Episode 15: Nurse Preceptors

This transcript was generated automatically. Its accuracy may vary.

Part I

Cara Lunsford

Oh, hey, nurses. Welcome to the Nurse podcast. Giving nurses validation, resources and hope. One episode at a time. Oh, Today on Nurse Dot podcast.

Larissa Africa

That expert preceptor should be about honing in on those skills and really focusing on clinical judgment and critical thinking. How do we make sure that we help our new growth and nurses get on the road map for how to really understand the clinical practice? The Kinder campaign that I try to run here in our E.R. with kindness, with patients and kindness with each other.

Tiffany Labig

I feel like sometimes we do eat our young and it's very difficult when you are new and you might feel like you don't have that experience. The only way to get the experience is to have the experience.

Cara Lunsford

Joining us today for part one of a two part series. Larissa Africa, a registered nurse and CEO of Versant, an organization Transforming health Care through competency based residency programs and fellowships. Also gracing our podcast today is a testimony of the innovation and impact that Versant creates. Liebig, a preceptor at Wayne Health Care and a graduate of the Versant residency herself, join us as we talk about their stories, the landscape of nursing education and how to make meaningful strides in our health care system.

I'm your host, Kara Lunsford. Registered nurse and VP of Community Ed Nurse AECOM. Oh, I want to start out first with Larissa. If you could just introduce yourself, give a little bio of who you are and where you started in your career. A little bit. And then I'll I'll move over to you, Tiffany. Well, we'll intro you.

Larissa Africa

Okay, Sounds good. Well, I'm Marissa Agatha, and I'm versus president and CEO. I have been a nurse for 24 years. My background is in pediatric nursing. I started my career as a new graduate nurse at Children's Hospital of Los Angeles. When the residency first started. So I'm so excited to be here today and to talk about Chris, because when I think about my own experiences and you graduate nurse, I could not have done it without my preceptors.

So I'm excited to be here today.

Cara Lunsford

Well, we are excited to have you. And when I first spoke with you, I thought, oh, this is this is definitely my jam, because I was also a nurse and was also pediatrics. But pediatric oncology and went through the first program, so the residency program. So I'm just a huge fan and true believer. So to go ahead and introduce yourself, tell us a little bit about yourself.

Tiffany Labig

My name's Stephanie Liebig and I live here in Ohio. I just finished my second year as a nurse. Nursing is my second career. I was in public education for many years prior to that. I'm a mom of five and went back to school. My husband's also in health care, so it's in our household all the time and went back to nursing school once my youngest made it to kindergarten.

I wasn't quite the oldest in my class. I was pretty close and really wanted to kind of dive in first with teaching and helping others. I feel like being a little bit older has helped me in my career field. I work in the E.R.. I thought it was going to do labor and delivery for many, many years. Now we're in the air.

So that's where I landed and absolutely love. It wasn't real Sure how I was going to feel about more schooling and more education. Once I got into the hospital setting, I was really ready to just go. And I waited such a long time to be a nurse. So going through more programs and more education was just something that I was a little bit nervous about.

But then I met Amy Jo and she changed my life for the better. I quickly grabbed on to the program and was able to graduate, obviously that program and now become preceptor, which I think is super important. So that we're not eating our young and that we're taking care of nurses that are new to this system and new to health care.

So I love it. I have several students under me. I have some new grads, and then I also have some capstone students from the community college where I graduated from. So I take great pride in helping them and presenting them early. And then they end up coming to our facility full time after they graduate. So, yes, all good things.

Cara Lunsford

Well, congratulations. Two years, two years end and in emergency room. So you wanted labor and delivery, but labor and delivery, they don't they don't like to take the new grads.

Tiffany Labig

My whole callings in nursing was when I had our second daughter. I was away from home. I was living in Colorado at the time and didn't have much family around me. I was miles away from my family and friends, so I had an experience with a labor and delivery nurse that changed my life. She was amazing. She ended up clocking out but staying with me for a few hours.

So our daughter was born and I just really wanted to be that person. I thought for 17 years that I had tied it to labor and delivery. But after going to clinicals and going to school, I quickly realized that you can really be that nurse and that person in any aspect of nursing. I had just tied it personally to my personal experience through labor and delivery.

So someday I'll still probably do babies because I love babies and I love kids and I love families, but I just really fell in love with the air as a student, and I started as a tech and worked my way up some school. I'll be in the E.R. for a while.

Cara Lunsford

I love it. Well, I am definitely not an E.R. nurse, so my hat's always off to those who take on the challenge of doing E.R.. I feel like what's really great about having both of you here is that you have two very different perspectives for Larissa. You've been doing this, say, 24 years.

Larissa Africa

Yes.

Yeah. So you've been a nurse 24 years, 10th. You're new into this profession, so you have kind of a little bit of a different perspective. Also, I imagine since you've been doing this two years, that you went through COVID. I did. In nursing school.

Tiffany Labig

I did, yes.

Cara Lunsford

That's a challenge. Even more so a reason to talk about there's always been a need for preceptorship. Does it matter if you go through a pandemic or not? You just don't get enough in nursing school to truly prepare you to independently go into the practice and really be confident and be able to provide the type of care that the public deserves.

Let's call it what it is. It really is, in my opinion. It's a responsibility of these institutions to provide this type of service. And I know it's not provided in every single institution, although I think it should be that that is just the next phase After nursing school and it's really a phased approach, I think, to becoming a nurse.

And so I'm going to start with you because I'm curious. When you graduated from nursing school and you entered the workforce and you entered in the E.R. during a pandemic, did you enter a facility where you had a preceptor or did you not?

Tiffany Labig

I did. I did have a preceptor. So and she was actually with me during my last semester of nursing school. So we had already kind of established the student role and different things like that. We're able to get the ball rolling on some of those checkups, which was wonderful. And then I was able to stay with her as a new grad.

So yes.

Cara Lunsford

That's pretty great. And then how long was your preceptorship?

Tiffany Labig

So I started in July and I was I want to say the very last week of September, I was on my own, okay? And we were able to kind of accelerate that process because I had done my last semester with her so already kind of been exposed to it as a student. So I was able to kind of like, we've done this and and checked it out a little bit quicker.

Cara Lunsford

So did they feel like they needed to move people through a little faster, too, because of the pandemic, that they needed to get people kind of on their own?

Tiffany Labig

There were I mean, fortunately, I'd had some previous experience as a unit clerk and as a tech, so I really knew my surroundings very well. But it was it was difficult because our staff was very tired, you know, And you as a new nurse, you're excited and everything's wonderful and butterflies and rainbows and you're ready to go. And things were great, but it was tough because my coworkers were very tired and I was tired from nursing school, but they were they were at a different level with patient care.

So it was time for me to go in and kind of pull some of that weight off them and help out. I think it all worked out for the best, but it was definitely okay. We got to we need people are tired and want to know. We need to get some staff to staff in general. It was just a nightmare.

So for health care in general and very difficult hospitalized. So was it was just time for me to kind of jump in. And I was thankful that I was a little bit older to be able to jump in and kind of have some of those life experiences where some of my classmates were just a year out of high school.

So they had seen extreme sickness before they had dealt with some of those things was very difficult. But I'm thankful that I was able to jump in and just kind of hit the ground running, so to speak, so that I had that preceptor with me and she prepared me very well for what I needed to do.

Cara Lunsford

Oh, welcome to our segment we call the Dart Spot, where you will hear more of your voice and a little less of mine. You can visit nurse dot com forward slash podcast to share stories, feedback and requests as a valued listener, you will also receive discounts on nurse dot com courses and C use by using code nurse dot at the checkout today on the dot spot, we welcome Amy Jo Stanley, a registered nurse and nursing coordinator at Wayne Health Care.

Amy Jo recounts the early days of the pandemic and how it affected new grads and nurse.

Amie Jo Stanley

Preceptors We were taking nurses from offices and putting them back at the bedside. We were doing what we needed to do to mitigate the issues, but we also had to do just in time training for nurses who had not ever been faced with the need to do proning before. How do we deal with all of these ventilators if we don't have enough of them, and how do we do all of the other PPE and all of the rest we did not need and 90 fives for the entire world for the pandemic.

All of that changed then. We also had all of these nurses who are burnt out who don't want to stay.

During.

A pandemic. New grads who did not get any clinical at all seem like they got virtual. And then we have to try to get them to be epic. Premier perfect nurses How does a facility get stability in a workforce that I think we were already on the cusp of facing that attrition and loss simply because our baby boomer generation is now our strongest numbers in nursing and they are going to turn into our biggest population of aging patients.

Oh.

Cara Lunsford

Larissa, when you were graduating from nursing school was that were there residencies at the time or was this was it really just preceptorship? Like, you kind of go in, you have a little bit of a preceptorship and then you get going.

Larissa Africa

You know what? I think back to the history of how we've onboarded nurses over the years of residency or internships. It wasn't a new concept, even when it started at Children's Hospital, Los Angeles, but it wasn't where it was formalized or had a lot of structure, or even at all kind of space for the matter. And not every organization facilitated the onboarding process at the same caliber.

So when I started as a new graduate nurse, it was the very first pilot program at the hospital where finally the hospital decided, you know what, we need to give something better for a new graduate nurses who are entering the profession because the nursing schools are doing the best that they can and they're trying to provide us all of the clinical experiences.

But there's still very high turnover of new graduate nurses. You have a lot of novice individuals into even the workforce. So similar to some of your experiences. I was 18 when I went to nursing school, graduate at 21, never really worked before, so there were a lot of new experiences in that reality was setting in. And around that same time when I graduated from nursing school, I don't know if you would remember this, but the magnet just started and they were the original researcher for the residency, started thinking, You know what?

This is what we need to do. We need to model a residency program after the 14 courses of magnetism, which is what it was called back then. But focusing on the outcomes, we want competent nurses, we want them to be competent. We want to reduce the turnover and we want nurses who are satisfied and who would give back to the profession.

So I was fortunate enough that when I graduated from nursing school children that I was offering the opportunity to be part of an internship. Essentially at that time. And it was robust. Even at that time period, it was not only providing education and classroom experiences, but it integrated the preceptorship into the whole experience. It also provided us the opportunity to be mentored by an experienced nurse and participate in self care sessions.

And we provided feedback on what's happening in the program. Who expected the program was, and also what's happening in the work environment that impacts our intent to stay in the organization. And we were successful. So I think when Children's Hospital started to really do well, what they were doing for orientation and rebuild a more structured approach to onboarding and changed the ballgame.

Cara Lunsford

Yeah, it did get more refined and I'm sure that the outcomes were measurable and that you could see how your changes were benefiting the new grads that were coming in and how the patient safety and patient outcomes were improving. And retention is improving. If you feel well prepared, you're way more likely to stick around.

Larissa Africa

Exactly.

Cara Lunsford

If every single day that you go to work, you are fearful. There's really only so long that you can do that right before you just tap out and say it's not worth it anymore. I'm every day my palms are sweating and I'm terrified of what I'm going to encounter because I just don't have the tools and the resources you know, available to me to feel really confident.

So that's what I really love about having a very structured preceptor program, because I know that a lot of hospitals, you go to a hospital and they'll say, Oh yeah, you'll have a preceptor. And nowadays the average number of years of experience on any given floor is about two and a half years. The average. I mean, that's frightening.

Very. Yeah, it's scary because that means that maybe like somebody with four years of experience is presenting somebody who's a brand new nurse or somebody with two years of experience is presenting somebody who's a brand new nurse. And that's okay. It's not that that's a bad thing, but you have to have different levels of experience because it's that experiential.

The time that you have that you can't replace, that you can't replace that with book learning or anything. It comes from somebody who has seen something 100 times, 200 times, right? So that's what I think is really interesting nowadays about why I think it's so important to have almost like this outside third party, I guess, what you could call it, you know, residency program or preceptor program, because you have to bring people in who have the level of experience that these new grads need.

It can't just be the person on the floor who has three years of experience.

Larissa Africa

But I love that you bring up the need to have different level of experiences among doctors, right? So when I think about the novice to expert approach or the married state of presenting or team preceptor approach or tiered skill acquisition model, so there's so many different sector models out there for every single one of those, it's really focusing on what is that experience like for the preceptor and for the preceptor and how much can the present be taken at that moment in time.

When you think about as an experienced nurse going into a patient room, they know exactly what's happening with that patient immediately, right? They know what's wrong with the patient just by looking at them. And they know exactly what they need to do. They know what needs to be done, even with one hand tied behind their back. When you partner that really experienced nurse with a new graduate nurse who hasn't had that experience, where are you going to get a new nurse?

That's like deer in the headlights because they had no idea. How might that skirt receptor get from point A to point B? So having different levels of preceptor experiences helps move that new grad that presented through their practice as a competent level preceptor, a newer preceptor a year and a half, two years. I still know how to get from point a to point B and outlines.

That's right. Yep. And then once I get more comfortable as a new gadget nurses are presenting, I can move on to the next level of preceptor who has a little bit more experience. And really that expert preceptor should be about honing in on those skills and really focusing on clinical judgment and critical thinking with life to think about how do we make sure that we help our new graduate nurses get on the road map for how to really understand the clinical practice.

Cara Lunsford

So, Tiffany, what do you think the answer is to that?

Tiffany Labig

That's a tough one, ladies. So and I tend to wrestle with that question quite a bit. I just got done presenting a nurse that's been a present or has been a nurse for 18 years. So I didn't know that when I bumped into her the day that she just happened to be on my schedule. And I never assume anyone's experience or age or any of that because we're all at different walks.

So I kind of went into the room and, you know, and introduced myself once we went out back to the nurse's station and I said, So tell me a little bit about yourself. And she said, I've been a nurse for 18 years. So I was like, okay, perfect. I was like, Well, I'm Jeff and I've been a nurse for a little over two years.

So I said, There's probably a lot you can teach me, but what I can do for you is just show you kind of how things go here. And we are a smaller role hospital, so it's a lot different. Usually the nurses that have all that experience, they haven't been in our type of setting before. So I'm able to just kind of explain a lot of the people that I care for our community members, extended family people that I know.

So when you're at a big trauma level hospital, you might not know your patients, but here's how things kind of are on our level. So I still feel like there's things that I can share with them that will help in our specific setting. So I think that's probably why I'm in the role that I'm in and the Kinder campaign that I try to run here in our E.R. with kindness, with patients and kindness with each other.

I feel like sometimes we do our young and it's very difficult when you're new. And Clarissa was saying you might feel like you don't really know and you don't have that experience. The only way to get the experience is to get the experience. So we have things that happen every shift that everybody sees, and it's very routine. But there's some nurses that they might have seen something six times in the last week, but I've never seen it before.

It just depends on when you're scheduled. So just being able to work together. Let me show you something that I learned or something new or this is how these things work in our department, in our smaller E.R. versus, you know, 40 or 50 bed E.R. So just kind of working through those processes. And I feel like that's very valuable as well.

To kind of get that great patient care is to understand your population age groups that you're treating. We are 45 to 50 minutes from the highest trauma level center in the state. So a lot of times patients will come here and stay with us for a week. We have to really be prepared for those types of things, but they don't happen every day.

So it's really just sharing those experiences and having that teamwork in that that atmosphere. And I really feel like when we go through those versus steps, even if it's not something you're seeing that day, you're still able to speak to those things with your preceptor. And that's very, very helpful.

Cara Lunsford

Yeah, humility. Humility goes a long way for everyone, whether you are the preceptor or you're the person getting precept. Did that being humble, coming in and saying, maybe I have 18 years of experience and I've probably seen a lot of things that you have never seen, but I have not worked in this facility for two years, and therefore there are things that I do not know about this facility, about this demographic, about this patient demographic, that if I'm humble and I listen, I can learn something from you.

And I think that that's really important to learn that no matter how many years of experience we have, you seem to approach her with a level of humility where you said, I've only been a nurse, you know, a little over two years, and I probably haven't seen as much as you've seen. But here's what I have to offer you.

Oh, stay tuned for part two of this very special episode. If you are a nurse who enjoyed this episode and you have an idea for future episodes, you can connect with me by downloading the nurse dot com app. Nurse dot is a nurse dot com original podcast series Production music and sound Editing by Dawn Lunsford, Production Coordination by Rhea Wade, Additional editing by John Wells.

Thank you to all the listeners for tuning in to the Nurse Dot podcast. Until next time, keep spreading the love and the care.

Part I

Cara Lunsford

Oh, hey, nurses. Welcome to the Nurse Dot podcast, giving nurses validation resources and hope. One episode at a time. Oh. Welcome back to part two of this very special two part episode. Let's pick things up where we left off. Melissa, I had a question for you because when you were talking about these different approaches and you named off a few of the different approaches to precepts, can you kind of drill down a little bit on those and explain them in a little bit more detail just so the listeners kind of understand the different types of precepts that maybe they could come to expect or ask for if they're not getting it.

Larissa Africa

Sure, I'll do the best that I can. So, you know, within their residency, they've always followed the novice to expert team preceptorship model and have integrated a married state approach. So there's really kind of three models all in one. And basically what we're trying to do here is making sure, as I described earlier, where you try to partner your new grads with in your preceptor in the very beginning, you have a very novice new graduate nurse partnering them with a competent level preceptor who's currently in a novice preceptor role and then moving them to the profession preceptor and eventually to the expert preceptor level.

So there's a team of preceptors working with a new graduate nurse and in addition to that, there's the married state approach. And what that is, is you and your preceptor are tied to the preceptor and the new gadget nurse will take one patient assignment when the preceptor goes and break new ground, the preceptor goes. And when they have a patient who may have to go to radiology, for example, or need to get some test and the new grad precept, he goes along with that nurse that allows the new graduate nurse to have a safe place.

Right. To make sure that we're prioritizing safety, especially when you're so new in that environment, and then also get to experience what it's actually like if you're taking care of four six patients. What does that look like and how do you manage your time? What happens when you have to take your patient down for a test or somebody to ask for?

One of the physicians is asking for a report. How do you balance all of that? The whole concept of Merit State and a team approach also has several different opportunities there for organizations to implement. One, because you can use you can have a larger pool of preceptors, probably those that you haven't thought about, maybe including a practice doctor, because they're new, maybe a year and a half or two years out.

But they can present in that very beginning part of the residency program. If it's just about how do you get to the a medication room? How do we get the live in? How do I get started with having conversation with physicians? And so a newer nurse can certainly present in that manner. So that's one of the benefits of using the knowledge to expert team preceptor approach.

And that also helps with that bring out the key factors. Presumptions are a long time of hard work and there and you want to do the best for your patient. At the same time, you're also teaching your precepts during those interactions and you're talking constantly. So having a team preceptor approach helps decrease that patient burnout as well. So that's the model that we've used in verse and a couple of other things that we have seen as a tiered skill acquisition model that's very similar to the team preceptor approach.

But the new grads face with one preceptor the entire time. Their difference is the focus of skills grows over time. So it's looking at what are the basic skills you need to do? How do we then build in those skills and eventually again, moving into those clinical judgment, critical thinking skills. So these different preceptor model focuses on how do we help the new grads feel more confident and competent and have a safe space as they're orienting into their new environment.

Cara Lunsford

I love that. I think that it is really important, especially in today's climate, having to be so mindful of not burning out your preceptors because you need them. I mean, you have to have them. You cannot bring new nurses into a hospital system and not have them have preceptors at the same time. I think we have to think about how everything has now shifted with regards to travel nurses and how travel nurses coming to a new institution and requiring some level of preceptorship, even if it's for a few days where they're just orienting you for a couple of days.

After a while, these senior nurses or these staff nurses or they're just like, Oh my gosh, I just want to go do my job. Like I just want to go and take care of my patients. And I don't want to keep telling people how to badge in or how to do this or where the Band-Aids are, where they can get these, you know, these types of supplies.

And they're just in this perpetual training all the time. So in some ways, do you think it's the nurses that are on the floor that should be the preceptors, or do you think that it really should be people who sign up just to be like, let's say, for example, like I'm like, you know what, I haven't worked on a floor in a while, but I really would love to Presec I'd love to go in and just third party, like just contractor, like the contractor preceptor because you come in and you can shadow one of these new nurses, but you don't necessarily maybe you don't necessarily work at that establishment.

You go through a little bit of training, but you don't work at the establishment. But you're there, but you're not counted as a head.

Larissa Africa

You know, it's it's interesting that you bring that because there's a lot of new sector models that are emerging. Right? One is even having a preceptor lead role and the organized nation where there's one priest after the new grads are assigned a buddy, Buddy just serves that person. They're going there's one preceptor who's going around a unit with all of their different new grads, observing them, validating their performance and documenting their performance and their assessment and the new role that's being implemented by some organizations.

There's also a virtual priest doctor model that is up and coming. There's not a lot of data that's out there yet, but it's similar in a way to what you're describing, right? So if somebody who's not on the unit or just serves as a resource person, but not necessarily technically employed by the organization and not counted as head, I think with all of the challenges that we're having right now in the health care and all of that trauma, I think we need to be open to the possibility of having new preceptor models that we can implement.

What I would be cautious about is making sure that whatever model we implement, we support those individuals who are in that role to make sure that they are prepared to be a presenter, that they can support the new graduate nurses and that we we meeting all of the new grads, the preceptors, the organization, the leaders understand that we're working towards the same outcomes and the same goals.

That makes sense.

Cara Lunsford

Yeah, I mean, it's like when we talk about standardizing care, right? It's like you also want to have a standardization for preceptors so that there is a certain quality that you can expect from them. And for the people who are receiving the benefits of their preceptorship. I absolutely agree. I also think that it's really important to have diversity to what you're saying.

So if you only have one person on the floor who's doing it, then you have one person's opinion about something. You have one person's level of education, one person's level of experience, and that doesn't really provide a ton of diversity, you know, in terms of like thought leadership. Right. I think that there's all this stuff to consider. And I love just kind of having this debate around what is the best model If you could create the perfect model that would preserve the staff nurses at a hospital and allow them to do the work that they do, but maybe they come in and they do a day where that's their job for that day, but they

are not assigned a patient load.

Larissa Africa

And that's really the reason why that preceptor lead role is something that some organizations started thinking about. We're not going to assign you a patient load that you're going to visit with each new grad in their unit and see how they're doing, because you already have four or five patients are really busy. Sometimes you don't have time to really assess your new graduate performance outside of teaching and educating and just coaching.

So then this priest, Dr. Lee Chen, had that opportunity to do that. I think the other challenge for many preceptors do, especially when you start having multiple preceptors, it's great to have a diversity of knowledge and experiences. Even preceptors own professional development experiences. There still needs to be a way to manage a standardized orientation. So everybody is teaching you the policy and procedure that we're not diverting from the evidence based practice and out there.

So there's that level of sterilization that no matter who you are as a preceptor, whether you are brought in by another organization and your original predecessor, we need to give that student. And then all of the other pieces that you talked about, that's where we can customize the experience to the new grad.

Cara Lunsford

Absolutely. What are you thinking is you're hearing us talk about this. What is going on in your mind? Like, what are you thinking about?

Tiffany Labig

A lot of things. I think that it is so important to as a new grad, I think it is so important to feel some sort of sense of belonging. You need to as a new grad, you need to have a person, hopefully more than one or people that you feel comfortable with because inadequacy is a really real feeling for new grads.

I remember feeling that way, and there's still days that I do, but I know who my people are that will help me through that, that I feel comfortable asking questions to. So I think the reason why I love that something real so much for new grads is because I can meet them where they're at. And I still remember what it's like to be the new kid, my kids new old mom on the floor.

So I think that it's super, super important to make sure that you're building those relationships in the workplace so that when things hit the fan and it's stressful that you feel confident that your coworkers are going to support you and help you through that. So building those relationships immediately so that they feel comfortable is my big goal in life in our department.

But I also agree that you kind of need to get a taste of knowledge from all of the coworkers. So I think if you can build that initial great connection with those new grads that are coming in, eventually what I try to do after I've had a few times, I try to bring in new friends for them to feel comfortable with.

Not that I don't want to continue helping them, but there's going to be shifts that I'm not with them. If they're not scheduled with me, I still want them to have that sense on their shift where they feel comfortable being like, Hey, I'm not real sure where this is, or can you help me? Because it's hard to speak up and it's hard to speak up when you're new to the facility and not only just new to the facility, but new to the nursing profession in general.

There's so many things to learn. I think it's so important to be able to know who your people are. So the more teammates that you can get on board. But like I said, sometimes the burnout is very real. You find a really great preceptor and what do you want to do? You want to give her all your new people that you want to make sure that you do it her way and learn from her.

She's been here a great time, but it's hard because it's very difficult to take care of a full patient load and be teaching at the same time. You tend to run a little bit slower because I want to make sure when I see something, I want to make sure that my nurse is comfortable and that she understands the why.

It's not just we'll do this and we'll talk about there's never a good time to talk about it later because after 12, 13, 14, 15, 16 hours, which is our maximum here in our facility, there's not really time to talk about that. So if you can take that time, but it's difficult with that for a patient one at a time.

So really it's a kind of a time management. You said earlier our staff was very tired when I came on board. So with COVID, it's been difficult and some of these nurses have it had they made a lot of changes in nursing school post COVID. So some of the basics of, you know, making a bed and some of the long term care facilities that we were able to start.

And in first semester, these nursing students have never had they were never allowed to go into a nursing home or a long term care facility. So they don't have some of those basics. And that's where I learned a lot of great things. And was able to pick up from some senior nurses in that setting. So not only are we tired and busy, we also are tired, busy and we don't have the experience of what grads have had in the last five years.

So kind of making up for that lost time to be quite difficult. Oh.

Cara Lunsford

Oh. Welcome to a segment we call the Dart Spot, where you will hear more of your voice and a little less of mine. You can visit Nurse Dot, come forward slash podcast to share stories, feedback and requests. As a valued listener, you will also receive discounts on nurse dot com courses and C use by using code nurse dot at the checkout.

Today on the dart spot, we welcome Amy Jo Stanley, Registered Nurse and Nursing Coordinator at Wayne Health Care.

Amie Jo Stanley

Think about what your.

Preceptor.

Knew when they were your preceptor. They didn't get that training, they didn't know all of the things. And if that one individual preceptor did, that's great. But that didn't mean that she knew the same thing as her person. Sit next to her. So standardizing that knowledge for the department means that at any moment that I need to turn to my next door nurse and say, Can you help me?

We're on the same page. We know what we're doing. We can work together. And it doesn't have to be a let me bring you down to build you up to mold you into what I need you to be. But that is, I think originally the thought process behind that, whether that's military or otherwise. And it also comes down to is that a culturally accepted norm.

Is leadership supportive of lateral violence or is there a zero tolerance? Oh.

Cara Lunsford

We make assumptions based on the education that we received. So you have to get some level of understanding of like what they've actually been exposed to before you can even start to teach.

Tiffany Labig

Absolutely. So, so important. I do like a little interview with any nurse or student that I met, just all of those things asking those questions and then finding out there why? What's your why? Why do you want to be a nurse? Why do you want to be here? Just so that I can kind of, like you said, meet them where they're at, so informed, so that, you know, if they are passionate about something, then let's go talk about that a little bit and bring that into your practice, all those good things so that you stay and then ultimately enjoy what you're doing.

Cara Lunsford

Absolutely.

Tiffany Labig

And you're done in a year. I get it. So let's figure out the why and where you're at and let's go from there.

Cara Lunsford

Let's say you you came off me. What do you what do you think about this?

Larissa Africa

I'm just loving everything that they're saying. You know, when you started talking about your introducing the new grad to other nurses in the organization, and there's a tip for every share. I love that, by the way.

Cara Lunsford

Oh, my gosh, I'm so glad you said that, Larissa, because I literally, I we got too far from it. But I was like a tiff on your shift that is like the name of a program. I was like, versus is it going to have a tiff on your shift? It's going to be like the podcast series. Tiff I think you have a podcast coming.

Tiff on your shift, the verse in podcast, TIFF on your shift.

Larissa Africa

Reminds me of what and a couple of colleagues and friends and I had talked about, you know, I was, gosh, maybe two and a half years into my clinical practice when I decided I'm going to join the residency team and really build the residency program. So that is where it is now. And it's beyond just supporting new graduate nurses.

But really Versant now an organization that supports the onboarding and using a competency framework. So to me it's looking for my tribe, looking for those individuals who I can ask questions and build a space and talk through our experiences. Because as a nurse executive, I'm not a nurse executive from a hospital, I'm a nurse executive in a business.

So so when you were describing how you were introducing the new grads to other people in the organization, if you're helping them find their tribe and you really are promoting raising these new graduate nurses in the village, and I love that. And that's really one of those ways that I've seen and even in our data that we collect, if you feel like you belong in an organization, if you thought you belong in the unit, it's hard to leave.

Tiffany Labig

Absolutely. Yep. So I love that. And statistically, they might be able to go somewhere else for better things financially, but they're going to stay where they're comfortable. So my job, because I'm just a little bit of an older nurse, like I'm a baby nurse, I know the importance of if we're going to spend a lot of time together.

We need to feel like we're friends, like this is our second family. And with long hours and long shifts, it's really, really important to like here, working with it's not always going to happen, but it's really important to make sure that the things hit the fan. And we're really far away from the hospital that these patients need to go to.

You need to be able to have somebody to lean on.

Cara Lunsford

We sometimes have that kind of sibling ask relationship. I find sometimes like a brother, sister, sister, sister type of relationship. It's like, Look, I can say that to her, but you can't say that to her. You know, we have this camaraderie. We might be able to be very candid and frank and and honest and say like, Hey, you know what?

I need this and I need this right now. And maybe it sounded really rushed and frank, but I'm in an emergency and I can't mince words right now, but there will be that immediate kind of understanding amongst each other. We won't take it personally. Absolutely. You know, she hasn't had a lunch yet. Care hasn't eaten. She's hungry. Just ignore the fact that she didn't say thank you before or after something.

But we're very protective. But turn around and have somebody from the outside of that team say something to your colleague and you're like, Whoa, whoa, whoa, Don't talk to her like that, you know?

Tiffany Labig

So even so, care, like if that relationship isn't built and that foundation isn't there, if that person, you know, another nurse does get upset or is hungry or having a bad day, you do take it personal because you haven't built that bond with them or built that relationship with them because you're just have to help with one person.

So it's super important that's going to build that family line and make sure that you have a lot of chance where we're at.

Cara Lunsford

Here, a lot of tiffs. You have a tiff on your shift.

Larissa Africa

To trademark that or something.

Cara Lunsford

You really do. I am expecting a podcast to come out called TIFF on Your Shift, and I remember being like.

Tiffany Labig

I'll come to you wherever you come.

Cara Lunsford

I will subscribe to your podcast if All right, Well, I don't want to keep you ladies much longer. I'm just really incredibly grateful for the work that you both are doing. Larissa you're leading an incredible organization, and I really see what you're doing as the pathway to sustainability in this practice, and that if we don't figure out how to do this, we're not going to keep nurses around.

It's just not going to happen. I'm thankful that there's people like you that are out there doing it. And then I also, you know, Tiff, there's a tiff on your shift somewhere. You know, just find your tiff. I'm also so grateful for the fact that you went through nursing school during a pandemic. Came out at one of the worst times in history.

And yet you still have a light about you. I can tell that you're passionate and you might be tired. And I'm sure you're tired. I have no doubt. You have five kids and you're working in an hour and you're presenting Tired is. Yes, yes, Yes, ma'am. Yes. But you also seem to just exude an incredible amount of positivity and hope.

And I think like that is what we really have to keep with us. So I just wanted to say my thank you's.

Larissa Africa

Thank you so much. Thank you for this opportunity. And I keep thinking about how we continue to support our preceptors and how do we highlight their contributions to nursing. You were talking about nurses and how much we have done during the pandemic that has shown preceptors in an ongoing basis. So I appreciate that you're highlighting the role of the presenters in this podcast, and I know that the foundation has also just released their meaningful recognition program for doctors that's due to start highlighting.

Cara Lunsford

Probably long overdue. Like most things in nursing. But you know what? Better late than never, right?

Larissa Africa

Once upon a time.

Cara Lunsford

That's right. Yeah. One step at a time. That's right. Well, again, thank you. I can't wait to speak to you both again. Hopefully. Very soon. And I'm also very excited about the Daisy Foundation and their recognition of preceptors and, you know, the nurse dot com is just a huge supporter of of both versa and and and the Daisy foundation so thank.

Tiffany Labig

You thank you and thank you Thank you ladies. Thank you so much. It was so good to speak with you today and thank you for all that you're doing for our profession and for preceptors and moving us forward. All good thing.

Cara Lunsford

Until next.

Larissa Africa

Time. Thank you.

Cara Lunsford

Thank you.

If you are a nurse who enjoyed this episode and you have an idea for future episodes, you can connect with me by downloading the nurse dot com app. Nurse dot is a nurse dot com original podcast series Production music and sound editing by Dawn Lunsford, Production Coordination by Rio Wade, Additional editing by John Wells. Thank you to all the listeners for tuning in to the Nurse Dot podcast.

Until next time, keep spreading the love and the care.