How can I be a good preceptor??

URO-RN · Jan 15, 2005

Hi there,

You may want to check out the" nursing staff development "section here at the site. Just scroll down and you will see the forum jump then click "nursing staff..."

Hope this helps.

meownsmile, BSN, RN · Jan 15, 2005

I dont know that there is anything written about being a good preceptor. Try to be the kind of preceptor that you would have wanted. Dont expect miricles from a senior student to soon. If you do you will lose the student quickly and they will question if they even want to be there.

I think when they start writing expectations of preceptors is when they will quit having people even willing to take on the role. If you lose the flexability to work with a student at their individual entry level/understanding you lose the independant thinking skills we were taught.

You have to remember you are there to help the student bring their coursework into focus and show or help them learn to put all the little pieces of the puzzle together so they can function as a competant nurse. By watching and emulating the practices they see in you they will put things together and be able to learn the critical thinking skills they need.

Just my opinoin,, i take on my next senior student in late january. Good luck.

loulou10484 · Jan 15, 2005

this is coming from a new grad experience. I had a preceptor who was really good at asking questions and tying things together. I would understand the "book answer" and be able to spout off answers to questions, but i would sometimes have a hard time knowing what was really important, however, when pointed in the right direction i would begin to understand, and be able to start pulling various information together.

as for a bad experience, i also had a nurse who never seemed to be around when I went to find her for a question. and then later she'd be like oh i'm sorry I don't mean to keep ditching you, but....

nurscee · Jan 15, 2005

I think it is so nice for you to ask this.

I am a new grad/hire. I had very little experience in clinicals.

Don't forget how scary it is to be new and inexperienced.

Let her/him know that it is OK to ask questions, and maybe the same one 10 times!

If she says she is only ready to take on one patient alone, let her. Don't make her take two! What seems easy to you is hard to her. (I speak from experience here).

There's so much documentation, meds and organization to learn. Easing into it is the only way to conquer the fear.

And don't forget to praise her. She admires and looks up to you. It means alot. You have the power to crush her confidence.

You will be a great preceptor, or you wouldn't care. Good for you!!!!

I'm tired of hearing "nurses eat their young"

KRVRN, BSN, RN · Jan 15, 2005

I took an elective in the ER during school, paired with one of the ER nurses. I remember being very embarrassed and disappointed to have him tell me TOWARD THE END OF THE SESSION that I sit toomuch and everyone's noticed and I need to be more proactive.

Okay, sounds valid but let me back up a little. For the first several days, when we first came on shift he told all the other nurses that we wanted to perform their skills for them. So i was going around doing everyone's IV's, straight caths, foleys, etc. Meanwhile, apparently, he was taking care of his assigned pts. So then when there's down time I wonder what to do and he says nothing for now, until there's more skills. So I sit between skills. The elective goes on toward the middle of our time and I wonder again what I SHOULD be doing other than skills, helping out PRN and watching him and the other staff work. He says you're doing fine but apparently he's starting to wait for me to use some nursing logic and take INITIATIVE. Things like, go put a NC and heplock in that chest pain pt while waiting for the doctor. But I don't even really KNOW the role of an ER nurse and he never explained it. Furthermore I don't know that there's standing orders, and that I can use nursing judgment to carry them out, etc etc. So I basically I didn't even realize I should be doing different.

Then, at the end, when there's only a few more paired shifts together he tells me that I sit to much, and everyone is wondering why. WHAT? NOW you tell me that you've been waiting for initiative from a student that doesn't even know what I should be doing, BUT HAVE ASKED? So finally we get some decent communication and then for the last few shifts I did much better. I have to be told or shown at least once for me to take initiative to do some of the stuff he just assumed I would think up on my own.

The moral is to communicate your expectations and don't expect a new person to necessarily know something just because it's second nature to you.

GingerSue · Jan 15, 2005

I was a preceptor. Let the person know when you can both spend time together for the purpose of answering their questions.

In my experience, I was preceptor for people who often sincerely knew as much or more than I did (based on their previous experience before coming over the new place).

HappyNurse2005, RN · Jan 15, 2005

i did an student preceptorship thing this past summer, before my last year of nursing school. did 6 weeks in an ICU, 6 weeks in rehab. so, a good mentor/preceptor, from a student's perspective

-on the very first day, give her a short tour of the unit, especially noting the bathroom, where to put her things, and a fridge for personal food if you have one. sounds basic, but knowing where the bathroom is is quite important

-also on the first day, sit with her and ask her what she wants to gain from the experience, what her goals/objectives are. tell her what you will be doing with her, what you expect from her. tell her to not be afraid to ask you questions, to ask for help or advice.

-introduce her to everyone else working on your unit. when my preceptor did this, it made me feel more included, and not like they were all looking at me wondering who i was.

-on the first few days, show her the basic daily routine, let her watch you. then slowly, let her do more. let her see the routine of a RN on your unit, instead of just letting her do skills for you and others all day. that is one thing we dont learn so much in school, is the routine of a RN's day and how to do it. dont throw her in too soon, and don't wait too long to let her do things on her own. i had one preceptor who waited way too long to let me do things alone.

-provide routine feedback on how she is doing. dont let it become like above poster mentioned where she got to the end and didn't know the preceptor thought she wasn't as good as she could be.

-you'll be fine. both of my preceptors were nice.

Tiki_Torch · Jan 15, 2005

I've been a preceptor an over the years have discovered some things.

It helps in the beginning to assess the best way each new person you work with likes to learn best. For instance, some people prefer to learn by doing hands on procedures with you at their side while others would like to watch a few times and then try to do the procedure with you beside them.

As the beginning be nearby most of the time. You'll know when to let the person do things without you standing right beside them as time goes on.

I've heard complaints from nurses who said their preceptor did everything for them and they felt they never learned how to do anything themselves. This is what happens when you have a preceptor who can't seem to let a novice actually do hands on care. Then there are the other preceptors who let the new nurse loose and are not around, assuming the new nurse knows all she/he sould know. Seems that finding a fine balance is one of the most difficult things for a preceptor, especially because each new nurse is different. (If you are the type of person who wants to push the person out of the way and do "it" yourself, you should instead force yourself to hold your hands in front of you so you won't be tempted to physically take over something when you know they need to be doing whatever it is. Sometimes it's hard to know when you should take over and when you should let them do something... just remember patient safety and comfort come first.)

Beware of the new nurse who acts over-confident because they can be very dangerous. Over the years we have all learned that the new nurse who asks lots of questions, even the same ones over and over, is much safer than the one who wants to dive in alone...

I have found it helpful to talk about a procedure completely while having little examples of what can go wrong and what they should do before actually performing the procedure. I work in Intensive Care Nurseries and an example would be drawing blood from a umbilical catheter. Before we even touch the catheter we talk about everything from needing an order to draw blood to the need for having a heel warmer at the bedside because a complication is lack of blood supply to the lower body and it's possible (although not likely) for a baby to loose a toe. I'll say something like, "It's important during and after drawing the blood to reassess the lower extremities, especially the feet and toes for color, refill and warmth to be sure the blood supply has not been compromised. If you notice that the baby's left foot or toes has turned white, what do you think you should do?" If they don't answer immediately I tell them the importance of having a heel warmer at the bedside because they will want to immediately place it on the opposite foot as this will encourage the blanched foot to refill with blood. Doing some teaching before and after learning procedures has been helpful for the people I have precepted.

It all goes back to the nursing process... Assess before coming up with a plan or implementing a plan. So, assess the knowledge and needs of your new nurse before diving in with anything.

Being warm and receptive helps a lot. Listen very well to what they have to say rather than thinking of what you want to say next while they talk, look into their eyes while they talk. Ask them what they think they need, while remembering that sometimes they have no idea what they actually need. Remind them that it takes at least a year for them to begin to feel comfortable if they are a new grad and to not be too hard on themselves. Also, suggest a couple of excellent books in your nursing specialty which they should get and study at home. My NICU preceptor told me some things that helped me and I have carried on such as the book thing. Each day when we would work with a certain type of patient, I would go home and study up on that child's diagnosis, treatments, etiology, etc. and I can't tell you how much that helped me to really learn! Another thing is that when we would work with a certain patient, we would look at the Policy and Procedure Manual to see if there is a hospital policy concerning that activity. For instance if we are working with a umbilical artery catheter we would look at that policy before we would touch the catheter; this way I was able to learn not only how to work in a certain situation but also what my legal responsibilities at that hospital were too. She also had me look up every drug in our Neofax (little bedside drug book) before giving any drug and she encouraged me to continue this practice even if I've been a nurse for many years... I still do this to this very day and I can't thank her enough!

It mostly boils down to what someone else said about being the kind of person you would want to learn from. Have faith in yourself because someone certainly believes you would be a good preceptor or they would not have offered you the position!!! Kudos to you!!!!

Best wishes for a wonderful experience!!!

Tiki

Fiona59 · Jan 15, 2005

I remember my final placement preceptor. Six weeks of pure hell. My work was great, but she was the great she dog from hell.

Flash forward 2 years and she's now my co-worker. Doesn't even remember being my preceptor

Turned out her marriage fell apart the night before my first shift.

Leave your personal life at home, please. I spent six weeks in fear of this woman because I just couldn't read her moods.

leslie :-D · Jan 15, 2005

i've precepted several new nurses.

and after orienting them to the unit (15 minutes) i throw them right into it, with me present.

depending on their personalities, it will either be baby steps or full fledged hands on care, but again, i am always at their side.

while they are doing the task, i will either ask or explain the rationales and implications of the task at hand.

talk and do, do and talk.

it's imperative for them to understand the whats and the whys and why nots.

once i'm convinced they are adept at a certain skill, i loosen the strings but make sure i am always available and will still always supervise.

i don't hover but do acknowledge that i am responsible for their acquiring and mastering various nsg tasks and duties.

leslie

allele, LPN · Jan 16, 2005

I want to thank everyone for the excellent advice so far!! I'm taking everything to heart! One of my fears is something that has been mentioned a couple of times, I'm afraid that I'll 'forget' she's still a student and assume she'll know a lot of what I'll know. I know it sounds silly, I know she'll need a lot of support and teaching, I just don't want to fall into that trap. I also don't want to be 'hanging' on her every minute. I'm sure I'll reach a happy medium with that and I'll take feedback from her too. I love a lot of the suggestions here and plan to take them with me! Thanks again!!