preceptor questions?

Seaofclouds, BSN, RN · May 8, 2015

This varies a lot place to place and preceptor to preceptor. There is no one set standard that always happens with precepting.

Generally speaking, when I oriented new staff, I started with them following me and then had them start to take over the assignment slowly. They'd start with one patient for a shift or two, and then add another one, and so on until they were taking a full assignment on their own. I always wanted to make sure they were taking a full assignment before our time together was over. If that meant we needed more time, I would tell the manager I needed another week or so with the new employee. As they were being more and more independent, I would try to give them space to work on their own, but I would always watch them throughout the day. I'd check their documentation, watch their medication passes, and watch how they perform their clinical skills. There is always a packet that the preceptor has to sign off saying the new employee is competent to perform specific skills. If there is a skill we did not have a chance to do during the orientation period, I always make sure to discuss it with the nurse so they have at least an idea of what to expect for when it comes up.

dudette10, MSN, RN · May 8, 2015

so generally speaking, 6 weeks to precept for a new grad.. maybe more or less... how long into precepting should your preceptor leave you alone to handle the patients? and how often should the preceptor check on their "preceptees". should the preceptor be in with the preceptee or at least close to the preceptee? because nursing as a preceptee is way different from nursing school.

There's no set rule. It depends on how quickly the preceptee is catching on, the comfort level of the preceptor with the preceptee, and the personalities of both. Some orientees believe they are ready to be on their own, but the preceptors might have a very different opinion.

HouTx, BSN, MSN, EdD · May 8, 2015

This is a conversation that OP needs to have with the preceptor in question. They need to be on the same page re: goals and objectives for orientation, including time-lines for accomplishments & criteria that will be used to determine "success". Most of this should actually be written down somewhere on an orientation plan.

A good rule of thumb I have shared with all of our educators - by midway of the 'guided practice' (preceptor assisted) the new hire should be able to cope with a normal patient load. If not, it's time to foam the runway... having that crucial conversation to let the newbie know what needs to be changed/improved to avoid crashing and burning.

strive2Bbetter · May 8, 2015

yesterday was my third day precepting. and yesterday my preceptor left me alone with four patients... then we got an admit. I'm still learning... and there are things that I'm still not comfortable with, so I would ask my preceptor to just watch and make sure I am doing things right. I could not find my preceptor anywhere when I needed my preceptor. my preceptor hasn't checked on my documentation, barely shows me where to go on the navigator... I had to ask four or five other nurses for help because I couldn't find my preceptor anywhere on the floor. and when I found my preceptor I straight up told them, " I'm drowning, I'm need your help. " and they responded with, "me too". I know it's hard when the preceptor has patients plus me. but as I've said before it's my third day. my preceptor is nice.. but It's hard to know if I'm doing anything right because I don't get any feedback from her. and when we were giving report on shift change, they acted like they were busy. some of the nurses knew I was struggling. my preceptor left me to sink or swim. and I know that's how nursing is.. but isn't my preceptor concerned about their patients too? after all they're still patients. I see how the other preceptors are with their preceptees. they're with their preceptees in the beginning. then they let them take a few patients... and they tend to their preceptees and check on their documentation. after they're done with their patients, I see them standing out the door where their preceptees are watching them..

Seaofclouds, BSN, RN · May 8, 2015

How many patients are in a normal assignment on your unit? How many patients did your preceptor have that day you mentioned? Was something major going on with one of her patients?

You may need to discuss this with your preceptor and manager. Try talking to your preceptor first about your concerns and need for feedback. If that doesn't improve things, speak to your manager.

strive2Bbetter · May 8, 2015

How many patients are in a normal assignment on your unit? How many patients did your preceptor have that day you mentioned? Was something major going on with one of her patients?
You may need to discuss this with your preceptor and manager. Try talking to your preceptor first about your concerns and need for feedback. If that doesn't improve things, speak to your manager.

4-5 patients usually. and nothing major going on with the patients, because I was the one who took care of them all.. one of our patients went to the OR and my preceptor admitted another patient, but because they had me doing the work, I didn't get a chance to learn or see how to admit a patient. I guess I could handle the workload, but mind you, this was my third day and I spoke directly to my preceptor when I felt uneasy or uncomfortable with something that I haven't done or needed help with. a lot of the nurses and pca have already given me the sympathy face on my first and second day, as they knew I was trying my best to do it on my own. so I'm grateful for them. but it's hard when they have their patients and preceptees to look after. they can't take on another preceptee. I don't want to start any trouble on the floor, as I will be working along my preceptor when I am on my own. I feel like asking for a other preceptor would burn my bridges.

Libby1987 · May 9, 2015

If there is such a glaring difference between preceptor behavior on your unit with your preceptor being the stand out of neglect, that seems a simple clear cut thing to bring up, starting with the preceptor.

"Your style of attention and support is a 180 compared to everyone else, can we follow their model a bit closer?"

No? Well I have an unfair disadvantage, how would your prefer me to handle it?

Now if you're exxagerating about your preceptor's abandonment, that will probably bite you.

strive2Bbetter · May 9, 2015

If there is such a glaring difference between preceptor behavior on your unit with your preceptor being the stand out of neglect, that seems a simple clear cut thing to bring up, starting with the preceptor.
"Your style of attention and support is a 180 compared to everyone else, can we follow their model a bit closer?"
No? Well I have an unfair disadvantage, how would your prefer me to handle it?
Now if you're exxagerating about your preceptor's abandonment, that will probably bite you.

no I'm not exaggerating. this is my first job. I want to make sure that I am doing things the right way. it's better for me to get into the habit of doing things the correct way in the beginning. so yeah if I have questions I'm gonna ask. any of my concerns, I let my preceptor know. but my third day with preceptor, it was very hard. I had to ask other nurses for help because I didn't know where my preceptor was. I tried to stay as close to my preceptor to learn and understand, but as soon as I turn around because I'm being called about a patient, my preceptor is walking off doing other things. I don't wanna fail in this so of course n

NicuGal, MSN, RN · May 10, 2015

So, you have your own patients

and she has her own patients? Your post isn't making sense to me. What were you doing when she was admitting the patient? And if she is truly neglecting you, you need to say something to the manager or educator. It would seem that you should be setting a plan for the day and following it with her.

strive2Bbetter · May 10, 2015

So, you have your own patients
and she has her own patients? Your post isn't making sense to me. What were you doing when she was admitting the patient? And if she is truly neglecting you, you need to say something to the manager or educator. It would seem that you should be setting a plan for the day and following it with her.

I'm a new grad and was on my third day orienting when my preceptor started to hide from me when it came to our patients. they would tell me to get the meds and that they'd be right behind me. as soon as I look to ask for help my preceptor was gone. and then I'd end up asking another nurse for help, which was fine since most are helpful. and then when it came to passing meds, when I had my PPE on and waiting for them to come in and look to check if I was doing right, my preceptor was walking down the hall. so I would look for another nurse to guide me that day or I would end up waiting because I was uncomfortable. I couldn't bring my meds because of the isolation. when I didn't have meds but had questions regarding iv pump I would end up having to take off my PPE to look for the nurse who was gone. I've communicated with my preceptor that there are things I'm not comfortable with yet and would like for them to go with me to make sure i was doing things correctly, but I couldn't find my preceptor. my preceptor and I have the same patients. i don't know how or what the preceptors are supposed to be showing their new orients, but that day was definitely hard for me. my preceptor said that the admit was already done by the previous dept they came from, but I thought that each floor had to do their admits when they were getting a new one?

NicuGal, MSN, RN · May 12, 2015

Sounds like you need to have a chat with the unit manager. And you keep saying "they" as if you have more than one person, but I don't think that is the case.

You and and your preceptor should be doing the patients together, you need to speak up before something happens.

And as as for isolation, there is no reason you can't bring your meds with you. Check your MAR, get them and take them with you.