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Part I

Levels Of Nursing Practice

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Nursing Preceptor Workshop.

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Page 1: Levels Of Nursing Practice

Part IPart I

Page 2: Levels Of Nursing Practice

Objectives:

• Define 3 principle roles and responsibilities of a

preceptor.

• Distinguish how a preceptor’s role differs from that

of regular staff.

• Define Benner’s Levels of Nursing Practice.

• List 5 available resources for the preceptor.

• List 3 principles of adult education.

Page 3: Levels Of Nursing Practice

1. Unit Based Workshop

2. Review Preceptor Tools

3. Discuss Available Resources

4. Make the job easier

5. Make the preceptor more effective

6. Make efficient use of the preceptor’s time

7. Optimize the orientation process

Purpose:

Page 4: Levels Of Nursing Practice

1. What is a Preceptor

2. Preceptor Responsibilities

3. Orientee Responsibilities

4. Levels of Practice

The Preceptor Role

Page 5: Levels Of Nursing Practice

A preceptor instructs, teaches and supports an individual who is learning a new skill or is in a new position….

A preceptor works closely with the learner, and will watch and coach him/her in skill application.

A person may be precepted by a number of individuals simultaneously

What is a Preceptor?

Page 6: Levels Of Nursing Practice

Roles of a Preceptor

Page 7: Levels Of Nursing Practice

LEVELS OF NURSING PRACTICE

Advanced

Beginner

Novice

Competent

Proficient

Expert

Page 8: Levels Of Nursing Practice

1. To ask questions

2. Talk openly

3. Prepare

4. Follow through on agreements

Responsibilities of a Preceptor

Page 9: Levels Of Nursing Practice

Responsibilities of a Orientee

1. To ask questions

2. Talk openly

3. Prepare

4. Follow through on agreements

Page 10: Levels Of Nursing Practice

1. Adults need to know why they need to

know

2. Adults have the need of Self Importance

3. Adults are problem-centered vs.

subject-centered

4. Adults often know how they learn best

5. Adults usually actively participate in

their learning

Adult Learners

Page 11: Levels Of Nursing Practice

Preceptor Effective?

What makes a?

Page 12: Levels Of Nursing Practice

Desire

Knowledge

Experience

Organization

Teaching Skills

People Skills

What does it take?

Yes

Yes

Yes

Yes

Yes

Yes

Page 13: Levels Of Nursing Practice

What else do you need?

Objectivity

People Skills

Concrete Goals

Evaluation Tools

Effective Documentation

Page 14: Levels Of Nursing Practice

What works?

Goals & Agreements

Timeframes

Checklists

Evaluation Tools

Progress Notes

Resources

Page 15: Levels Of Nursing Practice

Goals are the single most important

factor in achieving success

Why make Goals?

Page 16: Levels Of Nursing Practice

Goals & Agreements

1. Turn Goals into Agreements

2. Make goals specific

3. Take one minute per day

4. Try 3-5 minutes a week

5. Evaluate daily

Page 17: Levels Of Nursing Practice

Timeframes

1. Be realistic

2. Be specific

3. Make expectations clear

Page 18: Levels Of Nursing Practice

Checklists

1. Use the checklists

2. Checklists are made to help

3. Write in additional needs

4. Review list weekly

Page 19: Levels Of Nursing Practice

Evaluation Tools

1. Refer to your goals

2. Be flexible

3. Keep notes (progress notes)

4. Keep up weekly

Page 20: Levels Of Nursing Practice

Progress Notes

1. Document progress

2. Record progress towards meeting goals

3. Keeps orientation plan on track

4. Gives credit for what you do

5. Covers yourself legally, good or bad

6. Establishes basic competence and compliance with Orlando Health Standards

Page 21: Levels Of Nursing Practice

Resources

1. Learn your resources

2. Seek out opportunities

3. Think and plan what you need

4. Don’t go it alone

5. Use your policies

Page 22: Levels Of Nursing Practice

A. The Change

B. Transition from staff to preceptor

C. Training

D. Working with tools

E. Value Systems

F. Results

Becoming Effective

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EVALUATE

NEEDS

How to be Effective

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USE

RESOURCES

How to be Effective

Page 25: Levels Of Nursing Practice

USE

THE

TOOLS

How to be Effective

Page 26: Levels Of Nursing Practice

PLAN

GOALS

How to be Effective

Page 27: Levels Of Nursing Practice

Specific

Measurable

Attainable

Realistic

Time Bound

Plan SMART Goals

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ASSESS

DAILY

How to be Effective

Page 29: Levels Of Nursing Practice

KEEP

NOTES

 

How to be Effective

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SEEK

OUT

OPPORTUNITIES

How to be Effective

Page 31: Levels Of Nursing Practice

THE EFFECTIVE PRECEPTOR1) Possesses and demonstrates broad knowledge

2)   Explains actions and decisions

3)    Answers questions clearly and precisely

4)    Is open to conflicting ideas and opinions

5)    Connects information to broader concepts

6)    Communicates clear goals and expectations

7)    Captures learners attention

8)    Makes learning fun

Page 32: Levels Of Nursing Practice

Part IIPart II

Page 33: Levels Of Nursing Practice

• Describe how to assist orientees in identifying of their own learning needs and in setting appropriate goals.

• Describe SMART Goals.

• List 2 important steps used by the effective preceptor.

• Explain how to apply principles of adult education as a preceptor.

Objectives:

Page 34: Levels Of Nursing Practice

TEACHING STRATEGIES

Page 35: Levels Of Nursing Practice

Teaching Principles

Build in active participation

Build in successful goals

Build in self-directed approaches (does not mean learning

in isolation)

Tap into learner’s life experiences

Vary the methodology

Offer mutual learning between participant and presenter.

Keep it simple

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1. Observation

2. Skills orientation checklist (unit specific)

3. PBDS findings

4. Progress Notes

Assessing Learning Needs

Ways to assess learning needs:

Page 37: Levels Of Nursing Practice

5. Frequently asked questions (by the orientee)

6. Questioning the orientee about previous work experiences

7. Ask (the orientee): what are your learning needs?

Assessing Learning Needs

Ways to assess learning needs: (cont..)

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1. Don’t handle it all alone

2. Know your options

3. Communicate

4. Document

5. Find the silver lining

Dealing with Frustration

Page 39: Levels Of Nursing Practice

Making Goals

TAKE

ONE

MINUTE

Page 40: Levels Of Nursing Practice

Making Weekly Goals

TAKE

FIVE (or less)

MINUTES

Page 41: Levels Of Nursing Practice

Give everyone direction

Generate measurable tools

Allow for multiple successes

Keep an ongoing record

Help guide the orientee

Encourage regular evaluation

Keep everyone on track

Why Goals Work

Page 42: Levels Of Nursing Practice

Specific

Measurable

Attainable

Realistic

Time Bound

Use SMART Goals

Page 43: Levels Of Nursing Practice

Sample Goals•Complete self assessment portion of competencies, outlined in orientation notebook, during the first week of orientation.

•Demonstrate good time management by documenting assessment and vital signs within one hour of assessment.

•Coordinate care and management of one low acuity patient independently by “anticipated date”.

•Effectively coordinate and manage care of 2 patients of intermediate acuity by “anticipated date”.

•Perform admission history and assessment and document completely in Sunrise within 1 hour of admission.

•Complete Interpretation of ABG’s & Mechanical Vent SLP’s by “anticipated date”.

•Complete real time charting within 1 hour of assessment

Page 44: Levels Of Nursing Practice

Making Agreements

Explain Roles and Responsibilities

Discuss Skills to be acquired

Determine Start Date and End date

Review Outcomes

Use Methods of Feedback

Use Methods of Evaluation

Page 45: Levels Of Nursing Practice

PBDS

1. Performance Based Development System

2. Measures critical thinking

3. A proven evaluation tool

4. Guides orientation

5. Makes your job easier

Page 46: Levels Of Nursing Practice

Using PBDS

1. Make goals simple and specific

2. Evaluate according to goals

3. Adjust goals according to results

4. Make your job easier

Page 47: Levels Of Nursing Practice

PBDSProgress Notes Examples

From PBDS Department

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0 of 6

Resp.

Neuro

1. Admit and manage 2 respiratory patients independently by 10/29/06

2. Give 4 organized reports to physicians by 10/29/06

10/20/06 - Admission for pneumonia with preceptor10/22/06 - Admission for COPD done independently. Followed appropriate protocol.10/23/06 – Managed PE pt. independently. Followed appropriate protocol. Participated in successful code.

2. 10/20/06 - Dr. Jones (+) 10/20/06 - Dr. Smith (+) 10/22/06 - Dr. Green (+ w/urgency) 10/23/06 - Dr. Davis (+)

1 4

DE

Ima Newtoyou

10/16 -10/29/06

Page 49: Levels Of Nursing Practice

2 of 6

Neuro

2 4

DE

Ima Newtoyou

1. Admit and manage 2 neuro patients independently by 11/12/06

2. Complete all charting by end of shift by 11/12/06

1. 10/31/06 - Admission for closed head trauma done independently. Followed appropriate protocol. 11/6/06 - Admission for r/o CVA, followed protocol for thrombolytics.

2. 10/31/06 - All completed 11/6/06 - 20 min. OT 11/7/06 - All completed 11/9/06 - All completed

10/30-

11/12/06

Page 50: Levels Of Nursing Practice

11/13-11/26/06

3 of 6

3 4

DE

Ima Newtoyou

Consistently manage 6 patients independently by 11/26/06

11/17/06 - 411/20/06 – 511/22/06 – 6 (w/little help)11/23/06 - 6

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11/27-12/3/06

6 of 6

Orientation complete

UBE reviewed reassessment video #107

CTA class scheduled 12/4/06

PBDS Reassessment scheduled 12/11/06

4 4

DE

Ima Newtoyou

Page 52: Levels Of Nursing Practice

Keep everyone on the same track

Don’t take long to do (1-5 minutes)

Help determine what else is needed

Generate tools for making further plans

Makes the preceptor’s job easier

Gives feedback to the orientee

Makes it easy to follow progress

Evaluations

Page 53: Levels Of Nursing Practice

Evaluate Daily

Take a moment everyday to evaluate

Give Continual Feedback to your orientee

Complete all documentation forms

Keep Leadership Informed & Up-To-Date

Complete Regular Progress Notes

Share Concerns with Leadership and/or

Educators

Page 54: Levels Of Nursing Practice

How to Evaluate the Orientee

Use Effective Communication

Use Preceptor/Orientee Agreements

Make Observations & Give Feedback

Page 55: Levels Of Nursing Practice

Offer additional information

Protect nursing licenses

Open additional doors for staff

Encourage self-sufficiency

Give preceptors a break

Expand nursing knowledge

Encourage staff involvement

Use Resources

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Keeps and ongoing record of progress

Backs up the preceptor

Provides proof of orientation

Establishs basic competence and compliance

with Orlando Health standards

Records progress towards meeting goals

Create a historic record of orientation

Documentation

Page 57: Levels Of Nursing Practice

Document Daily

Complete Skills Check List

Review and plan Goals/Agreements

List daily achievements

Evaluate if goals were achieved

Adjust plan accordingly

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Giving Feedback Deliver it in a timely manner Focus on behavior and learning objectives Present the facts, be specific Avoid feedback overload (concentrate on one thing at a

time) Maintain positive body language Be culturally sensitive Strive for win/win situation Encourage self-assessment Encourage Critical Thinking skills Always include positive comments Learn from one’s mistakes

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Role Modeling

We learn by example

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Goals can make winning easy and give us measurable tools

Winning Goals

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Make it easy to winSet reasonable goals

Make it Easy

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A standard procedure for teaching a task that a

student finds difficult is to break it down into

smaller units.

Breaking it Up

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Evaluate daily (were the goals met?)

Adjust new goals accordingly

Make Adjustments

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Adjust goals according to your evaluations

Turn ideas into plans for your orientee

Be Flexible

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SHARE IDEAS