Prescribing Nursing Practice In Nursing Education What Is Prescribing in Nursing?

In nursing, “prescribing” refers to the process of guiding and facilitating the development of nursing knowledge and skills in learners, whether they are students in educational programs or new staff members in clinical settings. Although the term “prescribing” is often associated with the act of giving medication, in the context of nursing education, it more accurately relates to the role of precepting.

Precepting involves a structured and time-defined relationship where a more experienced nurse, known as the preceptor, models, explains, and shares the realities of nursing practice with the learner. The aim is to bridge the gap between theoretical knowledge acquired in the classroom and the practical application of that knowledge in a real-world clinical environment. This involves an introduction to the work environment, individualized teaching, and immersion into everyday nursing practice, ultimately aiming to enhance the learner’s knowledge, skills, and patient care quality.

Implementations in Nursing Education

In nursing education, precepting is a crucial component, providing students with practical, hands-on experience under the guidance of an experienced nurse. This model helps nursing students develop their clinical skills, professional attitudes, and knowledge through direct interaction with patients and participation in the clinical setting.

Historical and Evolving Models:

• Traditional Approach: Traditionally, precepting was utilized primarily during the final semester or capstone experience of the nursing curriculum. This approach allowed students to apply their academic learning in a real clinical setting, preparing them for professional practice.
• Modern Models: Contemporary nursing education has evolved to incorporate various models such as clinical-academic partnerships, immersion learning, and dedicated education units. These models have expanded the use of precepting throughout the nursing program, providing students with more comprehensive exposure to clinical practice. This extended approach helps students understand the complexities of nursing roles and responsibilities beyond individual patient care to encompass multi-patient assignments and broader professional duties (Dean et al., 2013; Jeffries et al., 2013; Raines, 2009).

Phases of Precepting:

1. Planning: In this phase, the preceptor assesses the learner’s prior experiences and learning style, which may be facilitated by the faculty member before the student begins clinical rotations. The preceptor reviews patient care assignments, identifies learning opportunities, and sets goals and priorities for the day’s clinical activities.
2. Doing: During this phase, the preceptor and learner work together to provide patient care. The preceptor demonstrates nursing tasks and responsibilities while the learner performs these activities with guidance and support, allowing for hands-on learning and skill development.
3. Evaluating: The final phase involves reflecting on the day’s activities, evaluating the learner’s performance, and providing constructive feedback. This phase is critical for reinforcing learning and guiding the learner towards continuous improvement.

Importance of Perception in Nursing Education

Perception plays a significant role in nursing education, especially in the context of precepting. The actions and behaviors of the preceptor significantly influence the learner’s understanding and perception of nursing practice.

Key Aspects of Effective Precepting:

• Positive Attributes: Effective preceptors are often characterized by their empathy, respect, humor, fairness, flexibility, and dependability (Stiffler et al., 2009). These qualities help build a positive and supportive learning environment, enhancing the learner’s educational experience.
• Complexity of Precepting: Precepting is a multifaceted activity that requires strong clinical skills, the ability to explain complex nursing practices, and excellent interpersonal skills. Preceptors must simultaneously act as teachers, counselors, role models, coaches, protectors, socializers, experts, and leaders (Barker & Pittman, 2010; Carlson, 2013).
• Communication and Feedback: Effective precepting involves open communication and ongoing feedback. Preceptors need to work closely with learners and faculty members to ensure that educational goals are met and that the learner’s progress is monitored and supported.

Precepting vs. Mentoring:

• Precepting: Precepting is a structured, time-limited educational relationship focused on specific learning objectives and practical skill development in a clinical setting. It bridges the gap between theory and practice and is essential for transitioning from classroom learning to professional nursing practice.
• Mentoring: In contrast, mentoring is a broader, often voluntary relationship that focuses on personal and professional growth, support, and inspiration. Mentoring relationships typically evolve over time and may include personal and emotional bonds, without a specific agenda or time frame (Yonge Billay, Myrick, & Luhanga, 2007).

Effects of Precepting and Prescribing in Nursing Education

Precepting has a profound impact on both the learners and the clinical environment. It is crucial for preparing the next generation of nurses and integrating new staff into their roles and responsibilities.

Impact on Learners:

• Skill Development: Precepting helps learners develop essential clinical skills and professional attitudes, providing them with practical experience and confidence in their abilities.
• Role Socialization: It facilitates the socialization process, helping learners understand their roles and responsibilities within the healthcare setting and adapt to the complexities of nursing practice.

Impact on Clinical Practice:

• Quality of Care: Effective precepting contributes to improved patient care quality by ensuring that new nurses are well-prepared to perform their duties competently.
• Professional Development: Precepting also provides opportunities for preceptors to enhance their teaching and leadership skills, contributing to their professional growth.

Future Directions: As nursing education continues to evolve, it is important to evaluate the impact of precepting on learning outcomes and the professional development of preceptors. Research into collaborative academic-clinical partnerships and the effectiveness of precepting models can provide valuable insights into improving nursing education and practice (Dean et al., 2013; Jeffries et al., 2013).

Conclusion

The concepts of prescribing and precepting are integral to nursing education, bridging the gap between theoretical learning and practical application. Effective precepting requires skilled, empathetic preceptors who can guide learners through their clinical experiences, fostering their development and preparing them for professional practice. By investing in the preparation and support of preceptors, nursing education programs can enhance the quality of education and ultimately improve patient care outcomes.