weren't motivated or you were trying to show off. I'm merely suggesting that may be what he is seeing.

I've had numerous vets work for me. Some do things different than I would do and I try to not let that affect how I see them. Oh, at times there are some REAL head scratchers. However I take it as an opportunity to fix. My partner takes it totally different. His response is more like what your situation appears to be. Of course we are dealing with people who are done with school and suppose to know what they are doing because they have both a degree and a license, but its a similar mentor/mentee relationship. What you do reflects back on him so its a tough line, but I sense that in the long run it will work out fine.

[uklandrn]

So the latest from the world of the surreal. Today I found out my preceptor has NEVER passed a student he has precepted. This includes at least 5 people I have found out about. In a funny way it has actually made me feel better and realize I’m not the incompetent person he had me believing I was. I’m working this week with a different provider (mine is on vacation) and it has been amazing. I’m hoping I can possibly change to her for the remainder of the semester. If that is the case I will pass with flying colors. Thank you for listening.


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[CitizenBBN]

That's very interesting, in a very dark way. I'd think the school would find that to be a very non-useful person for such a role if he just fails everyone.

[Darrell KSR]

My wife's advice was to see if the preceptor had ever done it before. I guess that answer sort of tells a story.

Pretty cool. You get to be the first he passes. Use that as motivation for a ground breaking opportunity!

[Doc]

Sounds like an asshole, and an egomaniac

[uklandrn]

So for my latest update. My professor contacted my “substitute “ preceptor and they spoke for about 45 minutes Wednesday morning. She backed me up and said my original preceptor had basically berated and broken me by brow beating me and destroying my confidence. It now sounds as if there may be a permanent change in my preceptor- I’m just awaiting my professor to grant permission for the change. As it stands if I don’t have a change I’m certain my original preceptor will fail me. So now I just ask you guys to say a prayer that this works out. Thank you all again for listening to me. I appreciate it more than you will ever know. And if I do pass you all are invited to my house May 18 to celebrate my graduation!!


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[uklandrn]

Sounds like an asshole, and an egomaniac

Yes - but more passive aggressive and backstabbing while pretending to be supportive. It’s awful.


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[CitizenBBN]

His history has no doubt helped you a lot. Anyone who fails everyone isn't teaching or helping, they're just being an ass.

We're all pulling for you Nikki. Sounds like you have someone in your corner, hope it gets you on a better path.

[Darrell KSR]

Sounds good, Nikki.

[KSRdallen]

Wishing you all the best, Nikki. This sounds like it is going in the right direction. Hoping for a positive outcome.

[uklandrn]

Finally got confirmation- I have to be with my original ass preceptor tomorrow but after that I will be with my new preceptor until I graduate!! I’m too thrilled for words!! I’m am going to pass and I’m going to be a Honest to God Family Nurse Practitioner!!! Im so excited! Food and fun at my place May 18 - all are welcome! We’re going to drink a few assorted adult beverages; listen to and sing along to some great music; and eat Cake!! I’m totally serious. I’m going to post my graduation announcement on this board in a couple weeks so feel free to stop by and see the person who has been blowing your feed up the past 2 weeks! And than you all again for your support. My undying love and gratitude to every one of you who took a minute out of your day to talk me down off the ledge! God is good and even when we don’t understand why things happen he does. Sometimes type A personalities can’t let go until they are made to. That was the case here. Thank you again Woohoo I’m gonna be a Prac!!!


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[blueboss]

Congratulations!!


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[badrose]

YESSS!!!