Novice nurses anxiously enter the workplace on their first day, nervously approaching the unit desk to ask for their preceptor, who will play a key role in their transition to the unit. New nurses acclimate themselves to the unit, role, and staff with guidance from the preceptor.
The goal of the preceptor is to provide valuable teaching and learning experiences and to role model safe patient care using evidence-based practice. Preceptors may be working with a nurse in her first job or a nurse with 20 years of experience, but is new to the unit. And preceptors themselves have varying levels of experience in the role.
Whether you’re a new preceptor or simply looking to brush up on your skills, follow these tips to be successful. Although the focus is on the novice nurse, any nurse new to the unit can benefit.
Understand the preceptor role
The role of the preceptor is established by the institution and usually assigned to more experienced nurses. Hospital protocols, skill checklist, and teaching tools are specific to each institution and new nurses must become familiar with them. Making the most of this experience allows for relationship building with the new nurse and other staff members.
Keep in mind that a preceptor is much more than a teacher or mentor. A preceptor provides new nurses with a toolbox of resources and personnel to ready them to take on any situation or challenge set forth in the job. They also guide new nurses in adapting to the unit culture.
Set goals and responsibilities
Goal setting should be the first part of your initial meeting and midway through the orientation period with the nurse. Ask the nurse the following questions:
- What do you want to get out of this relationship over the next couple of weeks?
- What are your strengths and what are your weaknesses?
- What are some nursing skills that you wish to develop during this orientation period?
- What are your biggest concerns or fears?
- How can I best help you, as a preceptor, through this experience?
Provide the nurse with clear expectations of his or her responsibilities. For example, if the nurse will be responsible for two patients during the first week, then say, “You will be taking care of these two patients today on your own. I’ll observe you and serve as a resource for any questions that you may have.” Set clear responsibilities and tasks each day and check in midday to make sure the goals are being accomplished. At the end of the day, comment on how the nurse did in completing the responsibilities and provide clear directions on how to reach the same and additional goals for upcoming orientation days on the unit.
Establish a relationship
Share some of your own experiences as a new nurse including your initial reactions to the institution, staff, and role. Let the nurse know that you were once in his or her shoes. Narratives about your own experiences allow the nurse to feel a closer connection to you and this challenging experience.
Set clear expectations for new nurses, giving them deadlines or timeframes for each goal. For example, if the nurse will be advancing to take on two additional patients in 3 weeks, this should be clearly stated on the first day. You are a resource for the new nurse but at the same time you must correct any errors.
New nurses may find it hard to make decisions on their own. As a preceptor, assess their level of clinical competency and challenge them to develop their own clinical judgment skills.
Use effective communication
The new nurse needs to know that you are serving as a resource, ready to answer questions, clarify procedures, and help with understanding reasons behind tasks. When patient care is at jeopardy, there really are no dumb questions. A preceptor should foster growth in a supportive environment where the new nurse will feel comfortable asking any and all questions.
Provide structured learning experiences
Preceptorship does not come naturally and requires formal training. Many local nursing schools and organizations will provide educational workshops for learning these skills. An institution also may provide seminars on structured learning experiences for best practices in precepting. Education typically focuses on three areas: clinical competency, norms of the unit, and professionalism.
Clinical competency is knowledge that should be assessed, shared, and developed during this time period. Competency checklists guide the acquiring of skills to function in a given workplace. A checklist may include items like assessment, documentation on an electronic health record, care of chest tubes, administering tube feedings, and use of barcode medication administration. Let the new nurse review the checklist to know what is expected of him or her. The nurse should take ownership of seeking out opportunities for completion.
Norms of the unit or culture of the unit can be challenging to learn. Technology driven workplaces are now the norm and not all nurses are tech-savvy. Be patient with those learning a new system that you’ve already mastered.
Staff communication is another learned experience. From the unit secretary, to the technicians, to physicians, to other nurses, new nurses need to learn how to best communicate their needs to these individuals. Lead by example and engage them in every conversation you have with another staff member. In addition, the unit itself can be a maze to navigate. With codes, scanners, and locked doors, it may be difficult for new nurses to remember the location of every item on the unit. Provide them with a list of codes or a map of the unit to help assist them. Encourage them to explore the unit on their own.
Professionalism involves respecting nurses, staff members, and patients. Being professional is best learned through role modeling. Be courteous and polite to other staff members, patients, and family members. The way you communicate is what the novice nurse will see, hear, and remember.
Communication should be a two-way transaction with a clear message between sender and recipient. Formative evaluation is ongoing feedback throughout the experience. Both positive and negative are used. For positive feedback, try using encouraging words like “great work” but also try reinforcing statements like “you really handled that difficult situation well by notifying the physician and family right away.” Positive feedback is always easier to give rather than negative feedback. You should include recommendations on how to improve the negative behavior. Your message should be clear, empathetic, and respectful.
It’s also important to listen to the new nurse’s reactions and feedback in a calm manner. You are a co-learner in this process. When you complete a preceptor experience, think about how you could improve for the next time you’re asked to be a preceptor.
Summative evaluation occurs at the end of the experience. If there are any issues that you encounter, notify the nurse manager and nurse educator of the unit and provide them details of the new nurse’s learning needs and your concerns. Remember that you don’t have to handle problems on your own; tap into your resources. Your concerns also should be documented for placement in the nurse’s employment record.
A lasting mentor
A preceptor introduces a new nurse into the clinical environment using creativity skills, facilitation skills, a positive attitude, and patience. You’ll need to assess their needs and offer them challenging situations that will prepare them to practice independently. Share your written final evaluation with the new nurse. You should summarize your recommendations for improvements and state empowering statements to enable them to function independently. At the conclusion of this experience, welcome the new nurse to the nursing team, inviting him or her to come to you with any questions or concerns.
Tresa Kaur Dusaj is an assistant professor of Nursing and Health Studies and coordinator of the MSN Nursing Education Track at Monmouth University in West Long Branch, New Jersey.
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Walsh, D. The Nurse Mentor’s Handbook: Supporting Students in Clinical Practice. New York: McGraw Hill; 2010.