Has anyone went off and did their own clinical time?

ChristineN, BSN, RN · Feb 28, 2013

Just curious if anyone out there has done a few specialty hours in like the ED or ortho and just didn't count it towards their clinical hours? FNP programs obviously won't let you get your hours in the ED but whats the harm in doing it on your own time?[/quote']
Some FNP programs will let you do ER clinical, especially in a Fast Track area. I am trying to set up my own clinicals, including for an ER, but it most certainly will count.

kguill975, MSN, APRN, NP · Feb 28, 2013

I did ER and Ortho as an ACNP student. The ER rotation actually made me regret not doing FNP. You could observe in those departments, but in order to get some experience as a provider, you need to be covered under your school's Liability Insurance, so that means that you need school approval.

TraceyMarino · Mar 2, 2013

I spent some time with a radiologist, reading x-rays...no hands on there, just learning the basics. Spent some time with a derm, that was great too....assessing rashes, moles, etc.

I would have liked to do some ortho, I feel pretty weak in that area, and I am an FNP and see a lot of back pain and wipe outs on the ice....

Spent a couple days with a neurologist, learning how to do a really good neuro exam, this too was just a lot of observation. This was a great experience, because I also learned how to know if a patient is sandbagging or "faking" symptoms for secondary gain.

I was fortunate to know alot of specialists from my previous jobs, and these are good observational areas, where worrying about your malpractice insurance is not an issue. I would have loved to spend time with the orthopedic surgeon but my school discouraged it, and the paperwork to submit a new preceptor was such a pain in the butt I did not do it. I would really recommend spending some time with a radiologist, was very very helpful in my new job. Good luck---if you have the extra time, you can never learn too much!

Roseyposey · Mar 2, 2013

The problem with doing it on your own time is malpractice. Even if the hours don't count toward clinical hours, there needs to be an agreement between the school and the facility for you to be there, to cover them and yourself. I know my program will allow 10% specialty as "observation" time (even if we are technically seeing patients) which can fall outside the class objectives. That being said, I do not think we would be penalized for putting in extra hours for this purpose either, but the paperwork and approvals have to be done ahead of time.

HumptyDumpty · Mar 3, 2013

Thanks, thats what I was curious about. I have spent some days in the ER, and the PA I am following is treating it as a "shadowing" experience. He lets me evaluate, do a quick H&P, and tell him what I think needs to be done. But I don't do anything that would cause any type of malpractice. E.G. Participate in codes, procedures, etc...

Bumashes, MSN, APRN, NP · Mar 4, 2013

So why not do what I do? I finished the required hours in primary care last semester (180), and then did some Inpatient Int Med. They have told me that after I finish my semester hours I can do whatever I want to. They only care that I finish the required amount for whatever they have put forward for the semster. I just have to submit the same forms to them as for the other clinical sites. This is at USA in the AGNP track.

allnurses Guide · Mar 4, 2013

You can do FNP rotations in the ED/UC if you want.

I spent a lot of time in speciality rotations and did extra shadow shifts.

Most often, if you shadow someone, they aren't going to let you do much. If this is an actual clinic rotation, you should be doing it all from assessment to plan to orders to follow-up. If you aren't , talk to your preceptor to find out why? If you are competent, you should be nearly autonomous by your second rotation.

HumptyDumpty · Mar 4, 2013

Well I have just shadowed mostly and practically did everything you mentioned for the most part, but I am mostly worried of getting in trouble. I have a feeling my program isn't gonna let me do a rotation in the ER even though my clinical hours for primary care are just about complete and its now just march.

allnurses Guide · Mar 4, 2013

Well I have just shadowed mostly and practically did everything you mentioned for the most part but I am mostly worried of getting in trouble. I have a feeling my program isn't gonna let me do a rotation in the ER even though my clinical hours for primary care are just about complete and its now just march.[/quote']
How many more rotations do you have? Have you let your school know that you want a ED rotation?

HumptyDumpty · Mar 4, 2013

How many more rotations do you have? Have you let your school know that you want a ED rotation?

I am in my last semester, graduate in May. I have been busting out my hours so to speak. I really wanna work in the ER, so I want to do everything I possibly can to get there.