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The art of balance: Preceptors’ experiences of caring for deteriorating patients

AIM
To explore nurse preceptors' experiences of caring for deteriorating patients while providing guidance and supervision to a new graduate nurse.


BACKGROUND
Fostering novice nurse development during high-stakes encounters may be challenging for preceptors. Despite myriad preceptor literature, there is limited published research on experience of caring for deteriorating patients while serving as preceptor to a novice nurse.


DESIGN
Qualitative interpretive phenomenological analysis.


METHOD
Data were collected through one-on-one, semistructured interviews between August 2016-September 2017 until data saturation occurred. Diekelmann's method was used to analyse the narratives of the purposive sample of 11 nurse preceptors.


RESULTS
The findings reveal the experience of preceptors as they balanced their role as nurse with preceptor role to ensure patient safety and novice nurse development. Supporting the novice to care portrays the ways preceptors facilitated novice nurse development in caring for deteriorating patients. Impacting the preceptor role was remembering their own novice experience. Knowing when to step in was influenced by the preceptor's clinical expertise as they came to know (or not) when it was necessary for them to assume care of the patient. Debriefing: an essential preceptor tool emerged as a critical aspect of the experience to review technical aspects of care, vent emotions and provide evaluative feedback and reassurance to the novice.


CONCLUSION
Preceptors' experiences of caring for deteriorating patients while precepting novice nurses require a balancing of roles to ensure patient safety and novice nurse development. Preceptors' clinical expertise was critical in knowing when to step in and assume care of the patient.


RELEVANCE TO CLINICAL PRACTICE
Caring for deteriorating patients while serving as preceptor to novice nurses requires clinical expertise to ensure patient safety and novice nurse development. Clinical leaders may use the findings from this study to improve preceptor development and support.