Anybody precepting students?

Gompers, BSN, RN · Apr 18, 2005

Are you talking about the preceptorship you do in school before you graduate? I did one of those, and my unit precepts several students a year.

What's SUPPOSED to happen is that you are to be precepted like a new grad on nursing orientation. That's what we do in our unit. The nurse and student get a normal patient assignment to share, and for the first few days the nurse does everything and teaches the student. Then the student starts to do things herself, with the preceptor right there. By the end of the preceptorship (ours were about 160 hours) you should be acting like a nurse, with maybe an assignment that's a little easier than normal since really it's too short to be a proper orientation. The goal is to have the preceptor doing NOTHING by the time you're done, and you're doing EVERYTHING. The preceptor is always there though, because a student isn't licensed to give meds. I'm in an ICU, and we don't "give" students a patient of their own.

I've heard that with preceptorships in other, less acute areas, that things don't go as nicely. You should talk to your instructor or advisor at school about this before approaching your preceptor or her manager.

Good luck!

zambezi, BSN, RN · Apr 18, 2005

I am a new preceptor. I have precepted one of our new grads/travelers/floats, etc but never a student before this last year.

The school that my student goes to has a clinical path way that shows what is expected of them (and us). I work in a critical care unit, so if there is a really sick, interesting patient, we often pick that one--which is way over his head but a good experience none the less. I try to balance out easy/normal/difficult assignments. I try to let the student chart, do assessments, titirate gtts after discussing it with me, any other technical skills (IVs, drsg changes, ngs, foleys, etc), swan numbers, lab/abg review, etc. For the patients that have a lot going on, he does assessments but I chart them...we discuss all meds changes, etc that need to be made. I try to let him do as much as he can...for the bigger concepts we discuss it first...since I am a new preceptor, I am pretty open with him...I told him that I could get him any experience he wanted but we have a deal, he has to tell me if he is uncomfortable, he is not to do things that he does not feel he is ready for (I am at his side for all procedures, etc anyway but we have discussed this angle just in case). He also knows to tell me if he wants to do more. I think that the best thing this type of partnership can have is good communication...let you preceptor know what you want (in a nice way). Always offer to help with procedures, jump in with both feet, ask questions if its not too busy ...talk with you teacher and preceptor about your concerns. Most of all have fun. I always tell my student that enjoying what you do is the best thing for you and your patients, I when I precept, I try to have lots of fun and make learning interesting (even in stressful situations).

Ali_Oop07 · Apr 18, 2005

Thanks Gompers and Zambezi! I wish I was doing my preceptorship in an ICU (I'm on a general med/surg floor).

Just curious..what reason why would someone choose to be a preceptor? It kinda seems like a headache :specs:

Ali

meownsmile, BSN, RN · Apr 18, 2005

I precept students all the time. Have a student assigned now.

I usually start fairly slowly with them to see where their skills are and how comfortable they are with things. By the second day im usually having them do at least 2 patients, they do the assessment, check labs, orders, transcribe to MAR, do E note on care plans at the end of the day. I will work with them, behind them to see if they are doing ok,, and then they will procede with more patients.

The one i am working with now is doing all assessments on my team, working up labs, orders and in general working as the team leader for the shift. She gives report after listening to report with me, i sit in and will remind and add to what she is telling if she forgets something pertinent.

I always go with her to pass or give any meds. I am with her for any procedures, etc. Those things cant be done without supervision. I always make sure i go n and do my own assessment of patients and review her assessment to make sure she hasnt missed anything.

You may have time to answer call lights, etc. Thats something i do routinely anyway and the student should be able to do it in between her jobs too.

The BIG thing is communication with your preceptor. Go to her and tell her what you feel you need, want to experience etc. If there is something you feel you need guidance with tell her, remember she cant read your mind.

sbic56, BSN, RN · Apr 18, 2005

Thanks Gompers and Zambezi! I wish I was doing my preceptorship in an ICU (I'm on a general med/surg floor).
Just curious..what reason why would someone choose to be a preceptor? It kinda seems like a headache
Ali

The way I look at it, being a preceptor is like an investment, especially if I am going to be working with the preceptee someday. Work harder now, so I can work easier later!

Long Term Care Columnist / Guide · Apr 18, 2005

I'm a fairly experienced preceptor. The very first thing I do is assess the student---where she is on the learning curve, what she likes/dislikes, what her strengths and weaknesses are, and what she wants from the 120 hours we will spend together. The first couple of shifts, I have her 'shadow' me so she can get the 'lay of the land'.......where things are, how admissions/discharges are done, paperwork, etc. Then I'll start her off with one or two patients, depending on her level of comfort, and we gradually work up to where she takes most, if not all, of our assigned patients and I'm shadowing her. This way, the student is relatively comfortable with a typical patient load by the time she's done with the preceptorship, yet she knows she's always got backup if she hits a snag.

A lot does depend on the student, of course........I've only had one who I felt wouldn't make it on a med/surg floor, and that was hard for both of us. (I heard later that she quit during her last term of nursing school and went to work in a bank.) I have, however, had some who were really on the ball---knew what they needed to do and jumped right in there and did it. I love helping to develop these students.......I encourage them to use their heads and do that critical thinking that's so important out there on the floor, and I tell them to grab as many learning experiences as they can during their preceptorship, even if they have to work with different nurses during those times. It's a lot of fun! :)

zambezi, BSN, RN · Apr 18, 2005

Thanks Gompers and Zambezi! I wish I was doing my preceptorship in an ICU (I'm on a general med/surg floor).
Just curious..what reason why would someone choose to be a preceptor? It kinda seems like a headache
Ali

The ease or difficulty of a preceptorship for me really depends on the person I am precepting. If they try and are interested in learning then I have fun. Thankfully, I haven't had anyone who hasn't been interested in the position or been fun to work with. I love other's enthusiam. It is diffuclt being a preceptor. You not only have to watch the patients but the student as well. Teaching someone else can throw off the rhythm that you have (it's especially difficult if you are really anal about things like I am). I like my charting done a certain way, everything labeled a certain way, etc. I know that I can't expect my students to do it my way (and I don't expect them to...) but it is hard letting them do it their way all the same. It does crack me up though, when they pick up on my habits and use them when they are on their own...Things that take me a minute to do can take 10-20 minutes after discussing the procedure, doing it and then debriefing it (depends on the skill of the student and the diffuculty of the procdure, of course). Teaching something like obtaining swan numbers, the hemodynamics, rationale, gtt titration can take all semster. But it is so fun to see the studnet learn. When the student finally understands a concept or completes a procedure without trouble, it is a great feeling to know that you are facilitating someone's learning and comfort levels in an unfamiliar environment. Plus I love to teach. Teaching others helps me understand concepts better. It shows me that there is more than one way to look at situations. It helps me teach my patients. I feel it makes me a better nurse- so that is why I precept.