Preceptorship: How Experienced Nurses Can Better Help New Graduates

Preceptorship is a structured mentorship model in which experienced nurses guide new graduates through the often challenging transition from academic learning to real-world clinical practice. This model not only nurtures practical skills but also aims to build confidence and improve retention among new nurses.

Strategies for Effective Preceptorship

1. Establish a Supportive Relationship

• Build Trust and Rapport: Experienced preceptors should take the time to get to know new nurses on a personal level. Understanding their background, prior experiences, and learning preferences creates a foundation of trust. This relationship helps new nurses feel comfortable asking questions and sharing concerns.
• Create a Safe Learning Environment: Encourage open, judgment-free communication. Preceptors should recognize that mistakes can be powerful learning opportunities when addressed appropriately. A supportive environment helps ease the “reality shock” that many new nurses experience when confronted with the full scope of patient care responsibilities.

2. Serve as a Role Model

• Demonstrate Clinical Competence: Preceptors must model safe, evidence-based practices by demonstrating how to complete clinical tasks proficiently. For example, showing how to perform a comprehensive patient assessment or manage complex care scenarios can set standards for new graduates.
• Exemplify Professional Behavior: By maintaining communication with colleagues, demonstrating ethical decision-making, and managing stress appropriately, preceptors guide new nurses on how to integrate into the healthcare team and uphold professional standards.

3. Act as a Coach and Educator

• Enhance Clinical Reasoning: Beyond just teaching procedures, experienced nurses should help new graduates develop clinical reasoning skills. This includes identifying subtle changes in a patient’s condition, thinking critically about potential interventions, and prioritizing care when multiple patient needs arise.
• Provide Constructive Feedback: Timely and specific feedback is essential. Preceptors should acknowledge what new nurses are doing well while gently addressing areas that need improvement. Consistent feedback helps build self-confidence and motivates ongoing professional development.
• Tailor Teaching to Individual Needs: Recognize that each new nurse has a unique educational background and may progress at their own pace. Adjusting teaching strategies to suit individual learning styles—whether that means more hands-on demonstrations or guided discussions—can make the preceptorship more effective.

4. Facilitate Socialization within the Healthcare Team

• Integrate into the Unit’s Culture: Preceptors can introduce new nurses to the unit’s routines, team members, and interprofessional practices. This socialization helps bridge the gap between the academic environment and the complexities of the clinical setting.
• Encourage Collaboration: Encourage new nurses to engage with other members of the healthcare team. By facilitating introductions and promoting teamwork, preceptors help new graduates feel like valued members of a larger collaborative network.

5. Support Transition and Ongoing Professional Development

• Acknowledge the Learning Curve: Recognize that the transition from student to practicing RN can be overwhelming. Acknowledge their feelings of uncertainty or anxiety and work with them to set realistic goals.
• Guide Long-Term Career Goals: Beyond immediate clinical skills, experienced nurses can mentor new graduates on career planning, continuing education opportunities, and pathways for advancement. This helps create a vision for their professional future and encourages retention.
• Monitor and Adjust: Preceptorship is dynamic. As new nurses gain competence and confidence, the role of the preceptor should evolve from hands-on teaching to a more consultative relationship, ultimately empowering new nurses to work more independently.

Role of Preceptor Nurse

What can the more experienced nurses do to help their newer counterparts? Here are a few things to help those nurses who might be struggling to settle into nursing:

• Preparing. Onboarding and orienting new nurses vary widely between health systems and settings. Helping to prepare nurses to work in your specific unit may involve new graduates or experienced nurses transitioning to a new specialty.
• Mastering time management.  Nursing is a profession with tasks that must be performed within time constraints. Time management and triaging tasks are difficult for newer nurses who don’t have their routine timing down yet, not to mention for new tasks. Experienced nurses can help by verbally describing their rationales during orientation for the preceptee.
• Mentoring.  A new nurse needs that trusted human to go to with unit culture questions, situational advice, and an open ear. Being that person bears a responsibility to that new nurse to provide honest and evidence-based answers. If you are that mentor, It’s ok to say, “I’m not sure either. Let’s figure it out.”
• Patience.  Nursing is overwhelming. The amount of information we need to use regularly is expanding almost daily. Have patience with nurses who have asked a question before. Sometimes, experienced nurses forget how daunting it is to be responsible for another human life.
• Positivity.  Negative vibes are easily transmissible in nursing. We are a breed of professionals who tend to alleviate stress with sarcasm. Just be sure that doesn’t jade our newer nurses into dissatisfaction and doubt.
• Development of critical thinking skills. The use of checklists and task lists minimizes the nurses’ use of critical thinking. Experienced nurses should explain the “whys” of what they are doing, not just the need to complete a task. This helps to develop an understanding of the patient and their care and improves patient outcomes.
• Recognition.  When newer nurses perform well, make sure they know it. Often, nurses will not recognize themselves as doing a great job when they don’t meet expectations. Positive reinforcement helps build confidence and trust.
• Giving and receiving feedback.  But when they don’t meet expectations, we have a responsibility to help them improve.  Sometimes, these conversations are difficult.  Make sure the expectations for the new nurse are clear, preferably in writing, for them to refer to. Feedback should be both consistent and constructive rather than punitive in nature.
• Reflection and debriefing. Distinct from feedback, reflection, and debriefing are key teaching moments. Perhaps a patient deteriorated and needed a rapid response call.  After the emergency subsides, meet with the team and discuss what went well and what could have been done better.  Don’t allow the tone to become punitive or accusatory, but use it as an opportunity to learn how to improve next time.

Responsibilities and Duties

Many nurse preceptors offer daily, on-site supervision and support to new nurses. In addition to the four primary roles outlined above, a nurse preceptor may show new nurses how to:

• Effectively communicate with patients, friends, and family members
• Design a nurse practice plan
• Identify the signs of a critically ill patient and when they ought to intervene
• Hone in on time management skills
• Address task delegation
• Follow a healthcare facility’s protocols
• Handle unfamiliar care procedures
• Provide compassionate and meaningful patient education
• Evaluate the reasoning behind treatments
• Review medications and their potential side effects

Additionally, nurse preceptors may help new nurses boost their psychomotor abilities. This is key: Nurses (as you likely know) must be able to perform common procedures—like operating medical machines and injecting medications intravenously—swiftly, safely, and accurately.

Benefits of Nurse Preceptors

Nursing school is radically different from nursing itself. As such, new nurses need a helping hand until they obtain the self-assurance and skills they need to treat patients without round-the-clock supervision.

That said, a nursing preceptorship does not just benefit the mentee. Let us look at the perks of a nursing preceptorship for both new nurses and their mentors.

For New Nurses

Nurse preceptors help novice nurses bridge the gap between theory and practice. In doing so, a new nurse may experience:

• Enhanced critical thinking skills
• Improved adaptability and flexibility
• Enriched integration within a healthcare organization

For Experienced Nurses (Preceptors)

Nurse preceptors might have a full plate (more on this soon) but the role also has its advantages, such as:

• Higher nursing retention rates – The American Nurses Association (ANA) estimates that 18% of new nurses leave the profession within their first year of practice. Taking a new nurse under your wing may help ensure recent graduates remain committed to their career goals. In turn, you may contribute to fewer nursing shortages and better healthcare overall.
• Professional development – Put simply, nurse precepting may help you become a better nurse. How? By acting as a role model, you may hold your actions and practices to a higher standard. Your healthcare organization might also ask you to complete special training to become a preceptor, which may supply you with advanced knowledge, new skills, and a stronger sense of leadership.

Choosing to become a nurse preceptor might also prepare you well to enter nursing education, whether you are called to work as a clinical instructor or drawn to the idea of serving as a community health educator.

And above all? You might simply feel more fulfilled by sharing your wealth of knowledge with new graduates. After all, there are few better feelings than helping someone else fly solo—and succeed.

REFERENCES

1. Gregg, M., Wakisaka, T., and Hayashi, C. (2023) Senior nurses’ expectations and support of new graduate nurses’ adjustment in hospitals: A qualitative descriptive study. Heliyon. 2023 Jul 28;9(8):e18681. doi: 10.1016/j.heliyon.2023.e18681. PMID: 37576313; PMCID: PMC10412768.
2. Hong KJ, Yoon HJ. Effect of Nurses’ Preceptorship Experience in Educating New Graduate Nurses and Preceptor Training Courses on Clinical Teaching Behavior. Int J Environ Res Public Health. 2021 Jan 22;18(3):975. doi: 10.3390/ijerph18030975. PMID: 33499327; PMCID: PMC7908293.
3. Jochim V, Rosengren K. Nursing preceptorship, a supportive and reflective approach for promoting a healthy working environment: a multi-methods design. Nordic Journal of Nursing Research. 2021;42(3):147-157. doi:10.1177/20571585211025207
4. Lima MS, Alzyood M. The impact of preceptorship on the newly qualified nurse and preceptors working in a critical care environment: An integrative literature review. Nurs Crit Care. 2024 Sep;29(5):1178-1189. doi: 10.1111/nicc.13061. Epub 2024 Mar 21. PMID: 38511618.

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