Ask the expert: As a preceptor, how can I help new nurses overcome reality shock?

Staff Development Weekly: Insight on Evidence-Based Practice in Education, November 6, 2009

This week, Diana Swihart, PhD, DMin, MSN, CS, RN-BC, discusses how to determine what phase of reality shock a new nurse is in, and suggests ways to help staff members overcome it.

Q: As a preceptor, how can I help new nurses overcome reality shock and move forward with their day-to-day tasks?

A: New nurses enter their assigned practice settings eager to begin their new jobs, to meet their new colleagues, and to accept their new challenges. However, six months to a year later, disillusionment sets in and this may be when preceptees experience reality shock as they encounter change, conflict, and chaos associated with their new responsibilities.

Before you are able to help them, you must first determine which stage of reality shock they have. There are four phases to reality shock:

Honeymoon phase: Preceptees perceive the employment setting and their new coworkers positively, or through “rose colored glasses.”

Shock phase: Preceptees begin to encounter weaknesses, discrepancies, and inconsistencies in the work environment and their new colleagues.

Recovery phase: Preceptees begin to perceive the realities of the professional practice environment with a balanced view of both negative and positive aspects.

Resolution phase: Caution! Preceptees may adopt less than ideal values or beliefs to resolve the conflicts of values and find ways to 'fit in' with their coworkers.

After establishing which phase they are in, you can determine which ways to assist preceptees in overcoming their reality shock.

  • For a preceptee in the honeymoon phase, harness their enthusiasm for learning new skills and routines, be realistic but do not stifle their enthusiasm.
  • For a preceptee in the shock phase, listen attentively and model the ideals of professional nurses.
  • For a preceptee in the recovery phase, help them view situations realistically, and help them regain their sense of humor.
  • For a preceptee in the resolution phase, assist them in constructive and creative problem solving, and identify and manage any conflicts and confusions that persist.


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