Student Progression and Helpful Hints
Weeks 1-5
Week 1 Day 1
The student will work with and assist the RN preceptor with his/her assignment. During this first experience, the student will do basic nursing care on 1-2 patients as assigned by the RN and assist the RN with the care of the remainder of the assignment as directed. The student should note the organization and prioritization practices. The RN will supervise the student related to nursing care procedures, medications and treatments based upon observation and communication of students abilities and needs. The RN preceptor should discuss why certain decisions are made and give the student practical ideas on functioning as a team member. The student should also observe/assist in giving end of shift report.
Week 1 Day 2
The student will begin to function more as a team member under close supervision of the RN preceptor. Students should be assigned 2 patients. The student may be asked to make decisions with rationale, such as delegating tasks to other team members, organizing care, and reasoning for holding or giving medication. The student should give end-of-shift report for some or all of the patients on the team/assignment with the help of the RN preceptor.
Week 2 & Week 3
The student will continue to increase skills of leadership, problem-solving, and decision-making while participating in the care and management of groups of patients. The student’s assignment may be the RN preceptor’s assignment with supervision by the RN. Students are to give the end-of-shift report each day. Growth of patient assignment and nursing care ability is to be demonstrated each day (within reason of complexity and patient situations that are available).
Week 4
Continue with previous weeks activities. In addition, each student should be comparing and contrasting roles and responsibilities of the RN on different shifts related to management of patient care, patient care issues and overall unit management. Growth of assignment should be demonstrated each day related to unit situations and student capability. During the last 2 weeks, each student should be assuming most of the RN assignment under close supervision of the RN preceptor. (ie: ICU=2 patients, SD=3-4 patients, Med surg=4-6 patients).
Week 5
It is expected that the student should be caring for RN preceptor’s entire assignment. In addition, delegation skills, problem-solving, critical thinking components will need to be stressed in the last week of preceptorship. Organization and time management principles should be evident in the nursing care given to groups of patients and student participation as a team member.
Helpful Hints
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Potential student problem
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Suggestions to assist student
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Slow or unorganized assessment
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Ask student “what do you consider the most important assessment for this patient?” Assist student in distinguishing essential components of assessment vs. nonessential components.
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Missing meds or timed treatments
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Student formulates a personal worksheet before the shift starts to organize treatments and medication administration. Require students to review MAR and new orders every hour.
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Slow in completing procedures
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If unsafe, dismiss student from clinical unit and contact faculty immediately. If safe, but increased guidance needed, remain positive and be a role model. Assist in gathering and organizing supplies, and review steps of procedure before walking into patient room. Offer immediate feedback to the student.
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Unable to increase patient assignment
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Assist student in setting time limits throughout the day. Make student aware of time spent doing various tasks (i.e. charting, assessments). Offer suggestions for student organization sheet.
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Avoids supervision, unsafe practices
(i.e. charting erroneously, unethical medication administration practices, administering medications without knowing indications, completes tasks that requires preceptors supervision).
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Dismiss from clinical unit and contact faculty immediately.
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Unable to critically think
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Think aloud so that the student can understand preceptor’s rationale of problem-solving. Ask questions so that the student can begin to pull their facts together to formulate a decision.
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Unprofessional approach to patients and families
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Reflect with student on interactions. Have student ponder how they would like their loved ones to be treated.
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**Preceptors are to document all students’ strengths and weakness on Preceptor Evaluation Tool.
