How can I BE a better preceptor?

ruby_jane, BSN, RN · Jan 31, 2019

I feel you. I have my first nursing student (she's awesome) but Monday (our first day) I spent waaaay too much time talking her through what I did. Tuesday was better because she's a self starter.

SO..... don't feel you have to explain. Or explain later. Orient for part of the shift and then do the things you have to do. If you have a how-to manual of how and why and when things are done, get that out and let the preceptee read it.

And know that you're a good person for asking this stuff. I I've had amazing preceptors and terrible preceptors. The amazing ones ask for feedback.

JBMmom, MSN, NP · Jan 31, 2019

I think a good relationship requires ground rules and then work on both sides. Let your RN or NI know that sometimes you'll be thinking through things as you do them, and you're open to questions, but by stopping too much throughout the process you sometimes find it more difficult to follow through as you would like. I've been on the orientation side in the recent past, and I think the last thing any new person wants is to feel they're a burden to their preceptor. And in order to be successful on a unit, there's some level of self starting expected. But you don't know what you don't know, so as a preceptor I would try to hit the highlights of things that you think are the big picture issues and everything else will fill in with time and effort. Good luck, sounds like you're the preceptor people are lucky to get!

Been there,done that, ASN, RN · Feb 1, 2019

I precepted every body that came to me. My style was watch and learn. I would ask.. what should we do here? Right or wrong, we then did what was necessary . Your newbie will learn by example.

Every nurse I trained , was successful.

Best wishes.

Sour Lemon · Feb 1, 2019

You should have a smaller patient load if you're precepting. There's nothing that will make up for it if you don't.
I always start by asking the preceptee what they'd like to focus on, what they feel they need the most help with, what they never felt like they "got" in school, etc. I also ask them what areas they're confident about so I don't spend an excessive amount of time telling them what they already know.

JKL33 · Feb 1, 2019

34 minutes ago, Sour Lemon said:
You should have a smaller patient load if you're precepting. There's nothing that will make up for it if you don't.

Ditto. And Amen.

****

One thing that came to mind almost instantly when I started reading your post, SarHat17, was that (although there were other significant factors including gross negligence) the patient death for which Vanderbilt was recently in the news involved a nurse who may have been, at least to some extent, distracted by discussions with an orientee while in the midst of performing critical tasks. So I would like to bring that up as a caution and reminder above all else (including our desires to be good preceptors).

I am "an assume-nothing/start-from-the-ground-up" preceptor. With that said, I don't involve orientees in my entire patient load at the beginning. Therefore, although I may discuss/review a lot of details with them, it is limited at first by the fact that they're only involved in part of the assignment. This actually didn't start for my convenience, I adopted that method because my repeatedly-affirmed observation has been that the orientees learn more/better when they are allowed to develop thorough knowledge of limited/defined situations - - then expanding over time. They are also encouraged by feeling that they have a handle on something, even if it's just one, then two, patients. Etc., etc.

When you are at the front-end of a new-grad orientation, I don't think trying to cover every detail of every patient scenario is safe or effective. It contributes to the kind of problems you are experiencing and often enough leaves the new nurse overwhelmed. As time goes on, more patients are added, yes, but by that point the orientee has been developing a knowledge base all along - so that you still aren't putting yourself in the position of seriously disrupting patient care via a constant play-by-play. As you progress toward the end of the orientation, you are more over-seeing things and tasking, and your focus with the orientee is on pulling things together - again, still not "every step and every move" narration.

I don't know if this will help your situation or not - - and my disclaimer is that it won't be an effective/desirable approach for every preceptor-orientee pair. ?

Good luck. It's excellent that you are concerned about being an effective preceptor. ??