Nurse Preceptors: Assisting New Graduates Through Reality Shock

It has been said that “in theory, there is no difference between practice and theory. But, in practice, there is.” This quote may best explain the reality shock phenomena found in nursing.

Reality shock is the reaction of new graduate nurses when they discover that the work situation that they have prepared for does not exactly operate within the values and ideals they had anticipated. As a preceptor, understanding and recognizing the phases of reality shock will assist you in helping your preceptee to successfully work through these phases.

Honeymoon Phase

Preceptee’s Behavior              

1. high energy

2. fascinated by the newness of the experience

3. focused on skill mastery and fitting into new role

Preceptor’s Role

1. harness energy and enthusiasm for learning

2. be realistic, but do not put out their fire

3. assist in socialization and integration into their new culture

Shock Phase

Preceptee’s Behavior

1. experience frustration with conflicting values/practice

2. generally become negative

Preceptor’s Role

1. offer support — be a good, nonjudgmental listener

2. offer objective points of view by acknowledging negative and highlighting the positives

Recovery Phase

Preceptee’s Behavior

1. lessened tension/anxiety

2. objectively evaluates situations

3. differentiates between effective/ineffective behavior

Preceptor’s Role

1. assist in seeing the positives

2. support participation in improving the work environment

Resolution Phase

Preceptee’s Behavior

1. understands/accepts role in work environment/culture

2. conflicts resolved between school/work cultures

Preceptor’s Role

1. assist in use of new coping skills

2. acknowledge milestones

Helpful Attitudes for Preceptors, Preceptees

1. If at first you don’t succeed, try, try again.

2. Conflict is healthy, if it is dealt with directly and creatively.

3. There are at least two good solutions to every problem.  Keep an open mind.

4. Work that is meaningful is important. What you do everyday is important.

5. Develop a tolerance for your own uncertainty and conflicts. Be patient with yourself.

6. Develop interpersonal competency for maximum effectiveness. This is as important as learning to start an IV or transfuse a unit of blood.

7. Recognize that outside support is sometimes necessary and more than okay. Nursing is a team sport!

This has been shared with permission from the Health Alliance of MidAmerica, LLC as part of the Preceptor Academy.