How are you preceptorships determined & how do you decide?

[DayDreamin ER CRNP]

I've got two questions about precepting and I should preface my second question by saying that my middle name is Worry.

We got our "clinical preference" cards today in class for precepting next semester.

Our program places students based on our HESI scores in our med-surg classes but they also consider our other HESIs in Fundamentals, psych, OB and Peds but they put more emphasis on the 2 med-surg tests. Our benchmark score is 850 and out of 140 people in our class, only about 30% have passed the HESIs so far. They are telling us that they will give those that have benchmarked a choice of placement.

I take a little bit of issue with that because there are several of those students that are really book smart but can't even change a patient's diaper or put telemetry on a patient despite the fact that there is a diagram on the back of the device. Those that score higher and want to do the more 'preferred' placements will likely want to get STICU, ER, CVICU, MICU, NICU, etc. The students scoring lower than benchmark get placed on a med-surg floor. I currently work on a med-surg floor and I really just don't want to do my precepting there.

I have benchmarked on 2 of the 3 so far and I'm already nervous about our upcoming test. I know I'm a good clinical student but those tests totally stress me out!

There really isn't anything any of us can say to convince admin to consider our clinical skills in addition to the HESI scores. It is just frustrating to see so many of my friends that are really great with patients and are really good in clinical but are missing the benchmark but just one or two questions.

Question 2.

How on earth do you decide what you want to do for your precepting clinical? I work on a family practice unit and I did my clinical there last semester and I'm here again this semester. We don't get to chose our clinical or teacher; we just get placed. Needless to say, I was pretty disappointed that I'm 'stuck' here again. I have set up a day to shadow in the ER one day next week and I might possibly get to go to a cardiac floor during another clinical day but other than that I'm totally clueless!

I did have 3 weeks in L&D and I liked it. I did not expect to enjoy that rotation but I did! I think I enjoyed the one-on-one patient care there but I am still not sure.

I feel like I am having to make a huge decision that I'm just not prepared to make right now. I should mention that I'll be 40 when I graduate and I know that most new grads are getting hired on the floor or unit they precept in so I want to make sure this is something I think I'll like long-term. I think I just want someone to just say, "MJ, you belong HERE" and that's where I'll go.

How do you decide where to precept? How did you make your decision?