Rainbows Hospice wanted to improve the support it provided for newly qualified nurses. The hospice provides a specialised service but nurses need to have a good understanding of the basics before they can develop specialist skills.
A new 6-month preceptorship programme was developed, with accompanying documentation. It aims to enable newly qualified nurses to assess patients’ needs then plan, implement and evaluate care. It is clearly linked to the hospice’s clinical competencies, mandatory training and new starter package.
Outcomes
One preceptorship cycle has so far been completed and it has been proven to have a positive impact. A key aspect of the programme is tailoring training to individual needs and developing practical skills rather than just theoretical knowledge. For example, preceptees are given one day a month off rota. On this day they can do their own research or spend time with a particular team, depending on their development needs. Preceptees are also asked to complete a small project of their choice – this might be delivering bite sized training or developing paperwork to streamline a process. This helps them develop their practice rather than theory.
The hospice believes it is getting back the investment it made on the programme by supporting newly qualified nurses to become autonomous practitioners.
At a time when recruitment can be challenging, having a strong preceptorship programme in place can make the hospice more desirable to candidates and improve retention.
Facilitators, challenges and advice
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Key facilitators
The preceptorship programme is embedded in the hospice’s recruitment and development processes. It is linked to the probation period for new starters and underpinned by the proficiencies framework. At the end of the programme, a small ‘graduation’ ceremony is held, which has been very successful.
Hospice staff have been very receptive to the programme and supportive of preceptees. This is partly because the hospice is small and already had a close team.
Preceptees are encouraged to take responsibility for their own learning, thinking about the skills and knowledge they already have, what they need to acquire and who can help them. They also have responsibility for the documentation that records their progress.
Challenges
As part of the programme development, the team carried out a literature review. However the evidence they found was all related to adult care work (Rainbows is a children’s hospice). This meant the hospice had to learn and adapt as the programme went on.
During the COVID-19 pandemic there have been high levels of staff sickness, which has had an impact on some training for preceptees (such as shadowing sessions). However the hospice has been able to adapt to overcome this.
The hospice has been keen to avoid preceptorship becoming “another 6 months of being a student”. There is a clear focus on developing an action plan for each preceptee – looking at individual skills and which areas need improvement. There is also a focus on practical rather than theoretical learning.
Hospice staff initially had a lot of questions about what preceptees are able to do, particularly regarding administering medication. The hospice has put in clear guidelines about this, to avoid anybody being put in a difficult situation.
Tips and advice
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Make sure you’ve got a strong vision of what you want the programme to look like and what support you want to offer, then communicate your plan to everyone involved. Explain the benefits clearly - it’s really important that everyone buys in to the programme.
Keep good records of each preceptee’s development – but tailor this to suit your hospice.
Future development
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The hospice has recently recruited a new cohort of 3 preceptees.
The preceptorship programme will need to be continuously kept up-to-date, for example if national guidance about the nurse curriculum/band 5 competencies changes.
