Rebuilding Precepting

The June 2025 editorial about the preceptor shortage1 resonated deeply with our team. It affirmed what many of us in acute care settings have long experienced, that the traditional 1:1 preceptorship model, though once effective, is no longer sufficient with the widening gap among preceptor experience, increased patient care complexity, and workforce instability.Even as a 4-time Magnet designated facility accredited by the American Nurses Credentialing Center Transition to Practice Program, we have witnessed firsthand the impact of challenges to onboarding and nurse retention. In the typical orientation model, preceptors are often highly skilled clinicians, and many are not adequately prepared in foundational preceptorship competencies, such as adult learning theory, feedback delivery, and psychological safety, yet they are expected to mentor and educate new nurses while providing direct care to critically ill patients in high-acuity environments.2 Compounding this issue is the persistent struggle of nationwide nursing shortages. According to the 2025 NSI National Health Care Retention & RN Staffing Report,3 hospitals averaged a 9.9% nurse vacancy rate in 2024. Preceptors are stretched thin between patient care demands and orientee guidance.4 The result is prolonged orientation timelines, diminished onboarding quality, and reduced retention. Ultimately, this systemic strain undermines the health care organization’s ability to successfully integrate and retain new staff, despite a clear and enduring commitment to excellence in nursing practice.In an effort to reduce our dependence on contract labor and rebuild our community workforce, our intensive care unit oriented 50 new nurses in 2024. Nearly half of them were new graduates. Although this influx did address staffing gaps in the short term, our 1-year turnover rate increased from 18% in 2023 to 60% in 2024. This situation underscores the June editorial’s central concern, namely, without structural investment in the preceptor role, both retention and workforce culture suffer.Inspired by national exemplars such as the ENGAGE model2 and the wealth of literature published by Drs Ulrich5 and Porter-O’Grady,6 our team launched a research study with a redesigned orientation structure and an overall goal of reducing first year turnover and improving preceptor and orientee satisfaction. Our study is in progress with preliminary 6-month data available around January 2026, and the plan is to collect data for 2 years. Our aim is not just to orient nurses but to rebuild preceptorship as a clinical leadership role and safeguard the cultural hand-off essential to unit cohesion and safety. We have integrated digital tracking and real-time feedback tools to better support both orientees and preceptors.We believe that nursing must rewire, not just refill, our orientation models. By protecting preceptor time, compensating their contribution appropriately, and providing leadership and peer support, we can meet the future with intention rather than attrition. We commend Critical Care Nurse for amplifying this national conversation and hope that sharing our early-stage efforts will encourage other institutions to innovate boldly and collaboratively.