Attn: RN Preceptors - questions for you

bostonrnbsn · May 15, 2013

What do you look for in a new grad that will demonstrate he/she is going to make a good nurse?

I think a new nurse or really any nurse should be a team player and flexible, sometimes things change at the last moment and it always help to have a good attitude about it. I also like when new nurses ask questions (no matter how stupid you think it is) because it shows me your trying to process the information and want to learn. And hey, sometimes I don't know the answer and end up learning something too. It always makes me nervous about the new nurse that doesn't ask questions. Another great quality is the ability to take initiative, which could be as simple as taking a manual BP while your in the patients room versus tracking down the nurses aides to check that patient's BP next.

Do you have any examples or stories to share of good or bad experiences?

I appreciate when a new nurse arrives a few minutes early to drop their stuff off, find a pen and start looking through our patients for the day. I understand it's not possible for everyone, due to commute time or kids, etc. but those nurses usually are more prepared for the day. The last nurse I precepted arrived every morning at 7am, and our mornings were more hectic, despite my advice. I'm not sure if that was the answer you really were looking for, sorry!

Have you ever recommended a new grad for a job after being his/her preceptor?

I've never been a preceptor to someone who wasn't already hired, however I have recommended some of the nursing assistants who have passed their nursing boards.

What kinds of things do you expect a new grad to know, what do you expect as far as gray areas and learning/teaching opportunities?

I see new grads as a clean slate! Well, I expect them to know the basic meds and to look up meds they are giving they are not familiar with. FYI, don't give a med that you don't know why you're giving it or what it does. If you're giving a beta blocker for instance, check what the patient's HR and BP is prior to giving it.

When paired with a new grad, does anyone from the recruitment department ask for your feedback? Do you give an evaluation? Does it just go on file, or does recruitment look for areas for that new grad? (I know this obviously depends on what's available and whether they're hiring at all, etc.)

Again, I've only precepted nurses that were already hired.

Anyways, hope you have a great experience this summer. If you go to your externship every day with an attitude that you're ready to work, I'm sure you'll succeed. Stay positive and network with everyone, you never know who you'll meet (NM or CNO). Good luck!

SwansonRN · May 15, 2013

I'm not a preceptor yet,but I did have an internship that turned into a job offer. I agree with the previous poster when she said network and be kind to everyone. Towards the end of my internship I got into a conversation with someone about my clinicals and school and how I didn't like my pedi rotation, but loved working with adults etc. Afterwards my preceptor came up to me and said, "you know you were just talking to the director of nursing, right?" I had no clue. Not saying she got me the job, but you never know who you might connect with! Don't be afraid to mention how much you'd love to stay there as a nurse. Management likes to hear that!

classicdame, MSN, EdD · May 16, 2013

Ask questions. Find out the rationales behind decisions. Be willing to help. Put your cellphone on silence and only access it during a break and while out of public view. Read up on conditions/medications/procedures that you encounter, then ask why they were done. Why, why, why for everything. Good luck!

nurseprnRN, BSN, RN · May 16, 2013

"Why did you make that choice? Why did you choose that priority? What went into making that decision? What was the first one of those you saw/did/cared for, and what did you learn from it? Why do we care about _____ ?"

All these and related questions will help you start thinking like a nurse.

BrooklynRN11201 · May 18, 2013

thank you all for your comments - really appreciated!

I do know the Medical Director at this particular hospital and when I told him I will be in the nurse extern program this summer, he insisted that I stop by his office and sent me his professional info. I don't know if that means anything but I'm hopeful.

regarding the cell phone advice, I have a ton of nursing apps on my phone, including a Micromedex for all meds which I've used throughout my clinicals - but would you suggest the ol' drug book instead? I suppose if I'm near a med cart, it's obvious but I don't want people to think I'm texting or checking my Facebook page!

I'll never forget my one day preceptorship in the CCU this past semester - we were cleaning a sedated patient who was ventilated and had multiple lines including a swan ganz. she was obese and we were trying to clean her and assess her skin and she started desatting very quickly while in Trendelenburg. I was a little freaked out, and quickly raised the head of the bed back up and listened to her breath sounds and the RN said "you're going to make a great nurse" haha I also took a lot of initiative while she was busy with a more critical patient, I kept cleaning another patient who was expelling potassium over and over and over (to put it lightly). And when I accidentally broke the last magnesium piggyback in her pixus (those things are hard to reconstitute sometimes), I turned around and went to the satellite pharmacy to get a new one without her even having to ask. She told me to visit her the next time I had clinical on a day she was there, and I did, but another nurse told me her mother was sick and she couldn't make it in that week, so I left a thank you note with her - I will never forget that experience, I learned SO much more than just on a regular floor with my clinical instructor and other students - so I'm very excited for this opportunity.

I just want to make a good impression and learn as much as I can - thanks so much for the advice!

jadelpn, LPN, EMT-B · Jul 5, 2013

Yes, use a drug book, and not your phone. It can appear that you are using the phone for non-nursing things. Not to mention that some units have rules about phone use, wireless needs an encrypted device....lots of things. So to be on the safe side, use books or the information available to you from the facility itself.

Best of luck!!

classicdame, MSN, EdD · Jul 5, 2013

at your level I would expect you to come prepared. Know what are the common diseases/conditions treated on this nursing unit, and the common therapies. I would NOT expect you to know all about the procedures and meds, but you should know what to ask me about. I would expect you to volunteer for experiences, even without me. For instance, blood transfusion, bedside procedures - get involved. The more you do the more you learn. Recognize what you DON'T know and ask for help. I frequently arrange for students to go to Same Day Surgery, ER or the Cath Lab to learn how to insert IV's. Please, do not be too proud to assist the CNA's. If you cannot do basic nursing then you are not getting the big picture. We take care of the whole patient.

roser13, ASN, RN · Jul 7, 2013

The fact that you're asking already means that you're off to a great start. :yes:

aachavez · Jul 8, 2013

I'm up for mine soon too, keep the great advice coming!

BrooklynRN11201 · Jul 8, 2013

thanks again for all the fantastic advice!

I'm entering week 3 of the program and am in LOVE with the ED so far. I enjoy the quick turnaround - I get to provide care for new patients over and over, each with a different set of issues. It's a great learning experience. I actually feel like part of the team already - people ask me to do stuff I never did in NS - the only thing I'm not allowed to do is administer meds IV push.

In the acute area, I've done everything from changing beds and putting patients on bedpans to drawing blood and inserting IVs. In the critical care area, I assisted with CPR on a cardiac patient who sadly didn't make it, helped prepare the body and send to the morgue, etc... and then later that day, I assisted with another cardiac patient who did make it. I also assisted with two intubations and watch a femoral line be put in!

In the trauma unit, I asked the physicians if I could observe ALL the procedures - sutures, staples, bone resetting, cast application, even draining of an abscess (I actually almost passed out from that one - damn vasovagal)

Anyway, I just wanted to post again to let you know the advice definitely helped me - I'm not afraid to ask questions and it's made this experience so much better... I always arrive early, I always volunteer to help out and ask to observe, and I brought the med book the first day and was told to just use my phone or the Micromedex on the computer, so now I'm using my phone. I even attended a lecture given to ED nurses and physicians on the early treatment for ischemic strokes (pretty much to push the drug Activase) which was great.