Precepting...

Nurses General Nursing

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Specializes in ICU/Critical Care.

How long should someone work in a particular area before becoming a preceptor? What do you find most difficult about precepting? Do you feel your management backs you up as a preceptor? What do you tell your orientee to focus on with regards to their training?

Our precepting is so disorganized it's a joke. The first time I precepted a new nurse I had no idea. I walked in for my shift and was told, "oh, by the way, you'll have a new resident with you." I had no idea what to tell them, what to have them do, etc.

Now I've been around for awhile, and I have still received no formal training as to how to precept. Plus, half the preceptors on our floor have less than a year experience themselves, which to me is like the blind leading the blind.

Specializes in LTC, case mgmt, agency.
how long should someone work in a particular area before becoming a preceptor? in the hospital policy was a minimum of 3 years nursing experience. it was not always followed though. what do you find most difficult about precepting? for me the most difficult thing was giving constructive criticism without sounding like a royal *****. otherwise, finding creative ways to get the new employee to retain what i taught them. do you feel your management backs you up as a preceptor?yes. what do you tell your orientee to focus on with regards to their training?focus on the patients. use everything as a learning experience. learn from failures and celebrate triumphs. i do like to end the day by highlighting as many positives as i can. i tell them to focus on knowing why things are done the way they are. keeping up with charting and not always saving it till the end of the shift.

i am sure there is other stuff i am missing but that sums it up. most of the preceptors have taken a class on precepting. it seems organized for the most part. there is a strict checklist we must go through and numerous checkoffs.

This topic interests me, it's my research paper topic this year. "Quality Preceptorship/Mentorship for new grads related to retention".

There is evidence-based research on this topic recently, to give validity to funding for preceptorship programs.

As a nursing student about to graduate in June, I am seeking a position that has an established preceptor program. I'm looking for quality training and support during my first year as a RN.

Keep up the discussion.... please..... :)

Specializes in SICU, EMS, Home Health, School Nursing.

The state of Ohio requires a nurse to have a minimum of 2 hours of experience before being allowed to become a preceptor for a student. I think that should also be the minimum for new grads/hires also! I know for myself, my first year out of school, I was still trying to figure out things for myself and get into a groove of how I like to do things. I don't think anyone should be allowed to be a preceptor until they have proven themselves to be competent and able to teach.

For me so far, the hardest thing about precepting is all of the frustrations that come along with it. Take for example my situation now... I am precepting a senior level student that is supposed to graduate in June. I am constantly frustrated because we are always running behind. Half the time, I feel like my student is "slow as molasses" and no matter how many times I try to drill certain things into her head, she still continues to do the same things over and over.

I think that my NM and ANMs are supportive of the role. They are constantly asking how things are going and asking if there is any way to improve the process. Upper management is not very supportive at all. About a year ago we lost our precepting bonus.

For my student right now, we have been focusing on assessment skills, critical thinking, problem solving, time management etc.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
the state of ohio requires a nurse to have a minimum of 2 hours of experience before being allowed to become a preceptor for a student. i think that should also be the minimum for new grads/hires also! i know for myself, my first year out of school, i was still trying to figure out things for myself and get into a groove of how i like to do things. i don't think anyone should be allowed to be a preceptor until they have proven themselves to be competent and able to teach.

for me so far, the hardest thing about precepting is all of the frustrations that come along with it. take for example my situation now... i am precepting a senior level student that is supposed to graduate in june. i am constantly frustrated because we are always running behind. half the time, i feel like my student is "slow as molasses" and no matter how many times i try to drill certain things into her head, she still continues to do the same things over and over.

i think that my nm and anms are supportive of the role. they are constantly asking how things are going and asking if there is any way to improve the process. upper management is not very supportive at all. about a year ago we lost our precepting bonus.

for my student right now, we have been focusing on assessment skills, critical thinking, problem solving, time management etc.

two hours of experience?! surely this is a typo!

Specializes in ICU/Critical Care.

I'm sure it is.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
how long should someone work in a particular area before becoming a preceptor? what do you find most difficult about precepting? do you feel your management backs you up as a preceptor? what do you tell your orientee to focus on with regards to their training?

ideally, i think someone should have about five years of experience before they precept, but with the rapid turnover on so many units, that just isn't possible these days. my own unit had 17 orientees last fall so anyone that had more than two years of experience was precepting. unfortunately, for many new nurses two years seems to be a dangerous time. it's about the time they start to feel comfortable in their jobs and are asked to do things such as mentor nursing students, precept new nurses and begin to do charge. some nurses start to believe that they know everything at the time they reach the two year mark, and it isn't until about the five year mark that they begin to realize how little they actually know.

if a nurse is experienced -- more than five years as an rn -- they should be able to start precepting after a year in their present position. especially if the previous experience is in the same specialty. a nurse who has worked five years in sicu, for example, then moved across the country for their spouse's job and began work in another sicu may be able to precept a year later. however a nurse who worked in picu, er or med-surg for 5 years, then moved across country for his spouse's job and began working in micu may need two years before he's ready to precept.

as to management back-up -- it varies. in some institutions, i've had every bit of back-up i've needed to precept, and some forms of back-up i never even needed to take advantage of. in other institutions, not so much. when i worked in boston years and years ago, i found that i was always being floated away from my unit when i was supposed to be precepting, and they'd either stick my orientee with someone else (who didn't know her) or send her home. i didn't feel supported, and the orientee didn't feel mentored! but in my present job, even with the 17 orientees, i find lots of support. i'm an experienced preceptor, though. i'm not sure how some of the newer preceptors feel.

what i find most difficult about precepting is keeping my hands in my pockets! it's so much easier to just step in and do it myself than watch someone struggling with new skills. yet if i do that, my orientee won't learn! so i'm trying to find a balance between "helping" and stepping back and letting them do it themselves.

what i tell my orientee to focus on varies with each orientee. last year, for example, i was fortunate enough to precept an experienced nurse who had icu experience in a small, community hospital. their patients weren't nearly as sick as the ones we get in our large teaching hospital, but she already had the basics down pat. i told her to focus on what's different about our hospital from her former hospital. we spent a lot of time focusing on advanced concepts. this year, my orientee is a new grad. we're focusing on basic nursing care, beginning hemodynamics and remedial drip titration. i'm hoping to foster a relationship with her that enables her to come to me in the future as her assignments become more and more complex and she's ready for more advanced concepts. she won't be on orientation any more, but i can still mentor her.

i'm hoping to form a "preceptor support group" where some of us who have been precepting for a quarter of a century or more can mentor new preceptors as well.

Specializes in Telemetry, CCU.

As a new nurse (1 year on a tele floor) getting ready to go into the CCU, I hope I have a preceptor like Ruby Vee!!!

I wouldn't feel comfortable precepting anyone until I have at least three years in my area of specialty; on my tele floor I've seen someone who had about 10 months of exp. precept, just because some of the "older" nurses are getting a little burned out with it. Luckily the preceptee is a really sharp lady and her preceptor frequently went to the more experienced nurses with questions, but that was still interesting of the manager to do that, to say the least.

Specializes in RN, BSN, CHDN.

I believe you should have confidence in your own practice before you even think about being a preceptor, then you should at least attend a preceptor workshop.

Preceptor is a huge responsibility all your skills should be in place and is something that shouldnt be undertaken lightly.

Specializes in psych. rehab nursing, float pool.

Ideally someone should have two years under their belt on their unit before becoming a preceptor. This is not always followed though. We have preceptor classes which are to be attended now. This was enacted a few years back.

When I precept someone how I do it what I teach is individualized . It depends on what the new staff person needs, how they learn best, what their prior experience may or might not be.

It is both exhausting and rewarding. I find a new employee not only learn from me, but I learn from each of them. The hardest part is giving constructive criticism. I am known for being nuturing of my preceptee. I often will put an arm around their shoulder when I know they are struggling. I listen to them. I also focus on our goal of their becoming autonomous. I describe it to them as being like a parent with a teen and my goal for them is to become independent of me, but know that I am always avalable to them if they need once they are off orientation.

The downside. For those of us who are put in the role of precepting frequently it does put a strain on us. I had roughly 1 1/2 years where I had one new staff person after another. I finally requested to not precept for awhile. I needed to regroup and have the freedom to just come to work , take care of my patients without the additional responsiblity. With a one year break, I now feel ready again to precept.

Funny, the other day at work an Rn came to me and asked if I could show them/ refresh their memory on dobhoff placement. I said yes , I would do that. This was a seasoned nurse who had been a supervisor for many years in another facility. They simply had not performed this for many years. It ended up another Rn asked if they also could watch as they also had not performed the skill for years. Yes, we all three went into the room for the first patient. It went well, I talked outloud as I did the skill explaining not only to the patient, but the 2 nurses they whys and where for alls.

We then went to the next room of another patient who also needed a dobhoff. The original RN then did the placement. It was a good experience for us all. It reminded me I love to teach. They reinforced to me I am a good teacher.

Yes, I am ready again, bring on the new staff.

Specializes in Community, OB, Nursery.

I have been at my current job for 3.5 years, already with some nursing experience, and I still do not feel like I'm ready to precept. There are things that I'd still like to learn, or situations that I'd still like to see before I precept. But you can't just 'make' things happen - some conditions you might not see for years, then all of a sudden, you'll have 3 in a week. I'm guessing, like Ruby said, once I've got another good 2-4 years, I'll be ready to go.

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