Trust: Try to make trust rather than “checking up” the basis of your relationship. This places the responsibility for nursing care where it belongs – with the student. Encourage and expect the student to communicate honestly and openly throughout the shift and clarify anything that is unclear.
Questioning: Try to help the student think like a nurse, so whenever possible and reasonable use questioning to promote critical thinking. This includes validating assumptions, making inferences, considering other perspectives, problem solving, decision making, and being reflectively skeptical.
Questions to promote critical thinking with Practice of Nursing 9 students
- What are you assuming in this situation?
- How will you validate your assumptions?
- Is your information fact or inference?
- What cues did you pay attention to when identifying the problem?
- What are your early thoughts or hunches about this patient/client?
- What data do you need before you can make a decision?
- What other information would help you have a clearer and holistic understanding of this situation?
- What factors have you considered in coming to this decision?
- What is the patient’s/client’s perspective in this situation?
- Given the data you have, what action is reasonable?
- Thinking back on the situation, what might you question or remain skeptical about?
- How might you account for a different response to… (the same medication, treatment, surgery) between different patients/clients?
- Why do you think I asked you to… when you were with the patient/client?
Higher level questions to further develop critical hhinking with Practice of Nursing 10 students
- What else might you have observed about the patient/client?
- Is that information fact or inference?
- Does your current assessment support your earlier thinking?
- Can you be more precise about what you mean?
- How do you know he/she is experiencing…?
- What data goes together here?
- What do you know about the problem so far?
- What patterns do you see?
- What are the implications of this for the patient/client?
- What else do you need to know to make a decision?
Urgent situations: There may be times when the situation demands you give the student the answer, so do so. If you do not know the answer to a question, say so. Ask the student to look it up. The student needs to know that nurses do not know everything and this acceptable. What is important is the ability to use available resources to find the information required.
Modeling: Use the ‘role model’ approach to your advantage. For example, when you are making rounds together and the student seems to have missed a crucial observation, make the observation yourself. The student will learn a lot from seeing how you think and assess.
Feedback: Be generous and sincere with your praise. It is as important to celebrate successes as it is to critique. Positive feedback is motivating and constructive feedback provides direction.
Resources: Share resources and helpful hints you have learned that make your work more efficient.
Share ideas: Ask for the student’s thoughts and ideas and provide suggestions. Consider the student’s feelings. The student may have an equally acceptable approach. Being open to learning from the student makes the preceptorship experience valuable for both participants.
Patience: Find tricks to help you keep your ‘hands off’ when the student is slow. Some nurses have found talking with the patient prevents them from intervening too quickly. Try not to make the student feel rushed as errors or omissions are more likely to occur.
Time management: The student may get behind. You may need to step in to ease the situation. Later you may want to discuss how you recognized the student was behind and offer suggestions, such as how to organize the work, prioritize care, or work more efficiently.
Safety: Students are taught to use the MAR to identify patients when administering medications. Medication errors will occur if students do not maintain this level of safety.
Staying focused: Students get into trouble when they are unable to focus on the task at hand. This lack of focus may be due to fatigue, stress, or illness. Watch for cues suggestive of lack of focus and help the student identify and address it.
Smile: Remember to maintain your sense of humor. It is a very useful coping strategy.