6 Precepting Pearls for Onboarding Success

Within her first month of OR nurse orientation at Cleveland Clinic’s main campus in Ohio, Heather Stewart, BSN, RN, was paired with veteran preceptor Christine Dunker, BSN, RN. Four months after her orientation, Dunker has remained a close mentor to Stewart. “Chris had so much knowledge and experience to share, and I had a million questions I was brave enough to ask, which I think helped earn Chris’ trust,” Stewart says.

Dunker agrees, noting that new nurses like Stewart who are willing to speak up and ask questions helps her to plan for the next step in their education. “I try to foster growth in critical thinking so new nurses can be prepared for any challenge they may come across.”

Stewart, Dunker, and their Perioperative Manager Carol Lung-Paskoff, BSN, RN, who all specialize in the Urology department, share tips for fruitful interactions and approaches between a preceptor and an orientee.

Tips for Preceptors (from Dunker)

• Master your communication skills—Dunker took communication training courses outside of work to improve her ability to speak with and listen to orientees. She’s also honed her skill in assessing a nurse’s competence and confidence in the OR to know when to step in and when to let them work independently.
• Measure your pace according to a learner’s needs—"I ask, ‘what have you learned, and what do you need for me’ to start my work with a nurse in training,” Dunker says. “Every nurse is different and it’s important to listen and follow your gut as a preceptor to tailor what and how you teach.”
• Give feedback that is positive, but also realistic—Dunker always finds something positive to praise an orientee, but also does not hold back in explaining what they can improve. “New nurses need positive support, but it’s ultimately my job to be honest with explaining what they need work on—this is can be a tough part of precepting, but it’s crucial to be honest.”

Tips for Orientees (from Stewart)

• Be open to learning everything— “I had to realize I was starting at square one to learn so much, from sterile technique to instrument names and then how to work with surgeons and other members of the team,” Stewart shares. “I responded well to Chris’ direct feedback, and I think that’s why we worked so well together.”
• Be honest when you don’t know something—"The very first time I worked with Chris, I was nervous because I didn’t know a surgeon’s style,” Stewart admits. “She taught me by showing me through a few procedures until I got comfortable. Eventually I would take the lead and she would step back but stay close as a safety net if I needed her support.”
• Keep asking questions as you learn—There is such a steep learning curve in perioperative nursing, there’s no way to learn without asking questions, Stewart stresses. “Chris wouldn’t just give me the answers to questions that I asked, she asked me questions in return to get me thinking and to make sure I understood the rationale behind what I was doing.”

Tips for Managers (from Lung-Paskoff)

• Make smart matches when pairing preceptors with orientees—Lung-Paskoff closely monitors how her preceptors and orientees work together so she can shift collaborations to ensure a good fit for optimal learning. She says the goal with matching preceptors and orientees is to “make long-term mentoring connections like Chris and Heather have maintained to foster continuous growth and support for both nurses.”
• Emphasize the evidence behind practice—Cleveland Clinic’s orientation program is comprehensive across different specialties, Lung-Paskoff explains. “Orientation lasts six months and incorporates didactic and practical learning to make sure new nurses have a strong foundation in evidence-based practice before they start learning the tricks of scrubbing and circulating.”