Precepting New Grads

apillarofsalt · Jun 25, 2016

Your facility's orientation process sounds like the one I oriented at as a new grad.

My preceptor was a nightmare. She had me do most of her work, which is the only way to learn, and I tried to be as enthusiastic as possible. As time went on, I realised she had me doing a lot of unnecessary tasks as favours to other staff members (not fun). At one time I was watching 8 patients because she wanted to take a break with another nurse. Not safe at all for a new grad in the ED.

She had a "throw them to the wolves" mindset, and I performed very poorly under that pressure. One of my first IV attempts was on an incoming trauma patient, and I had never been in a trauma bay before. I panicked and missed, in front of over a dozen coworkers. After that, I kind of accepted that this nurse either *wanted* me to fail, or her approach was just one that was not conducive to my success and she didn't care enough to change it.

There were other nurses that went above and beyond for me though. Something as small as having someone offer to grab me a drink when they ran to get one, or introduce me to other staff went a long way. This made the ED feel less overwhelming, and I felt welcomed by these kindnesses.

Ultimately, I think the most helpful attitude is just to treat a orientee as an equal--in most cases they'll respond as one. The skills take time, but no new nurse should ever have to "earn respect" or "do their time". The orientee may not have equal experience or skill, but being treated well from the get-go makes a person more responsive to learning.

johsonmichelle · Jun 25, 2016

I think the most important things is good communication from both parties. Preceptor should be honest and upfront. I think bad communication is one of the reasons why precepting goes bad.

Career Columnist / Author · Jun 28, 2016

We have a board in the break room. And people anonymously post what they want to learn about. For example I gave a PowerPoint on Hyperkalemia. And u got a CEU for attending the class. It was fun and nurses won prizes if they could answer the big questions. The management loved it. And so do the staff. I try to make it fun. Plus if there is food nurses will usually come. We did it on the hour. Turned out well. Next time we r doing one on Sepsis. We have a lot of new grads and nurses that have been there for awhile. Me and the clinician r trying to help everyone. And make it a more positive place. Obviously since the trauma center we work at is bananas !! [emoji4]

Wow, what great ideas, I love to hear such positive educational activities

jessc16 · Jun 29, 2016

This thread is wonderful! I just graduated Saturday with my ADN (YAY!)

I have been accepted into a 17 week fellowship program at a level one trauma center pending boards. I am so nervous, excited and terrified. This thread gives me hope that I will be placed with a caring preceptor that will take time with me, allow me to ask questions and express concerns. Thank you to all the awesome nurses paving the way for us newbies!

vintagemother, BSN, CNA, LVN, RN · Jul 2, 2016

I precepted in the ED as a student, and have not worked in the ED, yet, as I'm a new graduate. I've precepted as a nurse in other areas, though, so take what I have to say with that in mind.... [emoji41]

I think it is helpful to allow the new grad 1 shift to simply observe you, rather than actually get involved in pt care. This way, she can see how you manage your time and watch you prioritize when unexpected things happen.

The ED I precepted in had different areas for different acuity levels. (I assume that this is standard in all EDs). My preceptor and the unit mgr tried to have me precept in areas with the most Acute pts, those who were likely to be admitted or needed extensive care.

I was responsible for a limited number of pts on day 1, then it progressed each shift until I was taking care of a full load.

I also had the opportunity to talk with my preceptor on the areas that I felt that I needed more practice on. For me, this was IV starts, codes, giving report to the floor nurses, and the new shift.

I don't know if this is helpful, but this is my experience.

I think, ideally, you will be able to give her unofficial feedback on areas that need improvement and then, you can allow him/her to have opportunities to work on those items.

I recall that there were certain areas of the ER in which only seasoned/ experienced nurses could work. (Lobby triage was one of these areas)

In those cases, it actually was helpful to me to observe my preceptor work and prioritize and triage, even though I couldn't do it myself. It was helpful to me to see how a good nurse gets it done.

Make sure he/she gets experience communicating with the MDs/PAs/Other Providers, as new nurses are sometimes shy about this.

Make sure she knows where to find policies and procedures, as well. This way, she can practice safely on her/his solo.

RescueNinjaKy · Jul 2, 2016

What I really appreciated was when my preceptor asked me how do I learn best. And I told her honesty. Show me the first time. Then let me do it but walk me thru it the second time and then help me only if I'm doing it wrong on the rest. It helps reinforce it for me. Those that just make you do it with no guidance makes me nervous.