Discouraged with NP programs

  1. Hi All; I am new to this site and wanted to get your options about the current state of NP programs. I started a FNP program at a brick and mortar university and did well my first semester. The discouraging aspect is we need to find our own preceptors for all clinicals. I have found that to be daunting. I seems that NPs and docs are burned out from precepting and I can understand that.

    There seems to be a surplus of NP students who need preceptors and a shortage of preceptors. I am discouraged and thinking about changing my MSN program from FNP to Nurse educator or administrater.

    Please tell me how your experiences have been with getting preceptors. I am searching for a reason to continue the FNP program and finding it difficult. I am on the "fence" and starting to think that the program will be impossible to complete.

    Thank you in advance.
    Last edit by Joe V on Jan 2, '13
  2. Visit greatpyr profile page

    About greatpyr

    Joined: Dec '12; Posts: 6; Likes: 6


  3. by   elkpark
    There are a lot of threads here about this topic, and a lot of people have had trouble finding preceptors (some have had to quit their programs and not graduate). There are also a lot of us who feel this is a really bad practice by some schools that should be stopped. Not all schools do this -- at the graduate program I attended, all the clinicals were arranged by the school and precepted by individuals who were full- or part-time faculty of the school, at facilities where they were employed and which had established relationships with the school. I would never have paid tuition to a school that expected me to find my own clinicals and preceptors. However, that was a "brick & mortar" school (that I packed up and moved cross-country to attend) -- I can see that the popularity of on-line programs puts schools in a difficult spot. Everyone now expects to be able to get whatever graduate degree they want in their own home, in their own town -- if that's the case, I guess people are going to have to find their own preceptors, because schools clearly can't be expected to arrange clinicals in every little town in the US. I think it's a pretty poor excuse for graduate education in nursing, though -- no wonder we don't get taken seriously by the other professions and academic disciplines.

    I hope that you will be able to work something out. Best wishes!
  4. by   traumaRUs
    What about a list from the school for prior preceptors? Your states APN organization? Your states specialty organization, ENA, ANNA, etc.?
  5. by   elkpark
    Quote from traumaRUs
    What about a list from the school for prior preceptors? Your states APN organization? Your states specialty organization, ENA, ANNA, etc.?
    Good suggestions; I know that my former state BON maintained records of who and where the advanced practice nurses in the state were -- I got contacted a few times over the years by individuals who had asked to be put in touch with someone with my credentials in my geographical area. Professional organizations can also be a good way to network and connect with people.
  6. by   myelin
    Consider switching to a school that actually provides the entirety of your education, including clinicals. There are many out there. These schools that get away without providing clinical training should be shut down.
  7. by   ChristineN
    Quote from myelin
    Consider switching to a school that actually provides the entirety of your education, including clinicals. There are many out there. These schools that get away without providing clinical training should be shut down.
    While I agree that brick and mortar schools should set up clinical sites, advising the OP to find a new program is not helpful. I am currently in a brick and mortar program, and while I admit that my program does seem to be lacking in some areas, most schools will only accept a max of 6 grad credits for transfer. I think Ellpark's advice was good about contacting state nursing organizations. I would also contact your state and/or local APN organization. Ask your teachers if they have any recommendations, or who students have used in the past. Ask doctors/NP's at work if they will precept you, and if not, if there are people they would recommend. My school will locate clinical sites but I have opted to find my own since I am attending a school that is not local to my location (I drive approximately 2-3hrs each way for classes).
  8. by   mom2cka
    I've also needed to arrange my own, attend a brick & mortar with a mostly online format, and they can help somewhat to arrange at a location ~ 3 hours from my home - usually only if I'm unable to find my own. One of my classmates had to do that. But... I asked my own OB/GYN 3 years in advance (knowing this was going to come up when I started school), my kid's pediatrician, my own FNP... turns out, I had the one set up and that 'in' gave me another option to work with an internal med physician instead of my FNP. Networking at work got me the final clinical... talk to classmates, go back to high school if you need, talk to those who've been through the program, find out who arranges the med students at your local hospital, talk to your coworkers, call smaller clinicals in your area (I'm semi-rural so there's not the competition of some clinics in the metro areas) and be willing to do work where and when you can to get this done. It wasn't easy, but lining them up a semester in advance allowed me to focus on the current activities and not stress about that. Good luck!
  9. by   Palliative Care, DNP
    I am about to begin my 3rd semester of a BSN to DNP program. I had a helluva time finding preceptors for this spring. I found my OB preceptor at the very last possible second before being told I would be held back a year. If that had occured I would have most definitely applied to the PA program at the closest medical school. It is absolutely ludicrous that NPs must struggle with placement when PAs and MDs do not.
  10. by   greatpyr
    Thank you for your reply. Actually the brick and mortar school that I have attended last semester is the school that requests we find our own preceptors.
    Their rationale is that they are severely short on facility and they need the student to do the preceptor foot work.
    Needless to say I am pulling out of that program because of this practice as it does diminish my opinion on the quality of education I would be receiving. Who's to say a student does not precept with a friend who will just sign that student off on assessment skills they have not really acquired?
    I am so discouraged, I have been a nurse for 20 years and have worked in my disciplines. I can not ask a colleague (actually it would be 4-5 collegues) to take all this time to work with me. I have thought of providing a decent compensation -

    Anyway - I am trying to find reasons to continue with the FNP program but am struggling.
  11. by   greatpyr
    I realize I will need to ask my colleagues to precept but I am finding it difficult to have the nerve to do that. I seems everyone is so burnt and overworked - it is hard to ask for something that will add to their plate.

    This is a problem and I am not sure how to handle it. I have gone through my local NP chapter - most are tied into a school and have committments to the school.

    Oh well this is my problem.
  12. by   Annaiya
    This is my perspective, and maybe it will help give you the courage to ask. There is a shortage of NPs, and while the schools try to graduate more students, there will be more students than preceptors. However, if the NPs who are working don't precept, then there will be no new NPs and they will be even more overworked. As nurses, we are all used to having to teach the next generation. It is just part of being a nurse. Precepting a student makes the preceptor stay up-to-date on information and keeps them in touch in what the current students are being taught by their schools. Plus as you get further along in your clinical semesters, you will be able to help with their work-load, by doing some of the work and they can just review and sign off on it. It is not like an RN program. You should start with a pretty good idea of what you need to be doing. It varies somewhat on settings, but for my primary care hours, I was going in and doing all of the initial questions and exam on my second day of clinical. Then I reported to my preceptor when I learned and found and she would go in and just confirm that I didn't miss anything and put a plan together. I have never felt like a burden to my preceptor. You don't need to compensate them for their time. Just make sure you're a good, prepared, interested student. There are very few nurses who don't like teaching (the profession is a bad fit if you hate teaching, lol), so just be the type of student that is fun to teach

    Good luck in your search. I had to find all of my preceptors for my program and this worked out great for me. The only time I had trouble was for primary care. But I loved the flexibility to work with the people that I thought could teach me the most. It isn't all bad finding your own preceptors.
  13. by   elkpark
    Quote from Annaiya
    I have never felt like a burden to my preceptor.
    The perspective is a little different from the "other side." I'm a psych CNS who has precepted psych CNS and NP students. It's up to my boss to agree to accept a student or not, and then the individual gets assigned to me (although I have the option of refusing and other arrangements would be made). I am happy to do it, but I can tell you that, even though the students have been bright and making a good effort and "burden" is probably too strong a word, there was no point in the process at which they didn't require extra time and effort on my part. I'm sure that the students I've had don't "feel" like they've been a burden to me, either, but the reality is that they do make my job harder and take longer for the duration of their preceptorships (although, again, "burden" seems strong to me) and I get no compensation for the additional effort and time required of me. Not a criticism, just a different point of view.
  14. by   mammac5
    It's a difficult situation. I arranged my own clinical sites because I wanted them local to my home. Others in my program were assigned to sites within a 2-hour driving distance from the location of the university. To each his/her own.

    I think my experience was typical in that out of three rotations, one was really awful. Some fellow students drove long distances to have awful experiences, so I count myself lucky that at least I didn't spend as much time in my car. By "awful" I mean working with docs/NPP who won't let you do anything but observe, complain about how much time you're wasting for them, witnessing some unethical billing practices, etc.

    So why does anyone precept students? Because THEY had to be precepted themselves. Because it can be a wonderful learning experience. Because it's our chance as practitioners to influence the practice of a whole new crop of graduates. Because we can learn from students who use new software to research EBP, or who are aware of recent changes in guidelines for practice, or whose enthusiasm just rubs off on us if we are jaded in our work.

    Most preceptors get no financial remuneration for their services. Smart potential preceptors will ask for some intangibles, though, from whatever university approaches them - access to the university online library, privileges to sit in on lectures of interest at no cost (and for no credit, obviously), listing as official nonpaid faculty (looks good on the resume), etc.