Precepting New Nurses

[pitt34]

In a couple of weeks I will be precepting a new nurse for the first time. I work on a med/surg unit where we average 4-6 patients per nurse with the help of a patient care tech. I was wondering how soon I should give her her first patient. How long do I wait to add a second patient? Do I let her solely focus on the patients that I have assigned to her, or do I have her go with me to see the other patients and do as many hands on things that she can?

I would like to hear how everyone else coordinates precepting a new nurse!

[BostonTerrierLover, BSN, RN]

It depends on where they are in the process. New grad or new to specialty or new to unit?

Generally first day, I let them shadow, and as we have time, let them do whatever they're comfortable with.

After the first day, we work together to decide on next assignment. If they have one or two patients, I have them come along with me for anything interesting on our other patients.

I tend to move pretty quick to the entire load while I work as a resource for them, and help them when they're getting a bit too far behind. For med-surg, the hardest part is staying organized and prioritizing the care for a whole load of patients. So I want them to start working on that asap. Figuring out what works for them and what doesn't, learning through trial and error.

I'm a big believer of throwing in the deep end and trying to swim, just making sure I'm nearby to keep them from drowning.

I learn best by immersion too! I bet your a great Preceptor!

[BostonTerrierLover, BSN, RN]

Hey, I need to admit that this AM when I replied, I didn't see "new" nurse. (sleep deprivation meets ADD)

I would still stick by alot of my plan, but the shadow period would be longer with skills practice, . . .then to the "deep end" like my quote from Wooh. I'm sorry I missed that.

I bet ya'll thought, "Wow, what a lazy XXXXXXX!" Lol, but I am always there if they need me, and watching from a distance. I always remember the shock of being new somewhere. But, with immersion, and full RN back-up, it does give them a chance to jump out of the plane with a parachute.

[BostonTerrierLover, BSN, RN]

Oh yeah,

And most Med Surg, and Med Surg/Tele floors I have worked on give them a skills checklist to work through before starting with a load. I try to help them get through that, But, kind of sit back and see how much initiative they have. I know this is a slippery slope, and I promise I don't mean this insensitively. As a nurse, you know how many deadlines we have, they have to feel out their own organization.

Plus, . . Give them a copy a of your cheat sheet! I know you have one, Lol, or at least show them how to format one. Once they master planning the day, unexpected events will be easier to deal with, and it teaches flexibility.

8 years later, when working as Staff RN, I still use the very same Cheat Sheet my Preceptor gave me.

:hug:

Lastly, if they are doing well, and advancing to your tastes and expectations, tell them! It really makes their day!! These first hours are crucial to how they will feel throughout their career!! They are going to be rigorous. Even though you get the occasional bad egg (extremely extremely rare), most are dying for postive reinforcement after 2 years of "constructive critism," and I don't want to sound like a self help book, but if you do have to correct them, tell them all the things they ARE doing well, then address where work is needed. Just saying, I know your going to do well here, but . . . makes a huge difference when addressing a negative. Chances are you won't even have to say it!

[Esme12, ASN, BSN, RN]

You have received excellent advice here but I would like to emphasize that you need to taylor your teaching to the students ability. A new grad needs far more gradual introduction to the life as a nurse and a seasoned nurse will have varying degrees of competence.

A new grad should spend the first few days learning the ropes. Watching you do orders, learning the computer, learning where things are, and where to go to the bathroom. I would introduce them to everyone we see AND be sure they spend a day or 2 with the UC/secretary/ward clerk to see what her job entails and get an overdose on the computer. Then slowly allow them to take on more and more responsibility by assessing the patients with you, then sending them to assess them without you, letting them see how an admission is done, then doing one. Slowly increase their responsibility until they have full load.

Positive reinforcement and gentle prodding with firm loving hand to guide them. Kind of like being a MOM. Everyday debrief and find out what they want/need.....and then just like a Mom, Let them fly solo.

Good Luck and Thank you for helping the next generation of nurses :loveya:

[nurseprnRN, BSN, RN]

if you think of any (and judging by a lot of these threads, none of us completely forget), you might throw in a couple of, "when i was new at this i thought thusandsuch, but then i learned/somebody taught me thisandthat was true/more accurate/worked better."

this accomplishes two things: 1, it validates that you know she's a work in progress and you are willing to help her get there with little pearls like that, and 2, it demonstrates empathy, shows that you remember what it was like to be a clueless beginner, which will make her less scared to approach you with a question. good things.

[GitanoRN, BSN, MSN, RN]

certainly, i agree with all previous post. in addition, i would like to add the following, as a preceptor not only the preceptee is being evaluated but also the preceptors capability in demonstrating their knowledge. furthermore, as a preceptor experienced nurses should share their knowledge and skills to help guide new nurses, while performing their usual duties. experience nurses in the role of preceptors, should embody confidence, capability, and excellent leadership. in addition, while mentoring their preceptees they should display patience and empathy. having said that, they shouldn't criticize their preceptees out loud in front of the patients, just to show that they are in command. moreover, preceptors should never gossip to their colleagues how inadequate the preceptees knowledge is or make fun of them. therefore, a preceptor should embodied a confident attitude without being cocky if you will. consequently, a preceptor should always remember that we were all in the preceptees position at the beginning. lastly, the preceptors role is to provide encouragement and support to future nurses in any given unit, since this reflects their capabilities to their facility. on the other hand, when a preceptor encounters a know it all preceptee deal with it accordingly. with that said, put an end to the well known statement that "experienced nurses eat their youngs"

[Vespertinas]

Everyday debrief and find out what they want/need

Important. You know how much you go home with in your head everyday...a new grad goes home with even more! A lot of it could be something misunderstood or very easily allayed. Some of those small things can fester if gone unchecked.