Preceptorship Research Project Report: Chesterfield Royal Hospital NHS foundation trust

Abstract

Nurse education in the UK has been solely university based since the mid-1990s but despite careful preparation and assessment of student nurses it has been considered necessary to provide a period of additional support for Newly Qualified Nurses (NQNs) to help them settle into their new role and responsibilities. Preceptorship is the process of supporting NQNs over this transition period from student to registered nurse and it is recognised that this can be a stressful and difficult time for NQNs. This project developed from work already undertaken by the clinical placement learning team at Chesterfield Royal Hospital NHS Foundation Trust and was led by the University of Derby in partnership with them and took a case study approach to evaluating how preceptees and their preceptors are supported in practice; what their expectations are and what factors in the clinical area support or inhibit transition to qualified nurse. A systematic review was conducted as part of this project (Whitehead et al 2012 and 2013). The evidence suggests that properly resourced and organised preceptorship is a positive and essential experience for NQNs and their employers. Negative experiences come from an absence of preceptorship; preceptorship being offered but not fully delivered; and feelings of poor self-confidence despite having sufficient competence. The implication of this is that organisations can improve their likelihood of producing reliable and competent registered nurses (RNs) by the introduction of properly resourced and organised preceptorship frameworks. Recommendations for practice and for further research are made. A modified version of Lincoln and Guba’s Naturalistic Inquiry (1985) was used. This provided an authoritative and reliable ontological framework upon which to base the project. A qualitative case study method was developed and consisted of a multistage approach to data collection including semi-structured interviews with key personnel; documentary analysis of preceptorship material and focus groups with key actors. Ten interviews and five focus groups were undertaken with a total of 40 focus group participants. The participants were purposively sampled from representative groups within the Trust. NVivo was used to support analysis and ethical approval was attained for the project. Findings are grouped under the headings of: preceptor training; preceptor support; experiences of preceptorship; what the nurse should be like at the end of a period of preceptorship and the use of the tool. In addition further themes emerged from the findings in relation to indicators for successful transition; formal recognition of preceptor role; confidence and resilience; culture of support including peer support and management structure to support preceptorship; selection and preparation of preceptors and clinical skills. It is evident that there are a range of factors which are seen to affect the success or otherwise of the preceptorship period and the transition to confident RN. The findings indicate that there are a range of factors which are reported to affect the successful transition from student to NQN with the period of preceptorship in this case. These are : the selection and preparation of preceptors; a need to formally recognise the preceptor role; specific time to engage with preceptorship ; a management structure to support preceptors and preceptorship; the individualisation of preceptorship needs and ways to ensure successful preparation of students and NQNs ; the acquisition of the right clinical skills for the job; the culture of support; peer support for preceptees and preceptors; the confidence and resilience of preceptees and technological support processes. Based on these factors recommendations are made for this case in practice and for further research generally.