spacegal52

I found it depending a lot on the preceptor. In my last clinical experience before graduation, I had an NP and MD preceptor that pretty much left most of the exam to me. If a patient came in for sore throat, they would look at the throat too but I went in alone first and did my own assessment, then presented to them, and they would ask "ok, so what would you do/prescribe?" The NP actually let me do all of the total health exams (yearly physicals, etc) and would just listen to heart and lungs and trust me on everything else. I also had a DO preceptor that semester who wanted to do her own assessments, so we would do physical exams as a team but she let me do the paps. She also let me do procedures under her supervision, such as an IUD removal, cryotherapy, etc, whereas some preceptors don't let you do any procedures. For my first clinical experience, I precepted with about 5 different NPs at a clinic, but spent the majority of my time with 3 of them. The first day with each of them I basically just observed and got the feel of things. After that they were all good about having me go in first and do assessments and letting me do all of the physical exams. I worked with a midwife my first clinical experience who let me do all of the pelvics/pap smears, so I got a lot of great experience with this common procedure! I actually felt pretty confident and had a lot of procedural experience after my first clinical. I actually got very lucky with most of my preceptors in the sense that they actually allowed me to participate. I did have one doctor I followed for a couple of half days who pretty much told me he was busy and didn't want to get behind schedule, so I would just be observing him. This doesn't really do us much good when we are trying to learn! It is stressful to get "put on the hot seat" as a student, but I learned and got so much more out of the clinical experiences where I was allowed to be an active participant in the patients' care rather than just an observer. I totally understand not wanting to "put out" your preceptor by asking to be given some opportunities; but remember, they did agree to precept you, and that is part of it.

I attended a Fitzgerald Review 3 day live course... 2 actually. They had sessions where I attend college so I got to go fairly cheap both times. Neither was presented by Margaret but both of the presenters were fantastic. The days got to be long but they really helped me figure out where my weaknesses lie, so that I can focus on those areas to study for boards. The presenters are working NPs too so they had a lot of great real-life examples and could answer any questions without a problem.

I am finishing up a semester with a preceptor who has been great. She has taught me a lot, advocated for me to have opportunities to shadow other physicians in the practice, and ended up precepting me for many more hours than she had originally planned. I want to do something to thank her. I am planning to write out a card of course, but am wondering from those who have precepted... what are your thoughts on gifts from students? What types of things did you appreciate getting, and what would you rather do without? (I am just thinking a small token of appreciation, nothing crazy... I am a poor student after all!)

I am looking for tips on how to make the transition from seasoned nurse to new NP student. I can do assessments and take histories like nobody's business, but have difficulty coming up with diagnosis, and then how to treat. I am a great student in class with a 3.8 GPA, but am having problems doing well in the clinical setting. I feel so dumb and I hate it! I have always thought I was a critical thinker but now I'm not so sure.... At this point I am so discouraged and am half-tempted to not continue, but I know that would be crazy after I have invested this much time and money in it. (I graduate in two semesters.) I have had some great preceptors, but there are others who just allow me to observe them and not participate. I know I need to get this down before I can even attempt to practice safety. Any tips are welcomed!