I've been reading through some threads, and it seems a large number are people desperately looking for preceptors so they can complete clinicals. I wondered how widespread this problem is, and starting searching online - my results were astounding. There are literally hundreds (maybe thousands) of stories online of people having to drop out of their NP program because they cannot find preceptors. This is absolutely unacceptable. Why is it okay for a program to take your money and not actually provide your education? It's bad for education quality, it's bad for professional perception, and it's just deplorable.
I would like to start a petition to the AACN/CCNE asking them to require NP programs to set up clinical rotations for students in order to gain accreditation. The whole purpose of accreditation is to ensure programs are competent and teaching what needs to be taught, and they are doing potential students a huge disservice by allowing programs to exist that do not meet these standards.
Would anyone else be willing to sign this petition?
Instead of creating/signing a petition, why not just only sign up for NP programs that provide preceptors?
^^ This. If students "voted with their feet" and only applied to programs that provided preceptors, other programs wouldn't have the choice of continuing their current practice. I suspect, though, that schools are able to get away with this because of the large number of students looking for the convenience of attending a distance program with local clinicals, and they don't realize (until it's too late) how difficult setting up those "convenient" local clinical experiences is going to be.
If students didn't continue putting up with this, and signing up for the programs in big numbers, schools wouldn't be able to get away with doing it.
(Also, be careful of what you wish for -- many of these popular, "convenient," on-line programs would just shut down if they were required to provide preceptors for students. God forbid we should quit churning out huge waves of minimally prepared NPs each year!!!)
From the threads I've seen on this site, it bothers me that some programs do not provide preceptors. What happens if you are unable to find one in time? Do you get a refund?
From the threads I've seen on this site, it bothers me that some programs do not provide preceptors. What happens if you are unable to find one in time? Do you get a refund?
You get no refund. Your graduation is delayed or you simply don't graduate at all. Outside of allnurses there are hundreds of horror stories of people having to drop out because of this. It's really pathetic and proves that some schools are just in it for the money and don't care one bit about their students....and the greedy accreditation boards turn a blind eye to all of it. They should be ashamed.
From the threads I've seen on this site, it bothers me that some programs do not provide preceptors. What happens if you are unable to find one in time? Do you get a refund?
A refund for what? Education that you've already completed? AFAIK, most of these schools make v. clear to individuals that it will be their responsibility to line up clinical preceptors, and people sign up for these programs in droves.
That makes no sense..why would admitting more students mean they stretch their resources less?
Second, it's ridiculous that schools are of the mindset that they need to not provide an education so they can take more students. Why do they need to take more students?? Just be selective and ensure everyone has a quality education. That's a ridiculous argument. Would you rather have a better quality education or more classmates. Schools do not provide preceptors because it's easier not to, and then they can take more students and make more money. The fact that ANYONE could support this practice is sad. It benefits ONLY the school.
I think the AACN should require the following, to be fair to distance programs: All schools must provide clinical sites to students residing within 50 miles of campus. If further, students can arrange their own clinicals, but the school must have a dedicated clinical coordinator who helps set everything up. None of this cold calling crap and leaving it completely up to the student, the schools must take some responsibility here. This would also allow distance programs to continue operating.
Actually future, it makes alot of sense. If they have to find a preceptor in my small town, they would have to develop a connection with those practitioners and compete with other schools that are also trying to gain those resources. All of this effort would have to be done by a fairly costly group of people who would also have to document their efforts in case there were any issues that arose later. A very labor intensive process.
However, as a local member of the nursing community, I'm able to do this footwork as a networking effort that not only helps me in regards to obtaining potential preceptors (my school then does site visits and background checks on all potential sites and preceptors prior to approval) but it helps me immensely when I transition into the provider role. I have far better connections with the provider community in my local region than I would have if the school had told me "go to clinic x, your preceptor is y".
If people want to pay more for the school to do more, I'm sure they can find programs that will do so. However, for me, and my program the current model is much better than anything that would force all programs to provide preceptors. I would be very opposed to anything that made it more difficult for rural students to stay in their location and complete their NP education.
This is the exact sort of attitude that causes nothing to get done in this profession. What if someone in North Korea and decided to spend their life dedicated to fighting the corrupt political system there to help everyone else. Would your response simply be "instead of fighting North Korea why don't you just move to another country?"
The point is that the no preceptor thing is bad for the entire profession. It affects ALL NPs, not just those in those programs. It makes the profession look bad while giving great talking points to those that oppose NPs ("did you know they can do their entire program online and choose whoever they want for clinicals, with no school oversight?"), and it allows schools to take hundreds more students than they should since they have absolutely no responsibility, leading to rampant market saturation.
Finding one's own preceptor is not bad for the profession. Nor is doing your education online. Show me one actual study that shows that either of these are tied to poor outcomes.
I would love to see all programs have high levels of oversight for their programs, and I hear individuals talk about there being programs that have poor outcomes. I have not seen any statistical evidence that identify these programs, and I know mine does not, so I can't say one way or another on that issue. However, assuming there are programs that are producing students who are having difficulties with the exams, and performing below standards when they do pass the boards, then the oversight of those programs needs to be improved. If that means new regulations that programs have more interaction with preceptors (assuming that is one of the findings) than that should be done by the oversight organizations and pushed down to the programs. If it means more proctored exams, than that should be pushed down on the programs as well. My program used proctoring for almost all exams and has regional faculty who spend enormous time on the road visiting students and preceptors during their clinicals.
I know that the dean of my program is in meetings on a regular basis with other schools and governing bodies to discuss ways to improve the outcomes (student success) of all programs. If you actually have evidence of issues, then working with these organizations would be a much better way to improve the system than posting threads here suggesting drastic changes that there is no evidence would improve anything.
The reality is that over-saturation is a serious concern. The fact that we have tons of online NP programs that accept everyone regardless of GPA, no GRE requirement, no interview, etc. is a problem. The fact that these programs do not provide preceptors, skills checks, live instruction, etc., is a problem. Anyone who denies this must be in some kind of alternate reality. How can anyone think that the lack of standards in this field + the huge increase in NP new grads is not a huge problem? A high schooler who has taken one economics class could see that this is unsustainable. It will hurt our future independent practice endeavors as well.
That isn't to say that current NPs are bad providers (we know that is not true), but falling standards will result in mediocre graduates. This has been played out over and over again in other fields. Previous studies looking at NP competency were done before the advent of for-profit "universities" and the lack of preceptors problem. Why do you think lawyers are a dime a dozen these days? Because a bunch of crappy professional schools will educate literally anyone and allow them to become a lawyer. Why do you think doctors are so highly paid and revered? Because they don't let that kind of crap fly. Sheesh.
I am just amazed at the excuses everyone makes for lackluster NP programs out there that do a disservice to the profession. Just think if med schools (or PA programs to an extant) made students find their own clerkships and turned their programs over to online formats. The nation at large would be up in arms about it and I guarantee it would make national news.
NP programs are bloating because people see a way out of bedside nursing and flock to the provider role that they have viewed from afar as staff RNs. I have seen completely moronic RNs pass through these online schools by literally doing assignments with ease during work. Don't give me this, "well NP education is WAY different than an RNs", a sub par RN is not going to suddenly be a great NP after 2 years of online class.
You are going to need realistic supporters to stem the flow of this ridiculousness.
You are going to need realistic supporters to stem the flow of this ridiculousness.
Myelin and Dranger - glad you stopped by! Always refreshing to see a few sane posts. You are correct this is clearly not the place to look for like minded individuals who actually see the cliff this profession is heading towards.
I know of a med school and PA school that have done just that, in fact the site the students setup with is one I will be doing my precepting with. I don't watch the national news, but I'm sure if they came here for an interview, I would have heard about it... Small town gossip and all!
I'm all for improving programs that are producing NPs that either can't pass the boards or are performing below standards after they do pass the boards. All I'm saying is let's IMPROVE the situation, not just change the situation. This is a discussion about FORCING ALL programs to provide preceptors. I'm totally opposed to that, and no one has shown any proof that allowing students to find preceptor sites is a bad thing if they are managed well. They have not been a problem for my schools midwifery program, their FNP program, or for the above mentioned schools PA program and med school. In fact the med school in question is very highly regarded.
Yes, I refuse to be told this model is in fact obviously inferior. I'm not saying it isn't, but since no proof has been shown to me that it is inferior, I'm not going to buy that statement without it. As I mentioned above, there are med schools and PA schools who use preceptor sites that students bring to them. So, that argument isn't valid.
Second, the online and prior to that mail based lessons model has been used by CNM programs since the 1950s when Kitty Ernst started her school. There are no studies I can find indicating that CNMs provide inferior care, or that the online programs produced inferior CNMs. In fact one of the most widely respected CNM schools has been a leader in online education, and remains so.
Third, CNMs have also found their own preceptors for that same period of time, and they continue to do so. Again, it has not produced inferior results. So, If you are going to claim that these program produce inferior results, please show facts.
What is a petition going to do? You should have been proactive and researched your program better. The program I attended over 10 years ago did provide preceptors. Some were better than others, but each took the time and effort to teach and train me. I have done the same for years. I feel obligated to help train the next generation of ACNP's. I will not take students who go directly from RN to ACNP and think twice before taking anyone from an online only program. A petition is worthless be proactive and search things for yourself.
elkpark
14,633 Posts
^^ This. If students "voted with their feet" and only applied to programs that provided preceptors, other programs wouldn't have the choice of continuing their current practice. I suspect, though, that schools are able to get away with this because of the large number of students looking for the convenience of attending a distance program with local clinicals, and they don't realize (until it's too late) how difficult setting up those "convenient" local clinical experiences is going to be.
If students didn't continue putting up with this, and signing up for the programs in big numbers, schools wouldn't be able to get away with doing it.
(Also, be careful of what you wish for -- many of these popular, "convenient," on-line programs would just shut down if they were required to provide preceptors for students. God forbid we should quit churning out huge waves of minimally prepared NPs each year!!!
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