Precepting New Grads - Tips and/or Advice?

zambezi, BSN, RN · Aug 16, 2004

I am interested in replies too...I start precepting my first new grad in one month...right now they are orienting on the day shift...Good luck with your precepting Begalli...

purplemania, BSN, RN · Aug 16, 2004

free information is very difficult to find and I have looked at research, websites, etc. I do not know of a site that offers the help you request. I do know of a book, however. It is an old standby---"Reality Shock. Why nurses leave nursing" by Marlene Kramer. She is still writing and has researched this topic >30 years. Read about change theories too, as changes is what describes the transition from student to nurse. I can tell you the GN will be overwhelmed with new information at first, and will complain about "this is not what we learned in school". Do not take that comment personally, because it is an expression of their anxiety over how to integrate knowledge with practice. Eventually they will make negative comments about their nursing school because they might feel unprepared for the real world. This too is normal. Eventually, they reconcile the differences, the anxiety level decreases, and they are able to learn. Encourage questions. Set goals (you create goals at first, then do them together, then let them do the goal setting). Any memory aids are helpful. Their biggest problems are time management and prioritization. Ask your co-workers to help the new nurse feel part of the team (so the new nurse gets acclimated to the unit faster and knows to use other nurses as resources). Let them see you make mistakes and learn how to handle it when you do. I could go on, but you get the picture. I HIGHLY recommend this book (only $5.99 used at amazon.com). "Managing transition: Making the most of change", by Wm. Bridges. It is easy to read and so very useful in many areas of our lives.

CCU NRS · Aug 16, 2004

Great question!

My only advice would besomething you have already touched on, remember what it was like for you, remember how you felt and the stress and anxiety of pleasing someone you felt probably knew so much more about what was going than you did. I have said before that part of the autonomy we as nurses enjoy is the ability to the tasks that have to be done in a manner that pleases us personally, I would suggest you remember there is more thah one way to skin a cat and be open to letting your preceptee attempt to do things in the way s/he feels comfortable doing them. I know as nurses we sometimes get hung up on the way we do things being the right way or the only way, this is not always the case, of course sterile procedure is sterile procedure but the set up and prep can be done in whatever way is comfortable, if you see what I mean. I think you will probably be wonderful just for the fact that you are concerned and want to do well.

Good Luck

missmercy · Aug 16, 2004

HURRAY!!! Good nurses who are not only interested in preceptoring but who want to make it work!!! BLESS YOU BOTH!!!

First tip: PATIENCE, PATIENCE, PATIENCE!!!!

Try to remember what it felt like to be the new kid, the new nurse -- whatever!

Loads of info is great -- but I tend to lean toward handing them information that they don't have to memorize but can digest slowly. We make a new nurse notebook for our new hires -- maps of the facility, their unit's map, a list of "little things that they chould be shown ie: where to find the bathroom, the break room, the kardex, the med cart code, the cafeteria, the pharmacy, the fire extinguishers..... etc. We encourage our preceptors to be sure to remember to introduce the new folks to docs, nurses, therapists -- and whisper reminders of names for a little while -- if they are not good at remembering names.

Being a preceptor is such a cool thing!! You get the chance to show off the skills you have learned and help someone else develop theirs!!!! Remember, there is no substitute for experience -- no matter how smart or good they are, it always takes 5 years to get 5 years of experience -- things that are second nature to us may be totally foreign concepts to the new kid -- explain - lots!! Maybe even repeatedly. Remember that they are smart folks - (they've chosen nursing!!!!!)so don't talk down to them -- but do be a little gentle. DO NOT bring up all the horror stories on the first day or two!!! Avoid the burning desire to tell them how we are always short staffed or how that other shift (or particular nurse) doesn't do things right..... they will find out all that crap soon enough!! Encourage questions -- if you don't know an answer -- tell them you don't know and see if you can't find a way to show them where you look for the answers!! That reenforces the fact that we are ( shock, shock) humans and may occasionally need assistance -- whether informationally or actually physically. Knowing everything is not a requirement -- (it would sure help sometimes though) -- knowing where to look for answers and being willing to do so IS a requirement!!

As someone posted earlier, it is hard to find free info. I liked the Covey book "7 habits of highly effective people", and the Bennet book mentioned too -- who moved the cheese is fun too -- all deal with handleing change, dealing with people and making the best of situations presented to us!!

I am SOOOOO happy for you guys! Have a great time with your newbies!!! I hope the experience will teach you too -- that you will all enjoy it and will all be better nurses, better people for having done it!!!

happystudent, RN · Aug 16, 2004

Well, Im a newbie, they call us "baby nurses" ((lovingly)) on my floor. Heres some advice from my perspective.......

First off, don"t underestimate what your preceptee knows. Unless you know this person, they may have skills from a previous position, like cna/tech.

Let her/him show you where "they are at, competency wise" and go with the flow. Its likely that he/she has picked up skills on days and just needs to be trained on evenings routine.

Try to stay away for saying, "do you have any questions " constantly. More than likey that person does but wants to figure it out for himself first (this was a big thing for me) 10 times out of 10, if I cant figure it out on my own or if I have even a twinge of doubt, I will ask.

Try to relax around the person because if we sense that you are nervous or stressed, it shakes our confidence even more.

Lastly, don't force "your way" onto her/him and if they do it differently, dont make her/him feel bad about it...even if the task produces the same results.

These are a few of my tips to maybe keep in mind. I think you are awesome to want to be the best you can be! Im sure everything will work out just fine. Keep us posted! :)

CarolineRn · Aug 16, 2004

Here is an excellent website created just for precepting in the ICU setting.

http://www.icufaqs.org

begalli · Aug 16, 2004

Thanks everyone for the great information and encouragement!

It's really unfortunate that there aren't more websites for preceptors! I mean, how important is it?! That icufaq's link however, is awesome!

I will be heading to the bookstore later today to see what I can find.

Thanks again for all your help!!

p.s. happystudent - Thanks for your perspective, I will keep that with me!

zacarias, ASN, RN · Aug 17, 2004

I will be precepting and mentoring my first new grad at the beginning of September. I want to make this a great experience for both of us. I remember -- it wans't too long ago-- what it was like coming on to an intense floor without any prior nursing experience. It was scary, but I had an insatiable drive to do it and my preceptors were nurturing and great teachers.
Thanks!!

This may not be practical for either of you but when I was a brand new nurse, we had a preceptor gal who meet with the new grads once a week for like 2 hours after our shift to talk about how things are going and if there are any questions. This preceptor got paid and so did the new grads so you may not be able to do that but I thought it was so great. Here after the shift was over and we were calmer, we could talk about our day, week, ask questions about procedures, protocols, dealing with other nurses, doctors etc.

If that's not an option, you can always spend time with them on breaks and talk with them. Most new grads I think are meek and timid and will appreciate any efforts from other nurses at making them (the new grads) feel more at ease.

begalli · Aug 17, 2004

Wow Zach! How lucky you were. It's kinda like debriefing which I think should happen even for experienced nurses following a stressful even such as codes.

I do plan to give my preceptee my telephone number so if anything comes up after she gets home and has a chance to think about our day, she can give me a call.

I remember being new too. I remember how wound up I was at the end of the shift and a little bit overwhelmed until I got home, took a shower and was able to sit and really think about the day.

I've met the new nurse briefly. She used to be an ER tech (I'm not sure for how long) and has a degree in kinesiology. I'm not sure she'll be that timid--takes a certain gutsiness to start out in critical care, I think. A perfect match for me!

RNinRubySlippers, BSN, RN · Aug 17, 2004

You sound like you are going to be a wonderful perceptor! Lucky student and good luck to you as well! Hope you learn something new too! What a bonus!

B :)

PamRNC · Aug 17, 2004

Congrats! I know you'll have a great time precepting! It's a great opportunity to share what you know and support a new RN.

At one of the places I worked they gave preceptors a little card with some questions to help the orientee focus on some critical thinking issues. It helps to couch the questions in terms or in relation to a patient she/he is taking care of. Here's a few of the questions:

What complications could occur?

What clinical data would lead you to believe this complication would occur?

Before calling a MD: What info are you going to give? What orders do you expect to get? Why do you think these orders are needed? This is especially important for those 3am phone calls to sleepy/grumpy interns/residents.

What actions do you need to take and why? - say in response to a change in status, ie. SOB, c/o CP

What clinical info requires immediate intervention and why?

Ask about alternative actions if they chose an action/response that isn't acceptable.

These kind of questions should get a more focused response than a general 'do you have any questions?' You'll also help your orientee to continue the shift from student/tech to RN. And remember, be supportive and positive. I think you've got that part down though - Good luck to you both!