Choosing FNP Clinical Sites...HELP

Trauma Columnist · May 4, 2008

I did clinicals at the following places:

1. Busy trauma surgery office and hospital rounds.

2. Nursing home (with an NP contracted to them to provide care for the 300 residents).

3. Hospitalist (MD).

4. Crisis mental health workers - absolutely loved this!

5. ER - level one truauma center.

BChapp3182 · May 5, 2008

First you need to ask your teacher or school admin's for a list of past preceptors other students have used (school's will tend to keep a file of this). Also, try to contact other students ahead of you to ask what the good sites are. When you find a site your interested in ask if the preceptor has ever had students, what the population served is, what the language spoken is, hours, break time, etc. I also look up my preceptors license online to see how long they have been practicing.

So far I've done:

Pediatric Associates (not a good site, no hands on-they are nationwide I think)

A busy family practice in a low income area (great experience)

County Public Health Department Clinic (you have to start filling out background checks, fingerpints, etc to go to clincials with the state, start at least a month ahead of time).

I've found that low income or public health departments are awesome experiences. First because that population seems to be okay with students whereas in the private insurance sector, the population will tend to not want students. Second, because the low income populations tend to have all the cool diseases/infections/STDs and you get to see everything and do everything. In the private practice sector it tends to be the same couple of conditions over and over.

I've also had NPs and MDs as preceptors and the NPs seem to have a better understanding of the whole learning process, what we need to know, will point of stuff, are just more helpful in general.

This was just my experience and my personal thoughts on clinicals, I'm sure it's going to vary.

jer_sd · May 5, 2008

Also see what the requirements of your program are, even if you get a great clinical site but dont meet course outcomes it would be of no use toward graduation.

yellow finch, BSN, RN · May 5, 2008

Seeing how you're in a Family Practice focus, you'll likely need a Family Practice setting for your first semester or two of clinicals. There will be a required number of hours to fulfill in a number of areas. Be sure you check with your school/instructors as to where you're allowed to practice.

I spent my first clinicals with a Hospitalist. Next, at a Family Practice office. This summer I'll be working at another Family Practice office, a Peds office (since I'm pretty far behind in my peds hours), and hopefully a free community clinic.

For my last semester, I'll be rotating with a number of specialties... mostly my interest groups... neurosurgery, neurology, pulmonary, more hospitalist, psych, and possibly pain clinic.

Best of luck! The fun has yet to start.

jsully13 · May 6, 2008

Thanks so much for all of your suggestions! I really appreciate the insight! I'm thinking I'd probably like to work with a low income/underserved population at some point. I just want to have some different experiences, rather than being in a bunch of different doctor's offices the whole time!

Spacklehead, MSN, NP · May 10, 2008

So far, I've completed clinicals at an FP office, a public health children's and adolescent's health clinic, and a very busy OB/gyn office. Next semester, I will most likely be with an internal med MD who also does hospital rounds.

JaimeeG · May 10, 2008

Does your program not have specific courses for each semester? If so, you will probably have to make sure you are in the appropriate type of setting for that course.

In my program, we had an advanced assessment first semester. This had to be done in either family practice or internal medicine. I did mine in a very busy family practice office that sees mostly Medicaid patients. I was with an FNP and had a good experience.

For women's health, I was at Ft. Leonard Wood, a large army post in Missouri. This was by far my most beneficial clinical time. I was able to do almost 200 well-woman exams and also did many prenatal and postpartum visits. Some in my class had really poor preceptors and did under 5 exams total.

I just finished my adult course. For this semester, I was with an FNP in a family practice office. We had the choice of doing either family practice or internal medicine again.

Summer will be my peds course, and (of course) I will be in a pediatrics office. I will be with two different PNPs here.

Practium is my final semester, in the fall of this year. For practicum, we have to do 80% of our time in a primary care setting and then we are free to do 20% wherever we choose. I am going to be working with a local neurologist when I am done with school so I plan on doing my 20% with him and the other 80% with a local FNP.

Like I said in another thread, be sure that you choose GOOD preceptors. Some are not so willing to let you get in and actually do things. I spent a short amount of time with a local family practice doc, and I basically followed him around all day and watched. I learned some stuff from him, but I think it's much more beneficial to do the exam yourself and come up with your differentials, labs, treatments, etc.

Good luck, and have fun!

Jaimee