Shortage of Nurse Practitioner Preceptors

[ashonman]

Is there a national shortage of Nurse Practitioners who are willing to precept? I am finding it very difficult to find a preceptor, MD's are very quick to offer what they have, unfortunately as a NP student I have to have a FNP/NP for at least 50% of my 704 hrs. As Nurses/NPs we are asking and fighting for autonomy but not willing to help train more NPs to fight this cause. It is so easy for PA's to have their rotations lined up for them but can not do that for nursing? I am seeing more and more schools (Not just online schools) shifting that responsibility onto students. I love my school, great state school; but this issue of finding preceptors on our own bothers me, and they tell you today, when school starts in 10 days. However, if we are unable to find one, then "the school will step in". I just don't get it! I taught undergrad was difficult with unreasonable demands, but graduate school too? Are nurses in a way still eating their young? or now they are just putting hot sauce on it!

[Cessna172]

We also have to find our own preceptors. Luckily it can be MD or NPs who precept us. Last semester I almost didn't have an OB preceptor. She is the most kind person you could meet, but had quit precepting several years ago after having some problems with students at a different college. She agreed to be my preceptor and it was great, I hope she resumes having students again. Nonetheless, I do wish more NPs were available to precept too.

[traumaRUs, MSN, APRN]

I work in multiple dialysis clinics and even though I work FOR the physician practice, I'm credentialed to see pts at the dialysis units and they forbid anyone who is not credentialed from being present.

[elkpark]

I attended a graduate program (CNS track, not NP -- but the NP tracks worked the same way) that arranged our clinicals the same way undergraduate programs do, and all practica were taught by individuals who were full- or part-time faculty at the school and took place within facilities/organizations with which the school had a long-standing, established relationship -- so the school knew exactly what caliber of clinical education we were getting. I can't imagine paying tuition to a school that did it any other way, and I think this trend toward leaving students to fend for themselves significantly diminishes advanced practice nursing education.

[elkpark]

(Ooops, duplicate post. Sorry.)

[CCRNDiva, BSN, RN]

Totally agree, elkpark. I think it is unethical for schools to charge tuition for clinical credit hours while not providing clinical assignments. Can you imagine med students going from office to office begging for a physician to train them? Or how about pharmacy or law students begging for professionals to take the time to train them while the school collects the tuition? Sounds kind of ridiculous, doesn't it?

[Corey Narry, MSN, RN, NP]

I hate to say it but to me, it boils down to the loose standards the nurse practitioner field has created. There are so many NP programs with multiple formats (campus based, online, combination of both), dual entry models (direct entry, traditional), multiple certification boards competing against each other (ANCC, AANP, AACN, PNCB, NCC), disagreement over entry degree requirement (MSN vs DNP), a separate organization for NP faculty that is not a regulatory or accrediting board (NONPF), and an accrediting body that has no exclusive interest in the NP field (AACN). The result is a group of disconnected entities with their own separate agendas none of which involves creating a seamless, consistent, and rigorous training program for future NP's. Come on, the best we could come up with is a so-called Consensus Model that ironically does not reflect a consensus across NP's in clinical practice but rather a statement of meeting minutes from an agenda created by non-clinical leaders of disconnected organizations who could care less about improving clinical practice.

Currently, NP preceptors are unpaid, volunteer faculty. Some faculty members in any given university may have dual appointments as faculty and clinician in a clinical area of practice and may precept but I have not known of any program where preceptors receive separate compensation for precepting from the educational institution that is housing the NP program. There is no incentive to precept other than being granted credit toward recertification. Precepting takes effort and it adds the burden of taking extra time to provide teaching in addition to the typical patient care activities NP's already engage in. As a result, it is typically the well-established universities with long-standing affiliations with teaching hospitals and medical centers who have the ability to arrange clinical rotations for its NP students. I work for an academic medical center where the NP's on staff like myself are expected to precept students from the NP program the medical center is affiliated with. That does make it easy for the students in our university but others in different programs certainly suffer.

[CCRNDiva, BSN, RN]

Juan, I couldn't have said it better myself. Also of note, my ACNP director told us that they have also been getting competition from primary care (FNP, ANP) programs placing their students in in-patient environments to fulfill clinical requirements. My program is in a major metropolitan area that has 7 med schools, and at least 4 major university graduate nursing programs, not to mention several smaller programs and PA programs. There is major competition for preceptors.

Thankfully, I attend a university program affiliated with a large medical center like Juan described. Unfortunately they have had to limit the number of applicants accepted into their FNP program due to the limited availability of preceptors. They are pretty strict with where students complete clinicals, they want primary care students in primary care clinicals, and acute care students in acute care placements.

[traumarnrodney]

I also had difficulties find a preceptor for my FNP clinicals this spring. U must have asked around 30 providers before the perfect situation dropped in my lap. I primary care practice whose MD and 2 NPs all went to the same university as my program. Check for local alumni from your program. They ate almost always willing to help a future alum.

[Gator FNP]

I am a family ARNP. I wanted to be a preceptor, however, my salary depended on the number of patients seen daily in the office.

As I know from being a student, we slow down the provider. At my last clinic, I would see approximately 20-25 patients daily. I gave my patients my full attention and ended up working until 7:30-8 pm catching up on my charting (this was without a student).

I now work in a teaching hospital and precept nurse anesthetist students (during their health assessment class). The atmosphere here is very different since we are an academic, teaching hospital.

I hope this helps clarify the current lack of preceptors out in the community.

[DuckFan23]

Ashonman-I too had the same issue here in Oregon. It delayed me a full 6mos because I simply could not find one who would commit the the amount of hours to precept. I also had a few preceptors that simply did not work out. I did try one with a physician-but she was so controlling that I could not progress to the point where I could take a few patients and, with her assistance, manage them. I also did what would have been a great rotation with a geriatric NP that rounded in 3 nursing homes-he would have been great to be with-but he was so overworked that it wasn't helpful for him to take on a student. So even if you find one, sometimes it doesn't go as planned. In the end I found a fantastic preceptor at Kaiser Perm-and absolutely loved the experience. Keep at it-persistance and keeping a positive outlook is a must. Don't get discouraged! :) Hang in there.

[mellebelle]

Is there a national shortage of Nurse Practitioners who are willing to precept? I am finding it very difficult to find a preceptor, MD's are very quick to offer what they have, unfortunately as a NP student I have to have a FNP/NP for at least 50% of my 704 hrs. As Nurses/NPs we are asking and fighting for autonomy but not willing to help train more NPs to fight this cause. It is so easy for PA's to have their rotations lined up for them but can not do that for nursing? I am seeing more and more schools (Not just online schools) shifting that responsibility onto students. I love my school, great state school; but this issue of finding preceptors on our own bothers me, and they tell you today, when school starts in 10 days. However, if we are unable to find one, then "the school will step in". I just don't get it! I taught undergrad was difficult with unreasonable demands, but graduate school too? Are nurses in a way still eating their young? or now they are just putting hot sauce on it!

I am a Family Nurse Practitioner working in NC and recently responded to a survey (?) or a poll (?) from one of the professional advanced NP organizations (ancc) or (acnp) or (ana-np specific)...well anyway, I responded that I'd be happy to precept-any student that needed my time or guidance. THE REASON: Because I remember how difficult it was (12 years ago) to find willing preceptors...or even to approach a colleague to mention that I needed a preceptor. Reviewing these posts, makes me feel that some of us "older birds" have forgotten how difficult it was to build that first nest. If any of us more experienced "older birds" are reading this and would like to search our memory banks for what it was like to acquie preceptors when "we were back in time", please feel free to respond or post somewhere on this forum that you'd be glad to precept or you know a fellow NP who'd be willing to precept.

I'd love to precept....please respond. I am in NC in the Triad region-working in ED. Have no fear-I do not bark-I have not eaten anything young in years...well except my morning eggs!