Tips For Being A Preceptor

[pinkdoves, BSN]

For some unknown reason my supervisors have selected me to be a preceptor for the nurse interns coming this Summer. I have only a little over a year of experience and have never been a preceptor before. Also, as a new nurse, I had THE WORST experience with my preceptor so now I am kind of scared to be precepting someone.

Does anyone have any tips on how to do this?

I work at a teaching hospital so I guess I already teach students...but now it is more official and I'm scared/nervous I won't be a good resource to students since I am kind of new myself

[Closed Account 12345]

First, I would ask if this is a requirement at the one year mark.  If I remember correctly from other posts, aren't you still kind of struggling to find your own nursing groove? (I don't mean that in a bad way- to be expected for many new nurses!)

If you must precept:

-Let them observe you for first shift or two while you narrate and discuss your care in detail- things you're thinking through, supplies you need and why, related policies, how you're prioritizing things, what you're assessing and looking/listening for, expected findings, common variations from expected findings and how you'd respond if you identified an abnormality, medications you're giving along with related allergy information, contraindications, nursing considerations, etc. Just talk through everything and give them a chance to process. 

-Encourage questions. Don't make anyone feel stupid for asking questions. You remember what it was like to be a day 1 nurse.

-Ask questions to get an idea of your orientee's thought processes and understanding.  Never make them look stupid and incompetent in front of a patient by shaming, but once you step out, it's OK to say "Hey, can you tell me what you were thinking when ___?" With that said, also don't allow them to do anything that IS stupid or incompetent to a patient. If you see something dangerous, discretely intervene and address it privately afterwards. 

-Introduce them to unit staff from secretaries to doctors. Show them where to access unit policies. Show them where to find contact information. Make sure they have all needed access codes. Show them how to find the cafeteria, radiology, blood bank, etc.

-Before entering the room to perform a procedure for the first time, have your orientee walk you through supplies she needs, steps she'll take, what she's looking for, etc. Have her narrate what she's thinking/doing the first time she does a procedure so you'll know if she "gets it" or if you need to further intervene.

-You and your new grad orientee both complete assessments individually.  Afterwards, compare your findings. Did she hear clear breath sounds when you heard wheezing? Ask her what wheezing sounds like. Have her listen again. Check positioning of her stethoscope and ensure she's listening through entire respiratory cycle of inhalation and exhalation in each spot. Again, do all of this in a way that's encouraging and educational, not demeaning or shaming. Don't trust her to perform assessments independently until you two are consistently getting the same findings. 

-Give honest feedback at the end of the day. In your mind, think of 3 positive things you can address and 3 areas for improvement. It's easy to want to give positive feedback only to avoid hurting feelings or because you want to be liked, but that doesn't help a new grad grow... and there ARE always areas for improvement in a new grad. (ie time management, remembering to gather all supplies for procedure at one time, prioritization,  etc.) Give specific examples from your shift along with what you'd have done differently so they can make needed adjustments. Ask if there's a goal they'd like to work towards and how you can help.

-Don't gossip. Don't be the nurse who says "We're supposed to ABC, but you can just XYZ instead." Be a good example of doing things right.

-If you don't know something, find the answer together! Show your orientee that it's OK to have questions even 1 year in as long as you're willing to find the answers. That's so much safer than pretending to have all the answers.

[pinkdoves, BSN]

3 minutes ago, Closed Account 12345 said:

First, I would ask if this is a requirement at the one year mark.  If I remember correctly from other posts, aren't you still kind of struggling to find your own nursing groove? (I don't mean that in a bad way- to be expected for many new nurses!)

If you must precept:

-Let them observe you for first shift or two while you narrate and discuss your care in detail- things you're thinking through, supplies you need and why, related policies, how you're prioritizing things, what you're assessing and looking/listening for, expected findings, commom variations from expected findings and how you'd respond if you identified an abnormality, medications you're giving along with related allergy information, contraindications, nursing considerations, etc. Just talk through everything and give them a chance to process. 

-Encourage questions. Don't make anyone feel stupid for asking questions. You remember what it was like to be a day 1 nurse.

-Ask questions to get an idea of your orientee's thought processes and understanding.  Never make them look stupid and incompetent in front of a patient by shaming, but once you step out, it's OK to say "Hey, can you tell me what you were thinking when ___?" With that said, also don't allow them to do anything that IS stupid or incompetent to a patient. If you see something dangerous, discretely intervene and address it privately afterwards. 

-Introduce them to unit staff from secretaries to doctors. Show them where to access unit policies. Show them where to find contact information. Make sure they have all needed access codes.

-You and your new grad orientee both complete assessments.  Afterwards, compare your findings. Did she hear clear breath sounds when you heard wheezing? Ask her what wheezing sounds like. Have her listen again. Check positioning of her stethoscope and ensure she's listening through entire respiratory cycle of inhalation and exhalation in each spot. Again, do all of this in a way that's encouraging and educational, not demeaning or shaming.

-Give honest feedback at the end of the day. In your mind, think of 3 positive things you can address and 3 areas for improvement. It's easy to want to give positive feedback only to avoid hurting feelings or because you want to be liked, but that doesn't help a new grad grow... and there ARE always areas for improvement in a new grad. (ie time management, remembering to gather all supplies for procedure at one time, prioritization,  etc.) Give specific examples from your shift along with what you'd have done differently so they can make needed adjustments. 

-Don't gossip. Don't be the nurse who says "We're supposed to ABC, but you can just XYZ instead." Be a good example of doing things right.

-If you don't know something, find the answer together! Show your orientee that it's OK to have questions even 1 year in as long as you're willing to find the answers. That's so much safer than pretending to have all the answers.

I am still trying to figure things out for myself! that's why I am nervous

[Closed Account 12345]

2 minutes ago, pinkdoves said:

I am still trying to figure things out for myself! that's why I am nervous

I think it is perfectly acceptable (and wise) to communicate that to your unit manager and educator!  Let them know you look forward to precepting in the future when you feel more confident, but for now, you're still trying to figure out the day to day on your own.  They're doing both you and the new grad a disservice if they ignore your input. And don't feel bad that you're not ready and still figuring things out... You're still new! You'll figure it all out soon enough. ?

[pinkdoves, BSN]

1 minute ago, Closed Account 12345 said:

I think it is perfectly acceptable (and wise) to communicate that to your unit manager and educator!  Let them know you look forward to precepting in the future when you feel more confident, but for now, you're still trying to figure out the day to day on your own.  They're doing both you and the new grad a disservice if they ignore your input. And don't feel bad that you're not ready and still figuring things out... You're still new! You'll figure it all out soon enough. ?

yes-im confused bc my unit has nurses that are way more experienced than me. IDK why they weren't selected to do this? maybe bc they are generally older, in school, have kids? IDK the reason but I found it a little odd tbh

[Closed Account 12345]

16 minutes ago, pinkdoves said:

yes-im confused bc my unit has nurses that are way more experienced than me. IDK why they weren't selected to do this? maybe bc they are generally older, in school, have kids? IDK the reason but I found it a little odd tbh

I feel like so many times preceptors are assigned based on personality.

Example: Amanda is so nice and bubbly, and patients like her. Let's put a new grad with her! (....while giving 0 consideration to real experience)

[pinkdoves, BSN]

26 minutes ago, Closed Account 12345 said:

I feel like so many times preceptors are assigned based on personality.

Example: Amanda is so nice and bubbly, and patients like her. Let's put a new grad with her! (....while giving 0 consideration to real experience)

I guess that would make sense given I’m the “nice” one lmao 

[Nunya, BSN]

32 minutes ago, Closed Account 12345 said:

I feel like so many times preceptors are assigned based on personality.

Example: Amanda is so nice and bubbly, and patients like her. Let's put a new grad with her! (....while giving 0 consideration to real experience)

That's exactly what they did at a military hospital I worked at.  The "preceptor" had LESS than 1 year's experience on the floor, and it was her first assignment as a nurse.  But she was bubbly and fun and young.  Too bad she really didn't know what she was doing yet.

[amoLucia]

pinkdoves - I note that you have one very strong asset in your favor.

That is, by your own preceptor history, you know what DIDN'T work!  You have the opp'ty to provide a good experience for other newbies. It's normal, and even a good thing, that you have concern re your ability.

I say EMBRACE IT, GIRL!! And go for it.

Good luck to you. After a little while, come back and give us an update.

 

[Kitiger, RN]

All this talk about preceptors confuses me. As a student, I was always under the supervision of my nursing instructor. In my opinion, the school of nursing should finish the job, even if it means placing the (almost graduated) student on the hospital floor to work as a new nurse with their nursing instructors supervising them. That's almost what we did as seniors in Advanced Med Surge in my Diploma nursing school. We had almost a full load of patients, with instructor supervision.

Now, they graduate students who are anxious, fumbling, and lost on the floor, and they expect the overworked nurses on the floor to supervise the newbies. 

I don't get it.

[pinkdoves, BSN]

you guys will not believe this...I am precepting the new intern without issue but now...I just got an email from my supervisors saying I will be precepting one of the new nurses coming to our hospital. this RN has 4 years of peds ER experience (I have one year peds med/surg in total). I'm confused on how this is appropriate.Is this normal??

[Wuzzie]

10 hours ago, pinkdoves said:

you guys will not believe this...I am precepting the new intern without issue but now...I just got an email from my supervisors saying I will be precepting one of the new nurses coming to our hospital. this RN has 4 years of peds ER experience (I have one year peds med/surg in total). I'm confused on how this is appropriate.Is this normal??

So for this one you switch to orienting to policy and procedures for your facility rather than educating about pediatric care. She may have more peds experience than you do but you have more experience than she has on your unit.