Soapbox
Helen Calabretto
School of Nursing, University of South Australia, SA
PP: 187 - 189
Article Text
Do RNs preceptor new medical graduates?
In a recent tutorial with experienced RNs, discussion centred on the topic of preceptorship. There was unanimous agreement that new nursing graduates should ideally be preceptared as they make the transition from university student to working RN. However, lack of time and minimal staffing levels of experienced RNs were posited as creating barriers to effective preceptorship.
Discussion then moved to how other professions ease their beginning practitioners into their professional roles, with all of the incumbent expectations and responsibilities. Inevitably, the medical profession was mentioned in this process. As I have not held a clinical position in a public hospital for some years, I asked whether January was still a stressful month for RNs, as this is when the new medical graduates arrive in the hospital workplace. The response was overwhelming! 'Yes we have to teach them what to do.' 'They constantly ask us for help.' 'They rely heavily on us.' 'It's not only in January. Clinical rotations make this an ongoing situation.'
These responses raise many questions for reflection and research as they indicate that nothing has changed in the thirty years since I first entered nursing. Is the RN's assistance to graduate medical officers actually informal preceptorship? How is this extra teaching acknowledged by the clinical venues and the medical schools? What would it mean if RNs stopped doing this and focused instead on assisting and preceptoring graduate nurses?
This would appear to be an area of 'invisible' practice that may take many hours of individual RN's time, on a weekly basis. One wonders what this means for client care and whether this educative aspect of nursing work is ever costed into an RN's workload. It would be interesting to know whether any medical schools overtly acknowledge the expertise and commitment of experienced RNs. Listening to them talk about this aspect of their work, it sounds as though they may at times feel responsible for the safe practice of new medical graduates. How does this compare and contrast with their preceptoring of nursing graduates? What would clinicians like to see happen about this aspect of their work?
Perhaps it is little wonder that RNs struggle to find the time and the emotional energy to preceptor graduate nurses, if they are also having to invest energy in supervising/assisting/educating (whichever word is correct) graduate medical officers. Is this the reality in other states of Australia and other parts of the world?
In these times of change it is appropriate to review and challenge 'what has always been done', as the health system undergoes major restructuring for the next century. If experienced RNs are as important to graduate medical officers as they are to graduate nurses, what could this mean for nursing?
Merri Paech RN BN
(With thanks to the class of '95)
Care for the carers
In these times of economic rationalism we are all familiar with the shrinking health dollar. The front line impact is now very obvious - fewer nurses doing the work and the need to prioritise which part of client care can wait or even be omitted for the shift. Most nurses find it difficult to accept provision of substandard care. They will work harder, faster and longer in an attempt to maintain acceptable standards of care but often end up pay ing the price of physical or emotional ill-health.
Stress levels are rising amongst all levels of nurses from those who care at the bedside to those in administration making the difficult decisions. Some nurses have taken the opportunity to accept separation packages as they find the expectations on staff and diminished quality of care unacceptable. Others have chosen to stay and attempt to work though the changes, providing the best care they can and hoping for better times. All acknowledge the seemingly irretrievable process that the public system is experiencing in this economic climate. While endeavouring to help and care for our clients, let us not forget to care for ourselves and our colleagues as we survive the difficult times together.
Sally Holding RGN BN Grad Dip Health Counselling
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