First time as a preceptor

[newnurse012]

I have been an RN on a general med-surg floor for about a year now. I was asked to precept a newly graduated RN and am curious about our floor's preceptor program compared to others.

The maximum number of patients for one RN on our floor is 6. I always thought that as a preceptor, I would have no more than 6 patients combined with the nurse I am teaching. And it started out that way. But now that the nurse I am teaching is a few weeks into her preceptorship, I am being told by management that I am to take a full patient load and the new nurse I am orienting is to take a full patient load. This makes me uncomfortable because I feel responsible for double the patients and don't have the time to double check everything my orientee does because I have my own 6 patients to keep track of. My question is this.... if the new RN makes a mistake with one of her 6 patients while on orientation, who is responsible? Would it be her (she is an RN, afterall) or me as her preceptor since she is still on orientation for a few more weeks? I have asked management at our facility and they won't give me a clear answer, saying things like "well, your orientee is an RN so she can be held responsible but you are her preceptor so you still have some responsibility too". But they got angry when I said that I wasn't comfortable having 2 full patient loads while orienting a new nurse.

Thanks in advance for your thoughts!

[evilolive, BSN, RN]

Oh god no, that is just a mistake waiting to happen for the both of you. I have precepted two new grads in the past year, and we have shared the same patient assignment of 5 each time. You are responsible for teaching the new grad the ropes, and although he/she is licensed, I would probably venture to say you're responsible for the patient assignment at the end of the day.

If your immediate manager does not listen, go up the chain. Not safe. Who cares if they get angry. I say you should get angrier!! :)

[I<3H2O, BSN, RN]

First of all, a RN who has 1 year of experience I don't feel is qualified to precept anyone.

On to the question at hand, There is no way that you this new nurse is getting an adequate training if she does not have a "go to" preceptor. Let's face it, you are not going to be even remotely available to her if you have your own team of patients. I think you AND she should be upset about this situation.

At my facility, new grads get 6 weeks of training. At first, the two nurses take on a full team of pts. As the 6 weeks wears on, the new hired nurse gradually takes on the team little by little. The precepting nurse gets to be totally available to the new grad. Once the new nurse is taking the full team, this is the chance for the preceptor to teach new/better time mgmnt strategies, giving an adequate report (I find that new grads often don't give a good enough report as they are not required to do so when they are in school), prioritizing, "tricks", etc.

I think that you and your new hire need to both go to your nurse manager and talk to them about this situation.

[laRN1]

I'm currently precepting. I would not want to be associated with the situation. Both you and the preceptee should be angry. The hospital is playing with your licenses. As ScoutLeader wrote, you and the preceptee should have the same group of patients with you staying available to your preceptee for support. Near the end of this orientation period, the preceptee should function independently. Keep us updated.