Precepting After 4 Months Off Orientation

Nurses General Nursing

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Precepting After 4 Months Off Orientation

Yes, you read the title correctly. Although at some point a few months ago I mentioned my love of teaching and hopes to become an educator some day, I did not anticipate it would happen 4 months after working alone in a specialty of nursing I am new to.

I began working in palliative care May 2023 and finished orientation in August 2023. I am now someone's preceptor after just four months of working alone. It's the blind leading the blind and I feel we are both going through the motions and learning together.

This is not the experience I want this nurse to have. She should be paired with someone who has years of knowledge in this field to share.

Not only was transitioning from ambulatory/outpatient a huge learning curve for me but now I'm tasked with precepting someone who will be practicing on her own. She is also part of the RN residency program which means I'll be her preceptor for about 6 months and then she'll be assigned to someone else for the remaining six months (or so I was told).

I spoke with my manager when I heard about this. I was told I was chosen because I've been doing "great" thus far. However, I reiterated the fact that I've only been a nurse for three years and have only been working there OFF ORIENTATION to be specific for four months.

I feel this is being forced onto me as nobody else wants to take on this responsibility for 6 months to a year. It's making me want to quit even faster as I'm already feeling burnt out because of this job.

The understaffing, struggling to get a break, everyone complaining the nurses don't do anything, etc etc . If this is what it's like in an "acute" palliative care setting, I don't want to work in the acute bedside.

It's extremely stressful and I can see why so many nurses do not want to work bedside. It's a lot of work for very little reward and recognition. What should I do? 

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"It's the blind leading the blind and I feel we are both going through the motions and learning together." Yep .The nature of nursing. You have many complaints, do you have any answers?

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Been there,done that said:

"It's the blind leading the blind and I feel we are both going through the motions and learning together." Yep .The nature of nursing. You have many complaints, do you have any answers?

No. Which is why I came on here looking for advice and wanting to know if any others have had similar experiences and how they went about it. 

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Specializes in oncology.
Quote

The understaffing, struggling to get a break, everyone complaining the nurses don't do anything, etc etc .

  • You have been a nurse for 3 years
  • You have been off orientation in this positions for 4 months
  • Your complaints about the position itself are - understaffing, everyone complaining the nurses don't do anything etc

I hear what you are saying with sensitivity but: working fulltime is not an extension of school. You are a member of a profession and have been a fulltime member of this profession for more than 3 years.  Part of being in a profession is educating those who will come after you. Educating an additional worker will relieve the understaffing, struggle for break etc. Do you want help by contributing or just want to dwell on the 'unfairness' . Didn't someone help you? They probably had the same complaints, may be even more. If you don't want to help someone else - quit and get out of the way. Someone else may like the job better!

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Specializes in Med-Surg.

To the OP, at least you were four months out of orientation. I was two weeks into an expectant six-week orientation when I was told I was needed to cover a panel whose entire team was out with COVID....had to wing it as best I could. Of course, I have a very extensive acute care background. But every new position makes me feel like the first day out of nursing school, what with the new environment, strange faces, unknown access codes, lack of knowledge regarding policies and procedures. The list goes on and on. Wing it. Or as infamous "they" say, fake it till you make it. But most importantly, do not be afraid to say "I don't know, but I will find out".?

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I'm no expert in this field of nursing. I am surrounded by other nurses who have not only been in this profession for years, but have been working in palliative care for quite some time. I just started and still have a lot to learn myself. I still ask my preceptor (when we have a shift together) and the other more experienced nurses various questions when I am there. In other words: Why am I being put in a position to teach so prematurely when there are so many nurses with way more knowledge ? Never did I dwell on the "unfairness" of the situation. It just does not make sense to stick her with me when she can be getting a much better orientation with someone who has more experience and can offer her better guidance. I think anybody who precepts should have more than just 4 month's experience in the specific field for which they're precepting in. Aren't there certain requirements as far as years of experience to meet before being allowed to even precept? I don't even care about getting preceptor pay. I just want her to get the best experience she possibly can out of her orientation and I don't feel that's something I can offer now.  

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MDelainy said:

No. Which is why I came on here looking for advice and wanting to know if any others have had similar experiences and how they went about it. 

I enjoyed precepting.  I precepted  most new nurses.  If you are not  into it..notify your  manager and decline.

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Been there,done that said:

I enjoyed precepting.  I precepted  most new nurses.  If you are not  into it..notify your  manager and decline.

I did. I politely declined and said this is not something I'm ready to do at the moment & a few days later I was told it was pretty much still going to happen. So yea  Not sure how to proceed now. 

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Specializes in Public Health, TB.

You spoke to your manager and they gave you an explanation. As I see it, you have 3 choices:

1) Continue to precept

2) Refuse to precept and risk disciplinary action

3) Resign. 

If I remember correctly, Benner's Novice to Expert prefers competent/proficient nurses for preceptors, rather than expert nurses. The competent nurse can empathize with the experience of being new, and has not retained  non-evidence bases practices. The expert nurse may take for granted the level of knowledge of the new nurse, and may confuse rather than give helpful guidance. 

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Specializes in Psych, Addictions, SOL (Student of Life).
MDelainy said:

I'm no expert in this field of nursing. I am surrounded by other nurses who have not only been in this profession for years, but have been working in palliative care for quite some time. I just started and still have a lot to learn myself. I still ask my preceptor (when we have a shift together) and the other more experienced nurses various questions when I am there. In other words: Why am I being put in a position to teach so prematurely when there are so many nurses with way more knowledge ? Never did I dwell on the "unfairness" of the situation. It just does not make sense to stick her with me when she can be getting a much better orientation with someone who has more experience and can offer her better guidance. I think anybody who precepts should have more than just 4 month's experience in the specific field for which they're precepting in. Aren't there certain requirements as far as years of experience to meet before being allowed to even precept? I don't even care about getting preceptor pay. I just want her to get the best experience she possibly can out of her orientation and I don't feel that's something I can offer now.  

Orientation where I work (psych) lasts about 9 weeks. Once off orientation RN are consu oth ChRge nurses and preceptors. I have 20 years under my belt and am 1 of 3 Master Precepg on my shift. E dry new hire spends 7 days with one of us and we are also a resource for nurses fresh out of orientation 

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

@MDelainy, I feel for you and appreciate that your concern is for the other nurse coming into the field that you will precept. While you have a few years experience overall, I understand that you're still building your practice in the field, and teaching while developing your own skill set and knowledge will certainly have some challenges. However, it sounds like you've investigated other options and been told that this is going to happen.

So, I would recommend you try to reframe it in your mind as a positive experience for both you and the new nurse. Yes, he or she could have a preceptor with more years of experience, but it is still very fresh for you what starting in the unit was like. You will key in on the things that you think are most important to know for this new nurse. DON'T approach with them as a negative. Don't apologize for the orientation experience they will have, greet them with positivity and enthusiasm from day one. Let them know that while you're not the most experienced on the unit, you are looking forward to working alongside them and guiding them, while you BOTH learn more about the field. No one, not even with 20 years experience, would know everything or be able to teach it. Choose topics to explore together because in the see one- do one- teach one model, you're also learning, so acknowledge that and use it as a positive for both of you. I hope your unit has a clear orientation packet or checklist that you can use to guide the orientation so it's methodical and comprehensive. 

This is happening in units everywhere. In my ICU, there are only 3 nurses left (out of about 30 staff) with more than 3 years in critical care. We have nurses with six months total nursing experience (after orientation), taking charge in the ICU. They are supposed to be the resource when they haven't seen 10% of what could roll through our doors. But there's nothing that can be done to change that. New nurses need preceptors, and they are the option. You will be fine, the new nurse will be fine, and you may end up finding it's a great experience. Good luck!

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Specializes in L &D.

This happened to an amazing new nurse that I was precepting.  I knew she would be a great nurse. I encouraged her to seek a different employer who would be a better fit.  Them gave her a glowing reference.  

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