Precepting

[CPLove2013]

I have recently been asked to precept a new nurse to our facility. Although the nurse is new to our facility, they are not a new nurse. I understand that the computer/charting system is different at each and every facility so I have been focusing a lot of teaching on this process. Now, however I have begun to get frustrated that my orientee has caught on to some of the charting and I am trying to show them additional things, such as checking the charts for orders and I have to remind them several times to check your charts! Also, I guess that being an experienced nurse, I didn't expect to have to tell my preceptee certain things. For example, if you medicated the patient for pain and 1 hour later the patient is requesting additional pain medication you have two choices: explain to patient pain med is not available for 3 hours and offer non-pharm solutions or call the doctor for additional meds.

Any suggestions on how to 'push' my orientee to spread their wings and fly........because they are 'experienced' their orientation days are limited.

[veggie530]

I think your expectations of not having to show them certain things is telling. Just because they have experience doesn't mean they are fast learners... they may even be slow learners! They're not going to learn everything you tell them during your time precepting them. Take 5 minutes and make a short checklist of things you do:

a.) before you begin patient care (like 8 hour chart check, fill your pockets with supplies, etc.)

b.) before/after you go to break/lunch

c.) before you clock out

They'll learn the ropes over time. Or not and get fired, lol.

[HouTx, BSN, MSN, EdD]

If only all our preceptors were as conscientious as you, it would be a much better world for new hires/ new grads.

I suggest that you clearly communicate expectations in terms of measurable outcomes and timelines. For instance, make sure that your newbie understands the standards/policy for administration of prn pain meds which includes post admin assessment & patient education (dose, frequency, etc). Then - tell her that in order to meet the goals of orientation, she must be able to follow this standard without any reminders from you - no exceptions - by a specific date. Let her know that failure to meet expectations will result in consequences - including possible termination. Afterward, you need to follow up. If she is unable to implement a very simple standard, she is not meeting expectations.

Be sure that your manager is on board first. Your job is to ensure that the orientee clearly understands all of the expectations as well as the consequences for failure to meet them. You can educate, demonstrate, coach and reinforce... but DO NOT become a crutch (everlasting support) for inadequate performance. It's a patient care department, not a halfway house for semi-competent nurses.

Don't fall into the trap of equating experience with competence. As an educator, I can assure you that experience does not automatically produce expertise... it requires effort and the ability to actually learn from experience. Some people are incapable of this. Don't feel guilty, because your first responsibility is always to the patient.

[classicdame, MSN, EdD]

If you have an Educator in your facility I recommend you contact that person for assistance. Many people are not aware that Educators have special skills and resources regarding adult education and may be able to guide you further.

[CPLove2013]

Thank you everyone for the suggestions!