Multiple preceptors

kcochrane · Jan 28, 2010

I'm with you..as a new nurse I like having different preceptors. I had a few different views and took a little from each. I know some people like consistency and one preceptor is better for them. Of course it isn't always easy since you have to follow that one person. If they have vacation or are out sick you have to find another preceptor.

I'm switching jobs and will have one preceptor for a week and another the next week, since she is going on vacation.

If a unit can obligate someone with one preceptor that is great.

vanlo001 · Jan 28, 2010

I understand the concern about multiple preceptors and this seems like a loaded question. What I hear when I read this is what are these new grads complaining about. Having multiple preceptors is problematic especially for the new grad because each person has to establish where the preceptee is at in orientation. The preceptee may get used to being trained a certain way only to be switched around with someone else who does it a different way. This makes it difficult for the preceptee to become proficient because they are constantly trying to grasp the procedure itself and the preceptors rationale for their way of doing things.

Now our CNS says the same thing to new grads when they complain about to many preceptors and that is by exposing the preceptee to multiple styles they are exposed to more methods of doing things. This especially challenging for the new grad who is just trying to get a foundation to build on. They may not be ready to incorporate different styles let alone proficient enough tobdecide which method works for them. Im way experienced and even I expect a minimal amount of change among preceptors. It also has to do with trust between the preceptor and preceptee and the comfort level between the two that can be helpful in building confidence, allowing the preceptee to be vocal about their strengths, weaknesses and questions and the preceptor being able to provide feedback based on their working relationship and not the he said/she said of the other preceptors. IMHO.

Jules A, MSN · Jan 28, 2010

I understand the concern about multiple preceptors and this seems like a loaded question. What I hear when I read this is what are these new grads complaining about.

Actually just asking for opinions and sharing my thoughts that it has been a plus for me even as a new grad, thats all, but thank you for your detailed reply and reasons why you don't like it.

barlowjb · Jan 28, 2010

I had a main preceptor for my first few weeks, then I was switched to multiple preceptors including my main one. I was thrown off by the switch because I was not expecting it. My biggest issue at the time concerned establishing the level that I was at with each preceptor. Due to the fact that I was keeping a daily clinical log of the things I did during my training, I was able to tell each new preceptor how I was doing and the areas I needed the most help with.

Different preceptors have different documentation styles and the vary in the way they carry out their tasks. Additionally multiple preceptors provide tons of tips that probably would not be obtainable from just one particular preceptor.

I believe that if at all possible the preceptee should be paired up with one preceptor for the first few weeks of orientation in order to provide consistent baseline training which may help smooth the transition to working with multiple preceptors. Since depending on the situation it may not be possible for the new grad to be initially paired up with one preceptor, new grads will have to take the initiative to communicate their learning/training needs to whomever they orientate with.

fiveofpeep · Jan 28, 2010

I had multiple preceptors and it actually sucked even though I am a very flexible person. The reason I hated it so much was because me and my preceptor got along really well and I was with her most of the time so when I switched to others just for one day here or one day there, it really blew my confidence because they had totally different styles and chastised me for things that I didnt agree with nor my preceptor. It definitely helped me grow in dealing with personalities but not necessarily in my skills.

Also, I would actually have less responsibility as time progressed because of this. For example, I would go from doing total patient care for fresh ICU patients in the PACU to just watching when with someone else. I definitely understand how the people who precepted me only occasionally would trust me less because of not knowing me for as long.

I can see how multiple preceptors could help you explore different ways to do things and have experienced that in clinicals, but for some reason the preceptorship just didnt work out that way for me.

kcochrane · Jan 28, 2010

I think it is worthwhile to ask a new hire what they prefer. If they choose only one preceptor, explain that even though you can give them one most of the time, there will be a few times that they might not be possible.

One big downfall to having only one is if you get one that is not good. One example is on my floor we had lost a lot of staff and one nurse that had just got off being precepted was precepting the next day.

elprup, BSN, RN · Jan 28, 2010

kcochrane

Wow what a great idea...ask the new grad what they prefer!? Too bad it doesn't happen. My first several weeks I worked 3 12 hr shifts in a row, got whoever they thought I should be with and it was horrible for me. When I asked 1. if I could spread out my days (that last 12 I was really not learning much because I was mentally and physically drained - but I did it) and I asked 2. if I could have one preceptor most of the time b/c I really needed to learn the fundamentals and felt like I was totally lost with so many different preceptors...just as others have discribed. I told them this b/c I wanted to learn faster, ie save them money. When I asked these 2 things I was treated like I was a baby asking for the world and got answers like, we cannot accomodate your desires and from then on I felt I was looked at as "a problem who asked for too much". Obviously, that job did not work out, and looking back that was a total sign that I never would have fit in there anyway..even though I did and would have given it 150%.

caliotter3 · Jan 28, 2010

Planned changes of preceptor done in a thoughtful and purposeful manner could be a positive. Schlepping the orientee off from one person to another from day to day with no foresight or purpose does nothing for anyone.

vanlo001 · Jan 28, 2010

I'm sorry but how does a new grad know what they prefer. A structured new grad program based on evidenced based nursing education is the best for the new grad. But that's not an option for most new grads especially right now. We asked our new nurses to let the nurse educator know as early as possible if there was an incompatibility. My last job (my current job) I never saw an educator or manager or had a 90 day eval, nothing. I did fine because I have lots of experience but new grads don't know what they don't know and that's why I feel especially protective of them.

kcochrane · Jan 28, 2010

I'm sorry but how does a new grad know what they prefer. A structured new grad program based on evidenced based nursing education is the best for the new grad. But that's not an option for most new grads especially right now. We asked our new nurses to let the nurse educator know as early as possible if there was an incompatibility. My last job (my current job) I never saw an educator or manager or had a 90 day eval, nothing. I did fine because I have lots of experience but new grads don't know what they don't know and that's why I feel especially protective of them.

Actually I said new hire. And yes some new hires are new grads, but many are nurses already in the field and have already had the experience. Others could be CNAs that are new grads. Many others still have worked and have had the experience to be trained on a job. So is it very possible for a new grad to know what they prefer. Of course if the workplace is not going to be able to offer options, then it really isn't a good idea to offer it. But if it possible, why not? If they don't know, they should tell you. I'm going to a new job and was asked if I minded having different preceptors and I said no - because I don't.

Of course my suggestion would assume that the new workplace actually cares.

Its nice that you are protective over new grads...they do need it in this field. :)

maxthecat · Jan 29, 2010

I think people who come to the unit with an already established foundation of how they "do nursing" are usually comfortable with and even thrive on having a variety of preceptors. They're open to learning new ways, but they don't sweat it when they hear conflicting advice from multiple teachers, because they've seen enough to know there is often more than one "right" way to do something and they'll pick what works best for them when they're on their own.

For a new grad who has yet to develop even a basic foundation, though, I think multiple preceptors, with multiple ways of doing things and different expectations, can be a disaster. They need to learn one way and learn it thoroughly and start to feel comfortable in that style. Only after basic competence is established using Preceptor A's methods are they ready to learn about Preceptors B and C and their variations. It would be like taking a kindergartner and saying, "There are many ways of writing and you need to know them all. You'll be learning block printing, cursive, Palmer Method--we'll switch off each day." Too much information, too soon. Learn ONE method well first, even though as you progress in your career you may come to prefer a completely different one. I've seen too many people new to the profession who became frustrated from input from too many other people and ended up neither comfortable nor competent, just confused.