ACNPs-what was your preceptorship experience?

[Weeziebeth]

I am in the process of designing my DNP project. The basic idea is the design of an intra-institutional partnership (hospital, physician practice(s), and university) to provide a structured preceptorship experience. The idea would be provide clinical experience for a set number of students over the course of their entire clinical course-so 2-3 semesters. It would hopefully provide more of a comprehensive, residency-type experience, students would not have to scramble for clinical experiences, and potential employers could get an idea of potential job-candidates while participating in their educational experience.

My question(s), particularly for those of you operating in the ACNP role, is what was your school clinical experience like? Was it more structured or loosely organized? What would you have wanted your clinical experience to look like in comparison to what it was? I know this is asking quite a bit, but any information you all can provide would be greatly appreciated.

[Corey Narry, MSN, RN, NP]

I graduated years ago, 2003. Our school arranged our clinical sites but it was still very much individualized based on the student's stated goals as the school always said back then. We had a range of sites from Hospitalist to Critical Care to other specialties such as Emergency, Cardiology, Neurosurgery, even Trauma. There were many graduates of the program in the area who found good jobs all over the metro area and were willing to be preceptors for their alma mater.

However, because experiences were individualized, students graduate with mixed skill sets depending on what clinical rotations they did. Some benefitted from this arrangement - those who did Cardiology rotations got jobs in that field, some got hired in the ED they did clinical rotations in. Some students who were less aggressive and got clinicals handed to them without prior planning or forethought kinda was left with figuring out a niche specialty to apply to after graduation.

I work in a university setting now where we have an ACNP program. Their clinicals are more structured in that all students must have an Internal Medicine/Hospitalist rotation. The hospitalist rotation is excellent as the student is part of a teaching service with an attending, residents, and health professions students of all types. The other rotations are basically electives that students choose based on their preferred specialty or interest. Critical Care and Trauma are offered as options, specialties the program seems to be strong in.

What many ACNP students seem to beg for is a structured simulation experience. Universities should invest in a simulation lab for invasive procedures. Students are always afraid to practice on a patient not having been critiqued by an expert on their technique during a simulation setting.

[Weeziebeth]

Juan, thank you for your response. I am looking to design a program that provides, as you say, a bit more of a consistent skill set and solid foundation. Also looking to expand the simulation experience but 1 step at a time-at least from my project perspective.

[Annaiya, NP]

My clinical experience was completely unstructured. I had to turn in a certain number of notes every semester and I had to do 50 hours of primary care. Other than that, I could do whatever I wanted. For me, this was great. I was able to structure my experiences around what I felt I needed to learn the most. I found all of my clinical instructors in the areas I wanted to be in. We did procedure simulation at school and then I did art lines, central lines, intubations and LPs during clinical. Almost all of my preceptors had over 15 years experience in their field. I feel like my experience prepared me well for my current job.

So I caution you to not be so structured in your design that you prevent students from getting the experience they need. Everyone comes in with a different background and different needs.

Good luck with your project!

[LubbockNP]

I was in the second class of ACNP at Texas Tech and it was very unorganized. I did most of my clinical hours at the SICU/Burn ICU I worked in as a nurse. I regret that deeply. Since graduating in 2004. I have worked at Texas Dept Criminal Justice in patient hospital. I looking to get on with the VA now.