Why is it so hard to find a preceptor?

TicAL · Jul 21, 2012

I believe that NP students are on par for what they do compared to what residents do.

I think most people who work in the field of medicine (MDs and nurses alike) know that this is completely false. NP students have no responsibility and are there to learn. In that sense they are similar to medical students except for the fact that the NP students have had less educational training. Residents are expected to work (see patients, write orders, write notes, admit/discharge patients, etc). This is why they are paid. Yes a student can write notes, but none of it actually counts for billing or legal purposes.

A resident is there to learn, but they have their own licence (MD or DO) and are therefore able to practice medicine. A student is there solely to learn; if an NP student is writing orders and functioning independently they are practicing nursing without a licence and would be subject to severe penalties (and putting patients in danger).

CRNBSN18 · Jul 21, 2012

This is kinda off-topic but can MDs precept NP students? At my doctors appointment yesterday, my dr was asking about school And was talking about how she loves teaching students when I mentioned to her that I was only so many classes away from completing masters degree prereqs and I hope to bridge after graduating and getting experience. She started talking about how she use to teach at nursing school, and loved it, so I'm guessing the answer is yes? I told her I would keep her in mind for when the time comes and she said to definitely do that. I'm grateful for that. I live in a rural area and NPs are lacking from what I've seen online.

Good luck to you, OP. I hope you find someone!! I just recently started browsing about this so I have tons of

Questions. Right now passing school, the nclex, and getting lots of floor experience are more concerning. Best wishes!

Editorial Team / Admin · Jul 21, 2012

Guys, going to ask that all talk about the differences in Residents and NP students be taken elsewhere. Some personalization occuring and very off-topic.

Please stick to the topic about "so hard to find a preceptor"........o.k.?? Thanks.

WRNCEN · Jul 21, 2012

Guys, going to ask that all talk about the differences in Residents and NP students be taken elsewhere. Some personalization occuring and very off-topic.
Please stick to the topic about "so hard to find a preceptor"........o.k.?? Thanks.

Thank you!

Le-Lee_FNP, MSN, RN, NP · Jul 22, 2012

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

I am just wondering if you have a nursing backround at all? This is ALLNURSES.com not

allmedicalstudents.com You have your opinion and that's fine but when you as a medical student come on a nursing message board and insult nurses by saying things like "there's a reason a lot of physicians these days are preferring PAs to NPs" it does nothing but cause tension. I agree we should stick to the original topic of the OP.

OP, I will be graduating from a distance program this december. (and for those of you who are wondering I have 5 years of bedside nursing experience in critical care). I have also struggled every semester with finding a preceptor. My school for the most part requires that we find our own, however they have an affiliation agreement with two clinics and one hospital in which students can apply to every semester. It is very competetive to get into those sites and if you aren't accepted you are pretty much on your own. What i did was sent out a mass e-mail at the beginning of each semester to all of my fellow classmates in my non-clinical courses and all of my instructors asking if anyone knew of any sites, NPs, or MDs who would be willing to take a student for the following semester. One semester i lucked out ant one of my instructors volunteered to be my preceptor and i also got numerous leads from other students in my program. I also had to do the online searching, walking into clinics, and looking through the phone book.

It really is just all about asking as many people as you can and exhausting your resources. Its not ideal but why complain about something that we can't change. We chose to attend distance programs and knew ahead of time that this would be the requirement of us. I could have chosen a different program that was more expensive or prestigious or whatever because i had the grades for it, however i chose the program that was more convenient for my lifestyle of being a working mom, as well as what was the most economical so i have to live with the decision i made. Sure my education and clinical experiences may not be on par with other schools, but its my responsibility to bridge the gap by supplementing my education and getting the most out of the program. It took 40 contacts before i secured my first preceptor. Also see if your school will allow you to use the same site at least twice because most of them will. Be persistent and eventually you will find someone who is willing to precept you. Also don't rule out MDs because many of them enjoy teaching and have NPs that work with them in their practice.

WRNCEN · Jul 22, 2012

@student_FNP

Thank you for the suggestions. I too understood what I signed up for, being the top income provider for my family an online program was the only option for me, fortunately I was able to have a program that is close to my home and not a for profit That would not cost and arm and leg. I am beginning to think that many feel online learning is inadequate, but it's about what the student puts into it, a year under my belt I have learned a lot, but hope that it doesn't discredit my abilities to others in the future. His is why I feel a strong placement is important.

BigSkyFNP · Jul 22, 2012

Been there, done that. I also received my post-master's FNP cert. from an online distance program. Just passed my ANCC this May. I could not find a preceptor where I live either. I live in Northern CA. I ended up going to Montana where I had worked 10 years ago to get my clinical hours. I spent 4 months there. Thank God for an understanding family, as my husband and kids were not thrilled. But time was up and I had to finish. I am now looking for an FNP job and can't seem to find one that doesn't require me to relocate. I wish you the best of luck and wish I could help.

Le-Lee_FNP, MSN, RN, NP · Jul 22, 2012

@student_FNP
Thank you for the suggestions. I too understood what I signed up for, being the top income provider for my family an online program was the only option for me, fortunately I was able to have a program that is close to my home and not a for profit That would not cost and arm and leg. I am beginning to think that many feel online learning is inadequate, but it's about what the student puts into it, a year under my belt I have learned a lot, but hope that it doesn't discredit my abilities to others in the future. His is why I feel a strong placement is important.

Well people can feel that online learning is inadequate all day long, but the bottom line is if you pass ANCC or AANP then you are competent as deemed by the National certification Gods. So if people don't like that who cares thats their problem. Your license is the same as theirs and I don't see online learning going anywhere anytimes soon.

elkpark · Jul 23, 2012

Think about it. Would a nursing program be accepted if it told their students that they had to find their own preceptors ... This would directly contravene the regulations passed by the accreditation agencies.

Correct me if I'm wrong, but isn't this exactly how the Excelsior program works? It doesn't matter how or where they sought out the learning and skills as long as they pass the test at the end of the program? And all the pro-Excelsior people are always bragging about what a great program it is and how well-respected it is.

elkpark · Jul 23, 2012

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.

You don't get taken seriously by "expecting equal treatment"; you get taken seriously by undergoing a comparable educational process, which, at this point, nursing graduate education definitely is not. I would argue that, as long as graduate education in nursing is something that can be done on your own time, at home, while also working full-time, we're not going to get taken seriously by the medical community, and justifably so.

Advanced Practice Columnist / Guide · Jul 23, 2012

I think we all could agree that if one is enrolled in a distance NP program, expect to have a struggle with finding a preceptor unless you have an "NP friend" you can ask to precept you, your own "PCP" who will agree to precept you, or repeat the same site you spent your last semester's worth of clinicals again for the upcoming semester.

However, if you attend an FNP program that has a network of primary care practices both NP-run or physician-led from IM to peds, FP to women's health, then you are assured of quality clinical sites that have experience in training NP students, knows the expectations NP training requires, provides the appropriate caseload of patients, and communicates your progress to your NP program without any conflict of interest.

But who am I anyway, just a practicing ACNP who works under a university setting that hosts a number of NP training programs from FNP to ACNP, PNP and NNP to CNM, PMHNP to various CNS programs. The choice of precepting ACNP students is not a choice I made, it's an expectation I am to fulfill as part of an academic establishment.

WRNCEN · Jul 24, 2012

Personally, I am going to express my thoughts for a moment. I find it asinine to devalue the education received just because it’s online. No I don't attend lectures or participate in face to face discussions, but I do get the same information in my own home where I can spend undivided attention and time that fits my needs as well as my family's. I get more information out of a powerpoint or video lecture at home than what I would as traditional student in the classroom. Honestly, I put in more time than a traditional student, since I have to be self motivated, organized, and diligent to accomplish assignments and make sure I am learning what objectives are set for that particular course. Yes, I have to find my own clinical sites, I understood that when I signed up. It is difficult, but I put forth the effort to ensure I get the best experience possible and take nothing for granted. Would I get a better experience if it was with a practice that was aligned with the university, possibly, does that make the practitioner or student inadequate for practice, not in my eyes. I don't care how you received your education as long as you can provide care in that is effective and safe, knowledgeable in your area of expertise, and make me as patient feel like my needs are being met and meeting positive outcomes. Who cares if you graduated from a top notch program, because I could have went that route, but its not something that fits my lifestyle. Bottom line you get what you put into it, regardless of the way the knowledge and education is received.

When I started this forum it was about getting the NP perspective of preceptorship, why they don't and why they do, and insight to why its hard to find someone to be a preceptor. It was no intended to knock online education, which is not going away, so deal with it! I will graduate as an FNP (CCNE accreditation) just like anyone who was a traditional student who had their experiences provided for them, I will have the opportunity to take the same certification and be licensed just the same. If an employer wished to hire someone else due to my education, go for it that is his or her loss. I will be a new grad just like a traditional student, with NO NP EXPERIENCE! Yes, I will have an extensive nursing experience, I understand this is not NP experience as the scopes of practice are not the same, but what I have learned though my nursing experience and continue to everyday as I practice will only aide in becoming an APRN.

This forum was not intended to compare NP to residents, as they come from a different philosophy, as we all know. Education and practice is different so comparing the two is like apples and oranges.

So I ask you, if you want to debate online education or NP vs. other healthcare providers, take it to the appropriate forum and lets stick to the topic posted.