Why preceptors don't precept

[sauce]

I found this article in my E-mail recently, it was a pretty good read, and if one goes around the site they will see several other complaints by preceptors pushing the same issue.

Students are not prepared for clinical.

Has the Bar Been Lowered for RN/NP Programs? : Clinician Reviews

I have seen this in a few students I precept also (which I only do now from certain schools). I had a few kids from online universities (the for profit crap-wagons) as students a few times. It was awful. None of them had any clue how to diagnose, prescribe, or even really do a true physical exam. Basic stuff they should have learned in nursing school, much less an MSN program.

Get with the program people, you go to these for profit schools with no requirements besides a BSN degree, don't learn squat, and expect us to precept you?

Sorry this is real life.

This message is brief, and to all those people who attend these junky schools. Stop making our profession look terrible. If you cant get into a real school, then many you should just stay a nurse, you probably aren't cut out for the real deal MSN level thinking.

Yeah, yeah, I know I sound harsh, but your type are the reason that our profession is looked down upon by so many. Personally, I am pretty well respected, but every time I start a new job or meet a new doc or whatever, I have to prove myself, and it is because of sloths that attend these programs and lower our standards.

So the take-home is. Don't go to a crappy school and expect to find a preceptor, we know better than to waste our time with you. Go to a well respected school and we will be glad to help you out the best we can and accommodate you.

I already wrote a nice long, nasty letter to our credentialing agencies telling them this, of course they turn a deaf ear. The credentialing groups for nurse practitioners is weaksauce, and ran by a bunch of DNP- think they know it alls that are trying to I don't know what, by pumping as many nurse practitioners into the market, ignoring quality.

I cant wait for the flames from this one, people on this forum seem to resent the truth, and sit in their little happy-bubble world full of white coats, stethoscopes, and hopes for a big easy paycheck.

And to those who come here, from those, for profit schools and try to tell us that they were one of the students who "went above and beyond, because learning is about what you put into it" I have one thing to say. you already told us what you put into it by going to one of these programs. A lot of money and no thought. School is supposed to filter out those who aren't fit. PA and MD/DO schools do this. Yeah, every once in a while a junky one slipps by, but you know its a lot less frequent than NP schools.

Just fess up and admit that this is all true.. Preceptors are seeing it everywhere.

NP education is a lax joke with fluffy requirements.

I also gave psychguy and Jules A a personal spot to like this post. Why? Because they have great wisdom and common sense, and you all don't like what they say, because its the truth.

sauce out.

[shibaowner, MSN, RN, NP]

While it is definitely a step in the right direction if you look closely the tax credit is not substantial at all: $1,000 per student. The NP hourly requirement also went to emergency session for an amendment due to the unrealistic number of hours a NP would have had to precept to be eligible.

Maryland SB 436/HB 683

A $1,000 state tax credit per student is really a good deal - that's a credit, not a deduction. Many preceptors will precept at 2 or 3 students a year, so that adds up. (Maryland has a $10,000 max per year). One of my rotations was in a busy practice that had 2 students per semester. Colorado and Georgia also have programs.

Tax Incentives Aim to Attract Primary Care Preceptors

As far as hours required, at Hopkins each semester clinical rotation was 150-226 clinical hours. Fall and Spring semesters were 14 weeks and Summer was 12 weeks. That works out to a student going to clinical an average of 2 days a week, which certainly seems reasonable to me. Less than 2 days a week, it is hard to learn and remember anything. Given your constant complaints that NPs don't get enough clinical hours, I find it strange that you would complain preceptors have to put in too many hours! How else do you think the NP students are going to get their clinical experience?

Jules, I have a lot of respect for you, but you sometimes have a tendency to appear negative. While doing my rotation in the above-mentioned busy practice in Baltimore, I brought the tax credit to the attention of the two preceptors, who are MDs. They had not known about the credit and they were thrilled! They weren't precepting for money, but in order to give back to medicine. They precepted one resident and one NP every semester and were happy to do so. A good student can find lots of ways to be useful. One of my best preceptors is a practicing NP with 30 years experience. She practices full time, is a clinical instructor part time, and also precepts 3 NP students a year (one every semester). She is a dynamo and just loves what she does and is also extremely patient and kind. Everyone at Hopkins was in awe of her. That's what I want to be when I grow up!

In my new job, we always have several PA and NP students from UC Davis that are being precepted. The founders of the clinic do this because they are extremely passionate about giving back to the community as much as possible. In addition, once a year, the clinicians who want to can go to Panama for 1 week to provide care to a village they sponsor. They have also paid for a school and clinic to be built there, among other things.

Jules, with your knowledge and experience, you can be an active advocate in your state and work to enact real solutions to the challenges facing our profession. I sure hope you do so.

[Troll_Patrol]

Unfortunately I have to agree... I am very naive and found out while I was in my last semester of my NP school (that required 2 years RN experience) that programs are allowing new grad RNs to go straight into NP school! *****!? They don't even know how to be a nurse in the real world yet.

I would never precept a straight-through NP ... I hate when I have to babysit new 2nd year residents.

That being said and now that you all probably think I'm an awful person I did have trouble finding preceptors because no one wants to do it, so I do feel for the NP students out there that are qualified and ready for practice...I lucked out, ended up using all MDs as preceptors (because many NPs won't precept ) and had a very good preceptorship experience.

Ugh this struck a nerve

Rant Over LOL

[shibaowner, MSN, RN, NP]

Unfortunately I have to agree... I am very naive and found out while I was in my last semester of my NP school (that required 2 years RN experience) that programs are allowing new grad RNs to go straight into NP school! *****!? They don't even know how to be a nurse in the real world yet.

I would never precept a straight-through NP ... I hate when I have to babysit new 2nd year residents.

That being said and now that you all probably think I'm an awful person I did have trouble finding preceptors because no one wants to do it, so I do feel for the NP students out there that are qualified and ready for practice...I lucked out, ended up using all MDs as preceptors (because many NPs won't precept ) and had a very good preceptorship experience.

Ugh this struck a nerve

Rant Over LOL

You know, when I start precepting I think I will only accept direct entry NP students.

[Dodongo, APRN, NP]

You know, when I start precepting I think I will only accept direct entry NP students.

Ha. Have at it.

[Jules A, MSN]

Ha. Have at it.

I'm wondering who she will precept as a AGNP working solely in psychiatry. Maybe it would be approved for a week or so of elective type clinical hours but I would be surprised if all schools don't require their preceptors be board certified in the specialty they are precepting. The students I have precepted from 3 universities all required a copy of all my psych cert and CV.

[shibaowner, MSN, RN, NP]

I'm wondering who she will precept as a AGNP working solely in psychiatry. Maybe it would be approved for a week or so of elective type clinical hours but I would be surprised if all schools don't require their preceptors be board certified in the specialty they are precepting. The students I have precepted from 3 universities all required a copy of all my psych cert and CV.

You don't live in California. We precept NP and PA students from UC Davis. You seem to have a hard time understanding that NP and PA practice is regulated at the state level. Instead of fretting about me, why don't you work for positive change in your own state?