What is the role of preceptor?

ewilson3 · Sep 13, 2008

I think you may be mistakened...not all hospitals give preceptors extra pay.

My experience is a preceptor should be there to help you in the beginning, guide you in helping you make critical decisions, help you learn the culture of your floor and how things are run. they already have relationships with doctors so they would know if and when a specific doctor would want to be called, etc. Basically they should be a resource for you until you get your feet wet.

Unfortunately, it doesn't seem like you are getting that from the preceptors you have had. I would suggest speaking to your charge nurse of nurse manager about it.

Every day while i have been orienting the charge and manager always come by and see if i have any questions and make sure things are going smoothly.

they should be understanding that not all personalities blend well together. i think you should talk to a manager or educator about your struggles so far. hope this helps!

barbaratruth, RN · Sep 13, 2008

The preceptors are given extra compensation where I work. I know this may not be the case in all hospitals.

Thanks for your response.

lpnflorida · Sep 13, 2008

I am sorry your orientation has not been more organized.

Our hospital only in the past year started paying $1.00/hr extra for the time we are doing/being a preceptor. Ideally the orientee has the same identical schedule as their preceptor. It helps avoid any confusion, gains trust, helps orientee to gain confidence and to help facillitate a smoother transition from the (student) mode of thinking to nurse mode . Which means our jobs are to get you to a point of some sort of automy. To gain comfort in not only taking care of the patients, interacting with the doctors and other peers.

With that said, it does not always work out that way, there can be scheduling conflicts, such as nurse goes on vacation, or new nurse has other obligations with prohibit having same schedule as original preceptor. Not every nurse is a good teacher. While they say people volunteer to precept, that is not entirely true either.

Talk to your supervisor or nurse manager, who ever is so to speak in charge . Let them know your feelings. See if something can't be worked out. and if you have a preference in your mind as to who you would like to be your preceptor let them know that also.

again good luck

Pediatric Critical Care Columnist · Sep 13, 2008

I'm so sorry you're having such a negative experience. I agree with the posters above who have advised you to speak to your manager, but you should also speak with your clinical nurse educator. They both need to be aware of what's happening with you.

There are workplaces where orientation of new staff is A) organized and well thought-out, with the necessary resources to ensure a good result. There are workplaces where orientation of new staff is B) viewed as a necessary evil and somebody's gotta do it, as long as it's not "me"! But there's no real plan or guidelines as to how it's conducted. There are people who are A) excellent preceptors and there are some who B) are not so good. There are people who A) love to teach others and there are those who B) just want to be left alone to get on with their work. Some people A) are asked if they're interested in precepting and others B) have it thrust upon them. If all the A's are checked off, the experience will be great. But if you get someone with all the B's, then it's not going to be quite so nice. In a perfect world, every new nurse on a unit would have one or two consistent preceptors and they'd have smooth passage from hire to independence but we all recognize that this is never going to be a perfect world.

I love to teach and I think I do a decent job. My relationship with the person I'm teaching is a partnership. I ask them what their goals are at the beginning of the shift and suggest other things they might not have considered. I ask what they're comfortable with what they still need help with. I encourage questions, because there are no stupid questions other than the ones you don't ask. I am never far away and they know that if I'm not directly observing them do something it's because I've observed them doing it correctly enough times that I don't have to hang over their shoulders now. I accept that there are many safe and correct ways of doing things and only intervene if what they're doing is not. I give feedback throughout the shift and at the end of it I ask them how they feel it went. We talk about what should be done differently next time. I encourage critical thinking by having them talk things out. And I must be getting it right because long after they're on their own they still come to me with questions and for help.

But there are many others who don't enjoy having the extra responsibility and workload of precepting someone new. It is more work to teach someone how to do or be something than it is to just do or be it. Where I work, the only people who are paid for this extra responsibility are those who are supervising students, and it's a princely $0.65 an hour. The turnover in our unit is quite high, about 40%, and there are always new staff members being oriented. Too often lately people haven't been asked if they'd do it, they've just been scheduled for it. And because of our staffing shortfalls, the orientations are being left to people who have very little experience because the ones who should be providing orientation are looking after the really sick patients. It's a vicious circle.

That's a very long-winded response to your questions, but I hope it's helped you to uderstand some of the background issues. Now go talk to your manager and CNE, and make sure they know that as a new grad, you're feeling too much pressure. Ask for some consistency and some slack. You deserve it.

PennyNickelDime_RN · Sep 22, 2008

I have to agree that my preceptor experience has been quite hellish. I am rarely with the same nurse so there is no continuity. Second, even though I have been on the unit only a total of about 6 days (been in classes alot recently), I am expected to know how to do everything and if I ask a question or want clarification or god for bid request my preceptor to go into the patient's room with me to go over a procedure it is like I have asked for the world. I did an internship at a busy ER and haven't been in a med/surg environment for over a year.

The entire situation makes me very angry and disappointed because I did not think it would be like this. I work on an oncology unit and am given a total of 30 days on the floor for orientation. Other units in the same hospital that do not have a patient load of equilivant to mine are given anywhere from 2-3 months orientation. I find that 30 days is unreasonable and not safe. I'm sure some new grads can handle it in the 30 days but many more cannot. It is difficult to keep a positive attitude and remain confident in ones skills if everytime you ask a question you get a roll of eyes and a sigh...it's degrading and humiliating.

So far I must say that I am not impressed with the floor I am working on. I am hopeful that it will improve. I am also hopeful that if I am not prepared in 30 days that I will be allowed more time. I work with mostly young nurses, twenty somethings and I got a late start and am in my early 50's. I worked so hard to reach this goal and I feel as if I will never "get it" or fit in. I feel as if they look at me and wonder what the hell I am doing there in the first place. It is a very uncomfortable environment and all I want to do is learn what I need to learn and do my job to the best of my ability but that seems not good enough. I am at the point of dreading going to work and this should not be the case just starting my third week. Any advice?? :confused:

NurseKatie08, MSN · Sep 22, 2008

I'm beginning my fourth week of orientation. Each week I have a different preceptor.
Can someone please clarify exactly what the role of "preceptor" includes? I'm wondering if I have unrealistic expectations.
The preceptors are given extra compensation, however, they don't seem to want to precept and appear resentful at having to orient me and another nurse on the unit.
I was at the top of my nursing class, did internships, have additional education and feel that I was misled during the interview process. I'm making great progress, yet I feel the team wants me to be the equivalent of an experienced nurse.
I feel that I am on my own as a new grad and that if I don't meet the team's "approval", I'll be unemployed.

I'm sorry that your orientation has been so rough.

I'm on the TCU/rehab floor of a LTC, and although there is not a formal orientation program, my orientation has been great thus far.

Today was the start of my third full week on the floor (I work M-F). I primarily follow a nurse who works 4 days/week, so I have had a good amount of consistency. Also, I have been consistently with the same nurse on my primary preceptor's day off, which has been helpful, because she knows me and has some idea of where I'm at.

I think the role of the preceptor, as others have mentioned, is to introduce you to the culture of the unit, help you learn what needs doing and allow you to observe what they do so that you can gain confidence and develop your own routine.

My first few days on the floor I just watched.

The next week and a half, I did the med passes, a few treatments, and probably about half the notes/documentation needed. She did the other half of the txs, notes & did admissions and discharges.

I spent most of last week with the nurse who is our unit coordinator learning paperwork for labs, Coumadin, dealing with orders both on paper & in the computer, and going over what needs done for an admission & discharge. I did my first admission & several discharges toward the end of the week.

Today I refreshed my memory on the med pass (with the nurse I follow when my primary preceptor is out) and tomorrow, when my preceptor is back, she is going to have me try to do everything with her there as back up if I get bogged down or overwhelmed (which I imagine will happen easily--there are 10 patients on my team right now, one is going home tomorrow which will leave me two empty beds..)

Can you go to your NM and talk about your preceptor issues, just to let her know you'd feel less overwhelmed if there was some consistency? Or is there maybe another nurse on the floor you'd be comfortable to talk to?

Let us know what happens.

davezehm · Oct 31, 2008

Your precepting experience is an indicator of things to come at the hospital. A good experience means 1) you had an exceptional preceptor; and/or 2) the hospital values its orientees. I just saw a couple videos on precepting on youtube that discuss these issues: http://www.youtube.com/user/RealityRNVideo.

Butterflybee · Oct 31, 2008

I'm beginning my fourth week of orientation. Each week I have a different preceptor.
Can someone please clarify exactly what the role of "preceptor" includes? I'm wondering if I have unrealistic expectations.
The preceptors are given extra compensation, however, they don't seem to want to precept and appear resentful at having to orient me and another nurse on the unit.
I was at the top of my nursing class, did internships, have additional education and feel that I was misled during the interview process. I'm making great progress, yet I feel the team wants me to be the equivalent of an experienced nurse.
I feel that I am on my own as a new grad and that if I don't meet the team's "approval", I'll be unemployed.

We are sort of in the same boat except I am now on my own. I like it and I perform better without someone standing over me. Guess it was nerves or something. I went thru the exact same thing. If you can, make a few friends that you can go to to ask questions. It helped me a whole lot. Hang in there new nurse :nurse: