Nurse Practitioner clinicals/practicum

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Can anyone share how their clinical experience went? Did you shadow your preceptor for the first day or week only? When did you see patients on your own? Do you collaborate with your preceptor after every case or at the end of the day? How did you document?

I'm approaching my practicum date and am super nervous not knowing what to expect. I am in an online program so communication with other students is limited. My program is Adult-gerontology but I welcome responses from all specialties. TIA 

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Specializes in Nephrology, Cardiology, ER, ICU.

I did two post-MSN certificates so did 1250 hours of clinical total. I did a variety of settings so here's what I got out of it:

1. Nursing home round - accompanied the NP to each room for the first few days then I saw a pt and then the NP went behind me to provide feedback

2. Hospital - PICU - I was treated as a med student and expected to pick a pt and write it up and present when the attending came around. (Grueling)

3. Hospital - Med/surg/tele floor - let loose on my own and then went to resident after I developed by assessment and plan and then we came back to the pt room where the resident went over everything with myself and the pt. Best learning experience ever!  Had the best residents who really enjoyed working with NPs

4. Clinics - PCP - I did the entire assessment and plan and then presented to the NP who initially would go back in the room with me to re-examine the pt and go over everything. After a couple of weeks, the NP would go along with my assessment and plan but always reviewed it and re-examined the pt. 

5. Street level psychiatric emergency services - again such a great experience - learned so much. Not the traditional way to render care but it was so gratifying to meet people where they were: homeless, jail, but all in crisis

I did have to get credentialed at multiple facilities so had to plan ahead. Best wishes

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On 8/30/2022 at 10:59 AM, Bread&water16 said:

Do you collaborate with your preceptor after every case or at the end of the day?

You are a student so would have no business not collaborating until the end of the day; it would be inappropriate for both you and (especially) the patient.

FTR, I'm sure there are a wide variety of experiences had by NP students, but there is also growing negative sentiment about our lax educational standards. For your own good I recommend doing what you can to encourage appropriate proctoring on your clinical rotations. We have not yet sat for the appropriate boards when doing these rotations; we have no more business being turned completely loose than a student nurse.

My basic experience at all rotations (FNP):  saw patient (alone), performed basic components (General history-taking, HPI, ROS, exam, A/P), presented these to preceptor, discussion, returned to room together where they performed their own brief assessment of same, discussed w/ patient. I documented all my work in EMR w/ student-level access/credentials and submitted to preceptor for sign-off.  Some version of this occurred at all my rotations.

Good luck!

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I have precepted NPs inpatient. Usually I will observe a few interactions but generally let them see the patient on their own, then present at various points in the day. 

LEARN TO PRESENT. NP school sucks at doing this

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Specializes in Occupational Health.
On 9/2/2022 at 3:06 AM, JKL33 said:

My basic experience at all rotations (FNP):  saw patient (alone), performed basic components (General history-taking, HPI, ROS, exam, A/P), presented these to preceptor, discussion, returned to room together where they performed their own brief assessment of same, discussed w/ patient. I documented all my work in EMR w/ student-level access/credentials and submitted to preceptor for sign-off.  Some version of this occurred at all my rotations.

Pretty much how my clinicals went as well. I will say that I was surprised at how many of my classmates only got to "observe" their preceptor and not interact with the pt....even at the end of the program. My very first preceptor was horrible with communication and education with both myself and the pt...she couldn't explain her rationales, gave poor, outdated or just blatantly incorrect reference materials. I went to clinical but found a more suitable preceptor within a week of heavy "shopping around". Don't settle for a mediocre preceptor or experience...you'll regret it in the end. 

You ABSOLUTELY need to develop your interpersonal communications skills, interview techniques, assessment skills, etc. If you're only observing and being asked "what do you think" then you're not getting the clinical experience you need.

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Thank you everyone for your responses. Very helpful!

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