Elsevier

Nurse Education in Practice

Volume 36, March 2019, Pages 101-107
Nurse Education in Practice

Clinical education
Becoming a nurse preceptor, the challenges and rewards of novice registered nurses in high acuity hospital environments

https://doi.org/10.1016/j.nepr.2019.03.001Get rights and content

Highlights

This study has clinical and educational implications for nursing internationally.

  • The findings identify a need for all nurses undertaking the preceptor role to receive preparation in developing their teaching and learning skills to support student learning

  • Preceptorship skills should be included in all pre-registration nursing courses to prepare novice nurses to precept undergraduate nursing students upon graduation, as it is no longer the role of only experienced nurses

  • Novice nurses should be allocated an experienced nurse as a preceptor to help guide them in supporting undergraduates in high-acuity environments.

Abstract

Precepting is a common and expected role of nurses in clinical settings worldwide. This research explored novice nurse's experiences of precepting undergraduate nursing students in high-acuity hospital environments. An interpretive study was undertaken with 12 novice nurses (<3-years of post-registration clinical experience), who were precepting nursing students. Data was collected through focus groups and thematically analysed. The zone of proximal development theory was applied to understand the relationship of learning that occurs between students and nurses. Three themes were identified. Firstly, participants established that precepting students enhanced their own self-development, and was a rewarding role, that not only developed the student into a nurse, but provided opportunities for the novice nurse to learn. Second, precepting was both challenging and rewarding. The challenges involved the student, the context, and the preceptors' own teaching and learning skills, resulting in feelings of frustration and conflict between nursing care and preceptor roles. Third, precepting was an expectation of both the nursing role and from senior nurses. At times, the participants felt overwhelmed and drained, particularly when having students that challenged them on multiple consecutive shifts. Participants identified the need for guidance and support from more capable peers to develop confidence while precepting nursing students.

Introduction

Clinical education and practice are integral parts of learning in undergraduate nursing courses worldwide (Edgecombe and Bowden, 2009; Kamolo et al., 2017). The practical skills learnt through clinical placements are fundamental for students to develop into competent registered nurses (Edgecombe and Bowden, 2009; Strouse et al., 2018). It is important for nursing students to have dedicated clinical support with an invested interest in their education. One such model commonly used in nursing is referred to in the literature as the preceptorship model (Hilli et al., 2014a). A preceptor is defined as a nurse “who directly interacts (1:1) with the student at the bedside, or in the clinical facility” (O'Brien et al., 2014 p.20). In addition, a preceptor facilitates individualised education to link theoretical knowledge to practice skills and acts as a role model (Carlson et al., 2009). The preceptorship model has been shown to have positive benefits for students learning in the clinical environment ((Walker et al., 2012). Preceptorship is a key to workforce sustainability (Lafrance, 2018).

Section snippets

Background

Worldwide, studies have focused on experienced nurses perceived rewards and challenges of the preceptor role, in a mixture of chronic, low and high acuity health care environments (Broadbent et al., 2014; O'Brien et al., 2014; Cassidy et al., 2012; Hilli et al., 2011, Madhavanparphakaran et al. 2013). Rewards included: preceptor satisfaction; self-development and promotion; helping students apply knowledge to practice; and preparation for leadership positions (Liu et al., 2010; Hyrkas and

Aim

The aim of the study was to explore novice nurse's perspectives and experiences of precepting undergraduate nursing students in high acuity hospital environments.

Design

An interpretive study design, using focus group discussions and thematic analysis (Polit and Beck, 2017) was conducted to explore the experiences of novice nurses being preceptors to undergraduate nursing students. An interpretive study allows researchers to explore the lived experiences of participants and encourages the researcher to

Findings

This study explored the experiences of novice nurses being preceptors to undergraduate nursing students. Three themes were identified through data analyses. These themes were: (1) precepting as an enhancer for self-development as a nurse; (2) precepting is challenging but rewarding, and (3) precepting is an expectation.

Discussion

This study revealed new evidence that novice nurses have a responsibility of being preceptors to undergraduate nursing students in high acuity environments, without undertaking preceptorship training. Novice nurses expressed a lack of knowledge and skill at times when precepting students, resulting in an inability to cope with both their nursing care and student responsibilities. Preceptor education programs have been shown to lead to more positive attitudes toward students and the preceptor's

Conclusion

This interpretive study provided an opportunity to gain insight into the experience of novice nurses precepting undergraduate nursing students in high acuity environments. Through reflection and analyses we describe a deep understanding of the rewards and challenges novice nurses perceived and experienced in their precepting role. Applying Vygotsky's zone of proximal development theory to the findings identified the transition of novice nurse's development into confident nurses occurred through

Conflicts of interest

The authors do not have any conflicts of interest to disclose including any financial and personal relationships with other people or organisations that could inappropriately influence (bias) the work.

All authors have made substantial contributions to all of the following: (1) the conception and design of the study, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, (3) final approval of the

Funding statement

“This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.”

Acknowledgements

A special thank you to the staff of the Intensive Care Unit and Cardiothoracic Ward at the Royal Adelaide Hospital for supporting this research study.

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