Boycott schools that make you find your own preceptors

BrnEyedGirl, BSN, MSN, RN, APRN · Sep 15, 2014

I am currently scrambling to find preceptors. Every program in my area expects the student to find their own preceptor. I find this problematic for several reasons. One, finding someone is difficult. I was accepted into the program in May of 2014, officially started in August. Every office I have contacted has explained that they have students scheduled through 2016!! These students had to have lined this up before being accepted into the program,....really? My other concern is finding a good preceptor! Someone knowledgeable and able to provide the guidance required to give me the best learning experience I can get! I have no way of knowing who is good, who isn't etc. This is very frustrating. My only other option would be to leave the area, which isn't an option for me. I feel your pain, but not sure what to do about it at this point.

futureeastcoastNP · Sep 15, 2014

Programs do the find your own preceptor thing because they can. Most nurses care more about ease of admissions, as evidenced by the endless threads on this website looking for schools that don't require the GRE, essays, etc. They don't look into education QUALITY and will attend any school, even a for profit program with a stated goal of maximizing profit for stockholders, as long as it means they can become an NP as easily as possible. Since hiring preceptors costs money, schools choose to lay that burden on the student which allows them to take more students and maximize profit. The problem is not just found in for profit schools, many not for profits are guilty as well.

The whole system is a pathetic money scheme...and nurses don't gave a damn. Schools are literally running the NP profession into the ground due to lack of standards, and yet loads of airhead nurses continue to sign up in droves for their entirely self directed, find your own clinicals, online "education". What exactly is the school providing? The classes are pre designed and simply "facilitated" by someone online who checks in every once in a while to make sure people are posting on the discussion forum, the clinicals aren't even set up by the school. Where the hell is the tuition money going in these joke programs? It certainly isn't being spent on the student.

It's disheartening to see how gullible some people are. No other profession would stand for this, but as always nursing can't seem to understand the concept of professionalism. People will read this post, ignore the points, and continue to sing the virtues of these types of schools because it is where THEY attended. Meanwhile the rest of the professional healthcare world will continue to shake their head in disgust as they see ads for the latest "get your DNP in 3 months entirely online!!" advertisement and remind themselves to never hire an NP.

Editorial Team / Admin · Sep 15, 2014

But there are benefits to finding your own preceptor: Your chance of ending up in a location that is a hassle to get to is lessened, you can find someone you "click" with to be your preceptor, and it adds to the ownership of the clinical portion. Plus, many of the schools that do require one to find a preceptor on their own have lists of preceptors/facilities that have served as preceptors in the past for one to start their own search.

I had to find my own preceptor for my MSN in education practicum, and I am actually glad I got to find my own- less than a block from the facility I work at, so it was possible to have clinical hours immediately after my shift to cut down on driving, close to my home (15-20 minutes), and it was with a preceptor who I had met and worked with previously, which enhanced the relationship and practicum experience.

Bottom line, if finding your own preceptor isn't something you want to do, find a school that provides them. Both methods have their plusses and minuses.

zmansc, ASN, RN · Sep 16, 2014

Some prefer to have the flexibility to find their own preceptors, personally I would not want to go to a school that forced me to go to a preceptor I do not know or have input on. I have been able to select the preceptors I believe will give me the best foundation for my future practice. I choose to have several preceptors who have different backgrounds and approaches to their practice. Each preceptor has different strengths and weaknesses. Being able to select my preceptors from my own community, allows me to do my clinical without being forced to incur additional expense for traveling to clinical sites as well. I say stand up and demand the freedom to learn from the best preceptors around!

allnurses Guide · Sep 16, 2014

My personal/professional opinion is that NP programs should not admit more students than they can provide and monitor quality preceptors. The extant literature has demonstrated the importance of clinical preceptorships and mentoring to the education/preparation of novice nurse practitioners; it certainly seems to be an essential part of preparing quality NPs and, professionally, I don't find it acceptable that some programs have relinquished control of this key factor to (what accounts to be) chance. In my humble opinion, students don't have the knowledge to evaluate which providers will be quality preceptors and this should be done by professionals with experience in the field. A student finding a preceptor that saves travel, money, and time is wonderful for the student but there needs to be safeguards in place that ensure that convenience does not come at the expense of education. I know for a fact that there are preceptors out there that students just love but don't provide them with adequate preparation.

For me this boils down to two issues: 1. does the program provide the preceptors to the students and 2. does the program take appropriate measures to vet and monitor preceptors on a dynamic basis. If a program is not actively and continuously vetting/monitoring the preceptors provided than they can actually do more harm than good, so that (for me) becomes the most important part of the equation.

I feel that NP programs can/do have a duty to their students, and to the NP community as a whole, to provide quality preceptors; that statement includes both "quality" and "provide".

Go-GetterRN · Sep 16, 2014

One question I've always had about this issue is, how do programs monitor their student's clinical activity and progression throughout the program if it is an on-line, pick your own preceptor type of program? I wonder this because I personally know a lot of nurses working in my hospital that are concurrently enrolled in an on-line NP program that is located half way across the country. How does this school know that these students are working hard and developing into competent NPs during their clinicals, and not just sitting on a stool in the corner gnawing on a corndog all day?

futureeastcoastNP · Sep 16, 2014

One question I've always had about this issue is, how do programs monitor their student's clinical activity and progression throughout the program if it is an on-line, pick your own preceptor type of program? I wonder this because I personally know a lot of nurses working in my hospital that are concurrently enrolled in an on-line NP program that is located half way across the country. How does this school know that these students are working hard and developing into competent NPs during their clinicals, and not just sitting on a stool in the corner gnawing on a corndog all day?

They don't. And do you really think places like Walden or other for profit (and a lot of greedy not for profits) care whether or not they are creating competent providers? If they did they wouldn't have them find their own preceptors in the first place.

Editorial Team / Admin · Sep 16, 2014

One question I've always had about this issue is, how do programs monitor their student's clinical activity and progression throughout the program if it is an on-line, pick your own preceptor type of program? I wonder this because I personally know a lot of nurses working in my hospital that are concurrently enrolled in an on-line NP program that is located half way across the country. How does this school know that these students are working hard and developing into competent NPs during their clinicals, and not just sitting on a stool in the corner gnawing on a corndog all day?

How would the schools that do provide preceptors know this without actually sitting in on every clinical experience? Whether a student chooses a preceptor or one is assigned, without direct observation the school isn't going to be able to know for sure what happens during the clinical hours; they can only go by what the student and preceptor show them as evidence.

lhflanurseNP, APRN · Sep 16, 2014

How would the schools that do provide preceptors know this without actually sitting in on every clinical experience? Whether a student chooses a preceptor or one is assigned, without direct observation the school isn't going to be able to know for sure what happens during the clinical hours; they can only go by what the student and preceptor show them as evidence.

Schools send a faculty representative to evaluate the student in the field. They follow you around and observe your performance. They also talk to your preceptor and at times the staff. They will then submit a report and grade the student. This is sent to the school and is part of the students evaluation and grade.

Editorial Team / Admin · Sep 16, 2014

Schools send a faculty representative to evaluate the student in the field. They follow you around and observe your performance. They also talk to your preceptor and at times the staff. They will then submit a report and grade the student. This is sent to the school and is part of the students evaluation and grade.

And that also happens with unassigned preceptors. One of our educators recently completed her doctorate- not only was she observed, she also had to fly to the school's location. Reports were completed periodically as well.

Same thing with my MSN- although there was no observation, there were frequent phone conferences with the school, my preceptor, and myself as well as periodic reports filed by my preceptor.

It is not an either/or scenario where assigned preceptors are always good and found on your preceptors are always bad.

zmansc, ASN, RN · Sep 17, 2014

One question I've always had about this issue is, how do programs monitor their student's clinical activity and progression throughout the program if it is an on-line, pick your own preceptor type of program? I wonder this because I personally know a lot of nurses working in my hospital that are concurrently enrolled in an on-line NP program that is located half way across the country. How does this school know that these students are working hard and developing into competent NPs during their clinicals, and not just sitting on a stool in the corner gnawing on a corndog all day?

That would depend on the program. First, on-line programs are not the only programs that allow students to identify preceptors, there are many b&m programs that do so as well, so the one does not always mean the other.

I cannot speak for all programs that allow students to select preceptors, but my program has an office staffed with several people who spend all day every day credentialling preceptors for it's students. The process is very rigorous, as it should be. They also have many faculty members who spend time at clinical sites on a regular basis. In addition to numerous site visits, the preceptor, student and faculty member keep in contact via many written reports throughout the process. Finally, the faculty member tracks the students notes, all patient encounters must be documented with full soap notes and other documentation about the encounter electronically. The program does not turn over the entire clinical process to the student as if there is no oversight, I would guess there are many programs where the preceptor is assigned where there is less oversight of the preceptor/student process.

Again, I'm not suggesting all programs work the same way. I know my program also keeps track of past preceptors and past facilities, so that when students are looking for preceptors they can use that database as a starting point. If a preceptor was bad, they will keep track of that preceptor and not allow them to preceptor another student. There are many good programs that are on-line and many that have students identify their own preceptors. Neither means the program is bad, even if some on this board want to tell you they are bad programs. I think sometimes that has to do with trying to justify their over priced education more than anything that is fact based...