ANSWERS


1. C: Sam must ask Jane what the barriers are, as she is an experienced nurse and ordinarily would not question these types of equipment.


2. D: Sam cannot determine why an experienced nurse should have jitters. Because he feels confused, and Jane is not clear in her explanation, he should obtain help.


3. D: Because of Jane’s uncertainty, it’s important for Sam to check in regularly.


4. D: By documenting the issues, Sam is starting a key process: to identify problems using factual data. This documentation can be used to modify the orientation plan and provide a record in case the manager needs to take future action.


Learning to be a preceptor Many healthcare institutions have extensive pro- grams to instruct and support preceptors. Te programs usually include instruction on adult learning styles, conflict management, instruc- tional techniques, critical thinking, validating clinical competence, and ways to manage and document performance issues. Trough these programs, many seasoned nurses are able to change their thinking from “new nurses need to learn the hard way, like I did” to “I need to consider how to support their learning.” Clinical nurse educators in the facility


are usually assigned to design a centralized program that includes preceptor selection crite- ria, an outline of expectations for the role, a staff development program to provide educational support, guidelines for staffing when precept- ing, ways to recognize and select preceptors, continuous evaluations, and membership on an oversight committee. Some facilities hold activ- ities, such as “preceptor action days,” to support and retain preceptors by providing them with training on topics, such as teaching methods, which may include role playing and interactive sessions for sharing among preceptors. Many instructional methods are available for


preceptor development, including classroom instruction, vendor-generated CDs, online pro- grams, textbooks, and journal literature. Aca- demic institutions may also provide education for preceptors as partnerships develop between programs of nursing and clinical facilities.1,9 One expert developed the Preceptor Orientation Self-Learning Education module as a teach- ing/learning tool for preparing preceptors for senior nursing students. In a pilot study, this tool was found to be an effective and convenient teaching/learning option in preparing nurses for their roles as clinical preceptors to nursing students.10


Academic educators have become


increasingly involved in the function of the pre- ceptor role as healthcare institutions assume a more active role in supervising nursing student clinical experiences. Nursing schools often post their preceptor handbooks online, making them readily available to others.1,11 Doing research on the preceptor experience


provides evidence on how to improve it. Nurse researchers in Taiwan examined the impact of differences in preceptors’ backgrounds, demographics, and learning styles on their competence as preceptors. In a cross-sectional survey of a convenience sample of 242 clini- cal nurse preceptors, researchers found that higher teaching competence was associated with older age, being married, and more than


2017 • Visit us at NURSE.com 33


Sam has agreed to precept an experienced nurse, Jane, starting on his pulmonary unit. Jane has completed centralized clinical orientation; the nurse manager has met with Jane to review the unit’s mission, vision, and performance expectations; and the clinical nurse educator has reviewed Jane’s orientation plan, the unit stan- dards of care, thus completing Jane’s orientation. Sam expects it will be a “quick VWDUWq ZLWK -DQH EHFDXVH KHU UÆVXPÆ UHưHFWV SXOPRQDU\ H[SHULHQFH 2Q -DQHoV ƮUVW GD\ RQ WKH XQLW WKH\ DWWHQG UHSRUW DQG VWDUW URXQGV WR GR LQLWLDO patient assessments before medication administration. Sam reviews the comput- erized care plans for each patient. As the day progresses, it becomes clear that there are unanticipated issues. One patient is on remote monitoring of cardiac dys- rhythmias. Jane asks how that works. Another patient has chest tubes after lung surgery. Sam asks Jane to check the chest tube suction equipment. Jane looks at him blankly and asks, “What do I check for?”


$V D ƬUVW VWHS WR WKHVH LVVXHV 6DP VKRXOG a. Page the supervisor for immediate help b. Page the educator for immediate help


c. Ask the charge RN to cover his patients; go to a private area to talk with Jane about her questions


d. Tell the charge nurse Jane will never make it


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a. Start with the remote monitoring equipment, retrieving the step-by-step com- petency from the online computer link


b. Tell Jane to keep her phone on for the calls from the telemetry technician


c. Move directly to chest tubes and review all of the elements of chest tube man- agement


d. Bring the educator into the meeting with Jane so all three can discuss this together


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a. The educator assuring Sam to power on; Jane just has the jitters and will over- come them


b. The educator volunteering to create a detailed competency checklist for the equipment while Sam consults with another preceptor


c. The educator removing Sam as preceptor, as he and Jane do not seem com- patible


d. The educator recommending several short meetings during the day to check on Jane’s jitters


6DP FRQWLQXHV ZLWK -DQHpV RULHQWDWLRQ DIWHU HTXLSPHQW FKHFNRƪV -DQH LV WHQVH $W WLPHV VKH VHHPV FORVH WR WHDUV 7KH\ FDUH IRU DQ DGXOW SD WLHQW ZLWK F\VWLF ƬEURVLV ZKR LV RQ D FRPSOH[ LQWHUYHQWLRQ IRU GHOLYHULQJ PHGLFDWLRQV E\ SXPS -DQH VHHPV XQDEOH WR IROORZ WKH VWHSV IRU WKH SXPS VHWXS GHVSLWH WKUHH DWWHPSWV DIWHU ZDWFKLQJ 6DP DQG KDYLQJ KLP WDON KHU WKURXJK LW 6LQFH KHU MLWWHUV FRQWLQXH 6DP VKRXOG


a. Talk with Jane further about the acuity on the unit because the patient assign- ments on this day were typical of the unit population


b. Hold an end-of-the-day meeting with the manager c. Power on, hoping Jane will eventually relax


d. Fill out the hospital’s preceptor evaluation of employee form to document Jane’s continued issues. Sign the form, have Jane sign it and submit it to the educator.


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