RSSAuthor Archive for Julie Harris

Julie Harris

Julie Harris MSN, RN, is a nursing education specialist at Arkansas Children’s Hospital in Little Rock, AR, and develops online and classroom curriculums for nurse preceptors. Julie coordinates an acclaimed preceptor program and tele-nursing education series at her facility, and conducts a monthly preceptor workshop packed with practical tips and tools and activities to enhance learning, communication styles, and mentoring capabilities. She is the author of several published abstracts, articles, and learning courses, and the editor of the Arkansas Children's Hospital’s nursing newsletter.

Preceptor perspectives: Reporting a near miss event

by Julie Harris, RN, MSN

Who likes to get in trouble? I know that I sure don’t! Yet, reporting a near miss event sometimes feels like that. Let’s look at a scenario that demonstrates this feeling:

One night Mason noticed a medication error from the pharmacy. They sent up the wrong dose of medication for his patient. After sending the medication back to the pharmacy, Mason filled out an occurrence form and placed it in his manager’s box. Several days later, the manager called him into a meeting with the pharmacy and other managers. They wanted him to explain the near miss event. He did and then was excused from the remainder of the meeting. Mason left feeling like he received a slap on the hand for reporting the near miss. He wondered if he should bother reporting any other near misses in the future.

This scenario is common throughout hospitals and healthcare facilities. Mason felt like he was in trouble for reporting the near miss event.

Many nurses, like Mason, do not see the “big picture” when it comes to reporting a near miss. And many times, this is due to a lack of just culture training from the hospital. Nurses are told they have to report near miss events. But, they are not told why to report such events or the outcomes of their report.

Preceptors can help solve this problem by training orientees and other staff members on the “big picture” of near miss reporting. This training should include:

  • The importance of reporting a near miss event
  • What qualifies as a near miss event
  • How to report a near miss event (i.e. how to fill out the form)
  • Where the report goes after it leaves the nurse
  • Who to contact for follow up
  • Examples of near miss events and their outcomes involving process change, patient safety, etc.

High-quality, safe patient care is the goal for all hospitals and healthcare facilities. Reporting near miss events is one avenue for nurses, especially preceptors, to take in order to achieve this goal!

Preceptor perspectives on a just culture

By Julie Harris, MSN, RN

Just culture. This term has been thrown around in the nursing literature for many years. Many nurses, including preceptors, might think that it was started in healthcare. Actually, healthcare borrowed the idea from the aviation industry. After a terrible plane crash, the aviation industry started a program to change and correct pilots’ behaviors.

About 20 something years later, the Institute of Medicine published a report, “To Err is Human: Building a Safer Health System,” that cited tens of thousands of preventable human deaths per year in United States’ hospitals. This report was a wake-up call to many healthcare leaders. After seeing the success of the aviation industry, many hospitals adapted a similar process and the phrase, “a just culture,” was born.

What does a just culture have to do with me, a preceptor? My answer would be everything. As a preceptor, you are a front line leader. Your peers turn to you for advice, education, and role modeling, especially when it comes to creating and sustaining a just culture in your clinical area. Here are a few points to ponder to determine your fit in a just culture:

  • Do you report near miss events?
  • Do you teach orientees to follow your institution’s policies?
  • Do you proactively report any potential safety hazards?

Over the next several posts, we will examine different aspects of a just culture. We will also explore in-depth a preceptor’s role in creating a just culture. So come along for the just culture ride!

Preceptor Perspectives: I’m a leader, too!

In a complex healthcare environment, nurses seek out other team members they can count on. They want to work with people they can rely on and who can tackle and conquer daily problems. They are looking for leaders.

Leaders demonstrate traits and qualities that help them address nursing issues head on. They motivate other nurses to do their best. Does this description sound familiar? Of course it does – because preceptors are leaders!


Preceptor perspectives: Touch, look, and listen: Incorporate learning styles into orientation

How many times have you tried teaching a new skill to new orientees only for them to not “get it”? What about the hours and energy put in to this effort? If you calculated this up, you may realize just how much effort you really put in to teaching. Chances are, you are not teaching to your orientees’ learning styles.

There are three main types of learning styles: visual, auditory, and kinesthetic. Visual orientees learn by seeing, observing, and picturing things and events. Most people are visual learners. Auditory orientees learn by talking, hearing, and reading. They usually like to talk to themselves as they learn. Kinesthetic orientees learn by actively moving and doing. They often cannot sit still and must move around to keep their attention.


You can’t teach with apathy: Why it’s important to support your preceptors

by Julie Harris, MSN, RN

I occasionally peruse online nursing forums to see what the hot topics are. Last night, I was on a highly popular forum and came across an interesting discussion. A new graduate was being oriented and her preceptors were not interested in training her. She perceived their behavior as intimidating and somewhat hostile and she didn’t know what her next step should be. Should she quit and look for a new job? Should she stick it out?

Responses to her post ranged from “This is part of orientation. Try not to take it personal,” to “Those nurses shouldn’t be preceptors. If this facility supports that kind of behavior, you need to leave and find a new job.”

I find myself agreeing more with the last response. Nobody should be forced to precept. Some nurses are wonderful caregivers with excellent clinical skills; however they do not possess the desire to train orientees. Other nurses have a strong craving to teach and pass on their knowledge to orientees. Both options are perfectly acceptable.


Effective precepting: Giving feedback to orientees

Whenever I conduct a preceptor workshop, I always ask the question, “What is the most difficult aspect of precepting?” I usually get a range of answers, but at least one nurse will always say, “Providing feedback to orientees.” Providing feedback can be difficult, especially if it is your first time doing it.

In a preceptor-orientee relationship, the best type of feedback to provide is constructive feedback. Constructive feedback focuses on improving orientees’ performance by reinforcing desired behavior, and correcting poor performance. It allows orientees to maintain their motivation for learning, and enables them to experience at least partial success.


What is a preceptor?

Ask a new nurse what preceptors are and they may reply “teachers.” At first glance, I agreed with the definition. Preceptors spend a large amount of their time teaching orientees the clinical skills related to their specific role. But as I reflected upon my experience as a preceptor, I realized that preceptors are much more than just teachers or tutors. Preceptors are also:

  • Leaders. A leader is someone who inspires and influences others. Preceptors must be leaders in order to inspire and influence their orientees to learn their new role. This can sometimes be a difficult challenge as conflicts arise. However, a true leader can put differences aside and continue on the orientation journey.