What Do You Expect of A Preceptor?

NotFlo · Dec 1, 2010

I think precepting can be really difficult, depending on how it is set up. I don't really know how it's done in hospitals, but in the SNF I work at the preceptor is still responsible for their entire (20 patient plus) assignment, all meds getting out, all charting being done, admits and discharges, treatments and dressing changes, juggling labs and doctors and families while trying to give someone a good orientation experience. Many days lately I have been sitting at work charting a couple hours past my shift because of all the time I spent trying to teach the preceptee, allowing them to do as much as they can at their (much slower than mine) pace, etc. I'm looking forward to reading some answers from some new nurses.

shoegalRN, RN · Dec 1, 2010

Looking back to when I was a new grad, I expected the following:

-RESPECT (meaning do NOT talk to me like I'm stupid infront of pts, co-workers, and family members)

-do not gossip or discuss my "mistakes" with those in your clique at the lunch table.

-do not "micro-manage" by standing in the doorway with your arms folded watching me like a hawk. Then you wonder why I make little mistakes. It's because I'm nervous that you sitting there trying to be intimidating watching me like a hawk with your arms folded across your chest.

-please understand I am trying to build confidence in myself and my nursing skills. If I ask a question for "clarification" (maybe TWICE at the most), this don't mean I'm "not getting it". It means I respect your opinion about my nursing judgment and I want to make sure I'm just as strong as a nurse you are some day.

-please keep me in the loop. If you feel I am not "up to par", do not send a mass email to the DON, the educator, the charge nurse, and other preceptors talking about all my mistakes, but yet, tell me I'm doing "ok". Then the next thing, I'm pulled in to the DON's office to "answer" to your email. If you are gonna do that, at least CC me on the email and give me an opportunity to defend myself.

-please understand just because something is "second nature" to you because you have been doing it for years, it's still new to me and I may be a little slow catching on. Some people are hands on learners and have to do things several times before they are comfortable with it. And I'm talking about within a reasonable time frame (not something like asking the same questions after 2 months on orientation).

-last but not least, it doesnt matter that you graduated from nursing school many years ago, please never forget how it feels to be new. Treat me the way you want to be treated, period.

joanna73, BSN, RN · Dec 2, 2010

Well as you were mentioning in an earlier thread, it is up to the new nurse to continually review information, study, and adapt to the unit. I am always reviewing because in the end, I know that I am accountable. Also, asking for help is important, especially when performing new skills. However, I would expect that my preceptor be respectful, honest, and somewhat welcoming. I don't need a babysitter, but I would hope they would be patient and fair. I have trained many people when I was a manager myself in the hotel industry, so I do understand how exhausting this can be. Fortunately, I have had excellent preceptors in nursing. I think your experience is whatever you want to make it. Most nurses I have found, are very willing to help when they see a genuine interest to learn, as well as a little humility. Chocolate and candy also helps, yes :)

Orange Tree · Dec 2, 2010

1. Assess my capabilities - If I've never put a foley in a live person, come along with me the first time. If I've done it 40+ times, just point out the supply room.

2. Show me "your" way of doing things. And if you have a little extra time, show me an alternate way that works better for some people.

3. Let me know what your expectations are. Will you be upset if I don't clarify minor details with you, or annoyed that I'm asking too many questions and not functioning independently enough?

4. It would be nice if you liked precepting...or at least tried to make the best of it. Let me know what I can do to make things a little more bearable for you, and I will do it. I do realize that I am extra work.

5. Offer support and encouragement along with constructive criticism. Let me know about difficulties you've had and overcome or mistakes that you've made and learned from.

My orientation is over, but that's what I would have wanted if I had known better.

Blackheartednurse · Dec 2, 2010

Looking back to when I was a new grad, I expected the following:
-RESPECT (meaning do NOT talk to me like I'm stupid infront of pts, co-workers, and family members)
-do not gossip or discuss my "mistakes" with those in your clique at the lunch table.
-do not "micro-manage" by standing in the doorway with your arms folded watching me like a hawk. Then you wonder why I make little mistakes. It's because I'm nervous that you sitting there trying to be intimidating watching me like a hawk with your arms folded across your chest.
-please understand I am trying to build confidence in myself and my nursing skills. If I ask a question for "clarification" (maybe TWICE at the most), this don't mean I'm "not getting it". It means I respect your opinion about my nursing judgment and I want to make sure I'm just as strong as a nurse you are some day.
-please keep me in the loop. If you feel I am not "up to par", do not send a mass email to the DON, the educator, the charge nurse, and other preceptors talking about all my mistakes, but yet, tell me I'm doing "ok". Then the next thing, I'm pulled in to the DON's office to "answer" to your email. If you are gonna do that, at least CC me on the email and give me an opportunity to defend myself.
-please understand just because something is "second nature" to you because you have been doing it for years, it's still new to me and I may be a little slow catching on. Some people are hands on learners and have to do things several times before they are comfortable with it. And I'm talking about within a reasonable time frame (not something like asking the same questions after 2 months on orientation).
-last but not least, it doesnt matter that you graduated from nursing school many years ago, please never forget how it feels to be new. Treat me the way you want to be treated, period.

I had a preceptor from hell,all the points you have made she had!!!

**canoehead, BSN, RN** · Dec 2, 2010

afrocentric

Good points, no wonder you had problems with this preceptor, I would have too.

Leelee2 · Dec 2, 2010

Honesty is golden. If you have concerns, please discuss them directly with me first.

While I don't want you hoovering over me (as mentioned previously)

I also don't want to have to hunt you down, and interrupt your gossip time.

So please be available. Gossip on the floor is very unprofessional and a bad example to set.

Give me daily feedback, both positive and negative. I'm a big girl and I can take constructive feedback.

casi, ASN, RN · Dec 2, 2010

I want a preceptor who wants to be a preceptor and enjoys teaching. I also want someone who is willing to challenge me.

I'd also like it if my preceptor was more than 4 days off orientation. :rolleyes:

gracieD · Dec 2, 2010

The only problem that I had with my preceptor was that if she saw I was busy and there was something to be done (which is pretty much always), she would just go ahead and do whatever to "help" me. This was only an issue when it was not communicated back to me what had already been done. This resulted in multiple calls to pharmacy, physicians, duplicate orders entered, etc. It took away good learning opportunities and added frustrations with other members of the patient care team because they weren't sure who they were supposed to communicate with. When I realized this was happening, I just told my preceptor that I would prefer that she not help me unless I was seriously drowning and asked for help, and if she did something to let me know! Once we cleared that hurdle we worked really well together. Yes, sometimes I struggle but that is when I really learn the most about time management and communication. When I get caught up it feels so good to know that I am indeed capable of doing it all by myself!!

Other things that I expect from preceptors include

- mutual respect

- a knowledge of and adherence to policies and procedures --please don't teach me how to do something just for me to find out later that it is a shortcut or workaround - I don't want to start with bad habits

- specific feedback that is both positive and negative. It's not very helpful to me to tell me that I had a "good day" - think of something specific that I did or remembered so I know you are actually paying attention :)

- think out loud. The experience that a preceptor has likely allows them to assess a situation and jump straight to an action, however I need to either talk through it or hear your own thorough rationale. Personally, I'm far more likely to remember what to do if I understand the rationale for doing it.

Things that I wouldn't necessarily expect but would be nice

- keeping an eye/ear out for other patients who have something interesting going on and letting me know so I can be exposed to new or uncommon conditions, treatments, etc

- including me in the social aspect of the unit. Part of growing into the role of an RN includes understanding the culture of the unit. I'm not saying that you have to dish all the gossip, but introducing me to other nurses, physicians, etc. makes me feel like less of an outsider.

Overall, I think a good preceptor will let you struggle, if only a little bit. I can't possibly prove that I am competent to make independent, safe decisions based on my own critical thinking if I am simply doing what you tell me.

brotherbear · Dec 2, 2010

not necessarily a new graduate here but preceptors at the very least should be able to completely show you the "system" used in the hospital/nursing facility. By that I mean the system for med passes, patient care, e.t.c. They should in addition show you the system that works best. Of course this could be theirs or a method that one of the seasoned nurses uses. they should be responsible for a lot more but those two are critical.

vampiregirl, BSN, RN · Dec 2, 2010

I'm a new nursing grad, but not new to the medical field.

My expectations are similar to afrocentricRN's in many ways. I'll add a few items for my preceptor wishlist though...

Please give me clear expectations on what I need to be focusing on learning.

Teach me what resources I have available and where I can look things up.

Draw my attention to facility or unit specific preferences and explain why or how this helps things to run smoothly.

If there's one particular thing that I just don't seem to be "getting", please try a different approach or even have someone else try to explain it to me. Let me know particular topics that I might want to brush up or further research.

Remember that I'm an individual. While it may take me a little longer to become comfortable with one thing, I may amaze you with how quickly I catch on to something else. Along the same lines, I may learn a little differently than the last 10 people you precepted (do I do better watching you do it once or will I do better with you talking me though it?).

Please give me feedback. If I'm doing something incorrectly, please find a way to bring it to my attention (or I'll probably keep doing it again).

What I've learned about being a preceptee... If a preceptor doesn't seem thrilled about being a preceptor, I try to figure out why. Maybe they've had several preceptee's before me with poor attitutes or a lack of skill. It also could be that they have so much to do and having to precept someone is putting them very far behind. Or it isn't a good personality match - I unfortunately am very inquisitive and very detail oriented. I realize this makes me a challenge to precept, but it also makes me a good employee once I'm trained. I try to figure out what I can do to make it easier to precept me.