In his book Reclaiming Higher Ground, Lance Secretan describes the growth of the bamboo tree. "After the seed falls to the ground, it is nurtured by the rains and nutrients in the soil. During the first year, no stalk emerges although the rain and earth continue their work. Year after year passes and still no stalk. Finally, in the fifth year during a time span of no more than six weeks, the bamboo grows ninety feet." Secretan then poses the question of how long it took for the bamboo to grow 90 feet-6 weeks or 5 years.
The growth of the bamboo tree is a powerful metaphor for preceptorship. Each of us who are involved in precepting new nurses is confronted with enormous time constraints. We are challenged to get the orientee up and running as quickly as possible. Yet we know that for an orientee to flourish, time and patience are essential.
Forcing growth beyond the bamboo's natural pattern can cause damage and not allow for the establishment of a strong root system. An undeveloped root system cannot sustain the necessary growth of the plant. Additionally, the bamboo plant needs attention from the grower. The grower needs to adjust the environment to optimize the soil and sunlight so that the bamboo has the necessary nutrients to become strong and sturdy. The grower needs to be vigilant to the changing needs of the bamboo tree and protect it from weeds that may encroach upon it and cause harm.
The tale of the bamboo tree is a lesson for us all. The story illustrates three critical elements in a successful orientation: time, environment, and expertise. We must recognize that growth cannot be fast tracked, and a nurturing environment is essential for optimal growth. Lastly, the expertise of the preceptor is critical in facilitating the strong and steady growth of the preceptee.
The term preceptor is derived from the Latin word praecipere, to teach. Another Latin word, nutricia or nurse, means to take special care of; foster, cultivate. So, as nurse preceptors, we are called upon to teach and cultivate the life of another with special care; a formidable challenge, given the numerous constraints we all confront on a daily basis.
The term preceptor was first introduced into the nursing literature in 1975. Precepting became the primary method for orientation of new nurses in the 1980s and remains the primary method. Many issues that were presented in the literature in the 1980s are still challenging us today. Topics such as length of orientation, characteristics of effective preceptors, and preceptor use are still relevant.
New challenges have emerged-an aging population, medical errors, and sophisticated technology make orientation more complex. Diseases related to patients' lifestyles and new multi-resistant organisms require different nursing knowledge. Educated consumers necessitate innovative approaches to the nurse/patient relationship. Financial constraints require us to assess critically the efficacy of the orientation process and its outcomes. How have we adapted preceptor education to address these trends? We use checklists, orientation outcomes, and competencies to measure progress and document learning. Many of these tools are time sensitive. Should we measure learning outcomes that are not reflected in time such as perseverance, curiosity, and courage? Are we prepared to embrace the learning needs of the novice and new nurse within the context of this dynamic, complex, and sophisticated healthcare market?
As educators, you know the value of the preceptor role and its positive influence on the skill acquisition and clinical reasoning of the novice nurse. You have witnessed firsthand the expertise of the preceptor guiding the new nurse through the complexities of care, affirming decisions, acknowledging progress, and fostering independence. You know the importance of continually striving to create practice environments so that the preceptor can fulfill the role expectations without obstacles and advocate for the new nurse.
The Journal for Nurses in Staff Development has published approximately 55 articles devoted exclusively to the topic of precepting since 1982. This column has been created to explore preceptor issues specifically. Many of you have success stories to share. We are eager to hear them. Others have questions about precepting practices. We want to hear them as well.
We have both been involved in preceptor education for 20 years. Mary Beth Modic, MSN, RN, is a Clinical Nurse Specialist at a large tertiary care center in the Midwest. Mary Schoessler, EdD, RN, is the Director of a Staff Development department in a hospital in the Pacific Northwest. We both bring a passion for nursing, commitment to nurturing new staff, and a desire to promote the preceptor role. We look forward to your questions, comments, and stories. Please e-mail us at [email protected] or [email protected].
The lesson from the bamboo tree is threefold: Not all change is discernable. We must not abandon our belief that transformation is occurring before our very eyes. Patience is a marvelous gift.
Continue to plant seeds. You are shaping the future of nursing care!
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