Precepting in an Emergency Department: Examining Perceived Barriers and Motivators

Friday, 20 July 2018

Amanda E. Ward, DNP, RN, CNE
School of Nursing, Purdue University, West Lafayette, IN, USA
Sara A. McComb, PhD, MSES, BSIE, PE
Joint Appointment in School of Nursing & School of Industrial Engineering, Purdue University, West Lafayette, IN, USA

Purpose: Having an effective preceptor able to help new employees apply knowledge into a specific nursing field may help the quickly changing healthcare environment by adequately preparing nurses to provide safe patient care and increase nurse retention rates. Strategies that preceptors may engage in include being a role model, providing adequate and constructive feedback, and facilitating a person’s socialization into the nursing role and department. A review of the literature uncovered numerous studies done on precepting and nursing orientation. However, there is a gap in the current literature on the specific experiences of emergency nurses and their perceptions of barriers and motivators experienced during the preceptor process. The purpose of this study was to discover: (1) the barriers emergency department nurses identify while performing the role of the nurse preceptor and (2) what these nurses believe would motivate them to perform the serve as a preceptor.

Methods: This qualitative study used personal connections and snowball sampling to recruit individuals to participate in a 15-20 minute interview. The Institutional Review Board of Purdue University approved this study prior to the collection of data and informed consent was obtained from all study participants. To be included in the sample, participants had to be registered nurses who were currently working in the emergency department setting. There were no exclusion criteria based on age, gender, or ethnicity. Interviews were semi-structured with a set of questions used for guidance. General demographic information was obtained to stratify the sample for any possible data correlations.

Results: Individuals identified the lack of an orientation tool, time, and workload as the most common barriers preceptors faced in the emergency department. All participants reported the emergency department was busy and the unit was short staffed making it more complicated to teach. When reviewing common themes of barriers addressed by individuals with previous precepting experience and those with none, the themes that reoccur most often include time, workload, and support. The top motivator was compensation. Other potential motivators expressed were adequate staffing on the unit, sharing preceptor responsibilities, and implementation of a formalized orientation program. All individuals reported knowledge of educational resources available to them. Individuals new to their current job role reported they felt they still needed more experience and would be more likely to become a preceptor if they had confidence performing the role would improve overall department and patient satisfaction.

Conclusions: Emergency departments are a dynamic and fast-paced environment involving patients with a variety of presenting symptoms and acuity levels. These characteristics can make it hard for individuals to take the time to teach the preceptee the necessary skills for the transition into their new role.