Why are preceptors not provided in MSN programs?

[Lajimolala]

I don't mean to come off complaining. I'm genuinely prepared to search for my own clinical sites as I have already applied to three schools. But I just wondered, in my RN program, I never had to worry about it. Why is it the norm for RN education to have clinical sites provided, but not MSN?

[IrishIzCPNP, MSN, RN, APRN, NP]

An NP's teaching role can be dictated by the practice they belong to. As employees of a university medical center our NP group gets an ACNP student and/or a Medical Student rotating with us in the ICU. This is not our choice, as both Schools of Nursing and Medicine coordinate student rotation schedules at the medical center. Chances are you are contacting NP's who belong to a teaching service that is part of a medical school. You can't fault NP's for following their practice's teaching mission albeit leaving out non-affiliated NP students high and dry. Too bad NP programs can't do the extra legwork medical schools do to secure clinical sites -- I'm sure a big part of that is because medical schools have more funding and/or donor support.[/quote']

Oh I totally get why this is happening. The thing is...it's clear that most of these NPs are not happy about it. They don't seem to like turning away NP students for med students. Some have been told no NP students and only med students. So leg work or not...NPs are being told that med students take priority.

I personally will do everything in my power to ensure my contract states I make the choice of who I precept. I'm not going to precept med students over NP students when I am in the position. So some of this isn't dictating early on but NPs being overpowered by the MD world.

Seriously if MDs are going to try and stop NP independent practice....NPs shouldn't be educating future MDs.

[BostonFNP, APRN]

That's admirable. I hope you stick to your guns about that in the coming 2-3 years when you start getting the opportunity to precept.

Most major academic medical centers don't specifically limit NPs to "only" taking MD students. I trained in several of these facilities alongside MD students and PGY1-4s. It was an enriching experience and a collaborative one. I still talk to several of these people on a regular basis in practice.

Unfortunately, the academic centers often don't have much room for negotiating your contract so the choice would come between taking the job and not, and that is a tough choice over a volunteer work of precepting.

[IrishIzCPNP, MSN, RN, APRN, NP]

That's admirable. I hope you stick to your guns about that in the coming 2-3 years when you start getting the opportunity to precept. Most major academic medical centers don't specifically limit NPs to "only" taking MD students. I trained in several of these facilities alongside MD students and PGY1-4s. It was an enriching experience and a collaborative one. I still talk to several of these people on a regular basis in practice. Unfortunately the academic centers often don't have much room for negotiating your contract so the choice would come between taking the job and not, and that is a tough choice over a volunteer work of precepting.[/quote']

I'm actually seeing this outside of major universities as well. I knew a doctor who wanted to precept an NP at a non-hospital own practice. This practice was not with a major university...not even close. This doctor was told by the owners of the practice she couldn't precept...had to save room for med students.

There's always some room for negotiating...and there's always the ability to just say no. I've stuck to my guns on bigger things in the past. I will do med students...but not in place of NP students. If that isn't acceptable...I can't see that employment as a good fit. For me...not a tough choice. I've put more at risk in the past....

[BostonFNP, APRN]

I'm actually seeing this outside of major universities as well. I knew a doctor who wanted to precept an NP at a non-hospital own practice. This practice was not with a major university...not even close. This doctor was told by the owners of the practice she couldn't precept...had to save room for med students. There's always some room for negotiating...and there's always the ability to just say no. I've stuck to my guns on bigger things in the past. I will do med students...but not in place of NP students. If that isn't acceptable...I can't see that employment as a good fit. For me...not a tough choice. I've put more at risk in the past....

Many small practice physicians are actually paid by the community hospital. If that hospital is a teaching hospital they will have med students.

[IrishIzCPNP, MSN, RN, APRN, NP]

Many small practice physicians are actually paid by the community hospital. If that hospital is a teaching hospital they will have med students.

In this case...that's not it. This is private practice in a nice area. Some of the doctors...apparently aren't NP friendly. They don't have an NP on staff either...not shocked.

[BostonFNP, APRN]

In this case...that's not it. This is private practice in a nice area. Some of the doctors...apparently aren't NP friendly. They don't have an NP on staff either...not shocked.

They don't have admitting privileges to a hospital? They don't belong to an IPA? That's interesting. I don't know how they could even take medical students.

[IrishIzCPNP, MSN, RN, APRN, NP]

They don't have admitting privileges to a hospital? They don't belong to an IPA? That's interesting. I don't know how they could even take medical students.

They have privileges as the local hospital. They may get paid to precept med students. I'm just saying they aren't in bed with the local hospital for anything else. They didn't even care if they would get paid for the NP student. They have to "save room for med students"...yet several patients report never seeing a med student after being there for years as patients. Some suggestion...just anti-NP.

I had one NP tell me she had to precept med students over NP students...in the NP run practice. The NPs run the practice but aren't allowed to educate NP students. Hmmmm...

[BostonFNP, APRN]

Could also just be an excuse.

[Corey Narry, MSN, RN, NP]

They have privileges as the local hospital. They may get paid to precept med students. I'm just saying they aren't in bed with the local hospital for anything else. They didn't even care if they would get paid for the NP student. They have to "save room for med students"...yet several patients report never seeing a med student after being there for years as patients. Some suggestion...just anti-NP. I had one NP tell me she had to precept med students over NP students...in the NP run practice. The NPs run the practice but aren't allowed to educate NP students. Hmmmm...

This is exactly why NP students shouldn't be the ones knocking on the doors of clinics to ask for clinical placements. In schools that arrange clinical rotations, these happen behind the scenes where school administration (I.e., an associate dean or someone high up) makes the contractual arrangement with practice managers, NP practices, and physician groups to secure clinical sites. I bet you there's a difference in response when an academic administrator and a clinic administrator talk together. If what your insinuating is an MD vs NP battle I'm curious to know what state this is and whether AANP should be alerted if this.

[IrishIzCPNP, MSN, RN, APRN, NP]

This is exactly why NP students shouldn't be the ones knocking on the doors of clinics to ask for clinical placements. In schools that arrange clinical rotations these happen behind the scenes where school administration (I.e., an associate dean or someone high up) makes the contractual arrangement with practice managers, NP practices, and physician groups to secure clinical sites. I bet you there's a difference in response when an academic administrator and a clinic administrator talk together. If what your insinuating is an MD vs NP battle I'm curious to know what state this is and whether AANP should be alerted if this.[/quote']

You don't think there's MDs who don't like NPs? The MDs are part of the reason NPs have to fight for independent practice. Not all MDs are warm and fuzzy about NPs. That's nothing new.

The AANP knows that now all MDs are supportive of NPs.

[Corey Narry, MSN, RN, NP]

You don't think there's MDs who don't like NPs? The MDs are part of the reason NPs have to fight for independent practice. Not all MDs are warm and fuzzy about NPs. That's nothing new.

The AANP knows that now all MDs are supportive of NPs.

OK, I understand you're still on that vigilant student "NP Power" mode "the MD machinery is oppressive" mentality. As a practicing NP, I do not deal with MD's that oppress my practice. Sure, our state NP's battled and was left to lose in one of the most aggressive independent practice legislation proposal the state has even seen. That's all political. At the end of the day, my MD colleagues and our NP group continue to work harmoniously respectful of each other's role.

When you said, that NP-run practices in your state are being prevented by MD's to precept, that's a serious accusation worthy of investigation by a watchdog group and AANP is the organization poised to take on such a role.

[IrishIzCPNP, MSN, RN, APRN, NP]

OK, I understand you're still on that vigilant student "NP Power" mode "the MD machinery is oppressive" mentality. As a practicing NP, I do not deal with MD's that oppress my practice. Sure, our state NP's battled and was left to lose in one of the most aggressive independent practice legislation proposal the state has even seen. That's all political. At the end of the day, my MD colleagues and our NP group continue to work harmoniously respectful of each other's role.

When you said, that NP-run practices in your state are being prevented by MD's to precept, that's a serious accusation worthy of investigation by a watchdog group and AANP is the organization poised to take on such a role.

Wrong assumption that I'm in "NP Power" mode. You make so many assumptions about so much...you should stop. Is it possible I know doctors who don't like NPs? Why certainly that is possible...and I do know MDs who don't like NPs. They are out there and you are lucky you haven't run into them.

I was told by the NP that she has to take the med students and she tries to get NP students in when she can. It is an NP run...not NP owned practice...so the MDs make the decisions and have told them med students are the priority.