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Do you want to be a preceptor? - American Nurse Today

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Practice Matters —<br />

<strong>Do</strong> <strong>you</strong> <strong>want</strong> <strong>to</strong> <strong>be</strong> a<br />

precep<strong>to</strong>r<br />

By Karen Zwerneman, RN, MSN, CCRN, and Sonya Flanders, RN, BSN, CCRN<br />

PRECEPTORS MAKE ALL the difference.<br />

Without the right precep<strong>to</strong>r,<br />

the transition from classroom<br />

<strong>to</strong> patient’s room can <strong>be</strong> difficult, but a precep<strong>to</strong>r who<br />

demonstrates how <strong>to</strong> turn classroom theory in<strong>to</strong> skilled<br />

clinical practice can put a new nurse on the path <strong>to</strong><br />

clinical excellence.<br />

What a precep<strong>to</strong>r needs<br />

What does it take <strong>to</strong> <strong>be</strong> a good precep<strong>to</strong>r First, it takes<br />

a strong relationship with the new nurse. Every new<br />

nurse needs one designated precep<strong>to</strong>r. The precep<strong>to</strong>r’s<br />

schedule should match the nurse’s schedule, and the<br />

precep<strong>to</strong>r and new nurse should share a single patient<br />

assignment.<br />

Every precep<strong>to</strong>r needs certain key qualities: clinical<br />

expertise, organizational skills, teaching talent, patience,<br />

leadership and, most important, the desire <strong>to</strong> <strong>be</strong><br />

a precep<strong>to</strong>r. Those qualities form the foundation, but<br />

precep<strong>to</strong>rs need preparation. Precep<strong>to</strong>r courses should<br />

cover responsibilities, learning styles, documentation,<br />

communication, and conflict resolution. Roleplaying<br />

prepares precep<strong>to</strong>rs <strong>to</strong> handle<br />

conflict and give feedback.<br />

Precep<strong>to</strong>rs need on-going support.<br />

Effective men<strong>to</strong>rs can help<br />

precep<strong>to</strong>rs grow and flourish.<br />

Men<strong>to</strong>rs—including advanced<br />

practice nurses, educa<strong>to</strong>rs, managers,<br />

and experienced precep<strong>to</strong>rs—can<br />

demonstrate teaching<br />

skills, address precep<strong>to</strong>r–orientee<br />

relationships, and evaluate orientation<br />

effectiveness.<br />

How <strong>to</strong> prepare <strong>you</strong>rself<br />

<strong>to</strong> prepare new nurses<br />

Who <strong>you</strong>’ll meet<br />

Role-playing will help prepare<br />

<strong>you</strong> for <strong>you</strong>r precep<strong>to</strong>r—<br />

new nurse relationships,<br />

but <strong>you</strong>’ll still encounter<br />

challenging situations<br />

and interesting personalities.<br />

You’ll certainly<br />

meet the Expert<br />

Orientee, who<br />

<strong>be</strong>lieves she already knows everything<br />

and orientation is just a formality.<br />

Statements <strong>be</strong>ginning with,<br />

“In my old job, I...” are meant <strong>to</strong> challenge <strong>you</strong> as a<br />

precep<strong>to</strong>r. Meet the challenge by acknowledging the<br />

nurse’s past experiences as valid, but remind this nurse<br />

that performance must <strong>be</strong> validated <strong>to</strong> reinforce hospital-specific<br />

policies.<br />

The Social Butterfly surrounds the precep<strong>to</strong>r with a<br />

flurry of activities. This nurse is busy with after-work<br />

activities, spends time on personal phone calls, and<br />

manipulates others by flirting and brown-nosing. The<br />

Social Butterfly requires consistent messages from the<br />

precep<strong>to</strong>r as well as the manager and educa<strong>to</strong>r. Set limits<br />

by stating clear expectations such as, “Make personal<br />

phone calls only during <strong>you</strong>r break.” Try positive<br />

feedback, <strong>to</strong>o. Involve the Butterfly in activities, such<br />

as unit events and professional seminars, <strong>be</strong>cause they<br />

will foster group participation.<br />

The Disorganized Diva drives an organized precep<strong>to</strong>r<br />

crazy. This nurse is always late and has major life<br />

changes—new job, upcoming wedding, new city, new<br />

apartment, new friends, new pet,<br />

everything in boxes—all at the<br />

same time. Prioritizing problems<br />

and remem<strong>be</strong>ring <strong>to</strong> perform<br />

tasks such as checking lab results,<br />

giving medications on<br />

time, and following up on abnormal<br />

vital signs seem impossible.<br />

As a precep<strong>to</strong>r, teach this<br />

new nurse a quick patient assessment<br />

that involves the ABCs—airway,<br />

breathing, and circulation.<br />

Teach her <strong>to</strong> prioritize patients<br />

based on needs. Use checklists,<br />

schedules, or color<br />

codes <strong>to</strong> promote organization.<br />

Extending orientation<br />

may help.<br />

The Mouse is shy, asks<br />

few questions, and says<br />

“yes” <strong>to</strong> everything. By<br />

conveniently getting busy<br />

when approached, this<br />

Novem<strong>be</strong>r 2006 <strong>American</strong> <strong>Nurse</strong> <strong>Today</strong> 35


READY TO TAKE ON THE REAL WORLD<br />

HOW ABOUT THE WHOLE WORLD<br />

nurse tries <strong>to</strong> hide a lack of confidence. As a precep<strong>to</strong>r,<br />

<strong>you</strong> need <strong>to</strong> articulate <strong>you</strong>r expectations clearly: “I<br />

will <strong>be</strong> asking <strong>you</strong> <strong>to</strong> descri<strong>be</strong> <strong>you</strong>r clinical experiences<br />

on a daily basis,” “Prioritize <strong>you</strong>r tasks and discuss<br />

the priorities with me,” and “If <strong>you</strong>’re uncomfortable<br />

performing a task, <strong>you</strong> need <strong>to</strong> ask questions<br />

<strong>be</strong>fore performing it.” Also, use one-<strong>to</strong>-one communication.<br />

Provide regular feedback and ask open-ended<br />

questions. Be sure <strong>to</strong> distinguish shyness from a lack<br />

of competence.<br />

The Glo<strong>be</strong> Trotter is a foreign nurse experiencing a<br />

cultural transition. Speaking and understanding the<br />

language may <strong>be</strong> challenging. If this nurse was an advanced<br />

practitioner in another country, role confusion<br />

may <strong>be</strong> a problem. You must spell out <strong>you</strong>r expectations<br />

with a well-defined job description. Be culturally<br />

sensitive. Confirm this nurse’s understanding by asking<br />

open-ended questions, and provide a men<strong>to</strong>r of<br />

the same nationality for professional and personal<br />

support.<br />

The Needy <strong>Nurse</strong> will drain <strong>you</strong>r energy. This nurse<br />

seeks constant validation, and manipulates everyone—the<br />

precep<strong>to</strong>r, the educa<strong>to</strong>r, and other nurses.<br />

The Needy <strong>Nurse</strong> relentlessly seeks help and uses selfdegrading<br />

language. Provide honest feedback. <strong>Do</strong>n’t<br />

offer praise in response <strong>to</strong> neediness. Ask thought-provoking<br />

questions and give positive reinforcement when<br />

appropriate. Above all, avoid “mothering.”<br />

©2006 Paid for by the U.S. Air Force. All rights reserved.<br />

Rewards<br />

Yes, <strong>be</strong>ing a precep<strong>to</strong>r can put <strong>you</strong> in some interesting<br />

relationships, but it can also <strong>be</strong> very rewarding.<br />

A great precep<strong>to</strong>r can <strong>be</strong> the first and most important<br />

role model in a nurse’s professional life. And a great<br />

precep<strong>to</strong>r can help launch many successful nursing<br />

careers.<br />

✯<br />

You’ve studied for it. Trained for it. And now<br />

<strong>you</strong>’re ready <strong>to</strong> put everything <strong>you</strong>’ve learned <strong>to</strong><br />

use in the real world. Become a United States<br />

Air Force nurse, and <strong>you</strong> can put <strong>you</strong>r skills <strong>to</strong><br />

work treating Airmen here at home or aiding<br />

in relief efforts halfway around the world.<br />

1-800-588-5260 • AIRFORCE.COM/HEALTHCARE<br />

Selected references<br />

Alspach JG. From Staff <strong>Nurse</strong> <strong>to</strong> Precep<strong>to</strong>r: A Precep<strong>to</strong>r Development<br />

Program. Instruc<strong>to</strong>r’s Manual. 2nd ed. Aliso Viejo, Calif: <strong>American</strong><br />

Association of Critical Care <strong>Nurse</strong>s; 2000.<br />

<strong>Do</strong>ugal J, Gonterman R. A comparison of three teaching methods on<br />

learning and retention. J <strong>Nurse</strong>s Staff Dev. 1999;15(5):205-209.<br />

Lavoie-Tremblay M, Viens C, Forcier M, et al. How <strong>to</strong> facilitate the<br />

orientation of new nurses in<strong>to</strong> the workplace. J <strong>Nurse</strong>s Staff Dev.<br />

2002;18(2):80-85.<br />

Morse JS, O<strong>be</strong>rer J, <strong>Do</strong>bbins JA, Mitchell D. Understanding learning<br />

styles: implications for staff development educa<strong>to</strong>rs. J <strong>Nurse</strong>s Staff<br />

Dev. 1998;14(1):41-46.<br />

Speers AT, Strzyzewski N, Ziolkowski LD. Precep<strong>to</strong>r preparation: an<br />

investment in the future. J <strong>Nurse</strong>s Staff Dev. 2004;20(3):127-133.<br />

Karen Zwerneman, RN, MSN, CCRN, is Direc<strong>to</strong>r, Neurology, Renal, & Vascular<br />

Services at Baylor University Medical Center, Dallas, Texas. Sonya Flanders, RN,<br />

BSN, CCRN, is a Cardiovascular <strong>Nurse</strong> Clinician at Baylor University Medical<br />

Center.<br />

36 <strong>American</strong> <strong>Nurse</strong> <strong>Today</strong> Novem<strong>be</strong>r 2006

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