Precepting my first new hire.

jadelpn, LPN, EMT-B · Jun 20, 2013

I would be honest. "I am a relatively new nurse, but excited to teach you what I have learned". Because your new grad is fresh out of clinicals, ask how that experiece was for her. Ask what she liked the most, that she learned the most. Ask how she learns best. To get herself a really good "brain" sheet. To learn to keep herself organized and learn to prioritize. Your new grad may have never worked in nursing before, but if she made the most of her clinical experiences, perhaps is even a "type A" (still in school mode of notes and charts and studying) that works to your advantage, as well as a person who is used to banging out a paper complete with references once a week or more for the last 4 years.

What you will teach and say will go in one ear and right out the other should your preceptee be unorganized. So that needs to be priority. Then, a good assessment taking skill set. And have her write down questions. You can go over them at the end of the day, show her where she can get information in the future (ie: drug book). You both have an advantage of being tech savvy, therefore any computer charting should not be an issue. Hands on patient care may be, and that is what needs to have the initial focus.

Good luck and let us know how it goes!!

PMFB-RN, RN · Jun 20, 2013

So your hospital didn't send you to a preceptors course? Has your new nurse taken some sort of assessment test to determine her strengths and weaknesses as is normal?

I find new nurses really need help learning in 4 areas.

1. Hands on nursing skills. By far the easiest and most fun. Pretty much "Here's how you do this and why you do it this way. I will show you, then you practice". New grads now come to us with hardly any basic nursing skills. Be prepared to teach pretty much everything from bed making to dosage calculation to medication administration.

2. Critical thinking / patient advocacy. This includes decision making, time management and prioritization. Here it's helpful to ask a lot of open minded questions but be ready to help her come to the right answer / decision and don't leave her hanging to feel dumb when she doesn't know the answer. She will learn this two ways. By your example and the example of other fine nurses you indicate to her would be good roll models and by your open ended questions that encourage her to think for herself while at the same able to depend on you to help her arrive at the right answers. Hopefully, over time she will need less and less prompting and help from you.

3. What I call learning the system. Each hospital and unit is different. She needs to know her way around, where things are, who and what her resources are, who does what, how to use the physician call system, documentation system, your units protocols and standing orders, the RRT and a thousand other things. This is pretty easy and straightforward. Helps to make a list of things she will need to know to work on YOUR unit and add to it as you precept others. That way fewer things get left out.

4. Interpersonal skills. She needs to learn her place as a nurses and the place of all the other people on the care team. How to get along with her co-workers and interact with physicians, CNAs and all the other other people she has to work with. This also includes dealing with demanding / unreasonable physicians, nurses, patients and family members.

Before and after each shift try to have a brief review of how the day went. Take note of strengths and weaknesses. Make note of goals for the upcoming shift. Offer compliments and constructive criticize. Make and keep a list of skills to be learned/needs practice/mastered. Make and keep a list of over all goals as well as daily goals.

It would be normal for your hospital to have checklists to guide you.

DON'T WORRY! Even though you have only been on your own a year and a half you have learned a VAST amount about nursing and will seem like an expert to her.

Nurses with less experience but closer to the time when they had to learn everything are perfect for precepting. Our hospital uses a two stage precepting process. Initial stage I preceptors are nurses like yourself with 1-3 years experience and they have the biggest job to do. Phase II new nurses are places with senior staff. This is normal.

Hopefully since you are precepting you will have a reduced patient load to give you time to teach and supervise. Encourage her to ask questions and be a safe place for her concerned without fear of being made fun of.

Enjoy it! Have fun.

Mandychelle79, ASN, RN · Jun 20, 2013

Well, I am going to be taking a preceptor course, however I will be precepting before I actually take the class. The way it happened, all the seasoned nurses that trained me have moved on.

Because of the unit I am on I will not have a reduced load, there will only be two nurses on the floor ( if the census is high enough). Pretty much I will be the charge nurse ( my typical position, rarely am I not in charge of my shift). There are going to be times where I ask her to follow the therapists ( to learn that aspect) or follow the med nurse. So I guess I am a preceptor/coordinator of her orientation.

I just remember my first day of orientation, when the person precepting me made me feel like I was being thrown to the wolves.

I plan on looking over the new RN orientation book to see what is the expectation for the first day to match up with that as much as possible.

megan005 · Jun 20, 2013

I just graduated from my nursing program and my preceptor on my consolidation placement was amazing and part of the reason they hired me. Some of the things she did that were really helpful especially in the beginning was that she really made me feel like part of the unit and introduced me to everyone. After each pt (we were on L&D) we took 5 mins to go over what happened and she told me you did good a this but here are the things you need to work on. She also quizzed me about thing throughout the day, for me this let me know where my knowledge gaps were and for her I'm sure it let her know what I was confident in doing alone and what I needed support in.

I think the biggest thing is communication, let them know what you expect of them and tell them to ask you about everything, because it better they ask you then try and do something they have no clue about.

Morainey, BSN, RN · Jun 20, 2013

I recently precepted someone for the first time this week and my teachable moment was this:

Be patient. There's a lot of things that people on your floor probably just know that a brand new person wouldn't know. When I was brand new I thought asking questions made me look stupid, now I wish I'd asked more!

weirdscience · Jun 21, 2013

As a recent preceptee, agree wholeheartedly with WeepingAngel's comments above. I had one preceptor who made me feel stuuuuupid whenever I asked her, "how did you know (who to call/ask about a particular situation/problem?)"

She eventually told me she did not remember her orientation or what it was like to be new. Huge bummer, but also explained the treatment.

Mandychelle79, ASN, RN · Jun 26, 2013

Well, we both survived our first night together. I feel that I threw a lot at her, but the majority of the stuff was the here is where you put requests off, here are the fire pull stations, here are the extinguishers, type of things to get them checked off her list. She observed a few of 1:1 sessions and was will to try to do one ( with me in the room of course, and and one of the easier patients on my list) and we worked as a team to get it done ( meaning when she stopped before she should have, I just picked up and continued the one to one, without saying anything like hey you need to do this in front of the patient). I gave her pointers when we were done ( not asking if the patient is having hallucinations, because they may not know what they are, but ask if they are hearing anything/ seeing anything others cant). At the end of the night I started going over some paperwork that she will be seeing over and over again (admission stuff) so that the first time we do an admit together isnt the first time she sees the pages. I also let her know that when I first started an admit would take me a good 2 hours and now I can usually get everything done in 45 mins or so, just because the more you do them the easier they are. I think the night went well, I guess I will see if she returns today :)

Mandychelle79, ASN, RN · Jun 27, 2013

And she did return today and actually felt confident enough to do a few 1:1 ( with the lesser challenging patients) on her own when she seen how much I was trying to get done. She jumped right in to help cover work that needed to get done.

amygarside · Jun 27, 2013

I recently precepted someone for the first time this week and my teachable moment was this:
Be patient. There's a lot of things that people on your floor probably just know that a brand new person wouldn't know. When I was brand new I thought asking questions made me look stupid, now I wish I'd asked more!

this is true!

CelticGoddess, BSN, RN · Jun 27, 2013

This is something my preceptor gave me, that not many other preceptors on my floor give new nurses: A cheat sheet of what has to be charted and important phone numbers. I can tell you that it was a godsend for me. I would miss stuff and the cheat sheet helped me so I would get everything charted.

And the phone numbers (especially helpful if you are on tele and have to call the monitor tech from the patients room to make sure the box is working).

Personally, for me, I found the charting to be the hardest to learn, because there was so much of it and so many different places to chart on the computer. The hands on patient care was the easiest (except for the IV sticks)

Mandychelle79, ASN, RN · Jun 29, 2013

We both survived our first week. Yesterday, while we were talking through things, she said the best thing to me. She said I didn't make her feel like a burden.