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Sunday, April 5, 2015

How to be an Awesome Nursing Preceptor

Preceptor, nurse, nursing school, clinicals, new nurse, new grad, stress, compassion, self-improvement

How to be an Awesome Preceptor

As you know this blog is written by a nursing student for nursing students. So what in the heck do I know about being a preceptor when I've never been one? The truth is, I don't. But I have had many preceptors thus far in my studies and I can tell you what worked and what didn't work. I can also tell you what you need to be as a student for these amazing preceptors we have.

I value all of the input I received from every nurse I worked under. I appreciate their time that they gave to me. I know I slowed them down by asking a million questions but I will be better and it's all due to them. So Thank you, preceptors! You've all done a smashing good job.

What Didn't Work

I'm coming up on my final shifts of nearly 1000 hours spent in clinicals. WHOO HOO! So I've been around for a hot second, considering I'm still in school. I'll just quickly say my piece on the negative things that I didn't like in a preceptor.

  • Not setting a good example. 
    • I had a preceptor that would stream netflix on her phone and would take her time getting to the patient. I don't approve of that behavior. Granted she would rush to their room in a hurry if it were something emergent, but if it wasn't something immediate she'd relax and eat some pistachios and the patient would suffer because of it.
  • Belittling the student in front of the patient/family.
    • I haven't had this happen to me so much but some friends have. I don't find that to be a very nice environment to learn and grow in. I understand that every time I get a new preceptor I have to gain their trust, but there's probably a better way to go about things than resorting to that.

      I did once have a preceptor ask a patient if I could start their IV. She went on and on about how I'm a student and it would be a great opportunity, that I need practice, etc. At this point I was doing all of our lab draws and had placed at least 10 IVs with this nurse watching. I had placed IVs previously with other preceptors (not that she was there for that). So it frustrated me that she basically made this patient panic that I'm some idiot with a needle just poking him for the fun of it. Guess what? I got blood return but as I was advancing the catheter the patient jerked his arm and pulled it out. I'm not saying it was because of what she said, but I wished she spoke about me with confidence.
  • Not orientating the student briefly to the unit.
    • I have had this happen many many times. It sucks. I understand that preceptors are busy. I understand that the first few hours of the shift will be busy, but there is usually a lull a few hours into the shift. That would be a great time to show me where things are kept, briefly. I can't tell you just how many times this happened to me and just how many times I was made out to be a fool because I didn't know where certain items were stored. Or where to go when transporting a patient through the hospital. I'm not an employee of this hospital. I'm only here for 2-3 weeks. I don't know where anything is located. I'm not stupid, I just don't know.

Ok. I don't mean to be rude to preceptors. I really do appreciate everything it is that they do for us students. Not every hospital pays them extra to have us on their shift. We slow them down. We ask questions non stop for 12 hours. We're a pain in the butt. I get it. I totally get it.

I just wished every once in a while that nurses could reflect and remember that time when they were a student. I really hate that whole "nurses eat their young" thing. But it's true. And it sucks. It's also not necessary. Not one bit. But if you're reading this, I highly doubt that you are that type of person because you are taking time out of your life to read this to better yourself, and I thank you greatly for doing so! Seriously. Thanks! :)

What Does Work

  • Setting a good example.
    • Monkey see, Monkey do. Right? So if you're setting a great example then it makes it easier for the nursing student or new grad to pick up those habits and emulate them. I want hard work and positivity to be contagious. We're watching everything you do and soaking it all in. That's a lot of pressure and stress on you, but just be aware. Basically we're 3 year olds.
  • Make it a real relationship.
    • I'm not saying lets be friends on facebook. I don't need to be invited to hang out with you outside of the hospital. But I do find my best preceptors have been the ones that I can talk to. We all know examples of the nurse that you ask a question, she looks at you then she turns her head and walks away. That's crappy. I'm always touched very deeply when one of my previous preceptors texts me to ask how school is going, if I'm applying to any jobs, if they can be of some help. My god. That is SOOOOO nice of them. It almost makes me cry. It is just so sweet and very touching. Now not every relationship will be like that, but I love love love love when that happens.
  • Communication.
    • If you want to be a good preceptor or a good student you need to be able to communicate with each other with clarity. And if there is some miscommunication, don't scold one another. It's a two way street. If the student/new grad doesn't communicate that they don't know how to perform some task then the preceptor has no idea. Like wise the preceptor shouldn't scold you for saying you feel uncomfortable doing that task and would like to observe or be talked through it. Unless you've been shown this process multiple times. Then that preceptor is justified to show a little sassiness.
  • Patience.
    • Please be patient with your new nurses/students. We all are very task orientated because this field is so new to us. You don't have to coddle us or baby us, just please be patient and understand where we're at academically and experience wise. I think it's great to show the student how to do something once or twice. Use the teach back method to see if the student understands the procedure. The next time let the student perform the new skill.
  • Have a consistent routine.
    • This may not always be possible. Especially if you are being floated to other units. Or you've got patients that are crapping out on you. I understand that you can't always stick to a routine, but if at all possible it will help the student/new nurse learn so much better. Other wise you feel blind, you feel lost. Having a routine will help you out too. I firmly believe that organization plays a major role in being a successful nurse.
  • Introduce them to members of the team.
    • This takes barely any time and makes the student/new grad feel very more at ease and welcomed into your hospital. And it really takes no time at all. It also lets people know that you are with someone inexperienced. As a student, I can't tell you how many times someone has rushed up to me to tell me something and I have to say over and over again something along the lines of "I'm a student. I don't have access to the pixis" etc... This is because I'm in a majorly busy teaching hospital so students and new hires are shuffled around like crazy. Also, it kind of stinks but it's in some ways nice--- I wear the same uniform as the RNs. Other nursing schools distinctly identify themselves as nursing students, but my school doesn't. I do have a patch that says I'm a student, but no one ever notices that.
  • Drill your student/new nurse.
    • You probably shouldn't do this on the first week or two, but certainly you need to ask them questions. Make us think. "Why am I giving this patient heparin?" "Why are we giving an IV dose of pain reliever instead of a PO dose?" "The patient has a femoral sheath in, what is important to know about this patient's positioning?" etc... Drill us. When we ask a question ask it back to see how far we can walk ourselves through it. This is a great way to evaluate how good we are at critical thinking. We use teach back methods with our patients, why not with a student/new nurse?

As the Student Nurse

Don't be an arrogant know-it-all. Haha. You should ask questions. I try to not be too overwhelming, but you should definitely ask questions. Try to pitch in with anyone on the team that needs help. Don't be hesitant. You need to be enthusiastic. Even when you feel horrible, you're mad, you're sad, whatever; always show enthusiasm. You're a guest. You're also on an audition. Make sure you're a good night's sleep the night before clinical. You need to make sure you eat a big breakfast because you never know when you'll get busy and lunch isn't always guaranteed. (Even though you're there for 12 whole hours!! True story. Sometimes you don't get lunch. I try to pack sustaining snacks like a Cliff Bar.) I suggest trying to look up things that are specific to the patient population that is on the unit that you are placed at. Be as prepared as you can. You won't know everything, and they expect that, but when you know something they're very excited.

Here's a little secret: You can make most people fall in love with you by bringing in some sort of food/candy. Everyone has that inner fat kid. That inner fat kid is your ticket to acceptance. I've made many friends by bringing in cupcakes or sharing a fruit tray (because we are given a ton of sweets as nurses by thankful families so sometimes we all need one less donut and one more apple). 

Make goals. If your school doesn't already make you have clinical goals, you really should do it for yourself and for your preceptor. It has been a great way to inform my preceptors of what it is that is important to me. For instance, I had a preceptor once that never let me do any charting. It's not that I "want" to chart, haha, but I know I "NEED" to chart. It's a new system. I need to learn how to use this system. That skill will make me more marketable to hire. She didn't have any idea that I was wanting to chart so badly. So sometimes writing goals are a great way to communicate with one another what's important to you. Also, they may identify goals that are more appropriate or that will have a better pay off. It's just a great tool to utilize.

When your rotation ends with your preceptor, get them a gift. I've gotten preceptors their favorite snacks as gifts, I've given gift cards to my nurse so that her and her hubby can have a well deserved date night. I've given certificates for a massage. This time I'll probably give a few of the nurses on the unit that really took me under their wings gift cards to starbucks or candy.

I found the cutest, dorkiest thank you cards that are in the shape of coffee cups that say "Thank you very mocha!" or "Thanks a latte!" I'm a little lame, guys. haha. This unit has had a lot of changes so I've switched around and bounced from nurse to nurse quite a bit but they've all been extremely helpful. There's a starbucks downstairs that someone makes an afternoon run to so I know these gift cards will be put to good use. 

You're not expected to give them a grand gift, and maybe they don't expect a gift at all, but I'm a giver. So I've always given gifts. I don't normally give them to the whole unit though. If I give gifts to the unit it's like a big bag of candy. I'm poor. I can't help it. Fruit goes over well too. Aldi's has cheap produce. Just make sure that you say thanks. That's what is important here. Give thanks for their time, patience, energy, encouragement.

I think it's great to use your preceptor as a reference for job applications. Always let someone know when you're using them as a reference. I like the idea of using preceptors because they really know how you perform. Nursing faculty know how well your write, and how well you score on tests. High grades don't necessarily mean you're a great nurse and low grades don't mean you'll be a bad nurse. Preceptors know how ready you are to enter the field. Absolutely, try to use them as a reference. This is why it's so important to thank your preceptor and end on a great note. (I used to be a musician-- still am to an extent-- and, "You're only as good as your last note.")

**As the student, if you want to read something that will scare the crap out of you, make you cry, and probably kill your confidence then this post on All Nurses: Dear Nursing Student is for you. At first I didn't like it, but it gets a little better. I think it's a good read, though. Kind of harsh. Not really how I plan to be but I can see where this preceptor is coming from. Personally, I'd like to meet a little bit more in the middle though. Anyways, food for thought-- it's there if you'd like to read it.

Thank You Preceptors!!

I just want to give a very well deserved shout out to preceptors. It's because of you that we are all who we are today. We're shaped by preceptors. We're molded by our preceptors. You take on a huge responsibility to have a preceptee (is that a word?) and I want to thank you from the bottom of my heart for all the wonderful things you have given me/us. Thank you.

Preceptors: What do you do that is helpful in clinicals with your nursing students/new nurses?? Students: what traits do you like/dislike in your preceptors? What's most helpful? Leave a comment below so we can have an open discussion about precepting. 




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