contact details for the nursing - practice development...

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Contact Details For The Nursing

Professional Development Team

Name Job Title Phone Bleep

Sally Whitehouse Senior Practice Development Sister (un-registered staff)

and Preceptorship Lead Ext 2188 4343

Vanessa Pasquier Senior Practice Development Sister (Registered Staff) Ext 6945 4343

Simon Pawlin Senior Practice Development Charge Nurse (Students) Ext 2793 2793

Deanna Hodge Learning Environment Lead Ext 4835 4724

Alison Oram Practice Development Sister (Registered Staff) Ext 6945 4343

Caroline Covey Practice Development Sister (Registered Staff) Ext 2188 4343

Practice Development Sister for Theatres Ext 4106

Lizzy Clack Practice Development Sister for PACU Ext 4112

Jenny Ware Practice Development Sister for A & E

Clare Slater Practice Development Sister for ICU Ext 6740

Ext 6622

Names and contact details correct at time of ratification

Preceptor Handbook February 2014 * Sally Whitehouse * Mar-15. Version 4

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Successful

Preceptorship - The

Preceptor’s Guide Introduction Newly qualified nurses are often challenged by the

pace of their new role. This can include the level of

reasoning required around their work load, the level of

engagement needed with their patients and the

services that they will require. This transition maybe a

shock (Kramer 1974) as there is a realisation that they

are now professionally accountable for their actions

and need to quickly become acclimatised with care

responsibilities and practices in their local area.

What is Preceptorship? “A period of structured transition for the newly

registered practitioner during which he or she will be

supported by the preceptor, to develop their

confidence as an autonomous professional, refine

skills, values and behaviours and to continue on their

journey of life-long learning” (DoH: Preceptorship

Framework 2010)

“A foundation period [of preceptorship] for

practitioners at the start of their careers which will help

them begin the journey from novice to expert” (DoH: A

High Quality Workforce: NHS Next Stage (Review 2008)

The Preceptorship programme is part of the individuals

Probationary Contract.

Why do we have Preceptorship? Recommendation 190: “There should be national

training standards for qualification as a registered

nurse to ensure that newly qualified nurses are

competent to deliver a consistent standard of the

fundamental aspects of compassionate care.” (The Mid

Staffordshire NHS Foundation Trust Public Inquiry

2013)

Recommendation 4.3: The NMC recommendation that

newly qualified nurses undergo a post-qualification

“preceptorship “period of consolidation must be fully

implemented to promote safe, high quality care.”

(Quality with Compassion: the future of nursing

education, Report of the Willis Commission 2012)

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Who is a Preceptee? A preceptee is ‘a newly registered practitioner’ (nurse,

midwife or AHP) who is entering employment in

England for the first time following professional

registration with the NMC or HCPC. It includes those

who are recently graduated students, those returning

to practice, those entering a new part of the register….

who have satisfied the requirements of, and are

registered with, their regulatory body.’ (DOH 2010)

What is a Preceptor? The preceptor is ‘a registered practitioner who has

been given formal responsibility to support a newly

registered practitioner through preceptorship.’ (DOH

2010)

The role of the preceptor differs from that of a mentor

in that the professional being supported is accountable

for their practice. Preparation and follow up is still

required to support the preceptee through the

transition period.

The preceptor guides the preceptee to acknowledge

their strengths and deficits and help them to create a

plan to develop these areas.

What is the Probationary Contract? A probation period is a structured period of time during

which a new recruit is supported by their line manager.

It allows both the line manager and the employee to

take into account the individuals overall capability,

skills, performance and general conduct in relation to

the job in question, provide additional training as

required and assess objectively if they meet the

requirements of the role.

The Trust’s standard probationary period is six months.

This is a reasonable period of time to give the employee

the opportunity to learn the key elements of the role,

and receive necessary support and training.

For further information please see Probationary Policy


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The Benefits of Preceptorship

(Adapted from Preceptorship Framework for Newly Registered Nurses, Midwives and Allied Health

Professionals. DOH 2010)

New registrant (Preceptee)

•Development of confidence

•Increased job satisfaction which improves patient/ client/ service user satisfaction

•Feels valued and respected by the Trust

•Feels invested in

•Enhanced future career aspirations

•Feels proud and commited to the Trust's corporate stategy

•Develops an understanding of the commitment needed to work within the profession and the regulatory body requirements

•Allows the development of personal responsibility for work and further education.

Preceptor

•Allows the development of the supportive role

•Enhances the ability to progress through the AfC gateway

•Feels valued by the organisation, new registrants and the patients

•Identifies that you are commited to the development of other staff

•Identifies that you are commited to the profession and regulatory requirements

•Continued life long learning

•Enhanced future career aspirations.

•Satisfaction of building competence and confidence of team member

The Employer

•Better quality of patient care

•Better recruitment and retention of staff

•Reduction in staff sickness and absence levels

•Improved service user experience

•Improved staff satisfaction

•Highlights staff that require additional support or role change

•Reduces the risk of complaints

•Highlights staff for fast tracking to meet the leadership agenda

•Development of staff who understand the regulatory impact of the care they deliver and develop an evidence based approach

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The role of the Preceptor There are many elements that comprise the role of the preceptor. The following is not a comprehensive list of these

elements but are the main components;

A preceptor is a facilitative role: you are working on

the premise that the newly registered practitioner

already has a level of knowledge gained during

their pre-registration course. The newly registered

practitioner is professionally accountable for their

own actions.

The preceptor’s role is to give support for the on-

going learning of the newly registered practitioner

when conducting their own enquiries.

The preceptor guides the preceptee to explore

which skills they lack confidence or competence in.

Guiding the preceptee to prepare a plan of action

helps them to enquire about their new practice.

Plans will centre on care requirements, perceived

skills already mastered and any deficits remaining.

It will encompass local protocols, policies and

organisational systems that assist the delivery of

care.

To encourage and support the completion of

competency documents and any other documents

associated with the preceptorship programme in a

timely manner.

To liaise with the ward manager and the wider

support network i.e. professional development

team to escalate any development needs and to

avoid the duplication of support and resources.

To provide pastoral support to the preceptee

during a crisis of confidence.


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What does our

Preceptorship

Programme consist

of? The nursing Preceptorship programme at the RSCH

consists of a combination of fundamental care

competencies, Core Clinical Skill competencies, set

educational study days, including the LINKS course,

and self-directed learning.

How can you facilitate learning

throughout Preceptorship? Encourage self-directed learning/professional

reading by recommending reading of appropriate

journals, patient notes, ward learning packs,

patient information leaflets etc

Promote organisational based

educational/developmental/support days

Encourage reflective practice: encourage formal

reflection on good and bad experiences

Facilitate shadowing: Ensure that when a

preceptee shadows you it is not seen as just a

demonstration. It involves the reasoning that

underpins the skill as the skill is deployed.

One-to-one support : in person or

remotely/electronically

Work-based learning; Encourage initiative taking to

make the most of every opportunity within the

clinical setting

Recommend Web-based learning programmes

Attitudinal and behavioural based learning, e.g.

through role modelling

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What is the LINKS course? This is a 3 day developmental course facilitated by the

PDT for adult nurse preceptees in the Trust. The overall

objectives of the course are to gain competence and

build your confidence in your new role as a Registered

Nurse. It is mandatory course for every preceptee 1

focusing on;

Clinical Skills Assessment Stations

Time Management

Care of the Diabetic Patient

Sepsis

12 Lead ECGs

The Deteriorating Patient

1 Preceptees recruited to specific areas e.g. theatres,

A&E may not need to attend this full course

The paperwork – What does the

preceptor need to do? Completion of the correct documentation is necessary

for NMC Revalidation and successful completion of

Preceptorship and probationary period.

Alert the preceptee of the need to have been

assessed and signed as competent in the following

Hand hygiene assessment,

Fundamental Observational Clusters 1, 2, 3 and 4

Core Clinical skills within the timeframes set out on

page 9 of the preceptorship programme.

Please note that these competencies can be signed off

by any registered nurse with a mentoring qualification

and not solely you. When complete countersign the

record of achievement on page 9.

With your preceptee

Document the learning needs identified and linked

development plan on pages 11, 12 and 13 of the

Preceptorship programme at the 1, 6 and 12

month stage. Ensure all objectives are SMART.

Remember that the implications for the preceptee

not fully completing their first six months could

mean a termination of their probationary contract.

Read and countersign all records of reading, study

day records and reflections on pages 71-78 of the

Preceptorship programme ensuring that there is

evidence of learning. Note: each preceptee must

complete 3 reflections and reading logs in the first

6 months and again in the second 6 months. The

reflections are not an academic piece of work but

must show evidence of learning.


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How to be an

effective Preceptor A good preceptor will remember what it was like to

begin work as a newly qualified practitioner and will

support the socialisation of preceptees into the team.

Remember:

Your preceptee is an accountable practitioner.

Recognise previous experience.

You are a role model and your preceptee will

emulate you. The preceptee will be watching how

you make decisions, how you plan, think, respond

and behave in different situations.

Make contact and work with the preceptee during

the start of the induction period. Establish a

similar shift pattern. This is not practical all the

time but a couple of times a week is a good start.

Establish open and effective methods of

communication for the times when you are not

working shifts together.

Be familiar with the Trust preceptorship

programme, the Probationary Contract and all

relevant documentation.

Ensure that you and your manger utilise the tools

in the probationary Policy toolkit

Set realistic time scales for feedback and stick to

them. If you appear not to be bothered then your

preceptee will not bother to chase you and this

could be detrimental to their development.

Constructive feedback – the preceptee needs to

know their weaknesses but also how to develop

these areas. Ensure all objectives set are Specific,

Measureable, Achievable, Realistic and Time bound

- see below.

Ascertain your preceptee’s learning style – are they

a practical or theoretical learner?

Actively listen - your preceptee may be expressing

concerns.

Ensure areas of concern are escalated to the

preceptee as well as your manager when they

arise. Do not let it be a shock to the preceptee that

there is a problem.

Facilitate and support your preceptee to resolve

any problems or enquiries they may have.

Encourage initiative taking: try to avoid acting on

their behalf

Encourage your preceptee to reflect on how they

did and ensure the learning conversation

addresses strengths as well as areas for

development. Start with a strength, sandwich the

weakness and end with a strength.

Encourage your preceptee to reflect and

document on their practice, good and bad.

Provide learning opportunities - who and what do

they need exposure to for these opportunities.

Use your support network i.e. Ward manager /

Peers / Practice Development Team if you have

concerns about your role, your preceptee, and the

learning environment.

To maintain a record of your preceptor activity as

evidence of your own individual development for

Revalidation

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Areas to consider

when assessing

competence and

confidence

Clinical reasoning Can the nurse demonstrate clinical reasoning in real-

time? - This means making quick and accurate

assessments of situations, often under conditions

where there may be many demands on their time. It

involves working with evidence-based principles and

essential facts about the situation to deliver prompt

care.

Impression –they question what is happening: is it

dangerous, problematic or needing attention?

Enquiry –they ask is there anything that will

confirm or challenge their initial assessment of the

situation.

Decisions – they choose how to proceed, using the

process least likely to cause harm and most likely

to address the need.

Implement and monitor – they act on and attend

immediately to the reactions of others.

Skills review and refinement. As the preceptee progresses throughout the

preceptorship year they should start to show initiative.

Observe. Can the registered nurse exercise several

skills in combination i.e. listening, observing,

questioning, reassuring and reviewing. The process

should be fluent so that care appears skilful and

professional.

Listen. If a preceptee asks to discuss a skill of

concern, it is important that the preceptor does

not dismiss the request. No skill remains constant

in practice; skills may develop or deteriorate over

time. There should, however, be issues raised if

basic skills for example completing a fluid balance

chart cannot be grasped.

Question. The preceptee should be able to discuss

how communication occurs within the team and

how colleagues respond to one another in relation

to a particular care decision. It is important they

can review how care decisions are made, how

team members influence one another, and how

they help each other.


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How to Set Objectives Setting objectives is key to guiding your preceptee in their development. When setting objectives consider how the

learner best learns and the most appropriate people to support them in that learning. The objectives should be written

by the preceptee with your support and guidance. Precise documentation is essential when setting objectives to both

guide the individual and to provide evidence for learning, necessary for Revalidation, probationary period and PDR.

The objectives may also be valuable evidence for future management if the objective is not achieved.

All objectives must be S.M.A.R.T

SPECIFIC * MEASURABLE * ACHIEVABLE * REALISTIC * TIME BOUND

For example: The preceptee has identified that they lack confidence when taking charge of the ward. To set an objective

stating: ‘To take charge of the ward with the support of preceptor / ward sister’ is not SMART and does not guide the

preceptee in their learning

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What can you do to prepare for your role? Think about basic information that a preceptee would need to feel comfortable caring for a group of patients.

Complete the grid below to help you

Think about your first day as a newly qualified nurse.

How did you feel?

What made your first year easier and harder? Give

examples

What opportunities does your learning environment

have to support your preceptees?

Record your personal objectives to develop your

preceptor role. (remember smart)

REFERENCES Department of Health (2010) Preceptorship Framework for Newly Registered Nurses, Midwives and

Allied Health Professionals.

Department of Health (2008) A High Quality Workforce: NHS Next Stage Review

Kramer (1974) Reality Shock; why Nurses Leave Nursing

Nursing and Midwifery Council (2015) The Code Professional Standards of practice and behaviour for

nurses and midwives. NMC, London.

RSCH Preceptorship Guideline 2013 (Available on the Trust Intranet)

RSCH Probationary Policy 2012 (Available on the Trust Intranet)

Willis. P (2012) Quality with Compassion: the future of nursing education, Report of the Willis

Commission

ACKNOWLEDGEMENTS Thanks to Samantha Knipe, Preceptorship Lead, Ashford and St Peters NHS Foundation Trust. This

document has been adapted from her work.

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