Advice about getting a preceptorship!

[foreverLaur]

I recently picked up a few shifts on a random floor at the heart hospital where I work (I work in another hospital there, in psych). It turns out that I LOVE the floor. The heart hospital is somewhat unique in that it has 7 floors and they are divided by specific types of heart problems (cath lab, heart failure, eletrophysiology, post-ops, etc). Each floor may have a med/surg type patient, a step down type patient, or an ICU type patient. If a patient improves or goes south, the room does not change - that room just becomes an ICU room for example. So I love the variety. I have worked a few shifts on the heart failure floor and have decided that is where I want to work and ultimately want to focus my nursing career. I had a meeting with the nurse manager yesterday who said she would definitely allow me to precept there this fall (my last semester). All my school has to do is submit the application. I was REALLY excited because I have already learned a ton of this floor in just a few shifts (more than in clinical, honestly) and the nurses are so great at teaching. I was so excited that I went and met with our preceptor coordinator this morning. She said NO, I cannot precept there. They only allow students to precept on med/surg units. She had no good reason as to why. I have done THREE clinicals in med/surg, one in pediatrics, one in OB, one in rehab, and one in psych. I have taken a trauma and critical care elective courses through the nursing department. The unit is willing to precept me. I was appalled. I went to the dean (who is interim) and she said to avoid controversy and keep staff morale high, she is going to side with them on everything. I don't know what else to do. I feel like not being able to precept here is going to greatly damage my education. I have a 3.8 GPA and nothing but stellar reviews from past clinical instructors. What can I do to stop my nursing program from hindering my education and potentially a future job?!

[classicdame, MSN, EdD]

sounds like an over-reaction. You really need to get all the general stuff down pat first, especially assessments. Just another loop to jump thru and then you can go back to where you want to be. I do recommend you stay in touch with that unit's manager.

[PghRN30]

Honestly, if that's your school's policy, there is not much you can do about it. It does stink and sounds like a very interesting unit to work on. What you could do is sit down with that nurse manager again, and let her know that unfortunately your school will not allow that preceptorship, and do express your interest in possibly working there after graduation. Find out if they would even hire new grads first off, and find out about possibly working there more now, so you can learn more about that floor....which would also make yourself, as well as your work ethics better known to both her and the other nurses on the floor. And even though you are not precepting there, if you were working there, with them knowing you are a soon to graduate nursing student, they will probably teach you as much as they can.

[Double-Helix, BSN, RN]

I'd try again to convince your preceptor coordinator before giving up. Here's some things you might be able to do to get her to side in your favor:

1. Have a talk with the unit manager about the types of patients on the unit and the skills and comorbidities that are most frequently seen. Patients with heart failure also tend to have a lot of other issues: diabetes, obesity, PVD, hypertension, etc. They also get sick with other things, such as pneumonia and infection. There are all things you will see on a med-surg floor. Does this floor have post-operative patients? Wound care? Patient's with ostomies? Any patients on ventilators or with tracheostomies? Make a big list that focuses, not on the cardiac care, but the more med-surg stuff.

2. Compile a list of the skills that you completed in previous med-surg clinicals, including how much time you have spent there. Include your grades from clinicals and lecture and any clinical evaluations that show that you excelled in those clinicals. If you don't have evaluations, ask for letters from the clinical instructors.

3. Finally, write a mini-speech to say to your preceptor coordinator. Explain what you have already done in clinicals and present the material that supports that you have learned the med-surg stuff well. Explain your goals for the future and how you believe that the heart failure unit should be considered for your preceptorship. Then give her your information that shows the diversity of the patients on the unit, and how they really are the same patients that will be found on other med-surg units. Then, make sure that you mention that you already have the permission of the unit manager to precept. Give your coordinator her contact information in case she wants to discuss the arrangement in more detail.

Don't forget to include a few "schmoozing" statements to help your case. Such as, "I understand that it much be really hard for to coordinate the preceptorships of so many students. I can imagine it's a very difficult job. I want to help as much as possible and come up with an arrangement that works best for both of us."

Oh, and one more thing- see if you can actually find anywhere that says students have to precept on a med-surg unit. Review your nursing handbook, policies of the nursing school, etc. Ask the dean or an instructor if she can direct you to the place where you might find these policies. Because I really doubt there is a specific policy that states, "All students must do their preceptorship only on a dedicated med-surg unit." And if their isn't a policy, then it's just opinion. Be sure to mention that during your next meeting with your preceptor coordinator.

There comes a time when you need to take your future and education into your own hands. This is it! Good luck!