Tips for being a preceptor?

guest042302019, BSN, RN · May 30, 2017

Be friendly, supportive, yet give frank, tough, and non-judgemental love when needed.

Don't let a person feel stupid for asking questions.

When they are wrong, let them know but be understanding.

I don't know though. I'm no expert. Good luck! :)

Coffee Nurse, BSN, RN · May 30, 2017

Don't just give answers, try to help the student get there herself. If she has a question, help her find where to get the answer. If she makes a mistake, try to use open-ended questioning to get her to work through where she went wrong, instead of just telling her.

jennylee321 · May 30, 2017

frequent feedback is key, that way there are not big surprises at the midterm and final meetings

HermioneG, BSN, RN · May 30, 2017

I think it depends on the type of student and how far along they are in the program, but there are definitely some universal great qualities. Personally, I think that the #1 thing that preceptors have done that helped me the most as a student was making me feel welcomed. I can't even begin to tell you how much of a difference the little things make. So often as a student I was worried that I was in the way, or being a bother, or slowing the nurse down. The best preceptors seemed to pick up on that, I think, or they remembered the anxiety that students/new grads can feel sometimes. If the nurse was warm and welcoming it would build up my confidence so that I could take the tough moments and criticisms in stride. It set me up so that they could be my harshest critic and bust my butt and instead of cutting me down it would actually help me. Here are some little things my preceptors have done throughout nursing school that really made it a great experience:

I remember as a new nursing student I was still very shy. We were going to get report, and the NOC nurse was sitting at the computer. There was only one chair so I, of course, stood a little back and to the side so that my nurse could sit and I could stand behind him and listen in and take notes. Instead, my preceptor pulled the chair back, told me to sit down, and said "this is your patient today, so this is all you. If you don't understand something, I want you to stop him and ask us for clarification." Then he asked the NOC nurse to give me report while he stood in the spot where I normally would be and listened in and took notes. It was something small, but as a nervous student it meant the world to me and set me up for a really great day. Especially at the very start of the day when as a student I was the most nervous, it was a big deal. I appreciated it so much because he never made me feel in the way or a nuisance.

On this same unit I had a different preceptor who clearly didn't want students. An example is that we were allowed to chart and have the nurse sign off on it. She was charting and I asked her if there was any way I could help her. In a rather exasperated tone she said "um... you can help me by going away for awhile?" Now I get it, she was busy and probably didn't want a student hovering around. The unit was also going through an extremely stressful day as a whole. But small things like that can hurt really badly. There were moments when the friendlier preceptor needed to chart and I asked him if he needed help. Instead of basically telling me to go away he'd say "you know, I'm good right now!" asked then me to instead circulate the unit for a bit and ask if any of the other nurses needed help with skills. It was the same outcome for both preceptors, but a completely different experience for the student.

Other things that my preceptors have done that made it great was encourage me to ask questions, and would also ask me questions in return. I loved it when they would pick my brain and helped me form organized thinking about our patients. I appreciated it so much!

In terms of building my confidence and learning to use my voice, in ER they would have me go and report to the physician potential issues that I was seeing with the patient, or concerns with pain control. All of these things were critical aspects of building my confidence, and I saw a huge increase as I got more used to having a voice and interacting with the inter-professional team. Towards the end of my practicum it was expected that if there was an issue (short of an emergency) I was going to be the one communicating with the team. Bless the doctor's heart, I'm sure it was a trial of patience, but it was so meaningful to me to see my preceptor's look of pride as I got better and was able to address concerns independently. He would stand way off to the side and pretend to be busy doing something else, and would listen in as I expressed a concern or communicated a change of patient status. I loved that instead of just focusing on skills, they were building me up so that I could learn the ins and outs of nursing, advocacy, and communication.

Another fantastic preceptor that I had didn't let me listen to report for a complicated patient. Instead, she had me go in to the patient's room while she got report in at the door, and watched me do an extensive head to toe. She didn't let me ask the patient about their chief complaint, medical history, meds, etc. Instead I had to investigate and come back to her and tell her in detail what I found. I then had to guess admitting chief complaint, health history, meds, etc. based on my findings. Then, she gave me a report as if she was the NOC nurse. I learned so much from that exercise. I absolutely loved it!

JKL33 · May 30, 2017

Random things I've found beneficial:

- Work on developing a trusting and honest rapport right away. This includes taking the opportunity to tell the person a little about yourself (specific to your nursing experiences/your style, etc) and learn a little about the new nurse as well (perceived strengths, weaknesses, their estimation of their nursing education, etc)

- Familiarize yourself with the learning objectives given to them by the employer

- Know the time frame you'll be working together, and any relevant timelines/expectations associated with the orientation/precepting period; make a general plan together that will help the new nurse meet expectations. I like short time frames, and expectations that build week-by-week

- I am a proponent of more frequent (bi-weekly/q 2 weeks or so) brief reviews with management (or the education team/whoever is officially overseeing the orientation), for several reasons: Firstly - these quick get-togethers show the new nurse that WE CARE about his/her success, and go a long way toward properly receiving the new employee into the unit. Secondly, when things are going well, a "review" is a good opportunity for positive reinforcement and encouragement. When things aren't going well, this is a chance to talk about it, to make alterations, to source additional learning opportunities. Most of all - it is MUCH more fair to the new nurse. NO one should learn at or near the end of orientation that their performance has been disappointing and that the preceptor is concerned about the individual about to come off of orientation. There are so many posts here that illustrate poor orientation practices; I can't help but think this is one thing we could be doing to improve many of these situations. It promotes/expects open and honest 3-way communication (management, preceptor, new staff member) whether things are going great or need to improve.

- Encourage. Give positive feedback when it is warranted; look for strengths which you can commend or compliment.

- Let the new nurse know that you will be giving feedback in real time as much as possible, and that "let's think about this some more", "what else might we have done", or more direct feedback and all other constructive or even directive comments are not personal criticisms.

- Be the kind of person you would want to learn from, in attitude, communication style, helpfulness, etc.

- Tips and tricks of the trade are great, but make sure you don't overwhelm the new nurse with your own personal nursing style. S/he needs to develop his/her own style over time.

- Plan to do everything together at first. Let your orientee know ahead of time so s/he understands this is a benefit, not a negative.

- Plan phrases and actions you will use if you observe something (or something about to be done) that needs to stop immediately while you are in the presence of patient/family. Know ahead of time what you will do that 1) maintains patient safety and 2) is respectful to everyone involved. Simple example - you witness a breach of sterile technique during a urinary catheterization attempt. Instead of "YOU JUST TOUCHED _____", plan ahead by having an extra catheter/gloves or kit with you, so that you can cue your orientee to stop by simply stepping forward and opening the new items. Have a small repertoire of other phrases you can use to intervene when things don't seem to be going as they should or you need an opportunity to change course ("let's see if I can help"; "we need to go check one more thing before we get started...", etc., etc.)

- Give feedback as soon as possible but away from patients/families (and co-workers if necessary)

- Don't make mountains out of molehills.

- Do everything in your power to not let the new nurse be treated, for all intents and purposes, as just another body that can help take care of patients. You should not have a super heavy or double-assignment 'because there are two of you', or any other such BS. They also aren't there to do other nurses' patient care tasks (unless they need the experience in that particular task or skill). Ideally you will manage one patient load *together*, with the new nurse taking over more and more of it until they are managing it nearly independently by the end of orientation

- Don't talk negatively about co-workers; don't gossip about other nurses or their professional skills. It *can* be helpful, instead, to make sure the new nurse knows expert sources of information on the unit. There are 'go-to' people on every shift who are both knowledgable and helpful.

- Lastly....for the love of all that is nursing...help them hone assessment and analytical skills, direct care skills, prioritization, and communication skills above all the other distracting things that nurses are asked to do and care about. Personally I try to prioritize these things, because to me they ARE "nursing". I see this (orientation) as, possibly, the best opportunity a nurse will ever have to lay the groundwork for an entire career.

And remember - - they WILL remember you 20 years from now. Do all you can to make it a good experience. :)

/username, BSN, RN · May 30, 2017

In addition to what everyone else has said, make them think it out and understand the why of what you're doing. You can teach a monkey to do skills. It's very, very difficult to teach critical thinking.

breebree177 · Jun 4, 2017

As I have just graduated and completed my preceptorship, I can tell you what a student likes from their preceptor. I liked when my preceptors would ask why questions to develop my critical thinking, like "Okay, you're going to go do this task, but why? Why does the patient need this task done?". My preceptors and I (I had two as both were part-time) would do a check-in at the end of the day. It wasn't always long, just like "You did good today, I liked how you're progressing with this" or "Next shift we're going to work on this". Also every morning we would set a goal, and a weekly goal and how I was hoping to achieve it. And be prepared for lots of questions! :)