Staff development

Strategies to include preceptors in charge nurse training

After reading this article, you will be able to:

• Explain the benefits of using preceptors with a charge nurse orientation

Editor’s note: This article is an excerpt from the book Charge Nurse Program Builder: Tools for Developing Unit Leaders, written by Tammy L. Berbarie, BA, RN, RN-BC.

Before you can start your new charge nurses on the leadership journey, you will need to assign them a charge nurse preceptor. This is not a common or consistent practice, and I plead with those who are revamping or starting a new charge nurse program to invest the time in adequate training. A charge nurse role is a new role, and nurses require time to develop this skill. It makes it a lot easier to transition charge nurses into this role if they have preceptors solely dedicated to ensuring that the necessary education is provided. 

Many times in my nursing career, I have witnessed situations in which charge nurses are promoted to the role, attend a short charge nurse workshop, and then arrive on the unit to work with no one there to mentor them. Entering a job blindly, without someone to help orient you, is very difficult. How would you feel in such a situation? Could you comfortably perform your role? What do you think the challenges would be? 

I have also seen situations in which charge nurses are precepted by the manager of the unit, but the manager doesn’t spend quality time with the new charge nurses. Leaders in your organization are ultimately responsible for mentoring others, and nurse managers should be actively engaged in supporting and growing this role. 

Have a dedicated person to orient the charge nurse. The precepted program for the charge nurses on the unit should involve both an experienced charge nurse and the nurse manager/supervisor. 

Preceptor selection criteria

Choosing the charge nurse preceptor is crucial to the success of new charge nurses’ skill development. As a unit nurse manager or educator, you should never choose a preceptor based solely on his or her level of experience. Instead, you should consider a combination of elements such as the following:

• Experience 
• Competency
• Ability to act as a role model
• Professional behavior
• Mentorship and coaching capabilities
• Problem-solving and conflict resolution skills
• Resourcefulness
• Time management skills
• Communication skills
• Leadership skills
• Overall management skills

Note: This list was adapted from Preceptor Handbook: A Guide for Effective Clinical Teaching, Collaborative Rural Nurse Practitioner Project, Minneapolis.

As you think about these elements, I also challenge you to review past charge nurse preceptor evaluations. Take a look at how other charge nurses perceived their experience with their preceptor. Was it a positive experience or a horrible one? Do you really want to use that preceptor to mentor another new charge nurse? 

If you work in an organization without hardwired preceptor evaluations, consider implementing them as part of your charge nurse orientation program (see p. 4 for an example of a charge nurse preceptor evaluation form). 

Time invested in training is not just a succession planning opportunity but also a financial investment. 

Training charge nurse preceptors

You must ensure that your charge nurse preceptors have attended your facility preceptorship program before they begin precepting others, especially if they are new to the role. Preceptor classes teach methods for facilitating learning. Not all team members have the same learning style, so these classes teach preceptors how to adjust their teaching methods accordingly. 

Preceptors also learn about regulatory issues involved with precepting. It is crucial that they understand the regulatory issues for which they will be held accountable. In addition, most preceptor classes should review the documentation requirements of orientation. Your charge nurse preceptors should understand the significance of documenting a charge nurse orientee’s progress. Documentation is a critical communication tool used to demonstrate that an orientee was adequately trained to the position. The progress notes and competency assessments will be reviewed by the educator and nurse manager to assess whether the charge nurse is ready to complete orientation and be independent, and if not, what skills he or she still needs to develop.  

Charge nurse precepted time

Depending on your facility and how much time you want to invest, a two- to three-week precepted orientation may be sufficient. But be creative with your scheduling and think about how to get the biggest bang for your buck. Imagine that you orient charge nurses to a 12-hour shift and they work only three shifts per week. When they return the next week, which may be their last week of orientation, it is possible that they could forget what they learned the week before. Information overload is also possible. Try to schedule eight-hour shifts five days per week for the first two weeks of orientation. The more experience you give the charge nurses, the better off they will be when they are working independently. 

Also, consider cross-training charge nurses so they know what to do on various shifts. In my experience, day, night, and weekend charge nurses typically encounter different situations. If you want to have a robust charge nurse training program and also have the flexibility to be able to ask charge nurses to work different shifts, it would be to your advantage to provide training opportunities that allow charge nurses to experience different shifts. Doing so will familiarize charge nurses with the duties and responsibilities of each shift; it will also serve as a team-building strategy.

Think hard about how you can provide new charge nurses with as many precepted experiences as possible before they are on their own. Of course, even after orientation, they will not be completely on their own for a while. Nurse managers should be readily available and should round frequently with their charge nurses to ensure their needs are being met. Leaders and educators should also round frequently to assess needs. Visibility is crucial to the success of your new charge nurses.

As the new charge nurses approach the end of their precepted time, as a department leader or educator, you should meet with them to summarize their experience. This is a great chance for the charge nurses to evaluate the overall orientation program, ask for clarification on processes, and complete a preceptor evaluation. Use this feedback to make changes to the program as needed. 

Summary

Charge nurses should be treated as though they are brand-new nurses orienting to your facility and department. They may not need as much detail as new employees, but they do need precepted time in their new roles. 

You have a professional accountability to work with your charge nurses and ensure that they are competent and knowledgeable enough to perform their new skills. You cannot accomplish this if you do not assign them a preceptor to monitor their progress. If you hardwire preceptorship into your program, your new charge nurses will be able to provide effective leadership and maintain safe delivery of patient care.