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