Quesion: Is this good precepting?

[Jen2]

Hello Everyone:

I just have a couple of questions for all of you preceptors out there. I started my nursing externship at a very busy teaching hospital and am in my third week of the externship. The other day I worked a 12 hour shift and for the first time I took on the entire team. This is what I did:

0800: I went around and did all the assessments. When my patients needed meds I had to go and tell my preceptor what they needed and then she came in with me because I am not allowed to give meds alone. When I was done with my assessments I went back and charted on all 6 patients and went and got my preceptor to sign off. The whole time I carried around the cell phone, answed and fullfilled all patients requests, paged the Docs when needed, called telemetry to see what my patients were running (had 3 patients on Metropolol), and just basically everything. Like I said I just got my preceptor when meds were due, but I had to tell her what the patients needed and at what time and the side effects of the meds. Then I had a quick 15 minute lunch and was back to do the 1600 assessments. I reassessed and charted once more, got my preceptor to sign off, and then I had to call in report on all six patients.

Please don't get me wrong, because I love every minute of it. This is nursing, not like in school, but my question is do all of you precept in the same way? I have heard of GN's and new RN's to a facility that don't even take on a whole team for quite awile and I still have a year of school left. I must know what I am doing, otherwise my preceptor wouldn't be signing my charts. The director of the unit came to me and just raved about how great I was and offered me to stay on as an extern through my last year of school. This is a great reward for me, because most externships are for summer only. This is all new to me and I guess what I am asking is, is this the norm? Do you feel that I am taking on too much, or am I being used? I really don't feel that way, because I am loving it, and I have had such great feedback. I also had my team switched on my third twelve hour day and two of the patients were very upset that I wouldn't be taking care of them and their families talked to the charge nurse about it. Any feedback you could give me would be great. I am open to any comments or suggestions, because this is all new and I am wondering if this is the norm. Thanks.

[leslie :-D]

i have to add that it sounds like you have a lot of initiative....good for you! i've precepted new grads that follow me everywhere and are afraid to make a move. i think it's important that the rn and you collaborate on the assessments...i would let new nurses do them but i doublecheck everything. she should be giving you some direction as to what you should/shouldn't do w/o her knowing....sounds like you're doing great.

[Christine2]

Hello and congratulations on your externship. I remember when I was an extern there was a whole lot of paperwork that went along with the first week of classes before we went to the floor. The one list we received clearly outlined what we were and were not permitted to do as externs. I think we could do assessments but not sterile dressing changes, start IV's, etc. Your hospital should have such a list that you can pass on to your preceptor. As far as handling a full patient load, while staying within the scope of an extern, this will give you invaluable experience with time management, etc. The worse thing when you start as an RN is having your pager going off nonstop while you're a half hour behind on meds.....you will be miles ahead of this. Good luck.

[llg, PhD, RN]

I agree with the people concerned about the legalities. Make sure you are doing nothing on your own that should only be done by an RN.

Also, the goal of the externship SHOULD be to teach you things. While it is great that you are such a "self-starter" and don't need to have your hand held all the time ... where is your preceptor? What is she doing all this time? She SHOULD be teaching you things at least part of the day.

It sounds to me as if this hospital is using you for cheap labor rather than augmenting your education. Perhaps that is not their intention, but unless they are actively working WITH you, then someone is shirking their responsibility to you. As a student, you need to be supervised by an RN and it doesn't sound as if you (and your patients) are getting the RN attention you (and they) deserve.

llg