Preceptorship with no assigned preceptor?

[Kendrer]

Hello,

I am a last-semester nursing student, and I have just completed my first two shifts in my preceptorship assignment in preop/PACU. This assignment was not my first choice, but I decided to make the best of it. At first, I was told by my contact that I could simply make my own schedule and I would follow several nurses depending on the day. My clinical instructor said I needed to be assigned one or two preceptors. I was then assigned one, but she is the charge nurse, so she simply has me follow her for a bit, then has me follow one or two nurses after she starts doing her "charge nurse thing".  I am getting frustrated, because it feels as though I am being forced upon nurses that did not sign up to have a student accompany them, and it doesn't feel like a preceptorship experience at all. I have to re-introduce myself to each nurse, and then let them know that I am checked off to do most any skill. Of course I thought preceptorship would involve more learning to take ownership of a nurse's daily tasks, time management, etc. this simply feels like another unit rotation. I don't think I can change my assignment now, but I'm hoping that you all as nurse educators might have some words of wisdom for me, to try to get some value out of this final experience. I don't want to continually complain to my school's coordinator, but I feel like I don't know what else to do to advocate for my own learning experience?  I did try to get my assignment changed before preceptorship began, but was told there was nothing else. For context, I really want to be an OR nurse, and will apply to any OR new grad programs I can, but for now I am feeling defeated by this final clinical experience, that I was hoping to gain more from. Also, our clinical instructors are not on-site with us, and the instructor I was assigned to is not even a regular faculty member at my school. I have not even met her in person, only one time over zoom prior to starting preceptorship, so it feels very disconnected from my school program.  Any advice GREATLY appreciated!!

[NurseTechNurse]

This is an interesting dilemma. I hope others also chime in.

I am not a nurse educator but here are my two cents:

You are actually in a very prime position if you look at your situation from another angle.

With one preceptor, you can focus on learning that preceptor's habits. On the other hand, that preceptor may be doing things that are not necessarily correct and you may not know until you are told by someone else. Plus, your school would only have that preceptor's input on you to rely on.

With multiple preceptors, what you learn can get haphazard, especially if there is a lack of consistency between preceptors, but, with time and organization, you should eventually have an idea as to which preceptor is best to go to for "x" problem and when you are working with a particular preceptor, you will have an idea of what to focus on for the day. There are people who would happily showcase their strengths. Maybe there are nurses among them who are like that as well?

In your position, you have the opportunity to know several nurses, each with their own strengths that you can now absorb and make your own.

Do you have a list of specific goals you want to achieve during your time as a student in preop/PACU? Consider making a list of skills that you want to learn or improve on, and then, one by one, go down the list and make note of the nurse(s) who may be willing to let you practice that skill. 

Though, if none of the nurses seem willing to precept - 
-do what you need to do to pass, and if you can get the preceptorship done early, do so. 

-consider doing a Nurse Extern position with a more willing unit while prepping for the NCLEX. (Is your graduation this May? If so, you may not qualify for an externship, but, maybe you can work as a tech in an OR with the intent to eventually be one of their nurses) 

[Kendrer]

Thank you!  I will definitely use your advice, and I had never thought of trying to draw experience from different nurses who possess different strengths!  I want to make the best of this situation, and this gives me a game-plan for my remaining 4-1/2 weeks. Many of the nurses are also travelers, but at least I can take valuable morsels of experience and tips from nurses who come from all different areas of the country and experience backgrounds. 

[JKL33]

How is it going now?

I think this is an inappropriate situation, primarily because if I am correctly understanding that you are in a final preceptorship, the goal there is typically to work with someone who will help you gather loose ends and work toward being able to generally manage the basics of a daily routine and an assignment/patient load (obviously with help, but gaining some minimal comfort level and a bit of confidence and early-independence along the way).

It is not supposed to be following anyone around.

But you know that and I agree that if "it is what it is," then you are right to make the best of it.

If you're going to be with some different (and unsuspecting) person each day, then I would thank them, develop a good rapport with them as fast as you can by being eager and pleasant and very interested in the details of what is going on -- let them know that this is your final preceptorship and that your major goal is to learn to manage the basics of an assignment or at least part of their load.  Details are always important in nursing, but I dare say at the overarching goal with this part of your education is to get a big picture of what needs to happen with one's patient load on shift and the basics of facilitating/managing it.

If there's someone with whom you've had a particularly good day, see if there are any other days where their schedule may coincide with yours so that you could spend more time with them.

Good luck to you ~ ??