A new-to-practice nurse in the third week of nursing orientation in a busy surgical unit is assigned to care for a 65-year-old male who was admitted to the unit after having had total knee replacement surgery. Upon entering the room, the patient is alert and oriented and happy that his procedure has been successful, but while the nurse performs a head-to-toe assessment, the patient becomes diaphoretic with sudden slurred speech. He cannot effectively move his left arm. The new-to-practice nurse realizes something is wrong, and leaves the patient to find the nurse preceptor. The preceptor arrives and immediately calls for the rapid response team. When the team arrives, many questions are being asked quickly, lab tests are being drawn, and the room is filled with controlled chaos. Feeling inadequate, the new-to-practice nurse stays off to the side of the room hoping that no one asks any further questions. The patient is sent for a stat CT scan and then transferred to the neuro ICU. The nurse preceptor seems disappointed in the new-to-practice nurse’s care and provides harsh feedback regarding the way the emergency was handled.

1.

Recognizing Benner’s levels of proficiency, at what stage of proficiency is the new-to-practice nurse practicing?

2.

What would have been the professional action for the preceptor to take to prevent feelings of inadequacy for the new-to-practice nurse?

3.

How can the new-to-practice nurse address concerns regarding the preceptor’s approach and delivery of feedback?

4.

How can the new nurse improve performance?