Reimagining the Preceptor Role

Newly-licensed registered nurses work environment and workforce trends: Analysis of the 2022 National Sample Survey of Registered Nurses

BACKGROUND

The Coronavirus disease of 2019 (COVID-19) pandemic has intensified turnover challenges among newly-licensed registered nurses (NLRNs), posing financial and sustainability issues for healthcare systems.

PURPOSE

This study examines NLRN workforce trends, characteristics, and turnover factors using data from the 2022 National Sample Survey of Registered Nurses (NSSRN), comparing findings with 2018 data to observe post-pandemic shifts.

METHODS

A secondary analysis was performed on a weighted subset of NLRNs from the 2022 and 2018 NSSRN data. Demographic, educational, and employment variables were analyzed using descriptive statistics and confidence intervals, and turnover predictors were assessed through logistic regression models.

DISCUSSION

NLRN turnover intent remains high, driven by burnout, suggesting a need for broader systemic strategies to improve work environments and nurse retention.

CONCLUSION

Addressing NLRN turnover requires systemic strategies focused on mitigating burnout and addressing work environment issues through robust transition to practice programs, supporting workforce stability in a post-pandemic context.

Reject the "Practice Readiness Myth": Ask if systems are ready for nursing graduates instead

The nursing profession is engaged in robust national dialogue on how to implement competency-based education. This dialogue often conflates the concept of "competency-based education" with nursing "competence" or "practice readiness." Our aim is to discuss the potential harms of conflating "competency-based education" with "competence" or "practice readiness." This commentary explores the possible risks of issue conflation. Risks include (a) suggesting that nurses who have successfully obtained licensure are not "competent" or "ready to practice," and (b) de-emphasizing the importance of safe and sustainable work environments for new graduate nurses. We discuss the need to separate conversations about "competency-based education" and "practice readiness"; the need to increase the clarity and specificity of discourse surrounding competency-based education; and the need for strategic alignment across academia and practice.

Renewing the Nursing Culture: Sustaining the Professional Community of Practice Through the Role of the Preceptor

Culture is the driving frame within which all human action takes form. This article explores the elements and characteristics of culture and applies them to the nursing professional community of practice. As it drills down to the work in the cultural context, it argues for the central role of the preceptor in evidencing the influence of culture. For onboarding nurses and the nursing community, the preceptor becomes the carrier of culture, demonstrating the impact of culture in a way that exhibits its influence and impact on nursing practice and patient care.

Identifying Barriers to The Implementation of Communicating Narrative Concerns Entered by Registered Nurses, An Early Warning System SmartApp

BACKGROUND

 Nurses are at the frontline of detecting patient deterioration. We developed Communicating Narrative Concerns Entered by Registered Nurses (CONCERN), an early warning system for clinical deterioration that generates a risk prediction score utilizing nursing data. CONCERN was implemented as a randomized clinical trial at two health systems in the Northeastern United States. Following the implementation of CONCERN, our team sought to develop the CONCERN Implementation Toolkit to enable other hospital systems to adopt CONCERN.

OBJECTIVE

 The aim of this study was to identify the optimal resources needed to implement CONCERN and package these resources into the CONCERN Implementation Toolkit to enable the spread of CONCERN to other hospital sites.

METHODS

 To accomplish this aim, we conducted qualitative interviews with nurses, prescribing providers, and information technology experts in two health systems. We recruited participants from July 2022 to January 2023. We conducted thematic analysis guided by the Donabedian model. Based on the results of the thematic analysis, we updated the α version of the CONCERN Implementation Toolkit.

RESULTS

 There was a total of 32 participants included in our study. In total, 12 themes were identified, with four themes mapping to each domain in Donabedian's model (i.e., structure, process, and outcome). Eight new resources were added to the CONCERN Implementation Toolkit.

CONCLUSIONS

 This study validated the α version of the CONCERN Implementation Toolkit. Future studies will focus on returning the results of the Toolkit to the hospital sites to validate the β version of the CONCERN Implementation Toolkit. As the development of early warning systems continues to increase and clinician workflows evolve, the results of this study will provide considerations for research teams interested in implementing early warning systems in the acute care setting.

A Cross-Sectional Study on Nursing Preceptors' Perspectives About Preceptorship and Organizational Support

Background

A skilled and experienced preceptor enhances nursing candidates' education. Students can acquire invaluable insights by observing and learning from the preceptor's professional nursing practice. Organizations must furnish sufficient support to guarantee the efficacy of preceptors in their responsibilities.

Objective

To evaluate preceptors' perceptions of the preceptorship and the relationship between organizational support and preceptor perspective of preceptorship.

Methods

A cross-sectional correlational design was deployed using purposive sampling of 90 nurses in the UAE. Between August 2023 and December 2023, a self-reported questionnaire with 40 items on preceptor perspectives of preceptorship (PPP) was distributed to nurses. The student's t-test, Chi-square, Monte Carlo, Fisher Exact, and Pearson coefficient were used.

Results

The results revealed that most participants were female (71.1%), with 48.9% between 36 and 45 years old. The mean score for the PPP was high (73.81 ± 10.92). There was a significant association between age, years of nursing experience, work area, and overall PPP. A strong correlation was found between self-preparation (r = .675), preceptorship perception commitment (r = .762), and the benefits of preceptorship (r = .830), along with organizational support.

Conclusion

The preceptors in this study had a positive perspective about preceptorship. Their acknowledgment of preceptorship's benefits to the organization shows their optimism and dedication. Future studies should analyze preceptor training programs and devise initiatives to improve clinical teaching.