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Hello good friend!  Welcome to my second post in a series of three about how to become an awesome nursing preceptor.

Please keep in mind that this is aimed towards the orientation of a new graduate nurse on a general medical-surgical floor.  However, it’s pretty general so it can be adapted to fit the needs of speciality units.

In my last post, we discussed the first phase of orientation. Here is the link:  Becoming An Awesome Nursing Preceptor:  Phase One

I’m now going to discuss the ever-important second phase of the orientation process.

Phase Two:

During this phase, they’ll take a patient on their own. After seeing how you take care of a patient, they should be able to adequately care for one person while you’re nearby for questions.

They will take and give report on their patient. They will do everything for them, even call physicians and support staff, as needed. They will complete all of the documentation. They will talk to their loved ones. They will educate the them.

Again, if they don’t know how to do something, always direct them to the policy first. With one patient, they should have time to go look up the policies for everything.

Continue to give them homework. Print off information about your patient population and quiz them the next day.

During this time, I start to ask all of my why questions.  Depending on their progression and knowledge base, I try to challenge them with the questions.  I also try to think of questions that patients may ask about their care plan.

  • Why do you think they’re on subcutaneous heparin?
  • Why are they on Colace and Pepcid?
  • Why do we need to do a bladder scan if they didn’t void 6 hours after you removed the foley?
  • Why do you think you needed to put your patient with CHF on oxygen after he got two units of blood?
  • Why do you think we need a central line when initiating vasoactive medications?
  • Why is it imperative that you lay them completely flat when removing their PICC line?
  • Why are we still giving them IV pain medication when we have oral pain medication ordered?

Whenever they ask me a question, I just ask it back to them to see what they think. I want them to develop their critical thinking skills. We need to go from being task-oriented to being big-picture oriented. While developing these skills, it’s important to not give away the answers quickly.  Let them think.  Furthermore, if other members of the health care team (docs, MD’s/PA’s, CNA’s, etc.) ask them questions about the patient, don’t answer for them.  I’m terrible at this.  I have to try really, really hard not to answer for them.

You want to encourage them to ask questions, so don’t act like they’re stupid if they get one wrong or do something incorrectly. Handle those situations with grace. Please don’t use that opportunity to make someone feel bad about themselves.   That’s that terrible nurses eating their young thing.

It is really important that during all phases of orientation that you are treating everyone around you with the utmost respect.  If you are talking badly about other people in front of your orientee, they see and hear that. If you’re not being respectful of the CNA’s, you’re telling them it’s okay to do that. If you are nice to someone’s face and once they leave you talk about them, you’re not being a good role model to your orientee.  They are watching how you do everything, including how you interact with others.  If you want them to be a good nurse and supportive coworker, it is imperative that you model that yourself.

Amazing nursing preceptors out there – what is your routine with your newbies once they get their nursey feet under them?  What tips/tricks/advice do you have to share?  Please comment below!

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