recognition of perceptor

7/23/2019 recognition of perceptor

1/7317The Journal of Continuing Education in Nursing Vol 41, No 7, 2010

Recognition and Support for Todays PreceptorLori Biggs, MSN, RN, and Cheryl L. Schriner, PhD, RN, BC

Nurses often reflect on their earlier days and remi-nisce about those who helped to guide, teach, andmentor them on the road to a rewarding career in nurs-ing. That person is identified as a preceptor and is vitalin the facilitation of education, practice, and profession-alism for the novice nurse in todays hectic, challenginghospital environment. Carrying out this role requires apreceptors dedication and commitment and demandsattention from nursing administration. What recogni-

tion can be put into place to support todays preceptorand encourage more staff nurses to become preceptorswhile remaining financially feasible for health care or-ganizations?

SIGNIFICANCE FOR NURSING EDUCATION

New nurses acquire the education and competenciesneeded to obtain nursing licensure, yet are not fullyprepared for the job expectations they encounter (Jas-per, 1996). They recognize that completing an accred-ited nursing program alone is insufficient preparation

for the amount of stress and responsibility they face ona daily basis. Many new hires are disillusioned whenthey learn what actual nursing practice consists of be-cause their expectations are unrealistic (Duchscher,2001).

Duchscher (2001) further described the consequenc-es of these stressful situations, which can cause newernurses to concentrate more on tasks and less on criticalthinking principles. Staff members, including preceptors,assist new nurses in the acquisition of the knowledge andskills needed to support learning and critical thinking inthe new hire (Ferguson & Day, 2007). Preceptors are fur-ther challenged to foster clinical competence, along with

improved communication, organization, and time man-agement skills, during orientation with new hires. Theseskills will enhance confidence in the new hires ability tofocus more on the critical thinking components of nurs-ing practice.

Support during the transitional phase from graduateto practicing registered nurse encourages new nursesto improve their decision-making and clinical judg-

This article describes the development of a program to

support and recognize staff nurses as they embrace the role

of preceptor. A nursing educator from a Midwestern tertiary

childrens hospital, housed within an adult tertiary care fa-

cility, was challenged to develop a recognition program for

both hospitals that would adequately support the preceptor

role while being economically feasible for the organization.

A recognition program known as Preceptor Pride was de-

veloped to focus on the priorities of professional recognition

and individual dedication to education.

J Contin Educ Nurs2010;41(7):317-322.

abstract

Ms. Biggs is Pediatric Educator, Toledo Childrens Hospital, Toledo,Ohio. Dr. Schriner is Associate Professor, Lourdes College, Sylvania,Ohio.

The authors disclose that they have no significant financial interestsin any product or class of products discussed directly or indirectly in thisactivity, including research support.

The authors thank Barb Tassell, MSN, RN, Director of Staff De-velopment, and Mary Durfey, MSN, RN, Education Specialist, ToledoHospital, for their vision, enthusiasm, and support in the developmentand implementation of this program.

Address correspondence to Cheryl L. Schriner, PhD, RN, BC,Lourdes College School of Nursing, 6832 Convent Boulevard, Sylva-nia, OH 43560.

Received: May 6, 2009; Accepted: August 31, 2009; Posted: April 8,2010.doi:10.3928/00220124-20100401-05


2/7318 Copyright SLACK Incorporate

ment skills, assess clients more thoroughly, and pro-vide more holistic care (Ferguson & Day, 2007). Thepreceptor is the facilitator of this overall experience,which significantly affects new hires as they begin their

career path.

REVIEW OF THE LITERATUREReview of the literature showed little research re-

lated to the rewards and benefits valued by preceptors(Yonge, Hagler, Cox, & Drefs, 2008). Dibert and Gold-enberg (1995) were among the first to study the ex-trinsic and intrinsic rewards/benefits of preceptorshipin nursing (p. 1145). Some examples of extrinsic re-wards noted in the literature include (Hyrkas & Shoe-maker, 2007):

Differential in pay. Educational offerings. Dinners. Subscriptions to journals. Tuition reimbursement. Option to attend various conferences.Alspach (2003) surveyed 80 critical care nurses and

identified the top three incentives for nurses to serve inthe ongoing role of preceptor. These incentives demon-strate the worth and significance of the nurses work aspreceptors and include money, career advancement,and respect and support from others (p. 17). Addition-ally, Yonge et al. (2008) discussed that, from a facilityperspective, recognition programs for preceptors must

be financially feasible.In comparison, Hyrkas and Shoemaker (2007) identi-

fied some of the most commonly cited examples of in-trinsic rewards and benefits, including the opportunityto do the following:

Teach and influence nursing practice. Share and broaden ones own knowledge base and

encourage thinking. Consider and evaluate ones own practice. Help the novice nurse become a more confident

professional.Benner (1995) suggested that experiential studies sup-

port the idea that rewards must be unique to the indi-vidual to be worthwhile and stated that preceptors aremore likely to continue and commit to the role whenthey perceive that the rewards are personally meaningfulor professionally beneficial (p. 102).

Although little research has focused on preceptorrewards and benefits, information on how to fulfill thepreceptor role is found throughout the literature. Ac-cording to Henderson, Fox, and Malko-Nyhan (2006),preceptors need to be taught how to provide positivementoring, infuse socialization processes, ascertain grad-

uates learning styles, and give appropriate feedback(p. 131).

Alspach (2008) held an open forum with a group ocritical care nurses to discuss preceptor developmen

and support issues. It was concluded that preceptors oten received inadequate educational support, especiallrelated to the diverse population of new hires, including differences in age, sex, language, culture, experienceducation, and expertise. Even less support was providefor preceptors after they accepted the role. Many of thpreceptors attending the forum openly referred to lacof available resources when dealing with difficult situations, dilemmas, or frustrations.

Yonge et al. (2008) surveyed a group of nursing preceptors. Half of the preceptors stated that they felt thathey were well prepared to perform in their role as preceptor, and 56% credited their preparation to previounursing experiences serving in the preceptor role. Alonwith previous experiences, preceptors augmented thepreparation for the role with specific education througa course or continuing education class. However, it waconcluded that many of the participants in this surverecognized that they relied on their past experiences aa preceptor as the sole means by which they had beeequipped for that role (p. 23).

Finally, a study by Brasler (1993) recommendemandatory preceptor classes, including topics thawould assist the seasoned nurse to guide and facilitatnew nurses during orientation. The introduction of of

ficial preceptor education classes would in turn suppothe goal of implementation of effective teaching-learning methods used by preceptors and embraced by newhires.

THEORETICAL FRAMEWORK

Watsons (1985, 1988) Theory of Human Carinsupports nursing in a way that allows nursing to bviewed as more than just a jobas a truly gratifyinprofessional career. Watson is one of the few theoriswho consider caring for the caregiver as significant acaring for ill patients and their families. Initiation of

preceptor recognition program demonstrates caring fopreceptors. The support offered through this type oprogram will affect preceptors ability to show a caring attitude toward the new nurses they work with oa daily basis. The result is a significantly more carinbedside nurse who uses supportive nursing techniquetoward patients.

Sitzman (2007) described cultivating an awarenesof how to model professional caring in all aspects othe nursing profession to grow and develop both personally and professionally. Professional caring include



more than person-to-person interactions with patientsand families. Fully engaged professional caring en-compasses conscious cultivation of transpersonal in-teractions/connections with self, peers and others(Sitzman, 2007, p. 15). Caring also implies more thanconcern for others. It includes an overall knowledge ofleadership issues, local and worldwide topics, and en-vironmental causes, as well as online, web-based com-munication. Continued efforts at fostering profession-al, caring behaviors by increasing overall awareness of

these behaviors are essential to the nursing profession(Sitzman, 2007).

Watsons (1985, 1988) Theory of Human Caring isclosely aligned with a preceptor recognition program.Many of the 10 carative factors Watson described areinherent in the relationship between preceptor and newhire (Sidebar 1). For example, the second carative factorinvolves being sensitive to oneself and others. Introduc-tion of a formal preceptor recognition program dem-onstrates sensitivity toward the hard work and efforton the part of the preceptor. That sensitivity shown bymanagement encourages preceptors to display that same

sensitivity to new hires. The overall goal is disseminationof that caring concept to the end user at the bedside: be-ing able to show sincere sensitivity to patients on a dailybasis.

Development and implementation of a preceptor rec-ognition program demonstrates true caring. Watsons(1985) theory is the backbone of this proposal; it sup-ports the reasoning behind the endeavor and validatesthe necessity of its implementation to foster the devel-opment of caring nurses at the bedside, both preceptorsand new hires.

Benners (1982) novice to expert model, although notthe primary theoretical framework for the current pro-posal, provides additional support for the preceptor rec-ognition program. Both preceptors and new hires begintheir roles by exhibiting novice skill sets in the way theyguide and facilitate learning during orientation. Pre-ceptors proceed through the various stages, which arenovice, advanced beginner, competent, proficient andexpert, as they transition and grow in the role (Benner,1982, p. 402).

DEFINITION OF A NURSE PRECEPTOR

To proceed with the development of a preceptor rec-ognition program, the definition of preceptor was exam-ined. Usher, Nolan, Reser, Owens, and Tollefson (1999)defined a preceptor as an experienced nursing profes-sional who teaches, supervises, and serves as a role modelfor a student or graduate nurse for a pre-arranged timein a formalized program (p. 507). In todays health caresetting, the term graduate nurse is not commonly usedand would not apply to all new hires; instead the termintern or new hire would be more appropriate. The sig-

nificance of this definition lends itself to identify whichpreceptors receive formal recognition versus those whodo not. Historically hospitals have utilized preceptorprogram models of mentorship to provide short-termclinical orientation experiences for entry-level/newlyemployed nurses (Woodard-Leners, Wilson, Connor,& Fenton, 2006, p. 653).

Formal recognition, as proposed in the current pre-ceptor recognition program, is targeted toward nurseswho serve in an official preceptor role, with the intentthat it would be carried through over time, not simply

SIDEBAR 1

WATSONS 10 CARATIVE FACTORS

1. Practicing loving-kindness within the context of an intentional caring consciousness.

2. Being fully present in the moment and acknowledging the deep belief system and subjective life world of self and other.

3. Cultivating ones own spiritual practices with comprehension of interconnectedness that goes beyond the individual.

4. Developing and sustaining helping-trusting, authentic caring relationships.

5. Being present to and supportive of the expression of positive and negative feelings arising in self and others with the understandingthat all of these feelings represent wholeness.

6. Creatively using all ways of being, knowing, and caring as integral parts of the nursing process.

7. Engaging in genuine teaching-learning experiences that arise from an understanding of interconnectedness.

8. Creating and sustaining a healing environment at physical and readily observable levels and also at nonphysical, subtle energy, andconsciousness levels, whereby wholeness, beauty, comfort, dignity, and peace are enabled.

9. Administering human care essentials with an intentional caring consciousness meant to enable mind-body-spirit wholeness in allaspects of care, tending to spiritual evolution of both other and self.

10. Opening and attending to spiritual, mysterious, and existential dimensions of existence pertaining to self and others.

Note.Data from Sitzman (2007).



for a one-time experience. This concept is helpful whencalculating the actual costs associated with the imple-mentation of a preceptor recognition program because itnarrows the scope of who is considered a preceptor andwill be eligible for the program.

Selection of a preceptor is an integral part of the ori-entation process for new hires and can be defined in amultitude of ways, including:

Influencing the entire staff. Role-modeling positive teamwork. Bringing nursing theory to life by connecting it to

current practice. Fostering and enhancing collaboration among vary-

ing disciplines. Improving communication among all members of

the health care team.Helping new hires to practice independently and

competently, with the ultimate goal of improving patientoutcomes, benefits both the organization and the new

nurse (Ferguson & Day, 2007). Because preceptors im-prove staff morale through their ongoing willingness toshare their knowledge and skills during times of stressand fatigue, their value is immeasurable.

DESCRIPTION OF THE PROGRAM

The preceptor recognition program that was pro-posed is known as Preceptor Pride, focusing onprofessional recognition and individual dedication toeducation (Sidebar 2). This program is currently in thedevelopmental phase, with the intention to implement itin the upcoming calendar year. This requires continued

collaboration with both administration and staff devel-opment.

Preceptors need to be recognized by their employersand their peers in a manner that is relatively simple andcost-effective to implement and sustain. Staff develop-ment support of this endeavor is a major force towardimplementation and will serve to sustain many aspectsof the program, initially and over the long term. Thisprogram was designed to complement the existing pro-fessional enhancement program, in which precepting isrecognized as a part of the overall monetary compen-

sation offered to nurses choosing to participate in thorganizations clinical ladder program.

It is anticipated that the name Preceptor Pride (Sideba2) will be used throughout the organization and will b

easily identified by both preceptors and administrationProfessional describes the role of preceptors as they display clinical competence, ethics, values, communicationand leadership. Preceptors create a climate that nurturenew graduates by using open, honest, and sensitive communication that allows for discussion and understandinof graduates perceptions, needs, goals and aspirations(Henderson et al., 2006, p. 130).

Recognition must be provided for those who takon the important role of preceptor, working to mentothe next generation of nurses. Development of a rewarsystem for those who undertake the additional activitieassociated with the preceptor role has been identified aone strategy used by organizations to support preceptors (Henderson et al., 2006).

Individual describes those unique qualities and characteristics preceptors possess as they work to enhanclearning. Stone and Rowles (2002) reported that providing a day devoted to continuing education and appreciation of preceptors supports the idea of making preceptorecognition both individual and meaningful.

Dedication is the sense of caring and commitmenshown by the preceptor that should be commended anrewarded consistently. Murphy (2008) described thdedication that preceptors exhibit through their har

work, interactions that try patience, and encounters thsteal time and energy (p. 183).

Education indicates not only the knowledge and wisdom shared between a new hire and a preceptor, but alsthe groundwork that educators must lay when assistinstaff nurses in the transformation to preceptor. Preceptors must be educated on how to be successful in throle and should also be supported with ongoing education. Continuous and active facilitation of benefits sucas preceptor workshops seems to be vital for sustainabllong-term development of the preceptor role (Hyrka& Shoemaker, 2007, p. 521).

Preceptor Pride is a simple name that carries a lot omeaning. The goal of this program is to support and recognize preceptors in a caring environment so that thewill have the desire and willingness to advance the nursing profession through the orientation of new nurses.

STRATEGIESThe Preceptor Pride program includes strategie

that provide support, education, and recognition fothe preceptor (Sidebar 3). One strategy is an annuapreceptor recognition celebration, including individu

SIDEBAR 2

PRECEPTOR PRIDE

Professional: Professional role of the preceptor.

Recognition: Development of a reward system.

Individual: Unique qualities of preceptors used to enhancelearning.

Dedication: Caring and commitment displayed by preceptors.

Education: Ongoing preceptor development.



photographic displays of preceptors identified by man-agement throughout the two hospitals at a specified timeeach year. In conjunction with this recognition sharedwith peers and new hires at the unit level, preceptors are

given a preceptor pin and a certificate acknowledgingtheir dedication and commitment to the preceptor rolethroughout the year. This tribute would be in additionto the annual Nurses Week celebration currently recog-nized by both facilities in early May.

Another component of the program provides ongoingeducational support for preceptors using an online web-site. This staff development website offers the preceptora variety of educational tools, including scholarly jour-nals and Internet information related to precepting. Thiswebsite will include current relevant literature related toprecepting and will be supported and sustained by staffdevelopment professionals. It will be available to precep-tors 24/7 in the clinical setting. Most importantly, it willprovide preceptors with ongoing support and education,which are frequently verbalized needs of preceptors whoreceived only initial education on performing the pre-ceptor role (Yonge et al., 2008).

Additionally, staff development professionals will beinvolved in another portion of the Preceptor Pride rec-ognition program through the development and distri-bution of a biannual preceptor newsletter. This newslet-ter will serve as a communication tool for all preceptors,offering education and support. It may also be used as asharing tool to allow preceptors to communicate specific

issues or concerns and share their real-life experienceswith other preceptors. The initiation of a newsletter spe-cifically for preceptors is an excellent example of provid-ing support and caring to those serving in the role.

Recognizing individual nurse preceptors duringNurses Week each May, through the addition of a pre-ceptor category to the Nursing Excellence Awards pro-gram already in place, is another identified strategy.Currently, in this annual recognition of nursing excel-lence, staff nurses who serve as preceptors are includedunder the clinical category of nominees; preceptors donot stand alone as a unique group of nurses who excel

in communication, professionalism, mentoring, and car-ing. Preceptors deserve to be in a category all their own.Therefore, they are recognized independently of othernurses who excel clinically or as educators. Clinical ex-cellence in the hospital setting does not necessarily implyexcellence as a preceptor. Furthermore, there are qualitynurses who find the sharing of knowledge and mentor-ing of newer nurses overwhelming.

Finally, staff development professionals will continueto provide education to preceptors through preceptorworkshops. These workshops vary in duration from fa-

cility to facility, but are often considered an introductionto the preceptor role. Professionals in staff developmentwill continue to support and sustain these preceptorworkshops. Tote bags with the Preceptor Pride logo willbe supplied to all attendees at the completion of the sec-ond and final preceptor class.

ECONOMIC CONCERNSOne challenge associated with the implementation of

the Preceptor Pride program is that it must provide rec-ognition to preceptors and also must be cost-effective.Many of the items discussed in the current article areavailable at minimal cost to the institution. Online edu-

cational resources and newsletters, for example, requireminimal funding outside the costs of resources to sus-tain each of these elements through staff development.Expanding the Nursing Excellence Awards categoriesto include an individual preceptor category incurs noadditional costs because the committee responsible forthis program meets regularly. Photographs of precep-tors as well as certificates and pins can be obtained fora relatively low cost, which would be budgeted for eachyear. Professionals in staff development play a key rolein the overall sustainability of this type of recognitionprogram; therefore, their support is imperative.

CONCLUSION

Nurses are faced with new challenges in an era ofhealth care where the culture remains directed at pa-tient safety and improved patient outcomes. Nursing isthe driving force in meeting these goals. Nurses are ex-pected to know and do more with less, which makes thepreceptors role even more complex. Therefore, nursingadministration should support and recognize precep-tors for the instrumental role they play in the success ofthe new hires orientation experience. Additionally, the

SIDEBAR 3

PRECEPTOR PRIDE PROGRAM STRATEGIES

Annual preceptor recognition celebration, including photo-graphic display of the facilitys official preceptors, cake,

preceptor pins, and certificatesOnline preceptor education located on the staff development

website

Biannual preceptor newsletter, supported through staff devel-opment

Initiation of a separate preceptor category for the Nursing Ex-cellence Awards ceremony held each spring during NursesWeek

Complimentary tote bags with the Preceptor Pride logo givento each preceptor completing the educational classes of-fered through staff development



preceptor performs this challenging role while showingsincere compassion and caring for the new hire; the pre-ceptor helps the new hire to become successful in a verystressful environment.

Implementation of a preceptor recognition program

will encourage and motivate staff to become preceptorsas well as support those already serving in this role tocontinue to mentor, guide, and teach. The implementa-tion of a recognition program, such as Preceptor Pride,which is individualized, sincere, supportive, and feasiblefor the organization, should be embraced. Although theconcept of implementing a recognition program seemssimplistic, it should be acknowledged as a genuine at-tempt to show recognition and support for the organi-zations preceptors.

Tomorrows bedside nurses are only as knowledge-able, competent, skilled, and caring as the nurses sur-

rounding them, especially their preceptors. Often, thekind words spoken by a preceptor are remembered yearsafter the initial exchange. Support for preceptors todayindirectly affects new hires as they strive to deliver safe,quality patient care at the bedside; it directly affects pre-

ceptors because they know that they are both recognizeand cared for in this role.

REFERENCESAlspach, G. (2003). Recognizing and rewarding nurse preceptors

critical care. Critical Care Nurse, 23(2), 14-19.Alspach, G. (2008). Calling all preceptors: How can we better prepa

and support you? Critical Care Nurse, 28(5), 13-16.Benner, P. (1982). From novice to expert.American Journal of Nursin

3,402-407.Benner, Z. (1995). Preserving preceptors: A valuable resource. Critic

Care Nurse, 15(2), 101-104.Brasler, M. E. (1993). Predictors of clinical performance of new gradu

ate nurses participating in preceptor orientation programs. ThJournal of Continuing Education in Nursing, 24(4), 158-165.

Dibert, C., & Goldenberg, D. (1995). Preceptors perceptions of benefits, rewards, supports and commitment to the preceptor rolJournal of Advanced Nursing, 21,1144-1151.

Duchscher, J. (2001). Out in the real world: Newly graduated nurs

in acute-care speak out.Journal of Nursing Administration, 31(9426-439.Ferguson, L., & Day, R. (2007). Challenges for new nurses in evidenc

based practice.Journal of Nursing Management, 15, 107-113.Henderson, A., Fox, R., & Malko-Nyhan, K. (2006). An evaluation o

preceptors perceptions of educational preparation and organiztional support for their role. The Journal of Continuing Educatioin Nursing, 37(3), 130-136.

Hyrkas K., & Shoemaker, M. (2007). Changes in the preceptor rolRe-visiting preceptors perceptions of benefits, rewards, suppoand commitment to the role.Journal of Advanced Nursing, 60(5513-524.

Jasper, M. (1996). The first year as a staff nurse: The experiences a first cohort of Project 2000 nurses in a demonstration districJournal of Advanced Nursing, 24,779-790.

Murphy, B. (2008). Positive precepting: Preparation can reduce thstress. MEDSURG Nursing, 17(3), 183-188.

Sitzman, K. (2007). Teaching-learning professional caring based oJean Watsons theory of human caring. International Journal fHuman Caring, 11(4), 8-16.

Stone, C., & Rowles, C. (2002). What rewards do clinical preceptors nursing think are important? Journal for Nurses in Staff Development, 18(3), 162-166.

Usher, K., Nolan, C., Reser, P., Owens, J., & Tollefson, J. (1999). Aexploration of the preceptor role: Preceptors perceptions of beefits, rewards, support and commitment to the preceptor role.Jounal of Advanced Nursing, 29(2), 506-514.

Watson, J. (1985). Nursing: Human science and human care. NeYork: National League for Nursing.

Watson, J. (1988).Nursing: Human science and human care. A theoof nursing.New York: National League for Nursing.

Woodard-Leners, D., Wilson, V., Connor, P., & Fenton, J. (2006Mentorship: Increasing retention probabilities.Journal of NursinManagement, 14,652-654.

Yonge, O., Hagler, P., Cox, C., & Drefs, S. (2008). Listening to preceptors.Journal for Nurses in Staff Development, 24(1), 21-26.

key points

PreceptingBiggs, L., Schriner, C. L. (2010). Recognition and Support for

Todays Preceptor. The Journal of Continuing Education in Nurs-ing, 41(7), 317-322.

1 Preceptors directly affect the success of new hire orientation

and deserve adequate, caring support.

2 The definition of preceptor is significant in determining which

nurses in an organization receive formal recognition versus

which nurses do not.

3 Strategies used to support preceptors include the introduction

of annual celebrations, online educational resources, precep-

tor newsletters, the initiation of preceptor as a standalone

category for the annual Nursing Excellence Awards, andcontinued education via preceptor workshops.

4 Preceptors must be recognized by employers and peers in a

simple and cost-effective way that is easy to implement and

sustain.


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