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10 Essential Tips for New Grad Preceptors

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If you’ve been asked to be a preceptor, congratulations! It’s an honor because your organization has hand-selected you to represent them to a new hire nurse. Here’s some helpful tips to make your experience a success.

by Nurse Beth Nurse Beth, MSN (Columnist)

Specializes in Med Surg, Tele, ICU, Ortho. Has 30 years experience.

How do I become a good preceptor?

10 Essential Tips for New Grad Preceptors

TIP #1 Check your own practice

Over time you most likely have adopted, adapted and normalized some work-arounds or shortcuts into your practice. Maybe you carry a pocketful of NS flushes in your pocket, but know you shouldn't. Since you are now a role model to a new grad, go back to the basics, do a self-inventory and know your policies and procedures. 

TIP #2 Be patient

This is the most common feedback I get from new grads and residents “Please be patient with me. You have done this many times, but this is my first time.” It is crushing for a new grad to be asked “Didn’t they teach you this in Orientation?” Just assume that you will have to repeat yourself a few times because everything just does not sink in one pass. Isn’t there a saying that long-term retention takes seven repetitions?

TIP #3 Let your preceptee learn by making mistakes at times

Most of us remember making the rookie mistake of hanging and programming an IV antibiotic but forgetting to unclamp the rollerball clamp. Meanwhile the primary solution continues to infuse, so there's no alarm. Chances are you only made that mistake once, right?

If you observe your preceptee about to make this mistake, and you jump in with “Be sure and unclamp the rollerball!” it will have far less impact than if you let them make the mistake, wait a few minutes, and then send them back in the room for them to discover what they missed. 

TIP #4  Hands off

Literally, keep your hands behind your back and clasped together. Don’t jump in and “do for” them on the computer or during a procedure because you are impatient and want to do it yourself. Instead,  coach them. This is not to say you can’t demonstrate a procedure- you can, but that’s different than doing it for them.

TIP #5 Having a preceptee is a lot of responsibility

It's like having another patient. You will not be as available to your co-workers once you have a preceptee. For example, if you are the go-to person on your unit for starting IVs, you may have to “give up” your role as the expert IV starter temporarily in order to focus your energies on your preceptee. Some preceptors who get a lot of gratification from being the "go-to nurse" may find this difficult.

TIP #6 Give plenty of feedback

Preceptees crave your feedback. If your preceptee is frequently asking you “How am I doing?” it’s a sign they are not getting enough feedback from you. Find time every day to touch base with them on their performance. A good time can be walking out together after your shift and debriefing your day. 

TIP #7 Give specific feedback

Saying “I noticed how you used teachback with Mrs. Wolf when you were telling her about symptoms she should call 911 for when she gets home. You used plain language, too, no jargon. Good job!” is more meaningful than “Good job on the patient education with Mrs. Wolf!”

TIP #8 Give constructive feedback

When giving constructive feedback, frame the gap in performance as a patient safety issue (if it is), with a rationale, such as “Not confirming NG-tube placement with an Xray can put the patient at risk for aspiration” rather than “You forgot to order an Xray.” It’s a slight but subtle difference. 

You can also frame a gap in performance as wanting the best for your preceptee, such as “I would hate to see you get in trouble for coming to work late. Can we talk about you getting here at 0700?”

TIP #9 Speak up...

...when the Charge Nurse sees you and your preceptee as two fully functioning nurses instead of one unit, and expects one of you to admit a patient, while the other one discharges a patient. You are one unit, especially in the first few weeks. Consider you and your preceptee to be “joined at the hip” to provide the most teachable moments. Your primary job is to teach your preceptee, and the best way to do that is when you are together.  Recently a nurse I know left her preceptee alone to go help a colleague extubate a patient.  A doctor and procedural team then rushed in to the preceptee’s room to perform a bedside procedure, barking questions and orders at the preceptee. It did not go well, and could have been avoided if the preceptor simply said “Come with me and watch while I extubate”.

TIP #10 Encourage critical thinking

For example, if your preceptee asks you "What is a normal pH for ABGs?" you can say "Good question! Where could you find that out?"

After a Rapid Response or a code, ask "Let's talk about what happened. What questions do you have?"

 

I hope these are helpful! What tips can you share with us? If you are a preceptee, we’d love to hear your point of view as well. Also read Reality Shock and New Grads. It's Real

Hi! Nice to meet you! I love helping new nurses in all my various roles. I work in a hospital in Staff Development, and am a blogger and author.

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5 Comment(s)

NightNerd, BSN, RN

Specializes in Med-surg/tele. Has 7 years experience.

I was just told I'm going to have a new grad orienting with me for a month before she goes to night shift. These tips will be super helpful. Thank you!

TriciaJ, RN

Specializes in Psych, Corrections, Med-Surg, Ambulatory. Has 40 years experience.

I do love Tip #9 about being joined at the hip.  When I last precepted, the culture was for the student or orientee to "start with one patient".  That never worked well.  For starters, no one ever felt ready to move past that, and it was hard to monitor the care as well as care for my other patients.

It makes more sense for the preceptee to take report on all the preceptor's patients and work in tandem.  The first day or two the preceptee shadows, then assumes more responsibility under supervision.  Ideally, by the end of the rotation, the preceptee should be able to run with the whole load with some trouble-shooting by the preceptor.

Tip #2 can be challenging in an environment that's hectic and understaffed and no one is particularly patient with us.  But it is important to encourage the preceptee to ask questions and not fear looking stupid.  It's the ones who don't ask questions that are concerning.

Live.Intentionally, BSN, RN

Specializes in ICU, Cardiac, ACLS, ED, School Nurse. Has 10 years experience.

I think Tip #5 is super important.  Being a preceptor is a huge responsibility.  I would precept nursing students for a period of three months at a time, and if I had time off planned I always rethought my plans.  Rearranging my work schedule was also limited because my work calendar needed to revolve around my student.  They needed to complete a certain number of hours in order to fulfill their requirement, and I was always sensitive to that.  If I knew I had something planned, I would find another preceptor colleague and work it out with them, making sure an introduction took place and my student at least was able to recognize who they were before being paired with them for the day.  The perceptorship/immersion was the first "real-world" experience for most students, so giving them the best experience possible in the relatively short amount of time they had was important.

Tweety, BSN, RN

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 28 years experience.

On 4/23/2021 at 8:15 AM, Nurse Beth said:
10 Essential Tips for New Grad Preceptors

TIP #9 Speak up...

...when the Charge Nurse sees you and your preceptee as two fully functioning nurses instead of one unit.....

This ^^^^

This how my manager sometimes thinks, "well there are two of you, so....." 

Also techs think they can do less for you because "there are two of you".  

I love being a mentor and a preceptor and it's my duty, but it's tough most days.  Especially now as I'm precepting a student that was the victim of the pandemic and never was able to do clinicals her last year.

End of rant.

Excellent advice all around. Thanks!

Edited by Tweety

Tweety, BSN, RN

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 28 years experience.

On 4/23/2021 at 4:22 PM, TriciaJ said:

I do love Tip #9 about being joined at the hip.  When I last precepted, the culture was for the student or orientee to "start with one patient".  That never worked well.  For starters, no one ever felt ready to move past that, and it was hard to monitor the care as well as care for my other patients.

It makes more sense for the preceptee to take report on all the preceptor's patients and work in tandem.  The first day or two the preceptee shadows, then assumes more responsibility under supervision.  Ideally, by the end of the rotation, the preceptee should be able to run with the whole load with some trouble-shooting by the preceptor.

This is how I do it.  The first day they just shadow and then start with one, etc.   But I expect them to listen to report on all the patients and us work together while they are concentrating on the one patient.