Advice for new preceptor please

Bump....

I'm not sure if I'm the best person to respond, but I'm hoping to get the ball rolling here. I'm just about to start my first nursing job (don't stop reading yet!) but I have a teaching background and was also previously a director of a small organization and had to train employees and volunteers. It sounds like you're doing a great job and really care about your student learning.

One thing that helped me as a student, and also seemed to help my students as a teacher, is to ask the student a lot of questions. Instead of thinking out loud and saying why you're doing something, ask her why she thinks you're doing something. Instead of telling her the steps or telling her why something is the way it is, ask what she thinks the next step is. If she doesn't know, it's ok. You teach her. But the next day, or an hour later when it comes up again with another patient, ask her and expect her to recall it. If she doesn't, teach her again. She'll remember it next time.

The best teachers I had were the ones who, when I was learning a new procedure in clinical, would go over every step with me outside the patient's room, sometimes using the equipment if possible, and ask me to explain it back to them once or twice. Then when we would go together into the patient's room, I was confident (and the patient wasn't scared). They say the best way to learn something is to teach it. So, when you teach her, have her teach it back to you.

The best instructors I had were the ones who believed in me and had confidence in me. I find that too many nursing instructors and nurses think that critical thinking is something that exists in the nursing world alone. One needs critical thinking skills in just about every career, in parenting, and in most any aspect of life. As teachers we just need to help the student to use these critical thinking skills, which they surely already have if they made it this far in life, and be able to apply it in this environment.

Good luck. I'm sure you're teaching someone who will once day be a fantastic nurse. I hope you don't mind a newbie responded to your post. :)

Thanks NBC, that was helpful.

Anyone else?

I would also encourage feedback FROM her. Teaching styles vary. I agree with above poster- have her tell you the steps (outside the patient room of course). Don't forget to give her positive feedback when she has done a good job. As far as some critical thinking skills- when you get report on patients - ask her what she might expect to see in regards to lab results, symptoms etc. Sounds like you are doing a good job.

You were asking about how often or how to evaluate her progress. If you have a copy of an orientation packet from your facility that has check offs for certain skills etc. you could use this as a base and build or change from it. Having her repeat after you or research something will help her learn it better, sitting down with her and asking her what she thinks she needs to work on or where her weaknesses are will be beneficial to both of you. Maybe she feels she really does know something and does not need to have it repeated. You could use a tool that your instructors most likely used with you during clinicals to check her off on certain skills, that way she can see how much she has done and grown. Having her look up drugs instead of just giving her the answer will help her learn better also. Is there a nursing library at your facility? These are becoming obsolete with the use of the internet and space being very limited in facilities, but you could refer her to resources outside of the facility to help her expand her knowledge. She should learn that the journey in nursing is about learning new things and the dynamic field we work in will always require new learning skills, methods, techniques.

I know your preceptorship is probably over, but I would like to respond too. You sound like an awesome, passionate preceptor. I admire you for being open for ways to improve and help the student learn better. This is an important quality to have as a teacher. Keep in mind that students learn in different ways, so what works for one person may not work for the next. I recently completed my student capstone (190+ hr) and had an excellent preceptor. I completely agree with all the above advice, NightBloomCerus hit the nail on the head for several points.

My best teachers assessed my knowledge by asking me questions then walked me through the steps of the procedure/or rational and afterwards allowed me to apply the information. If it was a more complex skill she demonstrated it the first time while "thinking out loud". After observing that I demonstrated competence on a skill, I liked when the preceptor encouraged my independence and showed me they believed I was capable of doing tasks on my own, but also reassured me that they were available for help and questions at anytime.

My preceptor encouraged critical thinking, prioritization and independence by:

1. Having me receive and give report once she demonstrated how. We would sometimes do a mock trial run prior to me reporting to the next nurse. After report, she would have me look at all the patient's printed care plans and arrange the order of patients I would assess first and explain why (ie unstable/stable, chronic/acute conditions, critical labs, early meds/insulin/tests/dialysis, disorientation/confusion, fall/suicide risks, non-english speaking, grouping patients/care in close rooms ect). I did this from day one, with all the patients she had even if she only assigned me 2 to care for. Then she would tell me her order of assessment and explain why she choose that order. Also explained the overall plan for the patient that day to keep in mind and prioritize later care. This really helped me learn prioritization!

2. Asking me what I would do next (ie patient dysrhythmia, critical lab, low blood sugar)

3. If something was abnormal, she asked me to explain why and how it related to the patient condition. She guided me or answered it if I was unsure.

4. Encouraged me to do EVERYTHING a typical nurse would do in the day. First only for 2 patients including order supplies, call doctors/pharmacy/social worker, admission, assessments, d/c and instructions, education, nursing care/interventions, all computer documentation, charting pie notes/sbars for the 2 patients I was assigned and work up to 3, then 4, then 5. She didn't really give me a option, she just had me do it from day 1 and at first it was intimidating but then after a few days I had it down and was ready for an additional patient.

6. Giving me deadlines for how long a task would take. At first I didn't meet the deadlines and she would ask me what I could do differently and also give me tips to speed up the process. Later she had me independently set my own time frames and meet my goals.

7. She acknowledged and praised me often throughout the day when I did something well or she saw improvement. This really helped me gain confidence in myself and helped me better my weaker areas. We had 3 sit down evaluations and went over a list of performance goals my school had compiled. My school recommended initial meeting to understand goals, midway eval and final eval. She would comment on a couple things to work on at the end of the shift, especially in the first few weeks. As I got better she had less to comment on since I was at the standard expected.

The fact that you are here asking advise on how to be better makes you awesome. I hope that when I get hired I end up being paired with someone that cares enough of how they are doing as well as teaching. Good luck.