Early Days of Preceptorship

You 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.

• You must continue to wear your UNB student uniform with student identification as well as a UNB name bar. It is imperative that you identify yourself as a student nurse to clients, family members, and agency employees.
• In case of extreme weather, you must exercise your best judgment, based on your personal circumstances, to make a decision about going to or leaving clinical.
• You are expected to work all of your preceptor's scheduled shifts. If a preceptor is ill or unable to work unexpectedly, the you 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 you and your preceptor will discuss this with the faculty liaison in advance of the shift(s), to determine if you will work with another nurse.
• It is your responsibility to communicate with the faculty liaison if there are changes to your schedule.
• Should an injury or near injury occur, you must complete the required agency documentation in accordance with policy, as well as documentation required by UNB. You must also advise your faculty liaison.

A key component of the first few days of the placement is orientation to the clinical setting. For you, the specific placement area may be new or it may be an area in which you 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.

Placement Culture

In addition to providing orientation for you regarding policies, practices, and logistics, your preceptor shares information that is not as easily captured on a checklist, for example: unit culture and staff expectations. The context of a clinical setting is important for you to understand; the guidance of your preceptor in this area is key to you feeling comfortable in the placement area.

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 of you however, 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 you with an opportunity to acclimatize to the clinical setting and to become familiar with routines.

During the shadowing shifts, you should not be assigned or assume responsibility for client care. You should assist the RN in the provision of care and to ask questions. When you transition to a new shift for the first time (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 you and your preceptor to discuss your letter of introduction and preceptorship course outcomes. Reviewing your 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, you and your preceptor will set aside time to plan for the gradual transition for you to assume an increased responsibility for client care. This shadowing experience will increase learning and will improve your 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 you set aside some time together early in the placement to discuss your 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.

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.