Nurse Practitioner Program Fine Print May Scuttle Your Opportunities

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    Not all nurse practitioner programs are alike - which you probably know. However, there might be some challenges that are not clear at the onset. It is critical that you identify all the fine details of the program and challenges that may prevent you from completing the program before you sign on to a nurse practitioner’s program. Here are aspects of a nurse practitioner program that you should clarify before registering for your first class.

    Nurse Practitioner Program Fine Print May Scuttle Your Opportunities

    You're on the road to success. Accepted to a nurse practitioner program. The program looks doable. All you need to do is buckle down and study. But is it? For many programs this is true but some programs have less visible challenges that are not transparent on admission. One such challenge are clinicals associated with the program. Depending on the program and specialty, clinical training consists of about 600 hours which amounts to 75 - eight hour days or 2.5 months. In pre-licensed nursing programs, the college arranges clinical placements and provides clinical instructors. However, some nurse practitioner programs require you - the student - to find the clinical placement and the clinical instructor. And this is a factor that some admission representatives might gloss over.

    The college requires that the clinical site and the college sign an affiliate agreement, which the college is usually willing to discuss with the clinical site. Your clinical supervisor (instructor) too must sign an agreement with the college. The challenge is finding the clinical site and clinical supervisor who will sign the affiliate agreement. Success on finding a clinical site and clinical supervisor usually depends on your specialty and the availability of the specialty in your area. Students specializing in family, adults, and geriatrics probably have a better success since clinicals can take place in a practitioner's office. Students specializing in other areas such as neonatal and psychiatric nursing may have more of a challenge in finding a clinical site.

    Further complicating matters is that different clinical sites might be require for each course. A case in point is a psychiatric nursing program offered by a reputable university located in the north east. Child and adolescent psychiatry is a course required for graduation - and requires a clinical site that focuses on child and adolescent psychiatry. The reality is that there are few such clinical sites even in this highly populated area. Some of those sites refused to take nurse practitioner students and others are overwhelmed by requests. Only a few students are accepted. This is one of those programs where students find clinical sites without help from the college. As a result, students who don't find a clinical site are unable to complete the child and adolescent psychiatry course, which is a prerequisite for other courses in the program and as a result might have to skip semesters until the course is offered again - and a clinical site is found.

    There are a number of reasons why some nurse practitioner clinical sites and clinical supervisors are difficult to find. The clinical site and the clinical supervisor may not agree to terms in the affiliate agreement. There are legal liabilities related to a student nurse practitioner's practice and the liabilities are one of many items outlined in the affiliate agreement. Compensation is another concern. Will the clinical supervisor be compensated by the college? The compensation may be little or none offered by the college. And then there is the paperwork. The clinical supervisor must review and counter sign all the nurse practitioner's documentation plus complete and sign the paperwork required for the program.

    Prospective nurse practitioner students may presume that they can use their current employer as a clinical site. Well not so fast. Some medical centers and practices don't want employees to use their facility as the employee's clinical site. There are sound rationales for such a policy. First they don't want to blur the lines between the employee's official duties and clinical education. This was illustrated in an old ER TV episode when an ER nurse becomes a medical student and uses the emergency department as a clinical site. She was still an ER nurse in the emergency department and was constantly reminding everyone of her role - sometimes an ER nurse and sometimes a medical student. And some employers feel that going to a different facility broadens the experience because they see how other facilities work.

    Make sure that you know what is really involved in a nurse practitioner program before you start the program. Don't make assumptions only to discover there will be challenges you can't meet when completing the program. You'll probably meet those challenges head on - if you plan in advance. And you may forgo nurse practitioner programs that are too challenging.

    Here are a few tips that will help you explore nurse practitioner programs:

    * Who selects clinical sites?: If you, then identify the criteria and terms in the affiliation agreement then try to find sites before you sign up for the program.
    * Who selects the clinical supervisor: If you, then get the details. What credentials are required? What is the compensation? When is the compensation paid? What are the college's expectations of the clinical supervisor?
    * Will the college help you find clinical sites or a clinical supervisor?: If yes, then ask the admissions representative to specify the help they will provide - and get this in writing. Don't accept a list of possible clinical sites. You want a list of clinical sites/clinical supervisors that have already signed an affiliation agreement with the college and have continuously accept nurse practitioner students.
    * Speak with current students: Current students and recent graduations are a good source of information about the realities of a nurse practitioner program. Furthermore, they may help to identify clinical sites and clinical supervisors for you.
    * Will your employer provide a clinical site?: Find out your employer's policy on employees using it as a clinical site. Some employers have such a policy and others decide on a case-by-case basis. Identify the ground rules if your employer can be used as a clinical site. For example, you might be able to use an outpatient clinic as a clinical site if you are an inpatient nurse. This prevents blurring of responsibilities.
    * Maintain a sense of reality: You will have at least 2.5 months of clinicals. Within that time you are expected to develop clinical skills necessary to become a healthcare provider. You are diagnosing the patient and prescribing treatments to resolve the patient's problems when you graduate and are licensed. Consistency is the secret of success. Plan to attend clinicals in a block of time (weeks not random days). Some nurses alter their schedule so they can focus a consistent amount of time for clinicals.
    Last edit by Joe V on Jun 14
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    4 Comments

  3. by   DeeAngel
    The same thing applies to nursing refresher courses, you have to find a place to do your clinical hours at. Its almost like they dont want nurses to return to nursing. I fail to see where, after 40 years of being an RN I need a refresher course after not working as a nurse for three years.
  4. by   Jerry33
    Is it enough to ask if you are applying for a pre-licensed nurse practitioner program? Are you then safe if they say yes, or are may some courses of study be pre-licensed and others not in a given program?
    Last edit by Jerry33 on Jan 29 : Reason: I was a little unclear
  5. by   mariea1212
    Hi , Please can anyone help , I got an interview for band 6 and to do a 10 mins presentation entitled.
    As a band 6 what would your priorities be in order to support the ward manager to deliver Safe, Clean and Personal Care to a group of rehabilitation patients ?
  6. by   Jim Keogh
    Are you talking about taking an NP program without becoming an RN first? If so, then the problem is finding a job without any clinical experience. I know of a BSN nurse going directly to an NP program because she was unable to find a job as an RN. She also couldn't find a job as an NP either because she had never practiced nursing. She was competing with new NPs who had years of clinical experience as an RN so employers picked experience over new NP grad.

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