THE PRECEPTOR'S ROLE IN SHARING THE ORGANIZATIONAL STORY

The organizational story is alive and evolves daily through the multitude of actions taken on behalf of the organization by everyone from the groundskeeper to the administrator and by every hand that touches a patient, that is, by every nurse, every physician, and every care provider. The story must be told and retold often if it is to remain cohesive. Strands of the story must be reviewed and selected, and each selected strand must be picked up and knitted back into the whole. Paul Ricouer (1984), a noted French philosopher, says the most enduring act of societies is to tell their story because it is in telling and retelling of these stories that societies and cultures create and recreate themselves. It is through story telling that we transmit the organizational culture to the next group of individuals who enter it.

As newly hired nurses come into organizations, they are enrolled in the organizational story throughout the hiring and the orientation process. They hear the story through formal and informal conversations. During Human Resources orientation, they will hear the story of the organization through the selection of information shared. Is it all policy and benefits? Does it include information on how people in the organization relate to each other? Does it include the mission and the values of the organization? What is the story that is being told in between the words?

Then the newly hired nurse attends a nursing orientation program. Here too, newly hired individuals listen to the formal and informal story. What are they hearing? Do they hear about the basics: about infection control, patient and staff safety, documentation systems, and collective bargaining agreements? Do they hear about what is at the heart of nursing in the organization? Do they learn about caring practices, about caring for patients, self, and the team? Do they learn about how the organization is striving for excellence? Do they learn about how nurses in the organization participate in advancing the profession and evidence-based practice? Do they learn about how the organization cares for the most fragile members of society?

Perhaps, most importantly, the newly hired nurse learns the organizational story from preceptors. Preceptors must be kept close to the central story and tell their own unique version through their practice, conversation, and teamwork. They must know the major threads of the story and tell them in action on the nursing unit. They must be able to point to the story and call it out to the new hire. If the organizational story is about how we care for patients and families and how we use evidence in practice, you will want preceptors to be able to tell the story in their own words. So they can say, for instance, "On our unit we treat the whole family as the patient. We have sandwiches in the patient refrigerator if the family is hungry and doesn't want to leave the bedside. We can call dietary for a bereavement tray and have beverages and snacks brought up to the room. If families want to bring in their own meals for themselves and the patient, we let them. We have cots if family wants to spend the night. We spend as much time and energy on nursing the family as we do nursing the patient." In addition, they might say, "Skin care is really important for respiratory patients who spend much of their time sitting up and sliding down in the bed. We have to be really careful to protect them from skin shearing. We assess each patient for skin break down every shift so we can stay on top of it and we track how well we are doing through the skin prevalence study. The results are posted in the lounge."

If orientation is to be successful, all of these versions of the organizational story must align. But alignment does not happen by chance because the story is alive and will evolve in different ways throughout the organization. There must be a conscious effort to bring all the various threads back into connection with the whole. We have to stop every once in a while in our busy, often overwhelming, world to connect events into a coherent whole. If we do not, the events will remain random, much like a bead by itself is just a bead, even if it is lying near other beads. But when strung together, the beads can make a beautiful necklace or bracelet or ornament.

Bringing preceptors together to renew the organizational story is important. Begin by updating the story through connecting the organization's history with recent events. Make the connections overt: this is our mission; because of our mission, we did this and this; we learned from this experience that. Then invite the preceptors to discover how their practice story threads through the organizational story. Preceptors can share their stories in small groups; then each small group can select some stories to be shared with the whole group. Stories may be about patient care, quality improvement, or participation in education or research. By sharing preceptors' stories, the organizational story is strengthened and comes alive. The preceptors' story becomes part of the larger story; therefore, the larger story is easily remembered and shared. Giving preceptors time to reconnect their professional story to the organizational story and clarifying their role in sharing the story with newly hired nurses increase the likelihood that the newly hired nurse will hear, feel, see, and join his or her own story into the always evolving and unfolding story of the organization.

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