THE EFFECTIVENESS OF PRECEPTOR PROGRAMS IN ENHANCING THE RETENTION RATE OF EARLY CAREER NURSES: A NARRATIVE REVIEW
The Effectiveness of Preceptor Programs in Enhancing the Retention Rate of Early Career Nurses: A Narrative Review
The studies below were conducted across different geographical locations and the respondents belonged to various sociocultural and economic backgrounds. Notably, eight of them dwelt on the experiences of early career nurses during the transition period. They include; Drennan et al., 2016, Lewis and McGowan, 2022, Tracy, 2017, Coventry and Hays, 2021, Kelly and Mcallister, 2013, Ferguson, 2011, and Gazaway et al., 2019. On the other hand, thirteen studies focused on the importance of preceptorships in the retention of graduate nurses. The thirteen articles in this case are – Wardrop et al., 2019, Pasila et al. 2017, Allan et al., 2017, Schmitt and Schiffman, 2019, Herron, 2017, Jonsson, 2020, Austin and Halpin, 2021, Hollywood, 2011, Kennedy, 2019, Rebholtz and Baumgartner, 2015, Aparicio and Nicholson, 2020, Lindfors et al., 2017, and Regan et al., 2017. However, some of them, including Schmitt and Schiffman, 2019, Herron, 2017, Jonsson, 2020, and Wardrop et al., 2019 gave correlating information on the above mentioned topics.
Healthcare provision is essential to boost the health of the society. The medical profession encourages and demands practitioners to gain all the requisite skills to ensure that any patient who visits a health facility is attended to with all the available resources at their disposal to save that life. According to Pasila et al. 2017, preceptorship offers nurses critical orientation skills necessary for their practice by making them active participants in the diagnosis and treatment of patients (p. 25). Wardrop et al., 2019, note that preceptors act as both teachers and role models for their trainees by mentoring them on the appropriate approach for medical interventions for patients with different illnesses (p. 97). Furthermore, the study by Wardrop et al. asserts that expectations of preceptors about their role in aiding the transition of nurses into independent practitioners offer important clues about the overall competence of the preceptee upon completion of the program. Consequently, they aver that nurse managers have either a positive or negative impact on the suitability of a graduate nurse to handle medical emergencies, treat patients with chronic illnesses, and deal with individuals in dire need of special care.
Similarly, Maureen Rebholz and Lisa Baumgartner’s 2015 study in Attributes and qualifications of successful rural nurse preceptors note that student-centered instructions are vital in equipping rural nurses with efficacy, a sense of honor, and medical expertise, which is critical in their performance ( p. 5). For example, respondents recalled their initial experiences as nurse trainees and their attitude towards their duties as huge influencers of the conduct of preceptees once they exit the program. However, the study identifies the challenges such as lower salaries, higher workload, and burnout as some of the shared problems that rural nurses experience akin to their urban counterparts. Nevertheless, according to Allan et al. 2017, preceptorships act as domains of learning in which the ward culture is ingrained in the nurses hence fostering greater healthcare competence (p. 130). Additionally, the findings suggest that preceptees can learn “in action” by making supervised ward visits where they interact with the patients hence acquiring helpful insight into their future practice. The authors note that such structured mechanisms allow trainee nurses to apply theoretical models in their practical surroundings.
Consequently, the support given to the trainees by ward managers is integral in their acquisition of medical skills because the former have the requisite knowledge on different treatment methodologies and better understand the health facility’s operations. Allan et al. also cite the possibility of preceptees gaining informal learning through the “rounds” across the wards as a significant indicator of the importance of such programs during their transition period (p. 129). Therefore, the latter study correlates to Maureen and Lisa’s because it also highlights the value placed in ensuring that graduate nurses receive positive preceptorship experiences. Linda Ferguson asserts that mentorship programs should encourage critical thought among novice nurses to enhance intellectual development (2011, p. 122). The author adds that graduate nurses always have a premeditated vision about the nursing practice and endeavor to connect with a mentor who helps them to realize such plans. Therefore, the orientation programs need to be more attentive to the opinions of the novice nurses to give them a sense of belonging.
Drennan et al opine that “most people don’t come into nursing expecting high salaries-they have other motivations” among which is Maslow’s theory of self-actualization that inspires them to join the profession to save lives thus making a positive impact to the society (2016, p. 1045). The findings of this study indicate that novice nurses enroll in preceptorship programs to boost their understanding of healthcare matters. The authors also concur with Allan et al who assert that such mentorships facilitate interdisciplinary learning among the nursing workforce by exposing trainees to different medical departments, especially during major operations that require collaboration between various specialists. Pasila et al also reinforce this notion by stating that ward rotations are an important source of skills for myriads of nurses because the practitioners develop a broader perspective of their job requirements (2017, p. 18). The various ward visits increase their interactions with patients and colleagues alike thus helping them to be ‘’quick thinkers’’ because they are supposed to have immediate solutions to all types of problems.
Turnover intention is the willingness of an employee to change jobs or switch from one company to another. Nurses engaged in preceptorship are likely to exhibit such tendencies owing to the stress associated with the profession. According to Sandra Jonsson, Helena Stavreski, and Tuija Muhonen, the integration of recruitment criteria in the preceptorship program is crucial in the retention of nurses (2021, p.1846). The study illustrates that preceptorship adds value to an organization because it identifies the right personnel to hire later because the same nurses doing the preceptorship can be persuaded into seeking permanent employment in the same organization. Nevertheless, Jonsson et al., 2021, elucidate that negative preceptorship experiences play a huge role in the frequency of turnover intention amongst nurses. For instance, they note that the lack of reduction of clinical work undertaken by preceptors and unpreparedness amongst them contributes to a hostile demeanor towards the training program hence negatively affecting the ability of early career nurses to maintain enthusiasm for the job (1845). Tracey Coventry and Anne-Maree Hays highlight the above issue by stating that workplace bullying hinders nurses’ retention in various healthcare facilities, especially when senior nurses mete out such behavior against their trainees (2021, p. 35). Therefore, such toxic environments minimize the ability of teamwork. According to Tracey and Anne-Marie, positive preceptorships “foster positive workplace relationships, increase skill and knowledge development, and enhance patient safety” (p. 35).
A study conducted by Elizabeth Herron in 2017 asserts that New Graduate Nurses (NGN) benefit from positive experiential learning and mutual collaboration with nurse educators hence discarding the notions of quitting the healthcare industry or moving to another medical agency (p. 399). The study further reiterates that preceptorship is vital in eliminating doubt about the suitability of nursing as a career because it exposes graduate nurses to the joys of helping other people live safer and healthier lives for longer. Herron further adds that statistics on the performance of healthcare providers on the “failure to rescue” variable indicate the employees’ position on the turnover intention matter. Therefore, “nurse educators, nurse managers and new graduate preceptors owe it to their new graduate nurse to determine their knowledge base, experience and level of confidence to produce the safest practitioner” (p. 399). The quality of care offered in any given medical facility is dependent on the availability of workers hence nursing shortages are preventable through preceptorship programs that encourage trainees to remain in the industry.
Likewise, Jennifer and Margaret add that friendliness and compassion are vital ingredients during preceptorship because they motivate graduate nurses to perform their duties diligently and passionately (p. 173). Moreover, the authors note that “…nursing is one of the most stressful health professions, due to the fast pace of care, increasing levels of acuity, expectations of competence in a wide range of skills and support of the client, relatives and team members” (p. 175). Consequently, peer support, especially from nurse educators, is vital in attracting and retaining healthcare workers because they have the academic qualifications, institutional memory and are aware of the medical histories of most of their clients. The authors elaborate further by equating the likelihood of graduate nurses remaining at their current stations directly to their preceptorship experiences in such organizations. Accordingly, they argue for a friendlier approach in issuing medical briefs and urge for a more tolerant workplace culture among the registered nurses who should accord their trainees a better listening environment.
Consequently, Catherine Schmitt and Rachel Schiffman opine that institutional support is a major factor in reversing turnover intention among novice nurses (2019, p. 5). The unavailability of resources or delays in their disbursement hampers the learning process. It affects the level of service delivery within healthcare agencies because it deprives mentors and mentees of vital tools for attending to their patients. Moreover, the authors note that a shortage of resources for preceptorship programs incapacitates the entire organization because such trainees are relied upon to treat the same patients being attended to by the registered nurses (p. 5).
A 2016 study by Drennan et al. reveals that some organizations mine nurse leavers’ data to understand their departure and make the necessary changes to avoid an exodus of staff in the future (p. 1047). The study also highlights the ”push” and ”pull” factors present in a metropolitan labor market that forces the exit of nurses from one healthcare facility to another and a higher frequency of in-patient wards is flagged as a possible burdensome scenario for graduate nurses. Accordingly, novice nurses appreciate a robust support network from the senior registered nurses hence influencing their decision to stay rather than leave the organization. Therefore, effective preceptorships guarantee the retention of more workers.
Jennifer and Margaret’s work also reveals that “…new graduates were given heavier workloads, more night duty and terrible rosters with few weekends off” to highlight the importance of preceptorship to uplift the standards of job satisfaction in the medical field (p. 175). Additionally, according to Eleanor Hollywood in The lived Experiences of newly-qualified Children’s Nurses, hospitals are stressful environments that can easily disrupt the physiological balance of workers because emergencies often force medical practitioners to instantly abandon their routines and respond to the needs of such patients regardless of the personal or professional challenges they might be undergoing at the time (p. 661). Therefore, both studies show that graduate nurses use their job satisfaction levels to gauge their long-term commitment to the organization. The authors further cite the stressors mentioned above as “career-enders” because they lead to a demoralized workforce. The mentorship programs envisioned by the researchers are the ones that lead to contentment among graduate nurses rather than cause disillusionment.
Eleanor adds that preceptors should be prepared to handle the reactions of their various trainees once they are hit with the “reality shock” of the practice (p. 668). Fear and anxiety are the main emotional responses that most nurses experience during their transition, and Eleanor admits as much. According to her, graduate nurses are fearful of making mistakes and view the low staffing levels in their wards to be a huge challenge to their personal and professional acumen. The need for preceptors to alleviate such concerns is paramount, especially for nurse educators with a wide age difference from their preceptees. Indeed Ashley Kennedy concurs with this concept by noting that preceptorship programs should include the”… role of the preceptor, adult learning principles, communication skills, feedback and evaluation, and learning styles” (2019, p. 107). The author justifies the inclusion of these principles in the preceptorship curriculum by citing the need for such mentors to have people-skills before, during and after the transition phase of their graduate nurses.
Job satisfaction is a vital tool for retaining employees within an agency, and the nursing practice must also meet this objective to retain novice nurses after the transition period. According to Ashley Kennedy, shared governance between the mentor and the graduate nurse is integral during the decision-making process because it empowers novice nurses, thus making them feel part of the team (2019, p. 113). Moreover, such actions enhance the nurses’ loyalty to the organization and increase their level of commitment. Therefore, Kennedy suggests that preceptors collaborate with their trainees to formulate problem statements, assess gap analyses and hold regular brainstorming sessions to seek solutions. The integration of these strategies would also boost the confidence of the graduate nurses and improve the quality of care given to patients because caregivers would have multiple solutions to various problems.
Furthermore, a 2015 study by Lewis and McGowan established that graduate nurses lack a proper understanding of all the nursing concepts, and the preceptorship program should acknowledge this reality early enough (p. 43). Mentors are responsible for incorporating their trainees into the clinical practice at a pace that makes such learners autonomous within a short period. However, the authors note that giving unrealistic expectations only repels the newly qualified nurses from completing the course or dissuades them from offering quality healthcare to patients.
Nevertheless, mentors who give novice nurses the benefit of the doubt unreservedly motivate them to perform better each time they attend to a patient. The mentors under such scenarios realize and embrace the fact that early-career nurses are prone to mistakes. Rather than reprimanding them, they offer their insights on navigating the various treatments. Therefore, Lewis and McGowan advocate for consultations in the decision-making process across various preceptorship programs. According to Regan et al., nurse leaders are the major determinants of the nursing experiences associated with certain organizations (2017, p. 253). Notably, nurse leaders have enormous authority within medical facilities, and how they assign duties, solve employee disputes, execute the management policies and relate with their peers influence the perceptions that early-career nurses have about the agency. Successful mentorships thus enhance the reputation of the employer by assigning nurse leadership roles to competent but approachable individuals who market the positive values of the facility to novice nurses. The graduate nurses, in turn, derive great job satisfaction and cherish any form of affiliation to the company.
Regan et al. 2017, opine that formal and informal interactions are integral in establishing productive relationships within the healthcare industry for a safer medical environment and a higher quality of care (p. 247). The former refers to official meetings while the latter deals with any engagements outside the working hours, presumably away from the place of work too. The authors add that Nurse Leaders (NL) “… have the capacity and responsibility to foster positive unit cultures where NGNs feel supported, welcomed and safe” through socialization with colleagues and other relevant stakeholders who are vital in creating a support system for career progression, personal growth and emotional work-life balance. Similarly, Catherine Schmitt and Rachel Schiffman add that graduate nurses deserve and value the human connection arising from socializing within the workplace because it helps them to cope with the stress they endure on a daily basis (p. 7).
Linda Ferguson also cites the need for building trust as the ultimate goal for all mentors within the profession hence preceptors ought to interact freely with their trainees (p. 122). Indeed, Ferguson asserts that preceptorships should foster a welcoming social environment when a graduate nurse arrives at the institution. Such a mentee’s reception determines the scale of productivity that the individual can muster. Notably, she states that new nurses need a supportive mentorship network to develop sound clinical judgments that enhance the quality of care for all patients. Another study conducted by Carlos Aparicio in and Jennifer Nicholson in 2020 outlines a reduction in preceptor workload and the provision of “protected time” to guide their trainees on vital work-related skills to be essential techniques for maintaining objective staff engagements during the transition phase (p. 1197). The two researchers also emphasize that opening an informal support group is crucial because it would allow participants to discuss relevant curriculum issues overlooked during the formal sessions.
However, Gazaway et al., 2019, offer a different perspective by suggesting that graduate nurses aspire to have multiple mentors to enhance their bedside clinical skills (p. 1187). According to them, such relationships increase their chances of having secure medical foundations, which are integral in the delivery of patient care. Lewis and McGowan augment this notion by stating that the socialization of medical practitioners is a vital source of consistency in the medical field because such forums keep individuals accountable to their peers (p. 43). Lindfors et al., 2017, also cite preceptor orientation as a pertinent phase for developing trust among clinicians. It introduces graduate nurses to their mentors hence the need for such trainees to establish a working relationship beyond their wards, albeit while maintaining their professionalism (p. 258). Moreover, Andy Tracy opines that successful mentorship programs are built on holding regular formal and informal interprofessional meetings in which employees articulate issues of concern to them for action by the management (p. 443). Furthermore, Tracy posits that such meetings offer valuable interdisciplinary learning opportunities for NGNs thus enhancing service delivery within the organization.
According to Charlotte Austin and Yvonne Halpin, newly qualified nurses are better served by a preceptorship program that installs a personal professional mentor (PPM) role within the agency who acts as a confidant (p. 675). The holder of such a position would guide the nurse through the transition period. Similarly, the authors opine that such mentors should be allowed to enter into the learning space at various intervals because they understand the organization’s workings and can connect easily with other registered nurses for a faster educational process. Moreover, PPMs can tap and channel other resources into the preceptorship program, facilitating the learning process.
The major themes covered in this paper are competencies in the nursing profession, turnover intention, job satisfaction, and professional socialization. The themes mentioned above are integral objectives of any preceptorship because nurse educators seek to impart medical knowledge on their trainees, ensure that nurses take pride in their career choice, dissuade them from shifting to another profession and provide a conducive working environment for their holistic growth, in the healthcare industry and on a personal level as well. Therefore, preceptorships are useful programs for inducting early career nurses into the medical field because it helps them to learn, in real-time, how to treat patients from experienced registered nurses.
Newly qualified nurses join medical organizations with varying expectations. Once they settle into their roles, they often face a “reality shock” that can only be overcome by highly qualified yet affable preceptors’ structured and compassionate mentorship programs. Preceptorship is a vital transitional phase for nurses in which they undergo practical clinical skills under the supervision of a specialist. The studies mentioned above are similar in their findings because they accurately identify the roles of the mentor and the trainee and affirm that preceptors are a vital link in the delivery of healthcare because they transfer medical knowledge to graduate nurses within practical settings (Tracy, 2017, p. 440). Consequently, the transfer of skills requires building trust between the parties. Such a relationship is nurtured from the initial contact that senior registered nurses have with the newly qualified nurses.
Likewise, the rapport created during the preceptorship guides the formal and informal interactions between the preceptor and preceptee hence medical facilities need to assign PPMs for easier absorption of nurses into the practice. Thousands of nurses who enroll in preceptorship programs quickly realize the perils of staffing shortages because they are assigned more responsibilities, especially in odd hours such as abrupt ‘’return-to-work’’ calls very late into the night. Therefore, effective mentorship initiatives must integrate flexible schedules for the nurse educators and their trainees alike to encourage the latter to maintain the high levels of enthusiasm that they had during their admission into the program. Additionally, preceptors have the knowledge and clinical skills about the best approach to use when dealing with patients of high acuity hence mentorship programs equip nurses with valuable life-saving skills that reduce the rate of “failure to rescue” within healthcare facilities.
The studies also reaffirm the conventional belief that toxic workplace cultures lower employees’ self-esteem. Respondents were unanimous that turnover intention is a huge impediment to proper service delivery in hospitals. However, preceptorships that boost nurses’ confidence are advisable (Austin and Halpin, 2021, p. 674). For instance, embracing a friendlier approach in the issuance of instructions by supervisors and increasing the frequency of informal social meetings provides newly qualified nurses with a positive perception about the profession, encourages them to be more empathetic to patients, and increases the ties among colleagues for a healthier and safer working environment. Similarly, preceptorship enhances job satisfaction by increasing peer support among workers. The preceptorship curriculum outlines the roles of nurse educators and graduate nurses, which minimizes the chances of friction. Notably, senior registered nurses should always accompany their trainees by integrating a ward culture that encourages interdisciplinary collaboration within the agency (Allan et al., 2017, p. 129).
Furthermore, graduate nurses benefit immensely from the training during the transition phase due to the many highly skilled trainers at their disposal. Additionally, preceptorship programs are designed, so that newly qualified nurses spend most of their time conducting practicals in the wards rather than learning theories. Therefore, the learning modules improve the competencies of nurses by testing their public relations skills, knowledge in healthcare matters, and the bureaucracy within the organization. Consequently, graduate nurses who complete these programs can independently handle all types of emergencies and the healthcare needs of different patients (Hollywood, 2011, p. 668). Additionally, achieving a work-life balance is crucial in the medical field because nurses work in stressful environments and deserve the love and support of their peers, relatives, and patients. The ideal mentorship curriculum factors in the element of socialization. The mentee’s welfare is well-maintained through higher salaries, reasonable “off” weekends throughout the year, and opportunities for career growth within the organization.
Likewise, graduate nurses gradually gain confidence in handling patients through preceptorships. For instance, the presence of preceptors reassures novice nurses during their practical lessons since most newly qualified nurses suffer from anxiety which makes them afraid of making mistakes (Pasila et al., 2017, p. 24). However, it is incumbent upon ward managers to ensure that such nurses undergo intensive preparatory training sessions to help them cope with the high expectations. Consequently, preceptorship mentors must also undergo similar exercises because the pressure to perform their duties while still supervising various students may be overwhelming and lead to burnout. Notably, the curriculum for such individuals should include regular appraisal meetings in which an assessment is done to see whether the course’s objectives are met within the allotted period.
Trainee nurses have different experiences during their transition phase because their expectations differ. The healthcare facilities they train under have varying organizational cultures and their mentors have distinct personalities that may sometimes clash with theirs. Similarly, the type of patients they handle daily exhibit different reactions to the services offered. Therefore, effective preceptorship boosts the morale of the workers by offering a welcoming ambience which in turn motivates members of staff into a productive workforce. Consequently, effective mentorships are vital attractions of skilled nurses because they provide highly qualified registered nurses an opportunity to transfer their knowledge to graduate nurses practically.
The studies reaffirm the importance of fair remuneration of workers in lowering the turnover intention of early career nurses. For instance, Drennan et al. identify career progression as a major concern for nurses who seek higher salaries within the NHS in the UK (2016, p. 1047). Notably, healthcare organizations within metropolitan areas have a high demand for nurses which increases the risk of turnover intention during preceptorships. However, efficient mentorship programs integrate incentives, especially for nurses with exemplary performance, to encourage the trainees to remain in their current workstations and within the medical field too. Accordingly, preceptorships are vital tools available to the management to enhance the welfare of its employees.
Patient acuity determines the type and level of care that medical practitioners should extend to any individual hence preceptorships facilitate a higher quality of care for their clients. Mentorship programs for graduate nurses mostly focus on treating people with severe illnesses because such candidates challenge the mentor and the mentee cognitively to provide the most suitable interventions with minimal room for errors. Therefore, the participants must be alert and have a high recall memory of all the theories learned because any slight mistake could be the difference between life and death. The replication of such high standards of care towards all patients enhances the safety of all stakeholders within an agency while also improving the level of healthcare. Therefore, effective preceptorships are channels for enhancing the quality of care within organizations.
Moreover, preceptorships provide platforms for senior medical personnel to innovate safe treatment techniques, thus creating value addition to the industry. For instance, effective mentors, especially in rural areas, have the liberty to use the available resources when treating their patients without compromising their safety. The graduate nurses are also able to contribute their ideas on the best approach to use during such sessions, and both parties then develop a creative mindset which helps find quick solutions to medical problems. Similarly, preceptorships present organizations with the opportunity to identify members of staff capable of acquiring leadership roles (Jonsson, 2020, p. 1846). Nurse leaders are integral links in the administration of healthcare because they oversee the operations of certain sections of the agency, without which service delivery to all patients would be jeopardized. The individuals seconded to such positions are chosen on merit and become role models for other workers to emulate. Additionally, they inspire early career nurses to do their utmost and gain similar recognition from their peers because such accolades make them progress faster in their workplaces.
Preceptorship programs keep evolving with the changes in the health sector hence making the nursing department easily adaptable to change. The above-mentioned concept is useful during emergencies because medical practitioners are unaware of what to anticipate, and patients with all types of injuries, symptoms and illnesses may walk in at any time. Therefore the onus falls on the nurses on duty to perform First Aid, process the patient for treatment, administer medication and monitor the recovery, all of which require some flexibility to succeed. Similarly, the lived experiences among nurses provide them with enough impetus to respond in such instances. The mentorship programs are thus invaluable to healthcare provision because they prepare nurses for any eventuality. Accordingly, early-career nurses become critical thinkers (Wardrop et al., 2019, p. 101). Jonsson et al. assert that graduate nurses possess great communication skills courtesy of the preceptorships, and their prowess is often tested when they have to deliver bad news to the families of deceased persons (2020, p. 1844). Self-control is another vital aspect of learning that preceptors impress upon preceptees during the transition phase. It serves them well during the scenarios mentioned above.
Effective preceptorships also aid experienced nurses in transitioning into new specialty areas (Schmitt and Schiffman, 2019, p. 1). The workload for registered nurses is sometimes immense, and some may seek alternatives after working in the same station for a long period. However, doing so may prove cumbersome due to most institutions’ bureaucracy. Therefore, preceptorships offer such individuals the chance to actualize their goals. Nevertheless, the transition of novice nurses into the medical practice is always seamless despite such changes because the nurse educators are available to guide their trainees through the motions. The graduate nurses have a lot of time to decide their areas of specialization.
Mentorship programs prevent the early attrition of staff within the profession as well by ensuring that serious individuals are recruited (Schmitt and Schiffman, 2019, p. 1). Newly hired nurses signal the willingness of graduates to enter the job market in this field hence reaffirming their commitment to the industry by pursuing further education. The same individuals had the option of seeking alternative careers before joining the preceptorships. Still, their enrollment confirms their dedication to the profession, thus guaranteeing more workers for the healthcare industry. The supervision programs mentioned above are thus critical suppliers of a nursing labor force, and medical facilities can tailor their operations based on the predictable number of novice nurses set to join these organizations.
Limitations of Studies
The studies undertaken for this paper had various limitations. For instance, some of them were done within the same geographical location hence the data collected may not be transferable to other areas with different demographics (Lewis and McGowan, 2022, p. 40). Moreover, some of them, including Wardrop et al., 2019, Schmitt and Schiffman, 2019, and Lindfors et al., 2017 were also conducted in organizations with identical health facilities, thus containing inaccurate data on the state of preceptorships across other agencies with a higher or lower amount of resources. Furthermore, others were finalized more than ten years ago, yet current circumstances in the health sector and nursing experiences may differ sharply from those described in the studies. One particular example is Hollywood, 2011. Additionally, the respondents’ selection for certain research work was biased, especially on race, gender, and age, hence offering insight into only a small cross-section of the population. Likewise, some studies were subjective owing to the researcher’s professional interactions with the participants before the study. Language barrier is another limitation that affected data collection in some studies, while the homogeneity of the small sample size of participants, especially mentors, was another factor in others. Examples in this area, include Pasila et al. 2017 and Kennedy, 2019. Moreover, financial constraints also limited the scope of some research, affecting the veracity of the claims while other respondents changed their opinions during the follow-up interviews (Hollywood, 2011, p. 670). Others that faced this challenge include Aparicio and Nicholson, 2020 and Rebholtz and Baumgartner, 2015. The response time for some studies was short, thus weakening the quality of answers given, and others relied on secondary data whose credibility was difficult to establish for lack of direct engagement with the primary sources. Examples of studies that faced the challenge include Lindfors et al., 2017 and Josson et al., 2020. Consequently, others used participant recruitment methods such as posters which were inaccessible to a wider audience. These include Tracy, 2017 and Coventry and Hays, 2021.
Strategic leadership strategies tailored to specific sections of the nursing labor force are areas that deserve exploration to avoid applying general human resource tactics in a profession with a dynamic working environment. Similarly, there is need to expand the research on the criteria for selecting a personal preceptorship mentor because of the vital role such individuals play in the recruitment and training of early-career nurses. Moreover, it would be prudent to study the relationship between novice nurses’ expectations before joining preceptorship programs and the level of turnover intention within the healthcare sector because this area is underreported. The ward culture in the leading public and private healthcare providers is another issue that researchers should examine in the future to enhance the data on the contribution of ward managers in the success of preceptorship programs. Therefore, such a study should integrate the effects that ward managers have on the ”failure to rescue” principle, which is a useful indicator of the quality of care provided at any medical facility. However, the study must differentiate the rural from the urban settings to provide accurate data on the two variables. Similarly, incorporating the feedback of early-career nurses into the preceptorship curriculum is a potential area of interest as well because making the learning process more interactive would help give them a sense of belonging to the organization. Accordingly, research on the preparedness of mentors for the training programs requires further examination, too, owing to the numerous negative experiences claimed by respondents about the orientation they were exposed to during the transition phase.
Preceptorships demand specialized training because mentors are supposed to teach their trainees and simultaneously attend to patients as part of their duties. The programs are also time-intensive since the nurse educators must ensure that early career nurses grasp all the skills they need to independently treat patients later on. Consequently, effective preceptors should possess great interpersonal skills to enable them to relate well with novice nurses. The transition period is a crucial phase in the career development of graduate nurses and the experience attained during this period determines their job satisfaction levels and informs their decision to either remain in the profession or switch to another one.
Therefore, nursing competence is a vital skill that graduate nurses accrue during preceptorships. The combination of theory and practical, especially for patients with a high acuity, provides such nurses with essential life-saving skills that are required in the medical profession. Similarly, the nursing workforce depends on a friendly ward culture to discharge their duties (Allan et al., 2017, p.129). Consequently, preceptorships provide a structured mechanism for the realization of this goal. The curriculum mandates ward managers to chaperone novice nurses professionally while also demanding that preceptors create a rapport with them to prevent instances of high turnover.
Likewise, effective preceptorships present early career nurses with avenues for professional socialization where they interact with senior and junior colleagues and learn coping mechanisms that are integral in their wellness at work and at home. The workplace environment in the healthcare sector is filled with several stressors such as staffing shortages, bullying and lower pay which can easily lead to mental and emotional breakdowns. Accordingly, nursing experiences that raise employees’ self-esteem motivate them to be punctual, encourage them to attend to all their patients’ needs, dissuade them from causing friction among their peers, and increase their loyalty to an organization. The qualities mentioned above are a by-product of effective preceptorships.
Moreover, novice nurses cannot be thrust into the hospital environment without undergoing proper training because they cannot handle serious emergencies and require guidance from registered nurses. The studies mentioned above indicate that the rate of ”failure to rescue” is highest when preceptors ignore the inadequacies shown by their trainees (Herron, 2017, p. 399). Therefore, the mentorship programs envisioned above empower the nurses to embrace a proactive approach towards their learning for them to tap into the repertoire of skills inherent in their mentors for better educational outcomes. Furthermore, the health and safety of other human beings is always at stake. Clinical supervision programs for the transition of nurses into the practice need managerial support to succeed. Consequently, including a personal preceptorship mentor within an organization hastens this process and affords a graduate nurse a readily-available ”coach” who can shepherd the apprentice until the training is over. Therefore, effective preceptorships are vital for continually churning skilled nurses who in turn ensure that the healthcare industry remains a valuable service to society. Additionally, such programs instill ethical behavior among nurses hence insulating patients from the dangers of professional and moral misconduct. For instance, they lower the chances of medical negligence, which places patients’ lives at risk, increases the operational costs of an organization through the resultant lawsuits, and denies the accused an opportunity for career progression.
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