Preceptorship.....

[RnH15]

So-I am going into my FINAL semester of my BSN program (thank you jesus!) It's time for us to select units to precept on and I am looking for some thoughts/advice/insight......Many of my classmates know EXACTLY where they want to precept. While I do feel drawn to a couple of areas of nursing, and also have some ideas of places I do NOT fit in, I am not as sure about how to weigh that with my preceptor decision. My top 2 areas seem to be oncology and telemetry with L&D close behind. I feel that if I were to precept in something like oncology or L&D I would be placing myself in a small box way too early. Everyone talks about how "boring" med surg is( many classmates are running for ER or ICU ), but I'm thinking that choosing Med Surg or even Telemetry to precept would be beneficial because I would get a wider range of experience and skills. I just need to talk it out and bounce ideas off of people who speak the language

[NICU Guy, BSN, RN]

I would go with Oncology. Preceptorship is an in depth experience at a specialty that interests you. That way you can see if it is a good fit for you. What would happen if you took a job in another area and then applied and offered a job in Oncology and hated it? What you call a "small box" is also called specialized. You would be more likely be hired on an Oncology floor with a preceptorship in Oncology than applying for an Oncology position with a Meg-surg preceptorship. I chose a NICU preceptorship and I am sure that I wouldn't have been offered a position in a NICU as a new grad without the preceptorship.

[Lev, MSN, RN, NP]

Anywhere you will go, you will learn something. I had a student with me this past semester on my med surg unit and she learned a ton. Med-Surg is not boring. Med-surg is really busy and you will learn a ton. A lot of what you get to do depends on the policies of your school and of the clinical site. My student had some classmates with a med-surg preceptorship at a different hospital and they were not allowed to pass meds or put in IVs. By the end of her preceptorship, my student was passing all meds (but not IV pushes - not allowed by her school) on 4 patients (our ratio is 1:5) in addition to much of the documentation, including head to toe assessments. In addition, she got to draw blood for the first time, inserted her first IV, first foley catheter, hung blood for the first time etc. A lot of firsts. You will learn a lot whereever you go. Med-surg is always a good bet. Telemetry is also a great idea. My preceptorship was in PACU and my first job was in Telemetry. I was not happy about being in PACU initially, but I learned a lot and got to do cool things like an arterial stick and I made a great friend (my preceptor who I hang out with to this day). And I decided I will work in PACU one day when I want a less crazy job.

[RunBabyRN]

I agree that you will learn a lot, no matter where you go.

How are your med/surg skills? I don't think many people would be bored in med/surg. There's a lot of variety, and you are generally pretty busy. How many patients were you taking by the end of the last semester you were in med/surg? Our program didn't let you specialize unless your med/surg skills were solid.

I had actually requested either tele or med/surg, but then the med/surg manager was heading up to mother baby. My goal is to work in L&D. I liked the manager, and I spoke with her. She offered to help line up a preceptorship up there, and halfway through the preceptorship, she offered me a position. Sadly, there was a hiring freeze when I got licensed, and she couldn't bring me on board.

That said, looking for positions in that area of nursing, it's been good. Managers do ask about preceptorships. However, don't think that because you precept somewhere that you've been pigeonholed into that area of nursing. I've interviewed for ICU and ED and been the #2 choice in both units (so close!!), and I have another ED interview Friday. I currently have 3 jobs, only one of which has anything to do with my preceptorship (I work at a freestanding birth center).

While mother baby skills, for the most part, don't seem to relate to ED or ICU, I still learned a lot that correlates to those areas. There's a lot of patient education, managing family dynamics, watching for a patient who's about to decompensate on you (especially on the high risk MBU I was on), learning to manage your time well (especially with couplets, where it's not 4 patients, it's 8!), taking and giving report, taking an admission, discharging patients, the list goes on. Certainly there were things I didn't see, but any unit will have its limitations.

Ask your clinical instructors for guidance, because they've seen your performance in the hospital. This is something I did. I actually got very mixed feedback, because one instructor is very much of the mind that every nurse needs to start on med/surg before specializing, and that if you go straight into a specialty, you can never get out of it. The other, one I spent 3 semesters with, thought I was nuts for going with med/surg because I had it down (taking a full patient load and only asking the nurse to help with things beyond my scope of practice as a student), and she knew that L&D is my dream. She was really helpful with that manager and coordinating the change in my preceptorship.

[RnH15]

"That said, looking for positions in that area of nursing, it's been good. Managers do ask about preceptorships. However, don't think that because you precept somewhere that you've been pigeonholed into that area of nursing. I've interviewed for ICU and ED and been the #2 choice in both units (so close!!), and I have another ED interview Friday. I currently have 3 jobs, only one of which has anything to do with my preceptorship (I work at a freestanding birth center)"

Thanks! I think that is where I am getting hung up....I personally don't think med surge is boring at all, I enjoyed my time on a general med surge floor. It was my shortest clinical but I definitely learned the most. My med surge skills are good, Im a student so obviously they still need work-I had no problem taking a 3-4 patient load including all assessments, meds and discharge teaching. I know that my skills need practice (mainly things like insertion of IV, cath, NG)because I haven't been in settings with opportunities lately. I guess I was worried that if I precept in med surge and then go on to apply for a job in a more specialized setting there will be question of why didn't I try to precept in that area.....or vice versa, if I pursue a preceptorship in oncology or even L&D and then end up applying for a med surge or tele position I may lose out because I would have less experience.

[classicdame, MSN, EdD]

think of othis as another loop to jump thru. Where ever you end up will be fine as you are more interested in critical thinking, not specific patient. Take this worry stone out of your pocket.

[springchick1, ADN, RN]

I precepted this semester in the ICU. It was my last choice and I dreaded every second of it. I ended up LOVING it! I learned more and performed more skills during my preceptorship than I did over the course of the program. A girl in my class precepted in L and D and says now she wishes she hadn't.