Combating Preceptor Burnout - Emerging Nurse Leader

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

Kerry Martin, nurse manager at UW hospital, asked me to tackle preceptor burnout in a blog. Kerry writes, “Retention in the nursing workforce has become a struggle. This leaves younger, less experienced nurses at the bedside to care for a more complex patient population. The few experienced nurses that remain have high standards and are burnt out from this past year. The last thing they want to do is precept more new grads, but that is the reality we are in. How do I as a leader help these experienced nurses become inspired to teach and see the potential in this new generation of nurses again?”

Kerry’s situation is a common one in healthcare environments today. Nurse staffing is now a critical issue in most health systems now battling a fourth pandemic wave. When nurse managers can fill their vacancies – it is often with new graduates who come with significant skill gaps due to fewer direct care clinical experiences and more simulation. At the same time, seasoned and experienced nurses are burned out and exhausted from caring for high acuity COVID patients. The last thing that many want to do right now is to precept a new graduate. Yet if new graduates don’t get a good onboarding experience, we know that there is a high risk that they won’t stay. So in many ways, preceptors have become critical linchpins to staff retention.

Managers have been asking me recently whether their staff should be able to opt-out from being preceptors. The answer is to this question is complex. If nurses are truly burned out, exhausted, and disengaged, they are unlikely to be effective preceptors. On the other hand, what if you as a manager have few other options. This topic has come up in the retention workshops that I have been doing. Managers have suggested the following ideas to combat the current dilemma:

Six-week preceptor rotation experience – six on and six off.
Reduced patient care assignments for preceptors.
Preceptor appreciation days each quarter.
Preceptor support groups.
Premium pay for preceptors.
Using part-time retired nurses to precept new staff in groups of 3-4.
A preceptor rewards programs where preceptors receive points that they can use for gifts.
Rotating all new graduates through a dedicated education unit that is staffed to support intensive precepting.

There is a second part of this problem that involves today’s new graduates themselves. New nurses are stressed, anxious, and usually self-oriented. Most don’t realize that nurses on their units have experienced trauma and are emotionally fragile. Showing appreciation to a preceptor for their work is not something all new graduates will do naturally. Leaders tell me that many new graduates arrive on their units and immediately tell their preceptors that they will gain some experience but plan to return to school to become NPs and CRNAs as soon as possible. This often results in preceptors feeling like they are wasting their time in an endless cycle of orientation.

We know from resilience work that preceptors need the following:

To feel valued for the work that they do.
To feel like they are making a difference.
To feel a sense of accomplishment.
To have the support of their leaders and organization.

During onboarding today, nurse managers and residency program coordinators should talk to new nurses about how challenging the preceptor role is in the current environment. Sensitivity (don’t announce on day 1 that your career goals are not to stay with this team) and gratitude would go a long way along with the strategies mentioned above. At the end of each shift, the new graduate could be encouraged to share the following three things with their preceptor:

What I most appreciate that you did for me today was ………………………….

One thing I learned from you today that I did not know before was ………………………….

Thank you for being my preceptor and investing in me.

There are no easy answers to preceptor burnout, but special recognition from the leader, the organization, and the new nurse is a good start.

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