The One-Minute Preceptor

Being a nurse preceptor can be very rewarding, but it’s sometimes a rough gig. If you’ve ever been a preceptor, you probably had a “we’ll get to that when there’s time” task list that seemed to go on forever. A big hurdle for nursing preceptors today is finding enough time to coaching during the busy workday.

Imagine if there was a way you could effectively precept even when the only available time is 5 minute blocks (or less) throughout the workday. Enter….The One Minute Preceptor.

What Is It?

The One-Minute-Preceptor has been a tested and valued teaching tool for over 20 years. Instead of becoming overwhelmed with the “whole” of orientation, the One Minute Preceptor method makes the most out of time-crunched teaching opportunities.

The Five Microskills

The One Minute Preceptor method focuses on five microskills; skills that also teach clinical reasoning.

• Get a commitment
• Probe for supporting evidence
• Reinforce what they did well
• Give guidance on any errors or mistakes
• Teach a general principle

It’s Easy (Really)

Now, I realize “five microskills” sounds complicated, but the One Minute Preceptor is really easy to use. Let’s take a look at just one snapshot of the precepting day and apply the five microskills.

Case Study

You are precepting a new graduate nurse on a busy inpatient rehabilitation unit. A nursing assistant reports Mr. V (one of your 7 assigned patients) is asking for assistance to the bathroom for the 3rd time in the past hour. You tell the nursing assistant that you and the student will take Mr. V to the bathroom to assess what’s going on. The patient is 72 and is 3 days post stroke- with left sided weakness.

Assessment data

• Afebrile
• Urine frequency
• Voiding only small amounts
• No burning or itching with urination
• Pt obese and unable to palpate bladder
• Denies abdominal pain
• No history of prostate issues
• States “my bladder feels full”

Microskill 1- Get a commitment to the issue

Preceptor

1. Review the assessment findings with the new nurse
2. Ask them what they think the is going on with the patient

Examples

Microskill 2- Probe for supporting evidence

Preceptor

1. Ask what evidence supports the new nurse’s opinion
2. Ask what other alternatives were considered and why they were rejected

Examples

Microskill 3- Teach general principles

Preceptor

1. Use the opportunity to provide education
2. To make more memorable, phrase as a general rule “when this happens, do this”

Example

“Mr. V’s symptoms, other than urine frequency, do not suggest a UTI. Some stroke patients experience urinary retention following the event. When patients feel a strong urge to urinate but void little, it could be because they are not emptying the bladder fully. When this happens, the next step is to scan the patient’s bladder.”

Microskill 4- Let them know what they did right

Preceptor

• At the first opportunity, tell the new nurse what they did well. Be Specific
• Share the effect it had

Example

“You asked the patient great questions and were able to gather helpful subjective data. Mr. V appreciated your interest and concern.”

“You didn’t jump straight to the conclusion of a UTI and used deductive reasoning to eliminate what wasn’t the problem. We were able to address the issue faster without unnecessary legwork.”

Microskill 5- Correct Any Mistakes

Preceptor

If a mistake or omission is made by the new nurse, as soon as possible find an appropriate time and place to discuss:

1. Let the new nurse critique their performance
2. Then discuss what was wrong
3. How to correct in the future

Example

“You may be right that Mr. V’s prostate is enlarged. But, we still need to assess to determine if the patient is retaining urine”

“You correctly performed the bladder scan, but you need to be sure to explain the procedure to the patient”

Putting it All Together

You may be thinking… “This will take forever to get through”. But, the One Minute Preceptor is patient-centered and uses your nursing duties throughout the day to teach. This approach allows you to provide meaningful coaching in five minutes or less.