Preceptoring a new grad...

[Jen,RN]

Hey! I have been a nurse for almost two years. I was asked to precept a new grad and I was very excited and nervous. I had been a preceptor to a senior student before, but not a new graduate RN.

My issues that I am having....

• when to tell them what they need to do or have them figure it out.
  
• how to deal with a preceptee that does not take criticism, gets very defensive.
  
• feeling like my knowledge is not important because preceptee is doing 'ok' care to get though the day, but I am trying to make them do great care.
  
• feeling like I am having a nurse identity crisis. I miss being a bedside nurse and I feel like I am missing out on the things that I love doing.
  

I have been with my preceptee for 6 weeks now. At first I gave them the benefit of the doubt thinking that the reason why they are not asking questions or being responsive to me is because they are nervous. But my preceptee came right out and said they feel comfortable and compared to the other new grads is taking on more patients than anyone. I try to be kind when I give corrections, but I am afraid that I haven't been hard enough and my preceptee is taking advantage of me and not listening to what I have to teach.

[Piggles]

Thank you for sharing your perspective. I am just about to start my preceptorship in my senior year and I am trying to prepare myself by imagining what concerns and goals my preceptor will have. It sounds to me like you have high standards and you know what an asset you are. It is unfortunate if your pupil is not aware of this opportunity.

[HollywoodDiva]

Did you take a formal preceptorship class that is a 2 part beginner and advance class? Those classes offered by your facility would or should have taught you how to precept and handle situations.

[classicdame, MSN, EdD]

there are articles on precepting found on the internet. Also, if your facility has not done any training for preceptors, that is a MUST! The Association for Nursing Professional Development has a bookstore to order manuals.

[Liddle Noodnik]

I try to be kind when I give corrections, but I am afraid that I haven't been hard enough and my preceptee is taking advantage of me and not listening to what I have to teach.

The worst thing for me is finding out "in the end" that I was not doing a good job. Do them a favor and let them know honestly what you think. Maybe there is another person who could sit in with you while you tell them? altho that will make them even more testy. I don't know. All I know is a nurse who thinks he/she knows it all is a dangerous nurse, and it could also be that they are too scared to admit they need help or that they don't know.

hope it goes ok, I am no good w/ confrontation either

[Despareux]

I am a new grad and will be working with a preceptor for 12 weeks. I hear she's fabulous and I am super excited about working with her. Even though I am nothing like the preceptee you describe, your post helps put my expectations into perspective. Thanks.

Since you've been with this person for six weeks, maybe you could have a "mid-term" evaluation of each other. This may give you both an opportunity to be honest without hostility.

[FMF Corpsman, MSN, RN]

But my preceptee came right out and said they feel comfortable and compared to the other new grads is taking on more patients than anyone.

I guess it comes right down to what kind of care the patients are getting from your preceptee then doesn't it? At one point in your post you state that they are getting "okay care, but that you are trying to get them to do great care." You must have approved for the increase in the patient load right? Why would you have increased the patient load, if the care was only half-assed to begin with? It sounds as if you are doing both yourself and your preceptee a disservice by sending mixed signals. You need to be more precise in what you expect from them and you will in turn, have a better nurse at the end of the program.

[Tarabara]

What do you mean by "taking advantage of you"?

I'm a new grad with 6 months experience so my precepting wasnt too long ago. There was a day when my preceptor 'hid' from me so that I was forced to figure out issues on my own or learn how to go to coworkers without always relying on her. She of course was paying attention enough to know the patients were safe and I wasnt completely drowning. That day was sort of the turning point for me when I really began to take on the role by myself and only go to her for new things or things I didnt understand. Maybe you could try that?

[jennilynn]

There are some new grads where I work that are super cocky and know everything (more than our seasoned nurses), in their mind. They have precepted with some of the best nurses we have and carried out that attitude for 12 weeks. Resistant to what their preceptor was teaching, was very disrespectful to the techs and worked them to death, and, when confronted with an error, the response was always "I know" or an argument.

Guess what? They got a crash course in RN 101 once they were solo when they made several med errors, had a fall, and no one would step up to give a hand when they are drowning.

The preceptors do regular progress checks with our unit management, so these attitudes and actions were noted and they were allowed to go on their own.

A word of advice I always pass in to new grads is Be humble and be gracious, this will take you far in your career.

[ncat]

having precepted many...more exhausting than a tough day if u take the responsibility seriously. i found that-depending on the school new nurses graduated-that their self-perceptions could be quite dif. taught to be leaders and the go-to people many do not have an interest on bed side and day to day events. i agree-being humble and taking notes and listen'g is the best advice to give any new grad.

and...many preceptors are not ready themselves to precept and only u can answer that after u have been trained and precepted.best of luck and fufillment.

[Kayla.J.RN]

As a new grad currently on my 6th week of orientation. I am finding that feedback from my preceptor is the best thing that has helped me so far. I always like hearing when I am doing a good job, but I also like to know if there are certain things that I need improvement on. Little tips here and there about how to do things better or more efficiently is great.

If your orientee is not taking the initiative in asking questions... ask if they have any questions or if there is anything they would like you to go over with them. They might be too shy or embarrassed to bring things up on their own. It might also be good to ask your orientee what they think their strengths and weaknesses are.

I hope that helps a little. Good luck.