The pressures on new graduate nurses to transition from education to practice are often too much to take, causing RNs meant to fuel nursing’s workforce pipeline in the coming decades to question their career choice.
One thing that can ease the transition and help retain new nurses is nurse precepting, said Solimar Figueroa, PhD, RN, MHA, P-PCA, a clinical collaborator for the American Academy for Preceptor Advancement.
But precepting bedside nurses isn’t what many think and nurses who want to become preceptors should learn how to properly do it.
“Preceptorship and mentorship are two different things,” Figueroa said.
Although mentorship is a relationship that can last for much of a mentee’s career and occurs when an experienced nurse guides the professional journey of another nurse, preceptorship is an official relationship, designed in a limited time to evaluate new nurses and offer feedback that helps them gain traction in their practices, according to Figueroa.
Figueroa is a speaker for the Relias Nursing Preceptor Specialty Practice, a continuing education course that teaches nurses how to get the most out of their precepting experiences. The course fulfills one of the requirements for the American Academy for Preceptor Advancement’s Preceptor Specialist Certification.
Less confident; less competent
In nursing’s early years, charge nurses were preceptors. Diploma-prepared nurses would learn at the bedside, with more experienced nurses teaching them, according to Figueroa.
Now, nurses go to universities and colleges to learn the profession, getting arguably far less bedside experience before assuming their first jobs at hospitals and other settings.
“There’s a huge discussion about the gap between education and practice. When new nurses graduate, they are less confident and less competent,” she said. “What’s really happening with these new nurses coming in is they’re not prepared to handle a full patient load. So, they have what we call a reality shock, thinking things like ‘I wasn’t prepared this way. This isn’t what I’ve learned.’ Then they start questioning whether they have decided on the right profession.”
To ease the predicted nurse shortage in coming years, the Institute of Medicine recommends healthcare employers offer new nurses structured nurse residency programs. Preceptorship is part of nursing onboarding residency programs, and trained preceptors are vital for giving new nurses needed confidence and increase nurse competence, according to Figueroa.
“But that’s not going to happen if you don’t have preceptors, or experienced nurses, teaching these new nurses,” she said. “If your preceptors are not adequately prepared and supported, then your residency program will suffer.”
Experienced nurses have a responsibility to consider precepting as part of what the American Nurses Association says is nurses’ social responsibility to protect and uphold the well-being of the populations they serve, Figueroa said.
“As a preceptor, you ensure every new nurse to become confident and competent to deliver quality care. That means you’re ensuring the safety of the patients–the population you serve. So, it is actually answering to the call of our social responsibility as a nurse,” she said.
Being a good teacher is one thing — precepting is another
Preceptor certification is a nurse’s way to show he or she is an expert, Figueroa said.
“It’s really important that we have certified preceptors that follow the scope and standards of precepting,” she said.
Employers often compensate preceptors or consider the role a way for nurses to climb clinical ladders. But there are no universal guidelines for compensating nurse preceptors and nurses should inquire about potential benefits or advocate for adequate compensation if there isn’t any, according to Figueroa.
The Relias course covers topics needed for successful precepting, such as boundaries between preceptor and preceptee, critical thinking, communication skills, delegation, time-management, evaluation of competency, goal-writing, constructive feedback, patient/family engagement and more.
Tammy Franqueiro, MSN, RN-BC, CENP, vice president of the healthcare competency solutions company Versant Holdings and a speaker for the Relias precepting course, said there are many skills useful for nurse preceptors. Among them — giving feedback is among those.
“Feedback helps the preceptee to develop knowledge, skills and attitudes and establishes the expected performance,” she said. “Feedback should be objective, specific, timely, informal and done privately,” Franqueiro said. “Be able to flex your teaching style. Be creative, innovative to match your preceptee’s learning needs and experience level.”
Preceptors, according to Franqueiro, should employ multiple approaches to encourage preceptees to think critically and integrate the knowledge into their practice. One of those is to assist preceptees in establishing SMART goals—specific, measurable, attainable, relevant, timely.
“Establish timelines for goals, objectives and outcomes throughout the preceptorship with clear performance expectations specific to the individual,” Franqueiro said.
Experienced nurses who want to hone precepting skills should think back to their first orientations, according to Franqueiro.
“Whether you had a positive support system, were left to figure things out on your own, or worse yet, had a toxic coworker as a preceptor — whichever the situation, use that memory and learn from it to become the preceptor every preceptee wants to work with and learn from,” Franqueiro said.
“Be realistic. Be positive. Be an advocate. Be patient. Be available,” she said.
Precepting can be a satisfying experience, according to Figueroa, who recalls her own experience helping a fellow nurse on his journey.
“There was a new nurse in our residency program who was fascinated about preceptorship. He had a very good experience with his preceptors,” Figueroa said. “He asked me if I could mentor him in his professional growth as a preceptor. We established a trusting relationship. I listened to him. He trusted me. He became an outstanding preceptor, loved precepting and paid it forward. Now he is a manager in a span of four or five years. He keeps sending me cards that say, ‘I am who I am now because of you.’”
Learn more about precepting with this Focused CE series: