By: Sabrina Beroz, DNP, RN, CHSE-A, FAAN
New graduate nurses (NGNs) entering the workforce continue to struggle with the stressors of transition to practice, “the incongruence between their perceptions of nursing and what they find to really be true” (Duchscher et al., 2021, p. 46). The destabilizing effects of the COVID-19 pandemic on nursing education and acute care facilities have added another layer of complexity to the system, further challenging the NGN. In a qualitative study on workplace stressors for new graduates, three themes emerged: stress of the environment, stress of self-expectations, and stress of interpersonal interactions (Feeg et al., 2022).
The role of the nurse preceptor is critical to how well the NGN moves into the professional role. A preceptor has clinical competence and “facilitates and evaluates learning, [assisting] in critical thinking and [the] development of nursing skills while fostering independence and socialization” (Kennedy, 2019, p. 107). However, as experienced nurses leave the workforce, nurse preceptors are often selected by availability rather than expertise, leading to a number of questions:
- How do we prepare nurses for the preceptor role?
- How do nurse preceptors account for transition shock?
- How are the challenges imposed by the pandemic on undergraduate education, nursing practice, and the workplace affecting change in the orientation of NGNs?
Robinson (2022) finds that due to the pandemic, there are greater expectations for nurse preceptors to fill the role of clinical instructor and educator. Thus, there must be a shared mental model between nurse preceptors and leadership regarding the challenges of the role and the modifications needed.
With added responsibilities, preceptors will require knowledge in educational theory and the effects of debriefing/feedback techniques on performance and learning. Theorists in constructivism, experiential learning, and adult learning principles guide educational foundations, and theories in reflective practice direct debriefing and feedback. The National League for Nursing course Coaching for Excellence in Nursing: A Guide for Educators uses reflection and adult learning principles to cultivate the communications skills of preceptors and nurse educators.
Duchscher (2021) gives five grass-roots foundational elements beyond knowledge acquisition critical for preceptors to cultivate to smooth the transition to practice for new graduate nurses:
- Stability: How steady the flow of circumstances is perceived.
- Predictability: What, when, where, and with whom they will work.
- Familiarity: The experience of knowing what to do.,
- Consistency: Being exposed to similar events.
- Success: Feeling and experiencing success.
The role of the nurse preceptor has always been challenging and overlooked as a critical role in the onboarding of NGNs. Now, more than ever, the NGN needs well-prepared preceptors for transition into practice.
Duchscher, J., Corneau, K., & Lamont, M. (2021). Transition to practice: Future considerations for the new graduate nurses. Nursing Leadership, 34(4), 44-56. doi:10.12927/cjnl.2021.26690
Feeg, V., Mancino, D., & Kret, D. (2022). First job workplace stressors for new nurse graduates in their own words: A secondary analysis. Nursing Education Perspectives, 43(1), 30-34. doi:10.1097/01.NEP.000000000000894
Kennedy, A. (2019). Nurse preceptors and preceptor education: Implications for preceptor programs, retention strategies and managerial support. MEDSURG Nursing, 28(2), 107-113.
Robinson, C. (2022). Are nurse preceptors the new clinical instructors? MEDSURG Nursing, 31(1), 55-56.