Why is it so hard to find a preceptor?

myelin · Jul 19, 2012

I agree the forcing students to find their own clinical sites is utterly absurd and makes our field look bad, frankly. Fortunately, the market is fixing this, to some degree. In my area, grads from for-profit online schools (not affiliated with reputable universities) have a hard time getting hired.

WRNCEN · Jul 19, 2012

Yes I agree it does make the field look bad and can set the candidate for hire aside from others, that's were I feel experience and expertise should fill the gap. Many who I am in enrolled with are not new grads, I myself will have 10+ years experience as a RN, but this doesn't exclude the fact that I will be a new grad as an NP with no advance practice experience. I would love to go through a type of NP "residency program" to broaden clinical expertise. Truth is if I didn't have a family, I would have went on to med school.

BlueDevil,DNP, DNP, RN · Jul 19, 2012

I've only been in practice for 3 years, so I don't take students yet. My NP colleague refuses students because she feels she simply does not have time. It has nothing to do with the students, but she has a patient quota and can't meet it with a student in tow, and could not do the student justice if she were to try. It is that simple.

mom2cka · Jul 19, 2012

We're also competing with med students...and the clinics get paid for that..

Sorry - I should have clarified. What I've run in to is the competition of resources with the med students - not that they would use an NP as a preceptor. But if a clinic has to place med students, when they have a formal contract with a school, and I'm requesting to work with a preceptor as well...

IrishIzCPNP, MSN, RN, APRN, NP · Jul 19, 2012

Having students find their own preceptors is pretty common. I'm going to a top university in a major city....I hang to get my own preceptor. It's something bring done in top schools.

I agree the forcing students to find their own clinical sites is utterly absurd and makes our field look bad, frankly. Fortunately, the market is fixing this, to some degree. In my area, grads from for-profit online schools (not affiliated with reputable universities) have a hard time getting hired.

elkpark · Jul 19, 2012

Having students find their own preceptors is pretty common. I'm going to a top university in a major city....I hang to get my own preceptor. It's something bring done in top schools.

Not in the "top school" I attended. I don't see why students are so willing to put up with this. I wouldn't have been. As long as schools can get away with charging full tuition but making students provide half their education themselves, schools will continue to do this.

IrishIzCPNP, MSN, RN, APRN, NP · Jul 19, 2012

Not in the "top school" I attended. I don't see why students are so willing to put up with this. I wouldn't have been. As long as schools can get away with charging full tuition but making students provide half their education themselves, schools will continue to do this.

We put up with it because it's how it's is done. I don't see it changing. You are lucky your school provided preceptors but many don't.

Also, with the growing number of online programs, schools will find it difficult to provide preceptors all over the country.

Advanced Practice Columnist / Guide · Jul 19, 2012

I understand that even if schools arrange preceptorships, the clinical experience is not going to be the same for every student in the same program as there are many extraneous factors involved.

One thing medical schools have that is not as prevalent in NP programs is that clinical sites are established practices that are run by physicians who have experience teaching and have a passion for training future members of their profession. There are many physicians out there but not all of them understand the needs of medical students unless they are part of an academic establishment. Add to that the fact that you won't get exposure to evidence-based practice everywhere.

For NP education to evolve and keep up with the demands of a healthcare environment that requires rigorous training to gain respect, then it's time that we show the public that we are serious about training our future NP's. That means eliminating programs that require students to find their own preceptors because there's no way the quality of clinical experience could be measured in that setting.

IrishIzCPNP, MSN, RN, APRN, NP · Jul 19, 2012

Do you realize how many NP programs would go away? The push is now for online schooling which means students are coming from all over to attend. There is no way a school can take care of preceptors for students who are on the other side of the country. It's really not reasonable. I do wish my school took care of my preceptors but that's just not how it's done now and it's becoming more common for it to be up to the student.

The thing is becoming an NP isn't like a med school student. The med school students where I work are nothing but a student. An NP student in many cases is an educated individual with experience in the field. We are more like a fellow or a resident than a student...yet we won't get paid for doing our clinicals like they get paid for their residencies. So if we want to be taken seriously we should expect equal treatment that allows us to be paid for learning just like residents.

I understand that even if schools arrange preceptorships, the clinical experience is not going to be the same for every student in the same program as there are many extraneous factors involved.
One thing medical schools have that is not as prevalent in NP programs is that clinical sites are established practices that are run by physicians who have experience teaching and have a passion for training future members of their profession. There are many physicians out there but not all of them understand the needs of medical students unless they are part of an academic establishment. Add to that the fact that you won't get exposure to evidence-based practice everywhere.
For NP education to evolve and keep up with the demands of a healthcare environment that requires rigorous training to gain respect, then it's time that we show the public that we are serious about training our future NP's. That means eliminating programs that require students to find their own preceptors because there's no way the quality of clinical experience could be measured in that setting.

Psychcns · Jul 19, 2012

@IrishizRN. you are onto something!! When I did my practicuum psychologists were given a stipend , residents were paid minimal amounts, and Psych CNS students weren't paid. We

Were all seeing patients. And I think they were billing for my time--and why shouldn't they??

If students could approach sites and be able to bill based on our BSN, it would make us more attractive..

Advanced Practice Columnist / Guide · Jul 19, 2012

A Nurse Practitioner student IS a student. The RN license does not cover the scope that NP's do, hence, all the actions as an NP student fall done under the NP preceptor's license. A resident and a fellow have MD's or DO's on their names. They are able to function under that license (albeit a medical educational limited license as it is called in some states). NP fellowships are open to certified NP's, that's where a stipend can be arranged and is typically available.

We can debate ad nauseam about how many NP students have extensive experience at the bedside. I went to NP school with 10 years of RN experience. But you and I know that that's not the only route to NP now that we have direct entry programs. Personally, I don't care how long an NP student have been a nurse. They're still learning stuff they never did as an RN. I have not seen a positive correlation between length of RN experience and performance in NP school. I only agree that having that RN experience can be helpful in many cases.

I still uphold my belief that NP education has gotten way out of hand by sacrificing quality to favor widespread availability and ease of admission. I've never heard of a huge NP shortage either and I don't see it happening if we continue with the direction we're heading.

studentdrtobe · Jul 19, 2012

For NP education to evolve and keep up with the demands of a healthcare environment that requires rigorous training to gain respect, then it's time that we show the public that we are serious about training our future NP's. That means eliminating programs that require students to find their own preceptors because there's no way the quality of clinical experience could be measured in that setting.

Yea, that was the point I was getting at. :up:

The thing is becoming an NP isn't like a med school student. The med school students where I work are nothing but a student. An NP student in many cases is an educated individual with experience in the field. We are more like a fellow or a resident than a student...yet we won't get paid for doing our clinicals like they get paid for their residencies. So if we want to be taken seriously we should expect equal treatment that allows us to be paid for learning just like residents.

LOL! No. Just because you have an RN background and are an NP student absolutely DOES NOT make you equivalent to a resident or fellow! Extensive bedside experience as a nurse =/= extensive experience formulating differentials and treatment plans nor does it mean a sound theoretical basic science/clinical science foundation. Yikes, that's insulting to all the effort and training med students and residents and fellows go through! Not only that, how many people are entering through direct-entry programs these days? Please don't tell me that a few classes + a couple hundred clinical hours means you're equivalent to a fellow. As med students alone, we get several thousands of hours of clinical training. Even before starting the clinical years (ie. M1 and M2), we get several hundreds of hours of clinical training with our physician preceptors.

Also, didn't someone link in a prior thread a study that suggested prior nursing experience isn't as useful for NP/DNP training as people have assumed it would be? That also pretty much negates your bolded statement. So, no, you will not be treated, nor should you expect to be treated, as a resident or a fellow when you're an NP student. In the hospital systems where I'm training (and in the systems where I was a med student), our experienced NPs and PAs have the same level of responsibility as our PGY-2s do (our second-year residents). So, if they're held to a resident standard after years of experience practicing as NPs and PAs, why would students be elevated to residents or fellows? I would avoid making such claims on the wards if I were you; the only thing that would accomplish is souring relationships between physicians and nurses, which is really that last thing we want to encourage.

I agree with pretty much everything Juan has mentioned so far. I urge you guys to push for a national standardized education. IMHO, the lack of standardization is hurting you guys a lot more than it is helping. There's a reason a lot of physicians these days are preferring PAs to NPs: we know what they're training is like and can reasonably expect PAs graduating from various schools to have similar levels of training. With NPs, it's more of a lottery because of the wide variation in the education they receive. If this is fixed with better standardization, I can only imagine that the job market for NPs would improve.