Preceptorship .. HELP!

NM nurse to be · Sep 17, 2010

I was going to post this exact same thread today!!! I am starting in a few weeks though. I have all the same questions you do! What is a typical day like for a preceptee? It's funny that in class, the teacher likes to keep this part kind of a mystery and says we'll talk about it when we get there... But I would way rather be a little more prepared than that. Sorry I don't have any answers for you but I'm glad you posted :) Good luck with your preceptorship!!!!!!

himilayaneyes · Sep 17, 2010

well, let me start off by saying it will be okay. basically, tackle one task at a time. finish one job, before you start another. prioritize. abcs. delegate to your pcas. check your charts frequently. ask for help if you need it. if something a md writes isn't clear, call and get it clarified. do what's best for your patient. in the future, depending on which area you work in, managing 4 patients will be nothing. wait til you have to take care of 6 or more. best of luck.:)

tyvin, BSN, RN · Sep 17, 2010

In the old days it was called clinical and a preceptor was a nurse who took a student under their wing and guided them but times have changed along with syntax. Anyway....

Listen very carefully in report. I like to do walking rounds but many nurses will not do this especially with a student nurse. Make a cheat sheet with your client's name by room number and bed with their Dx, doc and DOB with the code status at the top then, any special meds to be on the lookout for (diabetic, pain patient etc...), procedures for the day like tests or a wound change etc... diet, limitations, PT/OT, length of stay and how long they've been there. Make sure you understand why they are there and know there mental status as well as the physical.

Arm yourself with this info and things will go a little smoother. Ask these questions in report as the nurse giving you report should know the answers. One thing I like to do when I go in to assess at first sight is inspect quickly the body for anything that shouldn't be like for pressure sores, infiltrated IV etc...

Good luck

catshowlady · Sep 17, 2010

You will be OK. Your preceptorship will be a little more "real world" than clinicals were. You will go in each morning and get your assignment as your preceptor does. You will get report with her (or him!), and move on to your tasks just like you would if it were your assignment - assessments, meds, discharges, admissions, etc. For me, my preceptor was right there with me for everything until she was comfortable with me. A good preceptor will be there to support you, help you practice safely, make sure you don't get behind, help you find what you need, and teach you. My first day, I shadowed her in order to learn what routine worked for her, and what was expected. If you don't understand something, ask. Ask your preceptor to show you her tips for organizing her time and her pts. (For example, I fold over my kardexs and make areas on the back for VS, IV's, assessment finding, I/O's, labs, and issues that need to be addressed.)

You won't be able to prepare ahead of time as you do/did in most clinicals. Each floor has its own routine. Know what kind of floor you will be on and what kind of pts you will be caring for, and brush up on those diagnoses, meds, and nursing care. For example, I was on a cardiac/tele unit, so CHF, arrhythmias, and CP were prominent diagnoses. I passed lots of cardiac meds, and had to know how to care for pts post heart cath. (I was already a tele monitor tech, so that helped a lot!) As already mentioned, don't be afraid to delegate (nicely!) to the PCA's. You are not going to have time to give baths this quarter!

This should be a great experience for you. It's much better than clinicals, where your experiences are limited by how much time your clinical instructor can spend with you. Not bashing CI's at all, but when they have to spread their time over 6-8 students, it limits the time spent with each student.

Good luck!

:paw:

roma4204, BSN, RN · Sep 17, 2010

Very much of it will depend on your preceptor...if you don't get a good one, find another nurse on the floor who you can tag along with as well

netglow, ASN, RN · Sep 17, 2010

In report, if your off-going nurse says that the patient is a little tachy, you say, "how tachy." If that nurse says the patient is confused ask, "how confused." These things can signal new onset many things. Best to nail it down.

netglow, ASN, RN · Sep 17, 2010

Oh, and also watch how your preceptor does an assessment. It will be different than you've learned. Ask!!! and always say thank you for the tips and tricks. Do not insist on doing things as you had to for school, yes do your med rights check always, but for some of the other stuff, watch and learn.

RNRooBee · Sep 17, 2010

i finished school not to long ago and i had the same questions you do! my preceptor was amazing! i'm not sure if you can request a certain nurse or not... we were given the opportunity to request a nurse as long as we were not related. i re-learned so much that i was "taught" but never really understood (come to find out) and was told things that i know i was not told in class! if you feel as though your nurse does things just to "get by" and finish her day i would request a new preceptor! along with the everyday hustle and bustle of being a nurse set one more goal for yourself... learn something new about each patient you have every shift (not about the patients life necessarily but more so their disease process)! when my preceptor told me that this is her goal for each one of her students (along with not killing the patients) i thought she was nuts! holy cow... she wasn't kidding! i left every shift knowing at least one new thing about each patient's disease process!! i was one tired cookie at the end of the day but it turned out to be awesome! after the first few shifts i realized i was not retaining as much "new" stuff that i was learning as i would have liked; so, after every shift i went home and made myself type up or write out what i had learned that day and how my day went. i flagged, with a post-it, the disease process so i could find it later if need be. i have to say, i've got most of it down like the back of my hand but every once in a while i look back at my notes and it really helps! be confident in what you know and very open to learning a new way of doing things!!! keep in mind that the "real" way of doing things is not the nclex way of doing things.... keep them separated in your mind for just a little bit longer and you will do fine! good luck and most of all learn alot!!!!!!!! :nurse:

debi49 · Sep 18, 2010

Good luck with your preceptorship. I did one the summer before my last semester in school and it was the best thing I did. I learned so much and was much more confident my last semester. Plus I got a job on the floor as a tech the last semester and then as an RN after graduation.

nurse2033, MSN, RN · Sep 18, 2010

If you haven't already, create a workflow sheet. This is and sheet of paper that has basically some space for each hour of your shift for each patient (you might need more than one sheet of paper). You can fill in ahead of time the basics like getting and giving report. If you know the flow of your unit (like times for vitals, I/Os and so on) fill them in also. As you take report you can note any tasks and the time given in report. Then take a minute to look at the MAR and pretty soon you should have a good roadmap of your shift. You can have your preceptor look it over and makes suggestions, and edit it each shift until it works for you. This is a good way to practice time management. You will be reminded to check the chart and other tasks as you write them in. Don't get too upset if you are a bit off because something took more time than you thought. But it will make sure you're not way late on meds or other timely interventions. Good luck!

Stu_RNSOON · Sep 18, 2010

This sounds super helpful I start in November, and thats a good way to look at it since I always feel like I dont retain information. I will try to do this!