There is a global shortage of nurses.

It's also been found that turnover rates are higher for new nurses than for senior nurses, and that many of these nurses are leaving the nursing field altogether.

Given this, there's a bigger need to recruit, mentor and then retain graduate nurses in the workforce.

How?

The implementation of an effective preceptorship program can assist in all of these areas as well as improve the morale of employees in both the clinical area and wider health service (Duffy & Flower 2017; Owens 2013).

Importance of Preceptorship in Nursing

Often, new nurses will experience a culture shock as they transition from study to the workplace and this may lead the newly graduated nurse to feel overwhelmed, unsupported and disillusioned. Often, the first three months of clinical practice have been described as the most stressful time during a nurse’s career.

A preceptorship program can decrease this stress, provide a nurturing environment for the newly graduated nurse, and allow them to learn, grow and adapt to their new role whilst being supported by their peers (Owens 2013).

A preceptorship program ensures graduate nurses:

• Have adequate resources and support available to them during this transition period
• Can link the gap between nursing education and the clinical environment
• Are provided with a good working environment that supports their professional practice and development.

(Owens 2013)

Preceptors have been found to help graduate nurses to:

• Develop their professional identity
• Socialise into the clinical area
• Practice safely and professionally
• Experience positive learning experiences and relationships
• Recieve feedback.

As well as these positive results, they have also been found to improve the quality of care that graduate nurse provides to patients, which, in turn, improves patient outcomes and increases job satisfaction (Duffy & Flower 2017).

Developing a Preceptorship Program

Prior to commencing a preceptorship program, a needs assessment must be completed. This will help to identify key focus areas to be addressed by the program.

It should also include preceptor training and education relating to teaching, feedback, evaluation and motivation. This will enable the new preceptor to further develop their role and take further ownership of their professional development (Owens 2013).

During the development of a preceptorship program, there should also be opportunities for relevant parties (such as nurse unit managers and any existing preceptors) to discuss and provide feedback on any potential changes and implementations that may occur, and how this will affect the clinical environment. This can assist in identifying any potential barriers to the development and running of the preceptorship program.

Some potential barriers that may be found include:

• Preceptors and preceptees finding time and support from their managers to attend preceptorship support sessions
• Having time constraints relating to having to observe skills being performed
• Lack of clear protocols
• Poor preparation for the role
• Restricted communication with other preceptors.

It is important to address any known barriers during the planning stage (Duffy & Flower 2017; Owens 2013).

During planning, evaluation must also be considered. Evaluation processes should effectively measure the success of the preceptorship program, as well as include a plan for implementing any consequent changes.

This can be done by collecting quantitative data on the retention of newly graduated nurses, as well as qualitative data through interviews and surveys on their job satisfaction and level of support they felt during this transition phase. From here, any potential issues can be identified, and changes made (Owens 2013).

Implementing a Preceptorship Program

During implementation, it is important that the three main parties of the preceptorship program are aligned and motivated to participate. These roles are as follows:

• Preceptors:/ nurture and support the newly graduate nurse
• Nursing administration and nursing educators: collaborate to provide training and support to both the preceptor and the new graduate nurse
• The preceptee: remain motivated and act upon feedback and support received.

(Owens 2013)

The following elements should also be addressed in the implementation of a preceptorship program:

• Clearly identified roles and responsibilities for the preceptor and preceptee
• Adequate time given to orientate and support the preceptee and preceptor
• Specific goals, expectations and measurable outcomes
• Application of adult learning principles
• Structured learning strategies – these must help the development of critical thinking and independent clinical judgment in the individual
• Constructive feedback strategies
• A safe and positive learning environment
• The development of a teaching and learning culture and the engagement of clinical staff as preceptors.

(Ford et al. 2013)

Selecting Preceptors

Having quality preceptors is a key component of an effective preceptorship program. Preceptors must:

• Be clinically competent
• Have enthusiasm for teaching
• Provide guidance for problem solving and clinical judgment
• Give positive and negative feedback in a constructive manner
• Be empathetic towards learning
• Provide autonomy when appropriate
• Be passionate about nursing.

It is also beneficial for them to be full time employees with a minimum of three years working experience (Duffy & Flower 2017).

Evaluating a Preceptorship Program

As mentioned, following the implementation of a preceptorship program, there should be assessable outcomes to measure the effectiveness of the program.  These outcomes should already have been determined in the planning stage of the program and could include:

• Improved retention of newly graduated nurses
• Increased confidence in newly graduated nurses
• Enjoyment of preceptors in teaching and supporting newly graduated nurses.

(Owens 2013)

It is vital that the effectiveness of the preceptorship program is evaluated following its implementation. An evaluation is important to ensure not only the effectiveness of the program, but also to ensure the quality of the program is maintained and regularly updated as required.

It is also important to remember that every health service will have slightly different requirements and needs, and therefore, the preceptorship program that they implement and the process of evaluation of the program will need to reflect this.