Beauty and the Beast: The Two Faces of Nurse Preceptors

She walked into the room radiating with excitement and nervousness. I stood next to her wearing my lab coat with a fancy name badge pinned to the collar, also eager for the day. I watched as the night nurses, donned in blue scrubs, prepared to give report to the next shift. I also noticed that not a single greeting was offered our way; there was an evident aversion towards us. It was as if our existence would be confirmed should eye contact be made, our invisibility cloak removed with a simple hello.

As I observed the awkward avoidance, I could feel my blood pressure begin to rise. “How long will they pretend we aren’t here?” I wondered. Several minutes after report was given, the shunning was finally shattered with the following greeting - “We aren’t that busy, so I’m not sure what to do with you; go sit over there until we figure it out.” My cheeks flushed with anger and I felt like a mama bear ready to protect her young. I turned and looked at my student. She was dressed in perfectly ironed white scrubs, notebook in hand, and still smiling. Aware of my indignation, she whispered, “It’s ok, this happens to us all the time; I’ll be alright.” Then she obediently walked to her appointed seat where she would remain–out of sight –until invited to participate.

The “Beast”

I recently retired from a local hospital after 25 years of employment and decided to take the next natural step and become a clinical nursing instructor. When I worked in the hospital, nurses were known to “eat their young,” meaning nursing students or new nurses were treated with hostility. Full-blown snubbing seems to have been added to that ageless practice. In a recent rotation, I was even pulled into an empty room by a nurse who wanted to gossip about ‘how terrible nursing students are these days.’ My students gave me an equally negative appraisal of that nurse.

Perhaps I’ve become naïve to the hospital culture, coming from a lovely outpatient oncology clinic, or maybe nurses are just that tired and burned out. Don’t get me wrong; I would be lying if I didn’t admit that one perk to working in the summers is having a break from students, but I could never deliberately ignore a human being’s existence. Sadly, in my short time as an instructor, I’ve been both embarrassed and discouraged by my peers and colleagues. What has happened to America’s sweethearts?

The Sequelae of Covid-19

Unfortunately, the pandemic resulted in many nursing students being banned from clinical sites. Beyond a few outpatient clinics, many have had to rely on simulation and virtual simulation to meet their required clinical hours. These future healthcare heroes need comprehensive hands-on clinical instruction more than ever! Giving them grace while they navigate caring for real-life patients is essential to their professional growth. One study suggests that positive clinical engagement fosters the desire for “deep learning.” ¹ Although more research is needed to better understand how clinical engagement can be enhanced, we can certainly agree that giving nursing students the cold shoulder does not make for an informative or constructive educational experience.

Underdogs to the Rescue

I love a great underdog story, and nursing students are today’s come-back kids! In post-clinical a few weeks ago, my students shared stories of needing to chase nurses around who barely spoke to them or being plopped in front of computers down the hall from where their preceptors mingled. One student pointedly asked, “Shouldn’t they want us to graduate and come back here to work? They are so understaffed it seems like they need us.” I couldn’t have said it better myself.

According to a survey analysis published in JAMA in 2018, approximately 31.5% of nurses who leave their jobs do so due to burnout.² But help is on the way, and just because they are in white scrubs today doesn’t mean they won’t be carrying your life preserver tomorrow! Teaching nursing students everything you know now will preparethem to keep the ship from sinking once they graduate.

Jenny Han said, “Victory is a thousand times sweeter when you’re the underdog,” so to every nursing student – hang in there, victory will soon be yours!

The “Beauty”

Alas, the beast exists, but its yang is always nearby, found in most nurse preceptors' bright eyes and warm smiles. I saved the beauties for last because they are worth remembering.

To all the nurse preceptors who take the time to engage with the students: You are the best kind of memory. Your name comes up often in class because students hope you will be their mentor for the day. They say things like “s/he is the type of nurse I want to be.” You renew their passion for our profession.

They know you are tired, yet have the patience to teach, because you recognize they are the future. They know you are busy, yet educate on-the-go, because you understand they will be your co-workers. They know you have personal stress, yet share your tricks of the trade, because you realize they will be caring for your family one day. They know, and they are thankful.

Nursing students are mere buds of the nurses they will become. Nurse preceptors can be the drought that stunts their growth, or they can be the warmth that encourages them to bloom. It takes a village to raise outstanding nurses, so next time you are given the opportunity to shun or shine, we hope you choose to bask with the beauties.

Reference

• Ghasemi MR, Moonaghi HK, Heydari A. Strategies for sustaining and enhancing nursing students' engagement in academic and clinical settings: a narrative review. Korean J Med Educ. 2020;32(2):103-117. doi:10.3946/kjme.2020.159
• Shah MK, Gandrakota N, Cimiotti JP, Ghose N, Moore M, Ali MK. Prevalence of and Factors Associated With Nurse Burnout in the US. JAMA Netw Open. 2021;4(2):e2036469. doi:10.1001/jamanetworkopen.2020.36469