The Art of Precepting: Passing the Torch

1. The Art of Precepting: Passing the Torch

2. PARTICIPANTGOALS • Learn preceptor role & responsibilities • Understand how adults learn • Explore effective communication, how to give feedback & conflict resolution • Discuss techniques for stimulating critical thinking • Review components of the UTT CON preceptor handbook • Complete preceptor post-test

3. Primary Roles of the Preceptor • Role Model--demonstrates how competent staff perform their job--most familiar, most comfortable • Socializer--helps preceptee feel welcome & integrated into the unit culture--less familiar, less comfortable • Educator--helps preceptee assess orientation learning needs, plan learning experiences, implement the plan, evaluate performance--least familiar, least comfortable • Role Model • Socializer • Educator

4. Role Model Definition, Criteria • Role Model-- “an individual who exemplifies through his or her behavior how a specific role is to be enacted” (JG Alspach, 2000) • Nurse role model exhibits these qualities-- Caring Positive interactions Empathetic Respected by peers Good communicator Strong patient advocate Expert practitioner Willing resource person Shares knowledge with others Respects dignity in all people Critical thinker Honest, accountable

5. Preceptor and Staff Nurse Roles— Balancing Dual Role Demands • Compare--your usual job activities with teaching others how to perform their job • Major Role with Preceptee--teaching rather than doing • Conflict--can arise if you “do for” the preceptee rather than guiding to do for themselves • Challenge--balancing dual role of caregiver and preceptor

6. Socialization of the Preceptee • Think back to your own orientation--how you felt, new circumstances • Reality Shock--4 phases HONEYMOON SHOCK RECOVERY RESOLUTION

7. Factors that Affect Learning, Working Styles • Adult Learning Principles • How Communication is Received • Generational Values • Learning Styles

8. Adults as Learners • Self-directed--want to be actively involved • Relate new knowledge to life experiences/previous knowledge • Goal-oriented • Must have a reason for learning • Practical--want learning to be useful • Want to state their views, be recognized, be accepted, feel important, be respected

9. How We Receive Communication Words Vision • 60% • 30% Hearing • 10% Content

10. How Generational Values Impact Work Styles • MATURES--<1946-- “duty” work ethic, follow orders, productive, “fixers” • BABY BOOMERS--1946-1964--teamwork, process oriented, desire recognition, uncomfortable with conflict • GENERATION Xers--1965-1980--self-reliant, skeptical, casual about authority, tech savvy, resourceful • MILLENIALS--1981-2000--tech savvy, less focused on problem solving & more on choices, buy into team concept, look for mentors, accepting of other cultures, expect management to be competent, demand equity

11. Learning Styles Left Brain vs. Right Brain LEFT RIGHT Analytical Global Uses automatic codes Wholes, not parts Arranges details in order Novelty Auditory rather than visual Intuitive Spatial Visual over auditory

12. How to Give Effective Feedback • I…Identify learning objectives • M…Make a feedback-friendly learning environment • P…Performance--assess it • R…Respond to your learner’s self-assessment • O…Objectivity--always keep it • V…Validate good work, suggest alternatives in weak areas • E…Establish a plan • Goal: To IMPROVE Performance

13. Effective Feedback • Feedback should be • Immediate • Clear • Positive • Objective

14. Causes of CONFLICT • Task • Interdependence • Individual Differences • Scarce Resources • Poorly Designed Reward Systems • Communication Failures • Goal Incompatibility

15. Conflict Resolution • Take responsibility • Agree to disagree • Define the problem • Allow venting • Establish ground rules--honesty, everyone will be heard, all listen, support feelings with facts • Ask open-ended questions • Listen objectively • Restate problem, set goals, establish action plans • Follow-up

16. Stimulating Critical Thinking • Create a climate of curiosity/questioning • Ask Open-ended vs. Close-ended questions, qualify answers--correct, partially correct, incorrect • Prepare for the unexpected-- “What if…” • Think out loud--Verbalize your processes • Compare assessment findings with report • Reflect on activities/findings of the day • Challenge assumptions • Seek meanings, connections, group data • Keep professional humility--readily admit erroneous conclusions, seek the truth always

17. 6 Steps for Success • Plan ahead—tell staff date preceptee is coming to unit, outline daily plans • First day—ask your learner to share their goals/needs, share your goals/expectations • Introduce to staff—integrate, welcome, include in break times • Give specifics about what you expect • Get/Give feedback often during the day • Reflect on activities, skills completed

18. Sample First Clinical Day • Identify student’s learning needs—ask for critical skills list, clinical objectives • Let student observe what you do, maybe only one client for student care • Seek opportunities for student to perform identified high-anxiety procedures first—reduces fear, stress • Have a brief conference with the student to double-check assessment priorities, medications changes • Ask the student to reflect on the day’s activities and discuss situations, ask questions

19. Preceptor Leadership Qualities • Practice good time management • Coach your learner towards excellence in practice • Follow NPA delegation guidelines • Create opportunities for learning • Encourage people to have fun, enjoy their work • Move from preceptor to mentor--assist new staff, peers in learning

20. CON Preceptor Handbook • Preceptor Program • Preceptor Orientation Information • Preceptor Agreement, Benefits • Clinical Guidelines • Evaluation Tool • Student Skills Checklists

21. Safe Practice • Medications --RN must be at bedside with IV administration by student --RN alone can access narcotics, sign narcotics forms for student --RN must supervise student medication administration and co-sign MAR

22. Safe Practice-- continued • Needle sticks/Exposures Student will: --Report incident to preceptor immediately and then notify appropriate person in clinical agency --Complete agency incident report --Follow agency protocols regarding wound care, reporting and notify clinical faculty as soon as possible --Seek treatment from Campus Health Center or private provider within 2 hours of incident

23. References • Freiburger, O. (2001). A tribute to clinical preceptors. Journal for Nurses in Staff Development, Vol. 17, No. 6, 320-327. • Kristofferzon, M.-L., Mårtensson, G., Mamhidir, A.-G., & Löfmark, A. (2013). Nursing students’ perceptions of clinical supervision: The contributions of preceptors, head preceptors and clinical lecturers. Nurse Education Today, 33, 1252-1257. http://dx.doi.org/10.1016/j.nedt.2012.08.017 • Ohrlin,K. & Hallberg, I. (2000). Student nurses’ lived experience of preceptorship. International Journal of Nursing Studies, 37, 13-23. • Robert, R. R., & Petersen, S. (2013). Critical thinking at the bedside: Providing safe passage to patients. MEDSURG Nursing, 22(2), 85-118.

24. Post-Test • 1. On the student’s first clinical day with you, the best way to verify their assessment skills is to A. Instruct the student to assess the client and relate the findings to you B. Ask the student to show you their documented findings C. Perform the client assessment with the student and compare findings D. Tell the student to complete the client assessment form 2. After the student completes a head-to-toe assessment, you allow them to document findings on the interdisciplinary notes. The correct procedure is to A. Sign your full name and title only when you are satisfied the assessment is accurate B. Sign your name and title after you correct any inaccuracies by writing “disagree with student assessment” and write the correct assessment information. C. Sign your full name and title on the blank notes form and allow the student to complete the assessment documentation. 3. A student has helped you admit a client with type1 diabetes and influenza-like symptoms. The ED lab results are: glucose 460 mg/dL, K 5.1 mEq/L. The student encourages the client to drink “all the juice and milk” on the new admit food tray. How would you begin to discuss this scenario with the student? A. “Why did you tell a diabetic with a blood sugar of 460 to drink fruit juice?” B. “Let’s review this client’s situation. Tell me first what you have learned about diabetics when they are sick.” (continued on next slide)

25. Post Test--continued • 4. At noon you find your students has not yet documented the two assessments you performed together earlier. When questioned, the student states, “I’ve been snowed under with these two busy patients.” How would you respond? • A. “Tell me what you have been dealing with so we can make a plan for the rest of the shift.” • B. “Why didn’t you come to me sooner? I could have handled them while you documented your care.” • 5. A student suffers a needle stick from an insulin syringe they just used on a client. The order of your actions should be • ___A. Have the student express blood from the stick and wash vigorously with soap and water for five minutes • ___B. Advise the student to seek treatment intervention from the UTT Campus Health Center or their private healthcare provider within 2 hours • ___C. Notify the student’s clinical faculty and the appropriate person in the clinical agency • ___D. Help the student complete the appropriate institutional incident report and forms

26. Test Answers • 1-- C • 2 -- A • 3 -- B • 4 -- A • 5-- A = 1, B = 4, C = 3, D = 2

27. Congratulations! • You have successfully completed the • University of Texas at Tyler • College of Nursing • Preceptor Self-Paced Tutorial!