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Precepting is crucial in retaining new nurses and helping them succeed

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.

precepting - Solimar Figueroa, PhD, MSN, RN, MHA,

Solimar Figueroa, RN

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.

Precepting 101

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.

precepting - Tammy Franqueiro, RN

Tammy Franqueiro, RN

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:

 

precepting - Preceptor Focused CE series

By | 2020-03-12T03:35:39-04:00 February 12th, 2020|Categories: Nursing education, Nursing news|4 Comments

About the Author:

Sallie Jimenez
Sallie Jimenez is content manager for healthcare for Nurse.com published by Relias. She develops and edits content for the Nurse.com blog, which covers industry news and trends in the nursing profession and healthcare. She also develops content for the Nurse.com Digital Editions. She has more than 24 years of healthcare journalism, content marketing and editing experience.

4 Comments

  1. Avatar
    Ebenezer Vander Pallen February 16, 2020 at 9:50 am - Reply

    Wow, can’t agree the more with what this article is about. I hope all nirse managers will find this piece and read and help aspiring new nurses survive this brutal terrain. It is very tough and sometimes depressing to go about your job knowing very well you’re absolutely ill prepared professionally.
    Thanks so much for bringing this huge problem to light.

  2. Avatar
    Raymond L Seels February 19, 2020 at 2:54 pm - Reply

    Excellent information that helps us as nurses. Thank you very much.

  3. Avatar
    Manoucheka Chery April 8, 2020 at 12:14 pm - Reply

    This was an informative article, and I agree with the statements made by Ms.Figueroa, there is a gap between education and practice. In nursing school, learn vital signs, laboratory tests but managing a full load of patients is not taught. Preceptorship can help fill that gap to help new graduates transition into their role. Structured nurse residency programs are needed, but more importantly, preceptors should have training and support to assume the role of preceptor.

  4. Avatar
    Gayle April 19, 2020 at 2:07 am - Reply

    You left out the LPNs who are doing the exact same as the RNs. We may not have the title but we do the same thing at least I know I do and have before. As I know many other LPNs with as many years as I have been a nurse or less.(30+). Just the same for new LPNs graduating as RNs. I’ve seen both LPNs as well as RNs come out of school without any knowledge of how it really is. I have trained and managed them both. There also should be a easier way for LPNs to bridge to a BSN or ADN program. Some move straight up in management and don’t have a clue about what it’s like to be on the floor of a hospital or any other medical setting. It all comes from experience no matter what the title.

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