More thoughts on orientation because, as I’ve stated before, I am about to be an orientee again, and am trying to psyche myself up so I can survive! I walked away from my last stint as an orientee with this thought: there is not a formula for the perfect preceptor—perfect preceptors do NOT exist! Through experience I adopted a healthy knowledge of preceptor personalities earned the hard way.

Granted precepting can be a thankless job–I know nurses who precept other nurses for free, meaning zero compensation from the hospital they work for. In fact, many preceptors do not have the choice of whether or not they will precept during any given shift and are just thrust into the job!

And then think of all the talking and teaching and time and knowledge preceptors are expected to part with–all under the usual pressures of getting the job done. Yeah, so while being an orientee can kinda stink times, being a preceptor for some can induce burn-out, in my thinking.

Added to the above is the fact that orientees often have more than one preceptor assigned to them. I was told I would have certain people precept me, then was switched on almost a daily basis from person to person. There was very little consistency and it drove me mad! I would get comfy with one nurse, then be reassigned to a new nurse who didn’t know what I had done, how I learned, etc. It was frustrating for me and the nurses I worked with.

Anyway, I started to generalize preceptor types and came up with some personalities that I think most new orientees encounter. Humor me here—

1. First off is the “Teacher.” This nurse knows it all and loves sharing it with an orientee. S/he is loved by her coworkers and especially management because S/he will take on any orientee under any circumstances and try to teach the newbie the ropes. The only issue with “the teacher” is that s/he is often a perfectionist type (OK, all nurses are perfectionists, but s/he is extreme) and harbors some stress created by the dualism involved in teaching perfect practice while caring perfectly for patients. In other words, the teacher can snap at any moment. And watch out, because it will be a crack heard around the world, everyone will know about it, and the fallout can be severe.

My “teacher” preceptor cracked so hard she had to take a week off work. She was orienting another nurse who made a med error that was life threatening and WHAM, the “teacher” lost it big time.

2. The second type of preceptor I’ve run across is what I call “Out-of-it.” “Out-of-it” does his job and manages to make the orinetee feel like they are in the way 99% of the time. Nothing is explained, nothing is taught, and the orientee is often on their own. The “Out-of-it” preceptor’s best feature is that the orientee gets to learn truly by hands-on and yes, by the ever-dreaded mistake. As long as the orientee doesn’t kill anyone, s/he can learn a lot by jumping in and doing everything without direction. Of course, if the orientee has any sense, they will ask for another preceptor!

My “out of it” preceptor left me alone to care for a full load of patients, and proceeded to take a 4-hour lunch break while I dealt with some seriously ill moms & babies on an antepartum unit one week into orientation! I taught myself A LOT that day!

3. Another preceptor I’ve run into is the “Hands-off.” In other words, the orientee will keep her HANDS OFF the patients while this nurse is in charge, and this kind of preceptor will do EVERYTHING while not imparting one iota of knowledge.

I actually had a “hands-off” during one of my first orientations and she was also a “set-up” – in other words, I wasn’t “allowed” to do anything with the patients and was there to observe only, UNLESS something went wrong, which was when I was “set-up” to take the blame. Bad combo and yet another preceptor to “trade-in,” if possible.

4. One of the best preceptor’s out there is the “Co-worker.” This person will work with their orientee, make a plan to provide good care to the patient while teaching along the way, and provide hands-on experience because they encourage the orientee to do as much as possible. If an orientee gets a “co-worker” they should count their blessings and make sure to provided a thank-you gift at the end of the whole ordeal!

The reality is that a good or bad preceptor makes or breaks orientation for a new nurse. So what have I learned? As a nurse on orientation, it is really, really important that I (1) give my preceptor a fair chance and really try to work with them, (2) work hard from the start and try to do as much as possible while I have someone as a back-up and (3) know when to confront a bad preceptor-orientee situation and/or ask for a new preceptor.