The word precept is often used to describe an activity whereby an experienced clinician helps a newly hired employee or student adapt to a new clinical setting. I don’t know how this word worked its way into the vernacular of health care. Merriam Webster (nd) defines precept as “a command or principle intended especially as a general rule of action; an order issued by legally constituted authority to a subordinate official”. I suppose the preceptor is, in a way, laying down the “laws” that “govern” their particular setting. Orienting and mentoring are also familiar terms heard in various work places. One of the feature articles in this issue by Dr. Ekong and colleagues explores why some home care nurses are reluctant to precept new nurses or students. The authors offered anecdotal evidence that home care nurses are unwilling to precept new nurses and students and wondered whether birth order or generation of birth influenced the decision to precept. I can’t help but wonder, as a nurse, if this is an issue for student therapists and social workers as well, or is it unique to nursing? I would love to hear your experiences as both a student and as a preceptor.
As an educator, I know how difficult it is to secure home care placements for student nurses. Yet, home care experience is just what they need most before going off to their first jobs, most often in acute care. What other way will they learn about the critical need for seamless transitions between the hospital and home? About the many community resources available to patients when they are discharged? About the importance of medication reconciliation? About effective interprofessional communication? A couple years ago a graduating nursing student wrote a commentary on what he learned in home care during his last clinical rotation as a student nurse (Quinn, 2014). Not surprisingly, what he really wanted was intensive care, and was quite disappointed at being assigned to home care. This is typical of most students whose orientation to health care was largely obtained through network television shows like Gray’s Anatomy and ER. They want to be where the “excitement” is. But through his home care rotation he learned about the special bond that forms between patients and home care clinicians. He learned about improvising in the home. He learned communication skills. He learned what information the home healthcare nurse needs to plan care for a newly admitted patient. Now, as a nurse working in the acute care setting, he can envision seriously ill patients being discharged, and knows what is necessary to make that transition to home safe. And who knows? He may find himself drawn back into home care once he gains the clinical skills offered in acute care.
Coincidently, one of the other feature articles in this issue by Dr. O’Connor and colleagues describes a project to expose baccalaureate nursing students to transitional care. The success of the project, and the education of the student nurses, depended on home healthcare nurses volunteering to act as preceptors for the students. While the project only involved a one-day observation (in addition to assigned readings, classroom lecture and discussion), it was successful in that the nursing students had a unique experience focusing solely on the needs of older adults during the transition from acute care to home. I’m sure the readings and lectures had plenty of useful and appropriate information, but seeing that information applied in real life is what produces the “aha” moments that are so important in the education of any student clinician.
So, whether you are a nurse, therapist, social worker or pharmacist, volunteer to precept a student. These experiences and relationships are critical to the development of student clinicians, and critical to the wellbeing and future of your profession. The student will thank you, the patients will benefit, and you will have the satisfaction of a job well done.
Maureen Anthony, PhD, RN
Merriam Webster (nd). Precept. Retrieved from http://www.merriam-webster.com/dictionary/precept
Quinn, S. (2014). Home care from a student’s perspective. Home Healthcare Nurse 32(7), 444.