The findings of this study will assist nursing educators to better prepare new graduate nurses with the clinical decision making skills they need in the complex healthcare environment today.

A convenience sample of newly hired graduate nurses was asked to participate in a study examining their clinical reasoning skills while they are working with a preceptor during nursing orientation. Data was collected through interviews with graduate nurses and their preceptors individually. Additionally, the researchers observed the nurses making clinical decisions, questioning techniques of the preceptors, as well as the overall interaction.

The preceptors stated that it was essential to know the learning styles of the new graduate nurses and to find out the nurses' background knowledge. Preceptors stated they often precept as they were precepted. Preceptors felt that a large role was to help the nurses learn to prioritize and organize care. The preceptors found it difficult to “let go” and “had to sit on their hands” to let the new nurses intervene. Preceptors stated that the biggest reward during the process was seeing their graduate nurse be successful and having others complimenting “their nurse”. Preceptors said they enjoying precepting because it allowed them to “pass on the legend”.

The new graduate nurses felt it was important to have a preceptor they could trust. They felt it was critical that the preceptor help them socialize to the unit and to the role of the professional nurse. They verbalized the importance of learning to prioritize and “make a plan”. The graduate nurses verbalized the difficulty getting comfortable with a patient load and learning to tie assessment data to the diagnosis, medications, and laboratory values. The nurses felt it was essential to feel comfortable asking questions of their preceptor. The nurses felt that the people were generally accepting of them.