Change is hard, particularly in a profession such as nursing. As nurses we should be always seeking to find new and improved methods to provide the best possible care to our patients. This suggest that there is a continued need to evolve and make positive changes utilizing evidence based practice and good common sense. During an assessment of current practice, a shortfall has been identified with the management of our nursing students as well as the on boarding of our new graduate hires. In the spirit of evidence based practice and embracing change, a nursing preceptor program needs to be established to assist nursing students as well as new graduate employees. Preceptors will be experienced and capable staff nurses serving as mentors to newly employed nurses and students. The installation of this formal preceptor program has resulted in better retention rates and improved competency among nursing staff at various hospital’s already using this model.
To incorporate this new program, Lewins model of unfreezing, moving and refreezing will be used to make the process as efficient and effective as possible. Considered a pioneer on addressing how and why changes occur Kurt Lewin branded these three areas through which change agents must progress before change becomes part of an organization (Mitchell, 2013). To incorporate a nurse preceptor program, the first step will be to “unfreeze” the status quo by providing nurses and all staff with the education and information as to why and how this change should occur. Secondly, we will need to actually make the change by beginning the preceptor program. Finally, we will “refreeze” with our new program in place and evaluate our results.
The Nurse Preceptor Program should concentrate on four main areas: education, support, critical thinking, and workplace environment (Lippincott Solutions, 2017). The benefits of a nurse preceptor program have already been proven at various hospitals and clinics around the country where they have already employed similar programs to train up students and new staff. The program will create a more organized environment when hosting nursing students and a better experience for all staff as well as patients.
Nursing students will have more oversight decreasing mishaps but also providing better education and practice. New graduate nurses working with a preceptor will be provided mentorship and assisted with the transition from school to clinical nursing. This would provide each member with continuity in process and ensures the new nurse is fully equipped for the job in a timely manner (Chatzipoulios, Flowers, & Nash, 2018). The benefits are not just for the students and new graduates. Experienced nurses participating in the role of preceptor will be provided with a formalized process to pass on their knowledge and experience. This is often where the most valuable learning occurs. Nurse preceptors will also be recognized monetarily, receiving a boost in pay for those hours spent with a student.
Implementation of the program will begin with unfreezing the current state of not having a formal program for students and new graduates. Data has been gathered from students and new staff that suggest a more formal process is needed to properly serve our new nurses. The nurse preceptor program should be introduced to each shift of the nursing staff addressing any concerns and gathering suggestions for the program. By introducing the staff to the need for the change and including them in the process the staff will become discontent with the current practice and responsive to the need to implement the new program (Marquis & Huston, 2017). The information presented to staff will include when the first round of preceptor training will take place, eligibility requirments to be a preceptor, how long new grads will be assigned a preceptor as well as when they can expect the program to begin. From program conception to implementation should take no more than six months.
The next step in Lewins change model theory is “moving” which involves making the change. This would occure the first day of preceptor training as this is when people are involved in the change that is taking place (Mitchell, 2013). Preceptor training will consist of 8 hours classroom training that will provide continuity among what all preceptors are expecting and teaching to students and new nurses. This training will provide chosen preceptors with the skillset to mentor participants to become capable and efficient nurses while increasing retention among the nursing staff. Overall, the program will provide the essentials skills to become a preceptor as well as continued support for acting preceptors (Lippincott Solutions, 2017). Upon completion of training, preceptors will begin taking on students on an as needed basis receiving additional pay per hour that they are asigned to work with a student or new graduate nurse.
Lastly, refreezing will occure once the program has been in place long enough to have sufficient data on the success or of the program. To evaluate the effectiveness of the program, surveys measuring the popularity of the program combined with performance reports of those nurses that participated should be used. Surveys are a cheap and relativily fast process to gauge how successful nurses felt the program benefited them or not. Performance reports will provide more objective data to determine if the program had its intended effect of producing competent and valuable nurses to the healthcare team.
The change of adding a nurse preceptor program to the hospital affects the nursing profession by formalizing the “passing of the torch” within the nursing community. It creates a positive environment for learning, a quality learning organization in which individuals not only get their first job but also a quality experience that can also increase retention and build the culture of continuing the cycle of new nurses becoming preceptors as well. There are many obstacles when it comes to making changes in an organization and no model for change will ensure success. However; By embracing the change and using a model such as Lewins, change agents are able to more effectively introduce the idea and alleviate as many obstacles as possible from the beginning (Mitchell, 2013).
Chatzipoulios, J. M., Flowers, M. D.-B., & Nash, D. M.-B. (2018, April 21). Development of a Nurse Preceptor Program. DC, Washington, United States: National League of Nursing.
Lippincott Solutions. (2017, September 6). Nurse Preceptor Best Practices. Retrieved from Wolters Kluwer: http://lippincottsolutions.lww.com/blog.entry.html/2017/09/07/nurse_preceptor_best-HNnZ.html
Marquis, B. L., & Huston, C. J. (2017). Leadership and Managment Functions in Nursing: Theory and Application (9th ed.). Philidelphia, PA: Wolters Kluwer.
Mitchell, G. (2013, April). Selecting the best theory to implement planned change. Nursing Managment, 32-37.
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