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Practice comment

‘Preceptorship support is an effective way to invest in NQNs’

Bill Whitehead

To attract newly qualified nurses, employers need to offer high-quality preceptor support, says Bill Whitehead, while newly qualified nurses need to shop around for good preceptorship in their first job

There is a UK-wide shortage of registered nurses. This isn’t because there are too few applicants applying to university, rather we are not training enough for the increasing demands of an ageing society. And then we don’t look after the nurses we have well enough to retain them in sufficient numbers. Once nurses have qualified, employers need to ensure they have the right pay, working conditions, professional support, post-registration access to education and training, and career prospects.

A big part of looking after nurses is supporting them during the transition from student to registrant. Although an exciting achievement, this can be a stressful time due to the shock of moving from the protected role of student to the professionally responsible role of registered nurse. Nurses must put the caring and life-supporting skills and knowledge they have been accumulating into action. This has been recognised as a difficult time since at least the 1970s, when Marlene Kramer presented her research prompted by statistics indicating that a large proportion of newly qualified nurses (NQNs) left the profession within the first few years after qualifying. The stresses of becoming a nurse she described 40 years ago have, if anything, increased.

Fortunately, this hasn’t gone unnoticed and a good amount of research has been conducted to find the best ways to support NQNs. Part of this has been undertaken by myself, researchers at the University of Derby and by local employers.

Most employers provide preceptorship support for NQNs. Our systematic review showed that doing so is better than providing no support for NQNs; consequently, research is now focused on how best to provide this. Our primary research outcomes were that NQNs need good support from more experienced nurses and the employing organisation as a whole. NQNs were competent to perform the role of the nurse but often lacked confidence. Three main recommendations emerged: employers should provide a culture of support for preceptors and preceptees to make them feel valued and supported, the preceptorship role should be recognised in a governance framework, and there should be an individualised programme of support for each preceptee based on their own needs and those of their first area of employment.

From these findings, we designed a toolkit to support preceptorship; the investment made in supporting NQNs was found to be worthwhile as it builds on skills and knowledge, as well as improving recruitment and retention.

The Nursing and Midwifery Council has recently reviewed its standards for nursing and continues to recommend a period of preceptorship support. Investment in high-quality NQN support will become increasingly important as demands on new graduates increase in line with improvements in healthcare technology and greater demands for care globally.

NQNs are a valuable, sought-after commodity. They can use their market power to ensure they get the best deal for their first post. Top tips for them from our research were to find out what preceptorship is on offer: remember, this is your first job not your last – if there’s no support, other employers are likely to offer a better preceptorship experience.

The advice to employers is to provide that supportive preceptorship experience to attract and retain nurses. Most importantly, we should be nice to our NQNs otherwise we will lose them.

Bill Whitehead is deputy dean at the College of Health and Social Care, University of Derby.

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Readers' comments (2)

  • This is an excellent point and this article highlights the life and professional skills needed for this demanding yet rewarding profession.
    We should be (and often are) developing the support skills and networks before qualification, as well as post qualification. My research on the peer support systems available within undergraduate curricula in nursing and other programmes shows many skills being developed that are transferable to NQN support. It should be a seamless developmental progression, supporting those who support and care for others.

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  • bill whitehead

    thanks for your positive comments Jaden. I'd be interested in seeing your research into peer support. An important finding from our preceptorship research was that peer support is one of the best ways for NQNs to benchmark their abilities and helps them see that they are progressing at a reasonable rate. Otherwise, often, NQNs continuously compare themselves with more experienced staff and feel that they will never be good enough.

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