Early Days of Preceptorship

Students will be expected to follow all relevant agency policies, procedures and guidelines. There are also some guidelines specific to being a student nurse that will be helpful for preceptors to be aware of.

• Students must wear identification required by the agency as well as a UNB name bar. It is imperative that students identify themselves as a student nurse to clients, family members and agency employees.
• In case of extreme weather, students who are completing preceptorship must exercise their best judgment, based on their personal circumstances, to make a decision about going to or leaving clinical.
• Students are expected to work all of their preceptor’s scheduled shifts. If a preceptor is ill or unable to work unexpectedly, the student will not be able to work that shift. If a preceptor will not work their scheduled shifts due to a planned absence (vacation, educational leave, etc.), both the student and preceptor will discuss this with the faculty liaison in advance of the shift(s), to determine if the student will work with another nurse.
• It is the responsibility of the student to communicate with the faculty liaison if there are changes to their schedule.
• Should an injury or near injury to the student occur, the student must complete the required agency documentation in accordance with policy, as well as documentation required by UNB. The student must also advise the faculty liaison.

A key component of the first few days of the placement is orientation to the clinical setting. For some students, the agency, or the specific placement area may be new to them. For other students, it may be an area in which they have had a previous clinical experience. In either situation, it is important to plan for an orientation to the clinical setting, as the context of preceptorship is unique.

The suggestions below provides some common considerations but preceptors are encouraged to share any and all information pertinent to their particular setting.

The following information has been developed by Em M. Pijl, BScN, MEd, PhD, RN © 2005 – University of Lethbridge. Adapted and used with permission of author by Debra Amirault, Dr. Lisa Keeping-Burke and Karen Tamlyn, University of New Brunswick, 2017.

Some students may be in a new clinical area or agency. Other students may be returning to an area in which they have completed a clinical course. For all students, working one-on-one with a RN is a new experience. As such, the initial days of the placement are typically utilized as shadowing shifts, providing the student with an opportunity to acclimatize to the clinical setting and to become familiar with routines.

During the shadowing shifts, students should not be assigned or assume responsibility for client care. The student should be encouraged to assist the RN in the provision of care and to ask questions. When a student transitions to a new shift (from days to nights, for example), this is also considered a shadowing experience, as routines and responsibilities are often different.

Time should be designated during shadowing shifts for the preceptor and the student to discuss the student’s letter of introduction and preceptorship course outcomes. Reviewing the student’s learning goals during the shadowing shifts will allow for the development of a plan for meeting the identified learning goals.

As the shadowing experience ends, the student and preceptor will set aside time to plan for the gradual transition for the student to assume an increased responsibility for client care. This shadowing experience will increase learning and will improve the student’s ability to move forward effectively during the remainder of the preceptorship experience.

Communication between preceptors and students is essential to ensure a successful and effective clinical practice experience. In fact, the vast majority of concerns and issues that occur during preceptorship can be addressed with effective communication.

It is important that preceptors and students set aside some time early in the placement to discuss their communication styles and preferences, and to establish communication practices and plans that both partners are comfortable with. We recommend that you plan to have several follow up discussions throughout the experience to touch base and see if the current communication strategy is working. The dynamics between students and preceptors typically evolves as the experience unfolds, so it is helpful to ensure that both parties are comfortable with how the communication is occurring. The points below can be helpful to guide these discussions.

• Open and direct communication is difficult for many people. This may be true of the student, the preceptor, or both parties. Acknowledging that communication can be uncomfortable often helps both individuals to move forward.
• The message sent may not always be the message received. Our interpretation of how we have communicated may not align with another’s interpretation. Ask questions to ensure that the message you intended to deliver was received as such. Non-verbal communication such as nodding may not be a clear indicator of whether or not the other person understands.
• Conversely, ask questions if you do not understand what has been said. While not questioning something may be the quicker approach in the short term, not having a clear understanding of what has been asked of you or communicated to you tends to create issues.
• Trust is a critical part of the preceptor/student relationship and respecting confidentiality and privacy is key in developing trust. Respecting the preceptor/student relationship by sharing information only with the faculty liaison about the teaching/learning occurring within the placement is important.
• Non-verbal communication is important. If verbal and non-verbal communications are congruent, it reinforces the message. If they don’t match, perhaps additional communication is required.

Ultimately, both the student and preceptor must be engaged in the communication process equally. We have found that if preceptors are accessible, supportive and authentic, the environment for effective and productive communication will be supported. This is especially important because in addition to the challenges inherent in the nursing program, students are often faced with multiple commitments related to work, home, and other personal circumstances.

A key part of communication is acknowledging and being aware of our own values and biases. Sometimes our assumptions are not always accurate; things may not be what they seem and it is important to consider other perspectives. The following section illustrates how our assumptions can sometimes be misleading.