Making most of preceptorship

Trauma Columnist · Sep 15, 2006

Hi and welcome. Congrats on the new ICU job also. It sounds like you have a great preceptor. I confess that while people seek me out as their preceptor, I talk very fast and flit from one activity to the next. I never ever mind my preceptee asking me to slow down and explain things in more detail. I would just be honest and upfront and tell her what you told us: "You are a great nurse and I am so fortunate to have you as my preceptor. I know you've been here a long time but I need to have some more details about...(insert your question here)." Have specifics ready: How to draw blood from an art line, how to wedge with a CVP line, how to talk with families when death is imminent?

Hope this helps...

subee, MSN, CRNA · Sep 15, 2006

Hi, I'm a new grad and I started with my preceptor recently. I love her. She is very experienced and smart. Patients, doctors, and nurses think she's wonderful. She's really is amazing. My problem is that she is too good. She's been here for so long that she can just do things without thinking about it. She knows what needs to be done and she does it. She's a good teacher, but is also very busy (we are in ICU) and doesn't have time to explain every little thing she does. I've already learned a ton from watching her, but there are so many steps that she can skip that I don't even know about.
I guess my question is, how can I learn everything I need to? She's taking a vacation next month so I am going to ask her if she will let me spend a day with the IV nurse and one day with the unit secretary to learn how to enter/remove orders, how to page, who to page, all that kind of stuff. Does anyone else have any ideas for resources that I can use to get a thorough orientation?

no preceptor can teach you everything to need to learn. There's this thing called the learning curve and right now you're in the uncomforable position of being on the bottom. Only time, experience and curiosity will get you to her place.

PennyMarsh · Sep 15, 2006

Blue-eyed RN,

I am in the opposite situation! My preceptor imparts TONS of information. I pick up as much as I can, but at the end of a 12h shift she may ask me about something and I can't remember, she says "We discussed this earlier...." in an impatient tone. This might happen two or three times over the 12h shift. I explained to here that I am a concrete person who needs to do something several times before it sinks in, but I think she is beginning to feel I am an idiot. Any suggestions from you preceptors out there?

BlueEyedRN · Sep 18, 2006

Hi and welcome. Congrats on the new ICU job also. It sounds like you have a great preceptor. I confess that while people seek me out as their preceptor, I talk very fast and flit from one activity to the next. I never ever mind my preceptee asking me to slow down and explain things in more detail. I would just be honest and upfront and tell her what you told us: "You are a great nurse and I am so fortunate to have you as my preceptor. I know you've been here a long time but I need to have some more details about...(insert your question here)." Have specifics ready: How to draw blood from an art line, how to wedge with a CVP line, how to talk with families when death is imminent?
Hope this helps...

You didn't find it too annoying to be asked so many questions? I guess I've heard too many horror stories about preceptors and I don't want to make her regret agreeing to it. I'm such a wimp! Thanks for the advice. I hadn't really thought of just asking her to be more detailed and slow. New grad brains freeze easy when things get difficult. :) Good questions too. I'll add them to my enormous list.

Thank you.

Ruby Vee, BSN · Sep 19, 2006

blue-eyed rn,
i am in the opposite situation! my preceptor imparts tons of information. i pick up as much as i can, but at the end of a 12h shift she may ask me about something and i can't remember, she says "we discussed this earlier...." in an impatient tone. this might happen two or three times over the 12h shift. i explained to here that i am a concrete person who needs to do something several times before it sinks in, but i think she is beginning to feel i am an idiot. any suggestions from you preceptors out there?

you already know how you learn best -- good for you! now you just have to keep reminding your preceptor that you need to so something over and over before you get it. most preceptors really want to help you learn, but it's the rare orientee who gets put with a preceptor who has the same learning style as they do! preceptors know this, but sometimes when you're busy and stressed, it's tough to overcome.

when you get your assignment in the morning, look at your patient and figure out what are the most important things you can learn from that patient and talk to your preceptor about those things. then maybe you can focus on drawing blood from an art line today, over and over until it sinks in. and lung assessments, suctioning, ventilator modes . . . whatever else that particular assignment has to offer. but concentrate on a few things until you get them right. as you start to develope more and more skills, they become building blocks and you can add more and more skills to them.

you should also be studying things on your own. go home and look things up so you'll be better prepared for the next day. so you've asked about blood gas interpretation five or six times today and you still don't get it. go home and review it until you do get it. or until you can ask your question in a slightly different way that might elicit an answer you can more easily understand.

most preceptors will work with you as long as they think you're trying! good luck with your orientation!

Ruby Vee, BSN · Sep 19, 2006

hi, i'm a new grad and i started with my preceptor recently. i love her. she is very experienced and smart. patients, doctors, and nurses think she's wonderful. she's really is amazing. my problem is that she is too good. she's been here for so long that she can just do things without thinking about it. she knows what needs to be done and she does it. she's a good teacher, but is also very busy (we are in icu) and doesn't have time to explain every little thing she does. i've already learned a ton from watching her, but there are so many steps that she can skip that i don't even know about.

precepting is hard work! we all have a sixth sense we've developed from years of experience, and most of us don't even realize how many steps we're skipping until you stop us and ask about them! so stop us and ask us! i'd much rather have you stop me and ask me how i know this or what i've just done since i did it so fast you couldn't keep up that not ask and not learn.

precepting is an excellent opportunity for us to learn, too. when i have to stop to answer an orientee's question, it solidifies my knowlege for me . . . or else it brings home to me that if i don't understand this well enough to explain it, i have some looking up to do! when i stop learning, it'll be time to quit nursing, so keep asking those questions!

i guess my question is, how can i learn everything i need to? she's taking a vacation next month so i am going to ask her if she will let me spend a day with the iv nurse and one day with the unit secretary to learn how to enter/remove orders, how to page, who to page, all that kind of stuff. does anyone else have any ideas for resources that i can use to get a thorough orientation?

a day with an iv nurse is an excellent idea -- sharpen your iv skills! maybe two days. also, a day or two with the unit secretary. you'll learn how things work, who to call, how to call and all that stuff -- plus it's an excellent opportunity to solidify a working relationship with the secretaries. that's going to reap benefits for as long as you work there!

how about a day with rt? if you're in a surgical unit, maybe you can observe in the or. if you'll be required to float to another unit once you're off orientation, ask for a couple of days with a nurse in that unit. if you haven't already done so, maybe a day looking through policies and procedures or a scavenger hunt on the unit. is there another nurse on the unit that you'd like to work with? maybe she's better at drawing abgs than your preceptor or has a different take on support of the family. maybe she'd be willing to work with you for a few days. a day in cath lab, par or pre-op holding to find out what goes there? anything you can think of that might interest you and be a good learning opportunity. your preceptor can let you know what's appropriate and what isn't.

good luck to you!

CritterLover, BSN, RN · Sep 19, 2006

you didn't find it too annoying to be asked so many questions? i guess i've heard too many horror stories about preceptors and i don't want to make her regret agreeing to it. i'm such a wimp! thanks for the advice. i hadn't really thought of just asking her to be more detailed and slow. new grad brains freeze easy when things get difficult. :) good questions too. i'll add them to my enormous list.
thank you.

if she is truly a great preceptor, asking questions isn't going to bother her. i love it when orientees ask me questions. it helps be to figure out where they are, what they understand, and what we need to be doing.

many people get "roped" into being a preceptor when they really don't want to be one. some a lured by a precepting differential or bonus to precept when they don't really have the heart for it. i think that the horror stories you hear stem from those sorts of situations.

every person has their own unique learning style. while it is part of the preceptor's job to figure out how you learn best, it is your responsibility to help him/her by letting them know what is working for you, and what you need more of.

Trauma Columnist · Sep 19, 2006

NO - I really even considered being a teacher when I got my MSN. I do like having new students because it keeps me on my toes too. I think becoming stagnant is easy without some stimulation from new nurses.

BlueEyedRN · Sep 20, 2006

a day with an iv nurse is an excellent idea -- sharpen your iv skills! maybe two days. also, a day or two with the unit secretary. you'll learn how things work, who to call, how to call and all that stuff -- plus it's an excellent opportunity to solidify a working relationship with the secretaries. that's going to reap benefits for as long as you work there!
how about a day with rt? if you're in a surgical unit, maybe you can observe in the or. if you'll be required to float to another unit once you're off orientation, ask for a couple of days with a nurse in that unit. if you haven't already done so, maybe a day looking through policies and procedures or a scavenger hunt on the unit. is there another nurse on the unit that you'd like to work with? maybe she's better at drawing abgs than your preceptor or has a different take on support of the family. maybe she'd be willing to work with you for a few days. a day in cath lab, par or pre-op holding to find out what goes there? anything you can think of that might interest you and be a good learning opportunity. your preceptor can let you know what's appropriate and what isn't.
good luck to you!

wow, those are great ideas. thanks!

BittyBabyGrower, MSN, RN · Sep 20, 2006

I find that I go thru stuff really quickly also when I orient....it is just habit and don't even realize I am doing it! Years of experience tell me to just do this or that and I can eyeball something and tell you if it is wrong or if the patient is going to do something bad. Please ask questions! It is hard sometimes for us to break things down step by step, esp if we have been doing it for years!

We only orient on 8 hours now because we were finding that 12 hours of us talking and the orientors going cross-eyed wasn't productive LOL And to be honest....I am ready to quit talking after 12 hours LOL We send our new people to the secretary for 4 hours, we have them go with RT for a few hours when we get to vents so that they can do the competencies with them.

Good luck!!!