Precepting: Revisiting Ground Rules with My New Grad RN

A return to precepting.

By Suzanne D. Williams/Unsplash

There is no question that precepting new grad RNs requires a lot of extra thought, time, and energy for bedside nurses also looking to take care of our patients and their family members. But even as an introvert who finds it challenging to talk nearly nonstop for an entire 12-hour shift, I have in the past still enjoyed precepting. I’ve found it deeply rewarding to watch someone under my mentorship grow in skill and confidence as a young nurse.

When the pandemic hit and sent my young children home for distance learning, I took a break from precepting, as my capacity for additional mentoring at work had shrunk significantly.

Now that my children are back on their school campus, I am preparing to precept a new grad who is part of a cohort that went through nursing school during a pandemic with considerable limitations to their clinical experiences. As I dust off my own preceptor hat, I have found myself revisiting what I want to lay out as a foundation for my new preceptee. […]

Helping New Nurses Find Their Way: The Art of Saying Yes

A Preceptor’s Example

Photo by Ed Eckstein Photo by Ed Eckstein

AJN’s Transition to Practice column is designed to help new nurses in their first year at the bedside. In this month’s column, “The Art of Saying Yes,” Amanda Anderson explains how as a new nurse she learned the benefits (to herself and her patients) of going the extra mile at work. She describes the surprising personal and professional benefits that come from “the times you choose to say yes when you might just as easily have deferred.”

Anderson paints a vivid picture of her first days on the job as a nurse: The fear of making mistakes, the feeling of being a useless novice, the shame of not always being able to keep up with seasoned staff. She was fortunate, though, to have an expert mentor in those early days. Her preceptor was an experienced nurse who modeled the art of saying yes—an art that might be described as a willingness to leap in to help when not required to do so: to take on a housekeeping task, for example, or pitch in unasked to help another nurse whose day is spinning out of control.

“There is no term […]

2016-11-21T13:00:48-05:00November 18th, 2016|career, Nursing|3 Comments

Bedpans and Learning: Nursing Basics Still Matter

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

Photo by Morrissey, via Flickr. Photo by Morrissey, via Flickr.

There I was, orienting to a busy medical ICU, perplexed over a bedpan. You’d think, since I was just graduating from nursing school, that bedpans would be my area of expertise. Critical thinking and vent strategies came easy; how could I possible admit I had no idea how to give a bedpan to a patient?

Frightening, to graduate from nursing school and a competitive externship program without this competency. Somehow, though, every unit I’d experienced offered patient care assistants, or patients who didn’t need this age-old tool. I’d certainly helped patients to the bathroom and cleaned incontinent ones. Despite the barrage of clinical learning, the basics of offering the pink plastic tool hadn’t sunk in.

Paralyzed, I stood with it in my hand, looking at my intubated, awake patient. I’d had the wherewithal to ask the family to step out, but couldn’t figure out which end went first. The horror of my preceptor finding it backwards would end me. Did the pointed end go towards the patient’s back? The larger end toward the feet for better coverage? Why couldn’t I remember?

Somehow, I managed to decide, […]

Three Nurses and a Doctor Go Sailing – Some Notes on Communication Style

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

Untitled from the series, Pareidolia. Charcoal and graphite on paper, 12" x 9," by julianna paradisi Untitled from the series, Pareidolia. Charcoal and graphite on paper,
12″ x 9,” by julianna paradisi

There’s an old joke about the personality differences among nurses of different specialties. It goes like this:

A medical–surgical nurse, an ICU nurse, an ER nurse, and a doctor go sailing. The doctor stands at the bow of the boat and shouts to the nurses, “Trim the sail!”

The med–surg nurse asks, “How do you want it?”

The ICU nurse replies, “I’ll trim, okay. But I’m doing it my way.”

The ER nurse shouts back at the doctor, “Trim the sail yourself!”

ICU style. The joke is a generalization, of course. However, I was a pediatric intensive care nurse once upon a time, and I have to admit that the ICU nurse characterization resonates with my own experience. Like the nurse in the joke, I always have an opinion, and rarely mind sharing it. In the ICU, if another nurse, a physician, a pharmacist, or respiratory therapist didn’t agree, conversation ensued. My colleague, equally opinionated, would state her or his position. Data was consulted, […]

When the Preceptor’s Attitude Is a New Nurse’s Biggest Challenge

FirstPreceptorIllustrationHere’s the start of “My First Preceptor,” the Reflections essay in the March issue of AJN.

“Manage your day,” she told me, not for the first time, as if it had been my fault that one patient crashed yesterday just as my second one returned from surgery with a new set of orders. I could not be in two places at once, keeping track of two critical patients, making sure each one received the care she needed at the moment she needed it.

A new critical care nurse has a lot to worry about. It’s easy to feel overwhelmed, even when you’re actually doing a pretty good job. A preceptor can play a crucial role in helping a new nurse find her or his footing. As one might expect, however, some good nurses are not good preceptors. In this essay, the author describes her struggles to deal with the time pressures of her new job, along with her preceptor’s constant admonitions and disapproval.

This fraught nurse–preceptor relationship reaches a crisis point against a backdrop of life and death struggles. I won’t try to summarize what happens in the essay, since different readers may interpret it differently, depending on experience and temperament. But it’s definitely worth a read.—Jacob Molyneux, senior editor

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