Why preceptors don't precept

Posted
by sauce sauce Member

You are reading page 4 of Why preceptors don't precept. If you want to start from the beginning Go to First Page.

Penguins10

Penguins10, MSN, RN, NP

Specializes in Primary care. 17 Posts

I like Diagnosaurus DDx. It is easy to use and helps to broaden my thinking. In addition to ddx for symptoms it provides ddx for various lab abnormalities which is helpful.

I downloaded DDx Teacher. I haven't used it much, but I like the concept and hope to spend some more time with it in the future.

sarahRN828

sarahRN828

13 Posts

I have to say, from the perspective of a current FNP student, this thread has been both enlightening and intimidating. My school is a large public R1 university in the midwest, and our FNP program has a traditional option and an online option. Both "tracks" are highly ranked. I am doing the online option, and while I did have concerns about learning in that format, so far I have learned quite a bit and I feel ready to begin hands on learning in my clinical courses, which actually start next week. I completely see the point of the importance of traditional classroom settings, and I agree that the for profit programs are largely a joke. For example, one of my friends received her nursing degree from the now-defunct Bohecker, and her clinical sites included watching babies at a day care. However, I am thankful, beyond thankful, for the online format of my program. I would love to not work or only work part time, but that's not an option for me (in my 30's mortgage, baby, etc). I am not sure I would have ever been able to achieve my goal of being an NP without it. I work from home full time doing "insurance nursing," and although it has been a few years since I have been at the bedside, I still learn a LOT every day at work. My schedule is flexible enough that I can play with my hours and I work weekends to make time for school during the week. I will say that the program I am doing is amazing, the instructors take it very seriously and monitor us very closely. They track how much time we spend in the course outside of class time, and expect us to come to class (we meet virtually once a week) prepared to go through patient scenarios and use clinical judgment to come up with differentials and treatment options. We will begin more in depth diagnosis and treatment skills this coming semester. We have a 100% boards pass rate. Not sure how that translates to the quality of nurses we put out, but I hope it does mean something.

ANYWAY, the point of my post is this: Knowing how many preceptors feel about online students, what advice can you give to help me prove myself to my preceptors from the start? What qualities in a student make you confident in their ability to take great care of their future patients, and make you want to invest your time in teaching them? I want to make the most out of this clinical year, it is going to be a very tough challenge making it all work with my schedule, but I want to learn as much as I can, and get my hands on as many patients as possible. My first clinical site is an urgent care with an NP, and my second site is in women's health with a WHNP. Would love to hear more specifics about what makes you confident your students are on the right track.

edit: I should also add that my program only accepts about 10% of applicants per year, and they do frequent OSCEs to assess our assessment techniques. They are not afraid to fail people. I am not sure my program is anything like some of the for-profit programs, but I have no experience with how rigorous they are.

Edited by sarahRN828
forgot to add something...

Psychcns

Psychcns

Specializes in Psychiatric Nursing. Has 30 years experience. 3 Articles; 859 Posts

Those of you with criticisms of np education should figure out how to be involved in np

curriculuum development and accreditation of np programs. The field needs to evolve and would benefit from hearing from people with criticisms.

elkpark

14,633 Posts

Those of you with criticisms of np education should figure out how to be involved in np

curriculuum development and accreditation of np programs. The field needs to evolve and would benefit from hearing from people with criticisms.

But it's sooo much easier to just gripe from the sidelines ...

PG2018

PG2018

Specializes in Outpatient Psychiatry. 1,413 Posts

I bought a gateway computer way back in the day. It sucked majorly. So I bought 12 more and went on allcomputers.com and complained non stop about how it didn't work and how my debt kept getting higher and higher and I couldn't do my job since the computers just kept sucking.

I kept posting on the forum that gateway should fix it but they wouldn't. But I kept buying their computers. IT JUST DIDNT MAKE SENSE???? How could they sell such terrible computers to poor old people like me who just wanted a computer to use for work? Those evil bastards!

Really folks, don't you understand economics? or are you so wrapped up in your altruistic nurse-bubble that you let people ream your wallet without second thought?

But they had nice commercials. That must mean something!

No, they were purchased by another cheap computer company, Acer.

I was going to make a comical analogy to other to PAs, but they aren't Acer quality. Nursing is t an Acer.

blondenurse12

blondenurse12, MSN, NP

Specializes in Family Practice. Has 13 years experience. 120 Posts

I think you are conflating the challenge of a RN starting NP clinicals with poor curriculum at for profit schools. I am not denying that most NP schools need to beef up their programs.

But I do think experienced NPs sometimes forget how difficult of a transition it is between RN and NP. I actually had a much better experience with my MD preceptors than my NP preceptors. They were more interested in actually teaching me and giving me time to learn and digest.

I was an ICU nurse prior to becoming a NP so there is a completely different perspective. Things that sent my NP preceptor into a frenzy didn't even concern me. Like she was militant about hga1c. It didn't matter how old the patient was, that damn lab had to be 6. Who cares if they black out from low blood sugar? But obviously because I "didn't know how to appropriately manage diabetes", I was a bad preceptee. Or because I didn't order a million dollar workup on a young, healthy female with nausea who wanted a work note, I was incompetent in her eyes.

There is somewhat an art to practicing. Some people are not effective teachers either. On top of that, some preceptors use their students to offload their workload which is wrong. It cuts both ways

Psychcns

Psychcns

Specializes in Psychiatric Nursing. Has 30 years experience. 3 Articles; 859 Posts

There is an art to practicing. We meet privately with patients who come to us for help. We use our interviewing skills and exam skills

to figure out what is needed. People practice differently and there is a range of good practice.

synaptic

synaptic

Has 5 years experience. 249 Posts

well, yeah i suppose it can be difficult to make that transition. I mean going from a nurse to a nurse practitioner your moving from a position where you simply follow protocols, pass out meds, start IVs, and clean people. The only real decisions that need to be made is pretty much when to call the doctor.

Then your thrown into a position that actually requires independent judgement and stuff.

Cwoods

Cwoods

Has 5 years experience. 60 Posts

150 bucks to follow a social worker around? lol, ill pass considering social workers making peanuts

I don't know man, I may switch and do social work just to precept. $150 an hour would be nice.

nursebay

nursebay

15 Posts

JUST FYI-Where I live they except 25 NP's per year PERIOD. the cut off date is Jan 15 of each year and its highly competitive. Personally I compared the local school to the "crappy schools" as you called and most of the learning is done with your preceptor. Have you been NP long enough that you don't remember your schooling days and your inexperience? Get off your high horse, YOU make the NP profession look bad ********. Remember there is a provider shortage and we all have to get there some how. Shame on you!

JustKeepDriving

JustKeepDriving

Specializes in Forensic Psychiatry. 119 Posts

Remember there is a provider shortage and we all have to get there some how. Shame on you!

Actually no, we don't have to all get there somehow. There is a significant problem when people think that an NP is like the participation trophy of medical professions.

At least in my region NP is going the way of law school - you have to graduate with the right degree, from the right school, with the right mix of clinical experience and Pre-NP RN practice experience to be competitive for the job market (and no, the DNP doesn't set applicants apart out here). This is just going to continue as more for-profits open their doors and more people flood into the field.

nursebay

nursebay

15 Posts

BS-just because you didn't go to one of those "crappy" schools does not make you any more qualified or high and mighty compared to others who did.

I went the traditional route for my ASN and BSN and did not learn **** until I was in the work force. I was only as good as my preceptors that trained me-and thank god I had some excellent ones that did not carry your nasty opinion. You want high quality NP's coming into the work force, then I suggest you get off your soap box and precept if you are so damn good, but maybe you're not that good and no one should be learning from someone who has their ego and opinions so far up their ass.