The Preceptor

Well, they've got me teaching other people now. How scary is that? It's been just over a year now in ICU, and just over two as a nurse. I'm finally starting to hit my stride, and wham! they throw me off with this new business! I could really sympathize the other day when one of my colleagues remarked, "I just want to come to work, do my job, and be left alone." It is not that we don't want new nurses to be guided, supported, encouraged, and actively taught, but it sometimes seems like a heavy burden to be that guide, supporter, encourager, and teacher.

You can really see the nursing shortage's effects in our unit where the nursing staff turns over quickly and the percentage of new grads is high. In a world full of travel assignments with housing allowances, sign-on and contract completion bonuses, there are lots of incentives to move around, even within the same city. Our unit management would really like to stop using travelers, so they pushed to hire more core staff. Well, who do you think is applying for those jobs? New grads! They all want to clamor their way into the ICU, many with that syndrome where people think they're too special to do floor nursing. The new grads don't have the experience to make them eligible for those non-traditional positions with more cushy offerings, and there are simply not enough experienced applicants. So we end up with a whole pile of them.

So okay, that's fine, I suppose. In a way, precepting has been good for me. It has helped me to realize how much I do know, and how far I have come in my development as a nurse. I am amazed by my efficiency, speed, and attention to detail. However, I am keenly aware of my lack of experience with so many things, and understand that time is the only way to learn a lot of this stuff. On that note, it is interesting how much nurses learn on the job. I learned a lot during my challenging BSN program at a highly regarded university, but the way the knowledge just keeps piling on, stacking up in layers and layers and building bridges all over the place is really amazing. From working so closely with the residents at our teaching hospital, I can see that a similar phenomenon happens for physicians. However, physicians have a formal residency time that differs dramatically from that of nurses. Maybe we need to rethink that. I don't know.

The balance of letting your orientee have enough freedom to learn on his own, yet remain well within safe practice, is not an easy one to achieve. Ever mindful of the limits of my own knowledge and experience, my obsession with efficiency, detail, and routine is my way of keeping my own practice safe. When I have to relinquish those few elements of control in order to let someone else feel things out, things can feel pretty sketchy sometimes. After all, I don't really know how much I can count on myself yet! I haven't been tested that much, I don't think. To hear about one recent test, check out Rapid Infuser.