I can’t always remember where I parked my car 12 hours ago or what I ate for dinner last night. But I can remember the name of my first preceptor when I was a new graduate nurse more than 25 years ago.
Busy nurses may not appreciate the impact they can have on new nurse orientees. But the fact that I, of imperfect memory, can recall my first preceptor’s name decades later suggests how important a veteran nurse’s guidance can be. My preceptor helped me apply what I learned in nursing school and supported my transition from student to new nurse. I believe she had a remarkable influence on the nurse I am today.
Of course, orienting a new nurse can be challenging—so challenging that some preceptors experience burnout. Why? Lack of preparation and training are common culprits. Some nurses get no advance notice that they’ll be serving as preceptors. Facilities may have minimal criteria for preceptor selection, and a nurse might be chosen as a preceptor only because she works on a certain day of the week. Lack of compensation is another factor; many preceptors believe they’re poorly compensated for their efforts.
Also, preceptors report feeling stress if they can’t accomplish the responsibilities they associate with the preceptor role. (See The preceptor as a standard by clicking on the PDF icon above.) They perceive a disparity between their view of the preceptor role and what they can plausibly accomplish. This disparity contributes to burnout and the emotional exhaustion that ensues. In one study, preceptors identified such stressors as added workloads, additional re- sponsibilities, and limited time for precepting. (Interestingly, several studies found preceptors’ reports of burn- out don’t correlate with the frequency of precepting.)
Financial implications of orienting new nurses
Precepting and new-nurse orientation have financial implications, and healthcare facilities have begun to analyze the costs related to staff turnover. By some estimates, the cost of replacing a registered nurse (RN) ranges from $42,000 to $64,000 (depending on the RN’s specialty). This amount includes precepting costs.
The turnover rate for new nurse graduates can be up to 61%. Turnover can be reduced by diminishing the stress linked to transition to the workplace, which preceptor programs are designed to address.
The results of a 2007 study support those of previous studies: Preceptors are more likely to be devoted to precepting when doing so brings meaningful benefits, rewards, and support.
So how do healthcare facilities typically reward their preceptors? Rewards vary widely but may include additional pay, educational days, recognition days, consistent day-shift work schedules, support to attend a conference on precepting, luncheons, recognition that the preceptor has met the criteria for a clinical ladder, and support from managers and administration.
Some rewards are less tangible. Preceptors say their role gives them an opportunity for teaching and continuous learning, along with greater self-fulfillment and satisfaction, acknowledgment of their clinical expertise by peers and supervisors, and an increased sense of professionalism.
Burnout prevention strategies
Giving preceptors adequate support and preparation can go a long way toward avoiding burnout. In a 2008 article, preceptors identified support and development of the preceptor role as ways to mitigate stress.
Preceptors need support, tools, and techniques to orient new nurses, including resources that address individual and generational variations in learning styles. In this uncertain economic climate, some retired nurses are returning to work; like new nurses, they’re likely to need orientation and may be assigned younger preceptors. Preceptor workshops can be a good way to help preceptors understand generational differences and individual learning styles, as well as cultural differences and how culture affects teaching and learning styles.
Preceptors also need immediate resources they can use when questions, problems, or dilemmas arise. They need support from clinical educators and managers who can answer clinical or professional questions. Connecting the new nurse with appropriate facility resources can reduce stress for both preceptors and new nurses. One study found a supportive workplace can protect against preceptor burnout, whereas a poor “social climate” tends to promote burnout.
Finally, nurses need to receive advance notice that they’ll be assigned as preceptors. Ideally, preceptors should get the chance to meet with new nurse graduates before their start dates and gain some knowledge of their clinical experience before orientation begins. This gives them time to develop individual plans for teaching each orientee, help determine how many patients the orientee can manage, evaluate her skills, assess her learning needs, and determine where she is most comfortable.
Multiple factors contribute to preceptor stress and burnout. The strategies discussed in this article are supported by the literature as effective ways to reduce stress among preceptors and their orientees. Providing preceptors with both intrinsic and extrinsic benefits of the preceptor role can bolster their commitment to the role and increase their impact on new nurses. And these new nurses just may remember their first preceptors forever.
Alspach G. Calling all preceptors: how can we better prepare and support you? Crit Care Nurse. 2008;28:13-16.
Baggot DM, Hensinger B, Parry J, Valdes MS, Zaim S. The new hire/preceptor experience: cost-benefit analysis of one retention strategy. JONA. 2005;35(3):138-145.
Hautala KT, Saylor CR, O’Leary-Kelley C. Nurses’ perceptions of stress and support in the preceptor role. JONA. 2007;23(2):64-72.
Health Care Advisory Board. Reversing the Flight of Talent. Washington, DC: The Advisory Board Company; 2000.
Murphy BE. Positive precepting: preparation can reduce the stress. Medsurg Nurs. 2008;17(3):183-188.
Barbara Blozen is an instructor at Seton Hall University in South Orange, New Jersey.