From Expert to Novice: The Importance of Educators and Preceptors

As an experienced nurse of 22 years who also has worked as a nurse educator in an associate degree nursing program, it was a huge leap for me to enter into the world of perioperative nursing as a novice. After many years of nursing practice and in academia, I was used to being the teacher, the experienced one, and the person students and new nurses went to for advice and direction. Moving into the complex perioperative specialty completely changed my role from educator to learner. This move was both a challenging and rewarding experience that brought forth feelings of excitement and enthusiasm, as well as insecurity and doubt, and that was splattered with a bit of frustration for not picking things up as quickly as I wanted. It was the support of my nurse educator and the knowledge and patience of my preceptors along the way that enabled me to remain open to learning and allow myself grace while discovering a new specialty.

Setting Up New Nurses for Success

One of the key factors that contributed to my success as a new OR nurse was the well-organized and well-appointed orientation by the nurse educator. The 6-month orientation encompassed not only classroom learning, but also many hands-on experiences, such as virtual reality simulation, sterile technique labs, a suturing lab, and a bone lab. Utilizing the Periop 101 program from AORN, the educator was able to integrate the lessons within the course to our experiences within the unit. The educator and preceptor collaborated on specific experiences to help enhance learning and application. For example, when we were learning about aseptic technique and sterilization in our online curriculum, we also had hands-on labs to practice sterile technique, gowning, and gloving, and had the opportunity to spend a day in central processing to see how the kits were cleaned and sterilized. We then took those experiences and began applying what we had learned during our cases. The ability to practice and then perform a task was extremely helpful in developing confidence and reinforcing what we had learned. This method also allowed us to see where there might be gaps in our learning to initiate more time for mastery.

Setting Expectations

When learning any new skillset, there are always obstacles that can inhibit confidence and learning. My greatest obstacle was my own expectations of how quickly or effectively I would be able to adapt to the roles of circulator and scrub nurse. As exciting as it was to delve into a new specialty, I was not expecting self-doubt and frustration to be part of the orientation process. My preceptor and the educator quickly reminded me that I was right where I was supposed to be and to allow myself to learn at my own pace without any deadlines or expectations. In their article on transitioning from an expert nurse to a novice nurse, Forbes and Jessup said, “Rather than set unrealistic expectations that then elicit irrational angst, the expert to novice should instead acknowledge his or her lack of command in the domain as a midlevel practitioner.”¹

Reflection

One of the tools that was effective for helping to overcome some of these feelings was reflection. Reflection was one of the approaches I often used with my students as an educator, especially after a difficult clinical shift. The idea was to not only reflect on what was challenging throughout the day, but also focus on what went right. In her book, Linda Caputi said, “Reflection on decisions made is important to improve thinking. People do not learn on experience alone, but by reflecting on and thinking about their experiences.”²

During orientation, we would also sit together with our educator or preceptor and debrief about the day. Adding this reflection component was helpful, as it allowed me to express how I was feeling, voice frustrations, and identify strengths. This truly helped me realize that I was progressing and doing good things and allowed me to focus on areas of improvement to continue to grow in my new role.

Support from Peers

The greatest support during this time was our small group of “new” perioperative nurses who all came with varying levels of nursing experience, none of which was in a perioperative setting. Although expert in our varied specialties, we were all novice learners in this new environment. This unique situation created a special bond between us, as none of us expected the challenges that were ahead of us. Having this group of nurses was a tremendous support as we learned from each other and helped to hold each other up when things got challenging.

We were fortunate to be able to develop this bond because we were a small group who developed a trust with each other and our educator. This may not happen in all instances, so I would encourage educators to allow time for these interactions to occur, whether they are facilitated or organic. These relationships really helped to foster growth in our specialty and trust in the new community we were engaging in.

Conclusion

Overall, having recently completed my training, I am thankful for the educator and preceptors who supported me during my orientation process. The well-organized and well-thought-out orientation and preceptorship really enhanced my direct learning and supported me throughout the process, especially when self-doubt kicked in. Beginning a new specialty midway through my nursing career was not an easy feat, especially as an educator, but the process and support my educator and preceptors provided made the transition for me a positive one and, in return, the perioperative team gained a skilled and enthusiastic perioperative nurse.

Nurses working in a new specialty should be reminded to allow themselves grace and that becoming an expert takes time. They should be encouraged to utilize any and all learning opportunities, immerse themselves in the experience, ask a lot of questions, and remember that they are in charge of their learning. Success does not happen overnight. It takes time and patience to become the nurse they need to be and achieve that success.

References

1. Forbes V. Jessup A. From expert to novice: the unnerving transition from experienced RN to neophyte APN. J Holist Nurs. 2004:21:180-185. 10.1177/0898010104266067
2. Caputi L. Think Like a Nurse: A Handbook. Rolling Meadows, IL: Windy City Publishers; 2020.

AORN Resources

Open access:

• AORN Position Statement on the Value of the Perioperative Nurse Educator
• Your Practice: 12 Tips for New Preceptors | AORN
• 6 Precepting Pearls for Onboarding Success | AORN
• 3 Keys to Creating Preceptor Stars | AORN
• 3 Precepting Tips for Priority Onboarding | AORN
• OR Educators: Take Your Practice to the Next Level | AORN

AORN members can access:

• Transitioning From Perioperative Staff Nurse to Perioperative Educator - AORN Journal