Precepting Pearls

[rac1]

Tell me what your preceptor did great that helped you learn, feel confident, and do a good job.

I'd also like to know what your preceptor did poorly that frustrated you, and made you had a poor relationship which slowed down your learning.

If you have any suggestions that are pearls of wisdom for teaching/precepting those that lack critical thinking/judgement - lay it on me.

I am precepting a new grad - precepted plenty of nurses at this point, this one is rough. New grad is eager and willing, but slightly entitled and cocky, also not a critical thinker.

Would love some ideas, fresh takes and best tips......

[rac1, ASN, BSN, RN]

On 5/25/2022 at 11:27 AM, DrNurseCNS said:

rac1 sounds like you are really trying with this new nurse and it's time for a "come to Jesus meeting" with you, the new grad, the manager and the educator. A formal action plan needs to be in writing delineating where she needs to improve and what the metrics are that will show improvement. Be clear and concrete (maybe use SMART goals?) so that upon the next meeting it is easy to show where she has had success and where she is falling short. Continue your Socratic method of making her answer what the main problems and priorities are for patient care that shift. I also agree that she may have figure things out on her own (as long as there is no danger to the patient etc) without you rescuing her.

Maybe she is not cut out for your particular area of specialty and might be a better fit elsewhere--just don't make her someone else's problem!

This action plan documentation will be useful in setting further goals and for probationary review, or worst case scenario, dismissal.

Manager meeting check. Educator meeting check. Come to Jesus check. I think I put some things in place that will move us forward. And I now believe that at this point it is time for the "figure things out on her own." I'm feeling more positive about the outcome!

Personally, I don't think she is fit for a specialty unit and she should have gone to a med/surg type floor. However, I wasn't asked my thoughts in the hiring process (har har). After some good reflection time, I think I've trained well-fit nurses. I don't think she was well-fit to come into a specialty, so the learning curve is steep. But that does not change anything about the situation because they aren't going to unhire her. So onward I plod... ? 

20 hours ago, NurseMentor4fun said:

I just participated in a webinar from ANPD that discussed Trauma informed professional development.  It was amazing and it had some ideas that I found useful. For some nurses the transition from student to able practitioner can be difficult or traumatic.  Remember to make discussions of how new nurses is feeling a part of normal orientation.  Sometimes we can find that a distraction outside of work is making it difficult for them to concentrate at work. It could be that their own lack of confidence is making it difficult to absorb the information that they really need.

Here is a link to the article that the webinar addressed. 

The Healers are Broken A Call for Trauma-Informed Professional Development in Nursing Https://doi.org/10.1097/NND.0000000000000761

I also believe the above mentioned action plan is a must do at this point. If a concrete plan with defined expectations doesn't fix the problem then maybe trying another specialty area is in order.

Good luck.

You're right - this is a hard transition and not every person does it the same. Thank you for sharing the link.

[rac1, ASN, BSN, RN]

14 hours ago, Michelle K said:

I will never forget this, but she made me check all the lines, IV, talk to the patient, and super fast environmental check, its likes going in as a super nurse with all the senses open. Of course, I never learned this immediately but have mastered it throughout the years. You will be surprise how many nurses waste so much time, when they are about to start an IV infusion, but the IV does not work. 

This is one of the first actions I teach nurses, and why I teach the importance of bedside report. One of my main issues in my current situation is that I have said things 15 times and she still isn't doing it until I say "did you check if your lines are all labeled?" or whatever (and I do wait a while to ensure she really just forgot). But great advice - I love it and I do teach this.

[londonflo]

14 hours ago, Michelle K said:

she made me check all the lines, IV, talk to the patient, and super fast environmental check, its likes going in as a super nurse with all the senses open. Of course, I never learned this immediately but have mastered throughout the years.

I always said it is like taking a photograph of the bed/patient,   in other terms,  you said an environmental check...bed at low position with call bell, IV at right rate, any questions about the site (swelling), NG draining,  patient  at least comfortable and appropriately responding to questions, foley draining, ( this can be a 'drive by assessment'. )