١

Page ١

Preceptorship

Naila Al MasriRN,BSN,CLNS,MSN

2014

١

objectives1. Define the difference between preceptor and

Mentor2. Define the terms and job functions of preceptor

and preceptee. 3. Identify the knowledge, attitudes, and skills

needed to be an effective preceptor. 4. Identify the rights and responsibilities of a

preceptor and preceptee within an organization. 5. Discuss ways of managing the emotion aspects of

both the preceptor and preceptee roles.

٢

٢

Page ٢

Preceptorship vs. Mentorship

l Preceptor

The definition of preceptor implies a teaching relationship. This teaching relationship ends when the novice is considered educated and able to perform independently. Task oriented with a definite time frame.

٣

Preceptorship vs.Mentorship cont.

ó Mentor

A nursing mentor is an experienced nurse who shares knowledge with less experienced nurses to help advance their careers. The mentor has a long term impact on the mentee and affects all areas of the mentee's career. There is no assigned time limit.

٤

٣

Page ٣

Definitions

l Preceptor: ÿ For the person who is a novice to the area (newly

hired/transferred) a preceptor serves as a role model with:

o Competence o Experience.

ÿ The novice to the area is guided by the preceptor to the roles and responsibilities, as well as:

o formal and informal rules. o customs o culture o workplace norms.

٥

l Preceptee: The preceptee, who may also be called the “orientee”, is new to a facility, department, and/or unit and participates in a planned orientation program.

l Preceptorship: The planned orientation program that helps to introduce and integrate the preceptee into the work setting.

٦

٤

Page ٤

l Orientation:This is a method used by an employing

agency to introduce a new employee to an organization’s: o Philosophy o Role expectations o Physical facilities.

٧

l Competence: Is determined by the measurement ofan employee’s knowledge, attitude andskill in a specific role.

٨

٥

Page ٥

Role Transition

l How are the roles of the Staff Nurse and Preceptor different?

l Role of Staff Nurse l Role of Preceptor l Differences in responsibilities l Ways to make a smooth transition

٩

Duties of the preceptor

A: Serve as a role model ¸ Maintain current practice standards¸ Serve as a resource person ¸ Participate in developing performance standards¸ Assist in defining the role of the Preceptor/

Preceptee

١٠

٦

Page ٦

B: Provide educationl Assess learning needsl Assess personal/ professional needsl Establish performance objectives/evaluation

criteria l Orient learner to organizational documentationl Teach how to locate resourcesl Review procedures/ policies for standard of

care

١١

B: Provide education cont.

l Plan educational experiencesl Review theory and the procedure steps l Demonstrate clinical skillsl Oversee return demonstrationl Provide emotional support and coaching

١٢

٧

Page ٧

C: Serve as a facilitator

l Orient to physical environmentl Arrange clinical experiencel Introduce employees/students to

corporate culture ÿ Unwritten rulesÿ Social norms

١٣

C: Serve as a facilitator cont.

l Integrate employee/students to staffl Introduce to organizational resources l Communicate mutual objectives with

dissimilar organizations/ departmentsl Facilitate communication with other

departments

١٤

٨

Page ٨

D: Perform preceptor evaluation

l Communicate progress to studentl Provide constructive feedback l Communicate progress to management/instructorl Document evaluationl Perform competency based evaluation

١٥

Preceptor Tools, Equipment, Supplies and Materials

l Reference resources l Check off list l Access to continuing educationl Rotation list l Student curriculum/teaching manuall Policy/procedure manual l Calendar for planningl Medical equipment l Patient bill of rightsl Evaluation tools

١٦

٩

Page ٩

Preceptor Traits and Behaviors

• Ability to establish rapport• Enthusiastic• Patience • Advocate • Initiative• Professional • Calm • Interpersonal

skills

١٧

Preceptor Traits and Behaviors cont. • Punctual • Common sense • Intuitive • Responsible • Communication – good skills•Intrinsically motivated • Sense of humor • Dependable • Level headed • Tact

١٨

١٠

Page ١٠

Preceptor Traits and Behaviors cont. • Efficient • Logical • Team player• Empathic • Loyal • Thorough • Flexible • Motivated

١٩

Preceptor Knowledge andSkills

• Possess academic and licensure/certification requirements

• Job experience in field • Serve as a resource to colleagues • Demonstrate excellence in field • Organizational skills • Desire to teach

٢٠

١١

Page ١١

Preceptor Knowledge and Skills cont.• Excellent needs assessment skills • Ability to develop learning objectives • Knowledge of learning styles • Growth and development• Cultural diversity • Objective evaluation skills

٢١

Preceptor Knowledge and Skills cont.• Excellent communication skills, verbal and

written • People skills/customer relations • Time management skills • Listener and leadership skills

٢٢

١٢

Page ١٢

Preceptor’s Expectations

l In addition the responsibilities that the preceptor carries, the preceptor also has expectations or “rights” that need to be supported by the preceptor’s employer and manger.

٢٣

Preceptors must have:

1.A job description that includes the role of the preceptor.2. A structured program to prepare the preceptor for the role.3. An understanding of expected outcomes for the orientation program.4. Access to preceptee evaluation tools that are valid and reliable.

٢٤

١٣

Page ١٣

5.A measurement of the preceptor’s performance expectations.

6. A description of the preceptor’s responsibilities in relation to others who are involved in the orientation program.

٢٥

7. Resources to help in the enactment of the role of preceptor.8. A facility support system that helps the preceptor to enact the role.

٢٦

١٤

Page ١٤

Responsibilities of the Preceptee

l Identifies his/her own learning needs.l Is an active participant in the learning

process.l Participates in regularly scheduled progress

meetings.l Identifies daily and weekly goals and

objectives.l Utilizes resources, library and department

resources.

٢٧

Responsibilities of the Preceptee cont.

l Readily asks questions regarding any job related or department issues.

l Reads and follows policy and procedure manuals.

l Completes all competencies by the end of the program.

l Reports concerns to preceptor or manager as appropriate.

l Evaluates the preceptorship program, preceptor and self.

٢٨

١٥

Page ١٥

Maui Sunset٢٩

Stress management

٣٠

١٦

Page ١٦

Reality shock:ó Novice nurses often

suffer reality shock as a result of the inconsistency between in the actual world of nursing and that of nursing school. As the novice nurse enter the new profession, reality shock begins.

٣١

ó Definition◦ Inconsistency between the academic world and the world of work

◦ Occurs in novice nurses when they discover a work environment toward which they worked for several years and suddenly realize that they are not prepared

Reality Shock

32

١٧

Page ١٧

StressInternal Stress

l Emotional Responses:Fear Self-doubt, insecurity, IsolationAnxiety, nervousness, Excitement, LonelinessGuilt over mistakes, Need to prove selfcompetitivenessPeer’s expectations of tough, none motionalresponse to stress, Emotional crisis

٣٣

Physical Responses:l Fatigue, exhaustion l Working when ill l Sore musclesl Lack of sleep l Working against circadian rhythml Working through breaks, mealtimel Body not accustomed to heavy workload or

fast pace

٣٤

١٨

Page ١٨

Mental Responses:l Worry about performance l Inadequate education l Criticism of performancel Unclear priorities l Forgetting information used in schooll Expecting perfection in selfl Lack of clear job description l Lack of knowledge about organizational policies

and procedures

٣٥

External Stressl Environmental Sources:ß High noise level ß Unattractive or disorganized work siteß Interruptionsß Exposure to pain, suffering or deathß Unpleasant odors Inability to find supplies or

informationß Hot/cold working area ß Accents interfering with communication

٣٦

١٩

Page ١٩

Interpersonal Sources:

l Loss of patient l Patients’ knowledge level l Working overtimel Inflicting pain on patients l Working holidays l Patients’ manifestation of stressl Staff conflicts l Large number of assignments l Being evaluated

٣٧

Interpersonal Sources:cont.l Expectations of manager Level of

responsibility l New peer group – lack of trustl New leadership role l Lack of performance feedback l Work short staffedl Problems with physicians l Pressure to document l Academic standards vs “real life”

٣٨

٢٠

Page ٢٠

Interpersonal Sources: cont.

l Missing old friendshipsl Interdepartmental conflicts l Lack of support or help from peersl Intimidation by co-workers from a

previous work experience

٣٩

Phases of reality shock

There are four distinct phases to reality shock:1. Honeymoonl Characterized by a euphoric feeling. l The new employee is eager to master new

skills.l Tasks are concrete and results are easily

seen. l Everything is great.

٤٠

٢١

Page ٢١

Characteristics of Honeymoon Phasel Everything is wonderfull Excitedl Looking at the world through rose-colored glassesl Enthusiasticl High energy levell Co-workers “helpful”l Pleased with being a “real nurse”l Focus is on learning routines and perfecting skillsl Wants to learn everything at once.

٤١

Strategies to Lessen Reality Shock in Honeymoon Phasel Take an interest in the precepteel Help to set realistic expectationsl Encourage to ask questions aboutthe history of the organizationl Assist to focus on developing a reputation

for competence in skills and interpersonal relationships

٤٢

٢٢

Page ٢٢

2.Shockl Suddenly the job isn’t so great, the managers are

difficult and cynical, and the patients are demanding and ungrateful. If an employee remains at this phase, it can prove fatal. This phase includes;

ß Outrage = you should have done...ß Hypocrisy = people saying one thing and doing the

otherß Rejection = loss of interest in work related issuesß Fatigue = feeling of negativity

٤٣

Characteristics of shock phasel Anger, moral outragel Frustration, rejection, Confusionl Disappointment, Disillusionmentl Realizing that the values are not the samel Discouraged because they are not grasping all the

information as fast as they though they wouldS/S:

l Excessive fatigue, superficial criticisms and a tendency to have a negative view of all things

٤٤

٢٣

Page ٢٣

Strategies to Lessen Reality Shock in shock phasel Be a good listenerl Encourage preceptee to look at things they have

learned so far and tasks they are able to do independently

l Focus on the good things that have happened during the shift rather than on the frustrating events

l Create a climate for learning where less than perfect behavior at new skills in acceptable

٤٥

Strategies to Lessen Reality Shock in shock phase cont.

l Communicate to preceptee that it is all right to be learners and that they are not expected to be proficient at performing every clinical skill

l Prevent preceptee from feeling abandonedl Encourage the preceptee to write down things

they think should be changed. These ideas can be used later in their career when the preceptee has earned the respect of their colleagues.

٤٦

٢٤

Page ٢٤

3. Recovery

l Characterized by a general feeling of accepting things because they will not change.

٤٧

Characteristics of Recovery Phasel Stress is reducedl Able to grasp the rolel Realized the truth and more than one

perspective existsl Sense of humor begins to return

٤٨

٢٥

Page ٢٥

Strategies to Lessen Reality Shock in the recovery phasel Nurture the ability to see humor in a

situationl Give positive feedback about progress and

share stories about the preceptor’s own first work experiences

l Assist to turn disappointments and unpleasant situations into learning experiences

٤٩

4. Resolution

l The world does not seem so bleak, a sense of well being.

٥٠

٢٦

Page ٢٦

Characteristics of Resolution Phasel Adjustment begins by job hopping, fleeing work byreturning to school, quitting or withdrawing from nursing, burnout (the result of unresolved conflict; characterized by chronic complaining)l Bicultural Adaptation, the only constructive type

of resolutionl Biculturalism is the integration of two conflicting

value systems ,e.g. school vs. work, balancing between the academic ideals with work realities.

٥١

Strategies to Lessen Reality Shock in Resolution Phase

l Assist to evaluate work situation objectively and effectively predict theactions and reactions of other staff

l Help identify appropriate and obtainable goals

l Discuss constructive problem solving,including how to go about positive change

٥٢

٢٧

Page ٢٧

Other strategies that a preceptee can adopt to reduce reality shock include:l Being flexible l Knowing what is expectedl Getting organized l Time management and keeping a time logl Asking questionsl Talking to other recent graduates, sharing

feelings and experiencesl Staying healthy

٥٣

Other strategies that a preceptee can adopt to reduce reality shock cont.

l Finding a mentor l Peer teaching; reflecting on one’s nursing practicel Having some fun l Having adequate knowledge to provide safe carel Knowing what is expected l Knowing own strengths and weaknessesl Being aware of self and job l Seeking feedback constantlyl Knowing the job description and expectations

٥٤

٢٨

Page ٢٨

Preceptor Roles

I. Role Model

٥٥

Behavioral Objectives

At the completion of this area of content, the participant will be able to:1. Define role modeling and specific attributes for modeling professional attitudes and behaviors.2. Demonstrates role model activities.3. Identify aspects of effective communication.

٥٦

٢٩

Page ٢٩

Definition

l Role Modeling is a process in which an individual identifies with and assumes the values and behaviors of another person that ultimately results in behavior modification that is usually permanent. (Bidwell & Braswell)

٥٧

Role Model Attributes

1. Clarity a. role model knows their role b. imitator receives clear and

dependable message regarding their progress

٥٨

٣٠

Page ٣٠

2. Consistency a. unvarying responses and behaviors (no Jekyl-Hyde) b. fosters stability, security, and confidence c. imitator learns what to expect in various situations

٥٩

3. Openness

a. realness-reveals self as a person b. admits doesn’t know it all c. honest, authentic d. others come for advice

٦٠

٣١

Page ٣١

4. Communicativeness

a. involves active listening b. validation of verbal and non-verbal cues c. assertive communication

٦١

5. Specificity

a. easy for imitator to understand and emulate b. behaviors explicit, no “decoding” needed c. role explains contextual meaning of situations d. imitator can see/feel behaviors and attitudes “rubbing off” on them

٦٢

٣٢

Page ٣٢

6. Accessibility

a. does not threaten or intimidate b. diffuses threatening situations for imitator c. let’s info and experience come a little at a time so as not to overwhelm

imitator

٦٣

Role Model Activities

1. Provides competent patient care 2. Maintain current practice 3. Participate in Unit Governance 4. Serve as resource person 5. Demonstrate time management and organizational skills 6. Promote effective communication

٦٤

٣٣

Page ٣٣

Thank You

٦٥