taking students, precepting - page 7

I do not precept and I do not take students. At one time I thought I would never say this. However, students deserve better. I want you to learn and do well and have good experiences. ... Read More

  1. by   MajorAl
    Okay, I precept, both students and new Nurses at my facility, because I enjoy it. I find students to be very challenging, especially when they ask: "Why did you do that that way?" The easy answer usually isn't (and shouldn't be) accepted. (I did it that way because I've been doing it that way for the past 30 years) This keeps me on my toes and helps me stay sharp in a field that I've been working in since 1967. Precepting isn't easy, because we are put on the spot to answer questions. But I remember what it was like back in the dark ages when I began my career. There was no such thing as a preceptor back then. I got a week or so of orientation to the hospital after graduation and then was on my own. I well remember working as a NA (no CNAs in those days) with a Nurse who was as close to retirement as I am now (3 years but who's counting) She hated having students on the floor because then she had to do things right! I guess that's one of the big reasons I look for students because I want to be able to explain why what I'm doing is the right way. Anyway I guess what I'm trying to say is that I think everyone should precept once so that you can "pay back" the Nurse who precepted you and also you will know if precepting is something you should be doing. I agree that Nurses who are not comfortable precepting should not be doing it.
  2. by   GEMINI06
    WOW! Great post! As a student in an entry level master's program, we don't always have the warmest welcome from staff nurses. So not only are we student nurses, we are resented for our program from the get-go. This is usually a common topic brought up at post-conference. Besides the fact that there is a nursing shortage, there is a nursing faculty shortage in my town. So our clinical groups are maxed out. Some of the ways our school has tried to deal with this is that we spend a lot of time with instructors in a lab first semester, and have competency check-offs on skills such as foleys, I.V., injections, even charting. That way, when we get into clinical, our instructors know that we have performed the skills before. Many still like to go with us the first time on the floor so if we have a "freeze" moment, they are there to help. The only thing we can not do is IV pushes and pull meds from the med-cart, so often our instructors end up chained to the med-room and is not available to help. I have had clinical days where the nurse I was working with made me nervous and anxious because she was too involved, and others where I was literally left on the floor with her entire patient load for over two hours (found her in the break room surfing the net :angryfire) There are many aspects to this situation that have been addressed in this post. I can see why people would want to be paid more to precept, and I am all for compensation for their time. My only concern there would be that people may want the incentive, but not the experience...not a good reason to take on students! But to address the original post...More important than teaching is providing safe, compentent care to our patients. Recognizing your limitations is important to meet that goal. And it takes a lot of guts to stand up for yourself. As students, it is our job to learn, and I think we can learn a lot from someone who has the courage to stand up and say "I can not take students because I want to focus on my patient and provide them with the best care I can". I don't think of it as "eating our young" but promoting self-care, advocating for you patient, and reminds us that we can not extend our actions any further than what we feel comfortable with. Thanks!
  3. by   newhome
    Quote from Agnus
    I do not precept and I do not take students. At one time I thought I would never say this. However, students deserve better. I want you to learn and do well and have good experiences.

    Taking students is very taxing and time consuming and frankly at times frustrating, when we are not on the same sheet of music.

    It takes a lot of energy and patience and teaching to take on a student. I don't have it. And when I have a day when the demands are already high I do not need to spend extra time and energy with a student.

    I will accept a student occasionally but not as a matter of routine. Ask me first. Perferably ask me after I know what I am up against for the day. If I have a patient go real sour very fast I need people I can rely on around me not a student.

    I will galdly allow you to do proceedures on my patients when you are with another nurse. However, if I say this patient needs cathed and you waite several hours until you get around to it don't bother. I saw this done when anouther nurse offered to let a student do a cath. The student was with a diffrent nurse and both accepted the offer. Yet more than 2 hours passed and they made no move toward doing it. The patient was suffering. The student with her nurse was not that busy. The nurse who had the patient continued to waite after reminding the student because another hour passed. Finally she did it herself. I am not here to waite until it suits the student to do a procedure. If you want the experience take it now or not at all. Life moves fast in a hospital. Be pro active.

    Be willing to jump on an oportunity when it presents itself. Waiting does not cut it. True you may not be able to jump on every oportunity if you can't because you are taking advantage of another opertunity say so. Say when you will be free and keep that commitment or at least tell the nurse you will not be able to keep it.

    I found myself a few weeks ago trying to explain something to a student and I realized that because it is so ingrained in me by now I do it automatically and could not explain it. For many of us it gets to be that way. I do not want to go back to where I have to think about every detail so I can explain to a student. I want to just do it and be done with it.

    Because you deserve better than what I am willing to offer I will not accept you on. If you are a pia (pain in the tush) for what ever reason I don't want to react to that in an unkind or unfriendly way. You deserve better. I deserve to choose to just do my job without the added stress and challenge of teaching, and being a textbook example because that is what you need right now.

    I did have a student last week for one day. He was within 2 months of graduating. I tried to get him to do the meds. He told me he, "has the procedure down and does not need to do it." He watched me. HELLO. I am not the student. I really do have it down. Either you are here to practice your clinical skills or you are not. I did not respond it was his loss. He watched me do assessments. I had to push him to do assessments and they were incomplete. Why was he even there. What a waste of both my time and his.
    I guess he had that down too. So why tell me why did he even show up if he had everything so down pat that he did not need to do anything. He lef tsaying he would ask to work with me again. I think not. I know this is not every student. But no matter how good you are you take energy that I am not willing to give as mine has become limited as I age.

    You may find that unfriendly but I can assure you you will see more unfriendly if I take you on. You need and deserve much more than I have to give.
    I am just ending my preceptorship in SICU, and I absolutely agree with what your saying and how you feel! I've been a nurse for 10 years, a hospital nurse for 6 of those years. During that time, I've been a student and have had students. As you stated, it takes alot of time to teach someone what you know and do on a daily basis in the ultra-fast pace found in the hospital setting. I have been truely blessed to have the preceptor I was given to help me aclimate to the intensive care setting. She's "Younger and Faster" and more thorough than most. You're probably a great nurse and a great role model. Students on the floor will still benefit from 'seeing' you professionalism. Thanks for sharing!
  4. by   rrepass
    I am a nursing student scheduled to graduate in May 2006. I understand that having a student with you adds to your work load and stress and I am sorry for that. BUT, there is only so much we are able to learn from the textbooks and we need that "hands on" experience. I would like to think that the nurses that YOU are today has a little something to do with your preceptor when you were a student nurse. We all want kind, compasionate AND competent nurses taking care of us and our loved ones when we/they are in need. What a wonderful feeling to know you had a hand in developing and shaping and teaching another great nurse.

    I am very nervous and need guidance when performing procedures with minimal practice and I appologize if this upsets you. I would appreciate any tips you could offer me. Please remember, you were a student nurse once also!
  5. by   mstigerlily
    Quote from Agnus
    I do not precept and I do not take students. At one time I thought I would never say this. However, students deserve better. I want you to learn and do well and have good experiences.
    Agnus, I fully support you and understand. I had an absolutely fantastic preceptor on the oncology floor when I was a student nurse. We did 10 12 hr shifts together. I never felt like a burden to her. She was friendly to me, but always professional.

    She got there early, she had "battle plan" written out for the evening, she gave me her "brain sheets" so I could copy/modify them. Everything she did, she kept a running narration. She called ahead to ask the charge nurse for patients that might interest me. She constantly sought out challenging patients and pushed me to do them, even if I was afraid. She taught me a skill, watched me do it, then pushed me out the nest to fly alone. When I made mistakes (and I did) she was quietly patient, never got angry, went over what went wrong, asked me how "we" could make it easier for me to remember next time or thought up tricks or mnemonics for me to remember. She took the blame for any mistakes, if they required an incident report we wrote them up together and she signed them. She CHOSE to be a preceptor and took a preceptor class to prepare and did it in spite of the fact that she didn't get paid extra - you need something like 250 hours precepting to get ONE 12 hr shift at our hospital. I absolutely loved her and gave her a really nice gift when I left. I see her precepting other students sometimes and they all rave about her.

    In contrast, I had a preceptor as a new grad that I foolishly expected to be like my old preceptor. She did not do any of the above things, in fact did nothing at all. I just followed her around while she chatted with coworkers, patients, doctors. She never introduced me, never taught me anything, never gave me any autonomy or responsibility of my own. When I asked her questions she got defensive. I don't think she is a bad nurse, but I was very disappointed in her as a teacher. Not all nurses are good teachers, some were but have gotten burned out. As for me I can't wait to be a preceptor, I LOVE teaching, that is one of the best parts of being on a postpartum floor. I can't wait to teach students, externs and new grads.

    I do not think people should be forced or required to precept for any reason other than an emergency when the regular preceptors are all sick and no one else is available. It is totally YOUR choice.
  6. by   sjrn85
    What disappoints me in some of these posts is the lack of recognition that Agnus did precept for quite a while. She "gave at the office," so to speak. Instead of recognizing what she gave, some have taken her to task for simply stating she can no longer it.

    I see a lot of entitlement, and little true appreciation for how difficult precepting can be. I would love for students/new grads to remember that we experienced nurses have been in your shoes, but you have not been in ours. You do not know what it is like to try to blalnce pt. care plus be there for the student's needs.

    And what is truly sad is that rather than adapting a preceptor's pt. load to make things more workable for everyone involved, typically management just continues to pile it on.

    I'd love for the students/new grads to read what they've written here 20y from now. I would be willing to bet they'd have a different perspective.
  7. by   rrepass
    I see a lot of entitlement, and little true appreciation for how difficult precepting can be. I would love for students/new grads to remember that we experienced nurses have been in your shoes, but you have not been in ours. You do not know what it is like to try to blalnce pt. care plus be there for the student's needs.

    I'd love for the students/new grads to read what they've written here 20y from now. I would be willing to bet they'd have a different perspective.[/quote]



    ------------------------------------------------------------------------
    My previous post was not meant as an attack on Agnus or anyone else. The above quote assumes that I feel entitled to something....and in a way, I suppose I do. I have been taught that teaching is a major responsibilty of nurses, or health care providers in general. I, too, hope that I will be able to read these posts 20y from now. That would mean that I am still nursing. And you are absolutely correct in saying that I haven't been in your shoes. But since you have been in ours, then surely you can understand how we feel. I am assuming that you may have had some of these same feelings. I understand that the patient load can be overwhelming, but the sooner we students/new grads complete our preceptorships successfully, the sooner you will have more qualified nurses to help ease the load!

    I have worked with both good and bad, nice and not so nice nurses. And....I learned something from each one of them. So, thank you!

    I don't want to be the added stress in any nurse's day. If we could discuss what is expected from each other, I will do my best to HELP you, asking for the same in return. I agree with Agnus!!!! If it is beyond your limitations to do this, BRAVO!! for saying this. It is the "seasoned" nurses that I look up to, admiring the work they do with such skill and finesse.

    I would love to lend an ear for the nurse to vent her frustrations. But, please, I want to learn to be a good nurse too!
  8. by   onconurseRT
    Well....I would like to say something. I saw a quote a long time ago that reminds me of this: In 20 years, I will not remember what one person said, or what one person did, but I will remember how that one person made me feel! I, being a "new nurse" of only a year, hope that every single new grad/new nurse does reflect now and in years to come. Granted- some of it we may laugh at ourselves, however, some of it we need to remember and not forget where we came from. I am taking very carefull notes, because one day... I won't be the new nurse.
  9. by   jesting15
    I'm late replying to this thread, but as full time faculty- teaching and leading 8 students clinically, I am compelled to reply. I know what kind of a day my students will have when I see which Co-RN they have- could be awesome, or could be a day when I warn the student to stay clear of the nurse. I agree with so much of this post- if a nurse doesn't like/enjoy precepting, they shouldn't have to. However, this isn't always possible. I rarely know who the nurse will be on the night I pick appropriate patients.

    I love teaching, and still precept at the job I work part time to keep my skills up. Yes, you're right, it *does* require extra time and work. But, I find it pays off in the end. Admittedly, some may not have the extra energy to give- those who don't want to precept shouldn't have to. Unfortunately, not always possible.

    I counsel all my students when interviewing for their first RN position to thoroughly ask what the preceptor program is: how long? who? vounteer or mandatory? what's in place if the new-grad/preceptor isn't a good fit? support for new grad? support for preceptor? allowances for extra time if new grad needs it? I could go on and on, but this is a start. The new nurse needs the very best shot at success. The new grad I teach or precept may one day be *my* bedside nurse, and I want them to be good.
    Sorry it's so long, thanks!

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