Need tips on precepting new grad RN

Blackheartednurse · Oct 29, 2009

I'm a new grad and just want to thank you for voicing your concerns,it really shows that you care..please be patient with us and just dont forget that we are scared as much as you and we want to do our best....

shoegalRN, RN · Oct 29, 2009

I am a new grad and I'm 35 years old. I want to say please allow the new grad a chance to do what is expected of them. Do not hover over their shoulder or micro-manage. This can be very frustating and can make the new grad extremely nervous. Some new grads dont need to be "told" to answer call lights or to watch the monitor. If you have a new grad whose learning style is hands on, it makes no sense to tell a new grad how to do something and don't allow them the time to do it on their own.

Another thing, as a new grad, I am already struggling with trying to build my confidence. It really makes me feel inadequate to have someone hovering over my shoulder, then constantly "reminding" me to do things that I already know I should be doing, and not given the chance to actually do them, before I'm reminded. I'm not a child, I don't like to be "nagged" about doing something, allow me to do it FIRST, then come back and give "constructive" criticism if need be.

Please set up weekly goals for your orientee and allow the orientee to focus on those goals for the week. Provide feedback at the end of the week if they met the goal or not. If not, come up with a plan to have said goal met. Don't provide constructive feedback without providing positive feedback as well.

It's okay to go back and evaluate the orientee's work. It's ok to provide constructive criticism as well, because as a new grad, I'm all about learning and trying to improve. However, it's not ok to hover over a new grad all the time, because at some point, the new grad will be on their own, and how can they develop confidence, when someone is always watching over their shoulder, waiting for them to "mess up"?

Just my opinion.

CrufflerJJ, BSN, RN, EMT-P · Oct 29, 2009

I have only been a nurse for 4 years. Spent 1st 3 years on Med/Surg, and the past year in critical care stepdown. I have been asked to orient new grad RN's. Although I am honored that my managers feel I have so much to offer, I feel I am too new! They have told me I am well organized and resourceful and would like me to pass those qualities on! So here I go:yeah:! I am a "Late entry" into nursing, starting my career in my 40's - I LOVE my job! Here's my issue: How do I get through to these "young 'uns" that there is more to nursing than passing meds? The last 2 I orients had to be told constantly to answer their call lights or respond to monitor alarms! They reply "I thought the aide did that!" :angryfire. How can I get across to them that EVERY aspect of patient care is THEIR responsibility? ANY hints for precepting (in any aspect) would be GREATLY appreciated:nurse:.

So you feel "too new"? You have 4 more years under your belt than the newbies entering your workplace. I am one of those newbies, and like preceptors who have some experience, but are still new enough to remember the nervousness/fear/excitement/confusion felt back when they themselves were a new grad.

As a newbie, I'm very task oriented - do my assessments, pass the meds, chart chart chart. It can be difficult for newbies focusing intensely on doing the "tasks" correctly and at the right times to take in everything going on around them. This includes call lights, monitor alarms, changes in their patient's condition, plus lending a hand to their coworkers when needed.

I think that if you are very up front with the preceptees that call lights/monitor alarms are THEIR responsibility, then it will eliminate the "aide" excuse. If the problem continues, then it comes down to either too much focus on tasks or deliberately ignoring call lights/monitor alarms (not good).

I'd ask you to give the newbies some time to "get their feet under them" with documentation/assessments/med passes before judging them too harshly on not catching all the call lights or monitor alarms. If they don't pick up on all job tasks after the acclimation period, then there's a performance problem that will need to be addressed.

mombuxx · Oct 29, 2009

Thanks for your thanks!! I have started my first day with each orient with this information: I am here to help you succeed. Contrary to what you have heard - I do not eat my young! I will ask you ALOT of questions, so I know what you know, where you need a little extra help, and to help you tweak your critical thinking skills. Sometimes I know the answers, sometimes I don't! In those cases - we'll search out the answers together. I believe that when you think you know all the answers, you become dangerous, as NO ONE has all the answers. So, please ASK, ASK, ASK - that's how we learn, and there has not been a single day since I started this career that I have not learned something! Seasoned nurses are great resources - use them! And don't ever forget, the each patient is YOUR responsibility! It's okay to delegate appropriate tasks to the aide, but they also have a job to do. If your patient needs a bed pan - get it for them. Don't leave them to seek out an aide who may be in the middle of a bath. Because ultimately, when the budget cuts come down, we can do the job of an aide, they cannot do ours. We are a team. No one sits unless we can all sit. If your caught up and your co-worker is running, help them. It will come back to you - that's the beauty of teamwork. "There is no "I" in team".

Hope my "words of wisdom" help! Good luck to you in your new career - I hope you love it as much as I do:yeah:

catshowlady · Oct 30, 2009

When I had my preceptorship my last quarter and then when I oriented as a new grad, I found it helpful to shadow on the first day. Obviously, I would help with things, but it gave me a chance to see how the workflow should go, and to absorb the picture since I wasn't bogged down in the details. You could lead by example as far as the call lights go.

Thanks for being a preceptor. I have been blessed to have had good ones throughout my short career. Thanks for being willing to take on the extra work and stress that an orientee represents.

:paw:

PostOpPrincess, BSN, RN · Oct 30, 2009

Try looking into generational differences and how they affect the work environment.

Gen X and the Millenial Gen think differently, but they can work together very well.

CrufflerJJ, BSN, RN, EMT-P · Nov 1, 2009

thanks for your thanks!! i have started my first day with each orient with this information: i am here to help you succeed. contrary to what you have heard - i do not eat my young! i will ask you alot of questions, so i know what you know, where you need a little extra help, and to help you tweak your critical thinking skills. sometimes i know the answers, sometimes i don't! in those cases - we'll search out the answers together. i believe that when you think you know all the answers, you become dangerous, as no one has all the answers. so, please ask, ask, ask - that's how we learn, and there has not been a single day since i started this career that i have not learned something! seasoned nurses are great resources - use them! and don't ever forget, the each patient is your responsibility! it's okay to delegate appropriate tasks to the aide, but they also have a job to do. if your patient needs a bed pan - get it for them. don't leave them to seek out an aide who may be in the middle of a bath. because ultimately, when the budget cuts come down, we can do the job of an aide, they cannot do ours. we are a team. no one sits unless we can all sit. if your caught up and your co-worker is running, help them. it will come back to you - that's the beauty of teamwork. "there is no "i" in team".
hope my "words of wisdom" help! good luck to you in your new career - i hope you love it as much as i do:yeah:

your "opening speech" sounds very realistic, supportive, and down to earth.

sorry i forgot to say in my first response...!!thank you!! for being brave enough for being willing to precept us nervous newbies. i know this results in a lot more work (& stress) than just taking care of the patients yourself, and appreciate those who are willing to help train new people.

shoegalRN, RN · Nov 1, 2009

Oh, how I wish I had a preceptor like the OP. I just had to ask for a new preceptor 4 weeks into my ICU orientation. My learning style is hands on, I like to actually "do" the task several times before I start to feel somewhat okay about it. I had a preceptor whose teaching style was anything short of a dictatorship. Despite telling the preceptor what I needed in order to try to suceed, it was met with resistance.

I was being micro-managed every night. I couldnt take it anymore. Not only that, I was being talked down to, and made to feel inadequate for asking questions that she felt were "simple" and I should have "gotten it" the first time it was TOLD to me. I was given nothing but constructive feedback, not ONE positive thing was told to me.

It was a couple of times I had two different preceptors because my main preceptor was off. It was like night and day in the different teaching methods. I was thrown into a very emotional situation, (withdrawing pt care for the first time ever) and although that situation was very emotional for me, I LEARNED so much because of how that preceptor explained things to me and talked to me.

My main preceptor did not have any patience, period. And she's only been a nurse for a year and a half. She is also 10 years younger than I am, and this was the first time she actually got to train a new grad. After "trying" to explain things to her plenty of times, I went to the educator and requested a new preceptor along with asking to be moved to my unit the MICU. I simply explained it was not working out, my learning style and her teaching method is not compatible, I feel like I'm not learning anything because I'm being micro-managed so much and treated like a 3 year old, and now I can't afford to waste another day going like this. Needless to say, the preceptor cried in the meeting and wanted to work it out, but I told her it's not personal, and at this point I'm too frustrated to try to work it out, despite all the times I've tried to go to her to explain my needs. I've shut down mentally and it's not a good learning experience, I need someone who is more patient, who is more laid back and like to take the time to explain things to me in a way I can understand and who is more supportive and encourging. I also told her I thought she was a good nurse and I would like to be as good as she is, but I have to find my own way there, and I also told her that although she is a good nurse, it does not automatically mean she is a good teacher.

The educator thanked me for coming to her so soon in my orientation and asking for another preceptor because she wanted me to get the best orientation possible. I felt horrible about it, but I couldnt take one more night of being "scolded" for asking a question. I just couldnt.

eyeball · Oct 13, 2010

Oh, how I wish I had a preceptor like the OP. I just had to ask for a new preceptor 4 weeks into my ICU orientation. My learning style is hands on, I like to actually "do" the task several times before I start to feel somewhat okay about it. I had a preceptor whose teaching style was anything short of a dictatorship. Despite telling the preceptor what I needed in order to try to suceed, it was met with resistance.
I was being micro-managed every night. I couldnt take it anymore. Not only that, I was being talked down to, and made to feel inadequate for asking questions that she felt were "simple" and I should have "gotten it" the first time it was TOLD to me. I was given nothing but constructive feedback, not ONE positive thing was told to me.
It was a couple of times I had two different preceptors because my main preceptor was off. It was like night and day in the different teaching methods. I was thrown into a very emotional situation, (withdrawing pt care for the first time ever) and although that situation was very emotional for me, I LEARNED so much because of how that preceptor explained things to me and talked to me.
My main preceptor did not have any patience, period. And she's only been a nurse for a year and a half. She is also 10 years younger than I am, and this was the first time she actually got to train a new grad. After "trying" to explain things to her plenty of times, I went to the educator and requested a new preceptor along with asking to be moved to my unit the MICU. I simply explained it was not working out, my learning style and her teaching method is not compatible, I feel like I'm not learning anything because I'm being micro-managed so much and treated like a 3 year old, and now I can't afford to waste another day going like this. Needless to say, the preceptor cried in the meeting and wanted to work it out, but I told her it's not personal, and at this point I'm too frustrated to try to work it out, despite all the times I've tried to go to her to explain my needs. I've shut down mentally and it's not a good learning experience, I need someone who is more patient, who is more laid back and like to take the time to explain things to me in a way I can understand and who is more supportive and encourging. I also told her I thought she was a good nurse and I would like to be as good as she is, but I have to find my own way there, and I also told her that although she is a good nurse, it does not automatically mean she is a good teacher.
The educator thanked me for coming to her so soon in my orientation and asking for another preceptor because she wanted me to get the best orientation possible. I felt horrible about it, but I couldnt take one more night of being "scolded" for asking a question. I just couldnt.

I have had almost exactly the same experience as you have described here and yesterday realized I could not do another day with my preceptor. Our stories are eerily similar down to the fact that I told mine she was a good nurse but that we were a bad fit in terms of preceptor/new nurse. I felt/feel pretty horrible...but I just couldn't do another minute with her. Management was very supportive and I have a new preceptor.

MJB2010 · Oct 13, 2010

As a new grad who just started training, I would recommend sitting down at the end of each shift (even when it is busy) and going over the day, Always START & END with something positive. We never go over anything and I have no idea if I am doing well or terrible. My preceptor is a great nurse, but does not always have a lot of patience. It takes me a long time to do meds etc, and this clearly annoys her. I understand that, but I dont want to make mistakes. Some days I go home and feel awful and dread the next day and other days I go home thinking I am going to get this and do ok. I get no feedback. Ever. As a newbie, I am so filled with doubt and I do not trust myself at all right now. I need some reassurance when I am doing something correctly. I also need to know when I am not. I am a big fan of the see one, try one type of learning. I like to see how you would do it first, then I would like to try. Then I want to try again. :)

I guess my best advice is to be patient, we are slow in the beginning. Give feedback when the newbie does something new, but try to stay positive even if they need work. Try to end every day on a good note.