This article is the original work of Mara Vander Pol.

Nurses have often been accused of “eating their young.”  I’m not gonna lie to you, there has been a time or two at work where I have been less than polite to the “newbe” that I have been assigned to train.  Working in a hospital can be incredibly stressful in the best of circumstances. Sometimes adding another dimension of worry to your day can make the nicest person slightly hostile.  

The thing is, it is incredibly important to train excellence into our new nursing staff.  Whether you are meeting someone who is new to the nursing profession, or you are training a person who has transferred into your department, solid training and education are essential components of building a body of qualified staff.  I am a bedside nurse in an adult ICU, and I have grown to understand that part of my job is precepting: training and educating new nurses to our unit. The frustrating thing about precepting is that there is no rule book. We didn’t go to school to be teachers; we went to school to learn how to be healers and caretakers.  

Knowing that it is vital to the quality of patient care, however, nurses, as professionals, have to take responsibility for guiding and teaching new nurses rather than “eating” them.  Here are a few principles on how to precept well.  

KNOW YOUR OWN LIMITS

This, in my opinion, is the most important rule.  By knowing your own limits, I mean that you should know what you’re good at.  If teaching is not one of them, don’t do it. If you are a person who is great at nursing, but terrible at explaining why you do what you do, then tell your managers that precepting is not for you.  Usually in life, I am a proponent of expanding your skills and trying new things, but precepting is an experiment that you should not try for fun.  

I remember one particular preceptor that I was assigned to as a new nurse.  She loved having a student or preceptee because she knew she wouldn’t have to do the bulk of the physical work that day, and she wouldn’t have to chart.  She also didn’t like being questioned about her own nursing practice. In essence, she wanted to get paid for being lazy and got slightly belligerent when asked questions.  Sounds like a truly horrible combination for teaching. Although some people think that precepting means someone else does all your work, in reality, precepting is MORE work.  My point is this: don’t teach if you don’t like it. Period.

SET EXPECTATIONS AND CLEAR GOALS

Like any other relationship, precepting requires the student and teacher to be honest with each other about expectations.  Unlike other relationships, the preceptor-preceptee expectations should evolve and change every day. I am going to have different expectations the very first day of precepting than I would have on the last day.  Every shift should have new goals to meet, and these goals need to be very clearly articulated at the start of the work day. Every student will be different, so it is up to you as an instructor to assess what characteristics and skills need to be enhanced or corrected.

BE PRESENT

This sounds like a no-brainer, but I have seen so many people abandon their preceptee that I feel like it needs to be stated.  DON’T LEAVE YOUR STUDENT. Especially at the beginning, it is important to let your student know if you are going somewhere. Otherwise, they feel like they’re being abandoned, when in fact you simply need to use the bathroom or run to lab for a coworker.  Just TELL THEM where you are going! Communicate, people!

LET THEM FALTER, BUT DON’T LET THEM FAIL 

After you have been working together for a while, it’s important to start “backing off.”  The student needs to start feeling the bulk of the weight of the job. When this time comes, it’s okay to let your preceptee falter for a bit, but don’t let them fail.  You still need to be present and nearby, but you need to be a little stealth about it. When the preceptor does this right, the preceptee starts to feel like they are responsible for the happenings of the day, but you, as the instructor, still know what is going on.  You need to have confidence that you can step in and correct a mistake before it happens. Usually, I would say that failure is a natural part of life. When precepting in a hospital, however, we are dealing with people’s lives. It’s not an option to let your student fail completely. 

GIVE (AND GET) CONSISTENT FEEDBACK

I saved the best for last.  Feedback is a necessity in growing and getting better with any skill set.  In the hospital setting, I think it’s even more important. How can you expect your student to know what to work on if you don’t tell them?  And how can you get better at teaching if you don’t know what instruction is and isn’t seeping in? After EVERY shift, there should be some communication between student and teacher about what was learned that day.  What do we need to focus on more? What went right and what went wrong? What experiences do you, as a leader, need to search for so that your preceptee can grow and learn? Are they basic things or are they more advanced?  The point to take home here is that both the student AND teacher need to give each other feedback for growth. 

A great preceptor, as any great teacher in life, can affect the career trajectory and quality skill set of a nurse.  Let’s not eat our young, but they can still think we are capable of it. Let’s train them up thoughtfully and diligently with consistent presence and communication.  These are our colleagues, and might be your future nurse, so if teaching isn’t your gig, leave it to someone who doesn’t mind the constant explaining and questioning that goes on with learning a new life saving practice.