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Nursing Preceptorship Problem

lautemic lautemic (New) New

I am a Senior nursing student in a BSN program and am looking forward to my preceptor ship next semester but need some advice.

I cannot decide whether it is a good idea to do my preceptor ship in a specialty unit or not...I have mapped out the pros and cons, but it's still not clear to me. Here's my mapping so far,

1. Working on the OB floor/nursery - I am 98% sure that this is what I want to do in my career, I absolutely love it and actually cried when our 4 weeks of clinical were over. However, I know that working in OB would require more studying of general knowledge since I wouldn't be using it everyday as if I were on a Med Surg floor or something. So...Pro-I love it! Know I want to do it after grad, and doing a preceptor would most likely increase my chances of getting an OB job after graduation. Con -I would be working with less general knowledge all the time, possibly making it more difficult when it comes time to take my boards.

2. Working on a Med Surg floor - I am 98% sure that I do NOT want to do this when I graduate. But it might make sense to do something general so that I won't lose knowledge on medications or procedures when it comes to taking the boards. Pro - More across the board knowledge used everyday to help with passing the boards. Con - I really really don't like it and don't think I would enjoy my preceptor ship if I did this.

Anybody have any advice for me? We need to sign up for preceptors within the next two weeks and I am still at a loss. Any advice would be appreciated! Thanks! :)

I wouldn't place too much worry in to this decision. The world of nursing has changed. At least for now. Chances are most will not get offered any type of position based on preceptorship. Used to be you could reasonably approach preceptorship as a way to "interview" at a hospital. Not much anymore. The economy has put an end to this for the most part. I am sure a few have been able to make contacts in this way, but in reality there is such a backlog of GNs out there now with contacts but no job.

Here's my rec: Go to a floor where you've always dreamed your self to be one day. This way, you will get a good look at how things work on such a floor. Maybe, you'll find you've been putting that specialty on a pedestal and will find that OMG, now that you know a few things, much to your own surprise, you actually hate it with a passion!!! Or, maybe you will confirm your love for it... thing is, so many I know fight thru lesser jobs to get to that one specialty for years, and once they finally get there, having given up a lot to do so, absolutely hate it. So, use your preceptorship to test things, I think it is a good idea. I did.

Don't look at your preceptorship as something to be enjoyed. You will be sadly mistaken. It is a ramping up of more patients more responsibility. You will be tested. Not to say you won't enjoy it, but don't set yourself up.

DeLana_RN has 22 years experience as a BSN, RN.

I would go with OB for all the reasons you mentioned.

Don't worry about not getting more general knowledge - that's not really the purpose of the nursing school preceptorship (you should have learned that in school ;) ). Instead, it's a chance for you to "try out" what nursing specialty you want to go into - if you don't like med/surg, why do it? It's not at all unusual for students to precept in the area they hope to practice in one day, regardless of whether or not they choose to do "a year of med/surg first".

Best of luck to you!

DeLana

OB all the way. Don't let the NCLEX be a part of the decision. You have already learned that material and can review it before the test.

As for the preceptorship being enjoyable, I absolutely think it should be. Even learning experiences that test your limits are enjoyable when it is a specialty you love.

Despite jobs being tight I think if anything were to give you a leg up in landing an OB position post-grad it would be this experience. So go for it!

emtb2rn specializes in Emergency.

Follow your heart. If you want ob and can get it as your precept, then go for it. Plus, that rotation will open relationships which absolutely help when looking for a job.

head3rd specializes in Oncolgy, Neuro, Med/Surg.

If you are choosing based on finding if you really want to work in OB vs Med/surg, I would go OB. A coworker of mine thought all through school that she wanted pediatrics, after her preceptorship she knew she didn't want that after all.

Thank you everyone for your input! I've noticed the more I talk about it, the more I realize I am just talking up OB more and more so there really shouldn't be a question to it anymore! I am going to put down OB for my first choice and see what happens!

Thanks again.

cwhitebn specializes in General Surgery, Orthopaedics, ICU, ER.

I'd recommend doing the med/surg just because you need that background wherever your nursing career takes you. I wanted to do ICU/ER right after graduation until I really sat down and said to myself "If I can't handle whatever comes to a med/surg unit, then more than likely I shouldn't be working in a critical care unit." Get the background you need, a solid foundation, and then go to OBS is my recommendion.

OBS is a highly skilled area of nursing with a lot of legalities to consider. You're dealing with young people and their children...be sure you know your stuff before you take on a big role basically.

I would go with OB. That way you could really find out if you "love" OB. For my preceptorship, I went to the OR because OR really interested me. I used my 140 hour preceptorship to see if I truly loved the OR. Everyone asked me why I was going there since you don't use your 'nursing skills'. All my classmates and some instructors thought I was crazy! No I didn't pass meds or to head-to-toes assessments, but I learned a whole new set of nursing skills used for that area. And guess what...I found out that I do love the OR.

This was my rationale for going to a specialty. If hospitals are willing to hire New Grads that haven't been able to find a job in over a year and require a whole lot of training because they haven't used their nursing skills, why would it matter where I did my preceptorship. IMO, going to a floor because it is drilled into your head that to become a great nurse you MUST pay your dues in Med-Surg is a bunch of BS. I HATED med-surg and if I went there I would have become burned out of nursing. You learn the skills useful for the area you work. Now as a New Grad, I am working L&D and I don't feel like I can't manage my pt's because I didn't go to Med-Surg. Plus I still get to go to the OR. It's just different! Go with your gut! I would hate for you to get into OB, sign a 2-yr contract and find out you hate it because you went to med-surg.

Having the OB preceptorship on your resume will be the difference between getting a job in OB or not when you are a new grad!!! It will give you an edge over students with no experience in the area AND you might be able to network and get some good references our of it. Follow your heart! Otherwise you will spend the whole time wishing you had!

Do the OB!! Then take Kaplan or another program to help you prepare for your boards.

NeoPediRN specializes in Pediatrics, ER.

Go with your dream floor. You'll learn what you need to know over time, and if you ever wanted to transfer to med-surg, you would take with you many skills:

1. Post-op care from c-sections.

2. IV starts

3. Hanging blood products

4. Dealing with emergencies (postpartum hemorrhage, a baby who goes downhill, pulmonary embolism)

5. Organiization. Most hospitals focus on couplet care and the average ratio is 3:1...that's six patients who require a lot of education and can be very needy, especially during the taking in process

6. Assessment skills. Your assessments will be done quickly and naturally after awhile, but thorough. You'll know when you see a change in respiratory pattern, activity, a slight change in their uterus, heck you'll even know their lochia inside and out. I believe if you transferred to med-surg or a different speciality, you would be able to adapt to indepth assessments the way you assess postpartum mothers and their babies.

Do OB. Med/Surg for the sake of passing NCLEX isn't worth it... especially because "real world" nursing isn't NCLEX nursing. In NCLEX nursing, there are UAPs all over the place, there aren't facility specific protocols to follow, etc. It's too easy to confuse yourself with what you've been doing because "it's what we always have done" vs. "it's actually the right way."

Oh, plus that OB preceptorship will look better on your resume. ;)

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