Dear FNP Students, (This can apply to ANY NP, PA, or Medical Student!)
I recently had the pleasure of spending 3 days with some amazing pediatric nurse practitioner (PNP) colleagues at the National Association of Pediatric Nurse Practitioners (NAPNAP) Conference. I met some of the most wonderful nurse practitioners from across the spectrum: PNPs, students, faculty members, Deans of Nursing, and other types of nurse practitioners (NPs). It was a sincere pleasure networking with so many nurse practitioners who have dedicated their professional lives to improving the lives of children and their families. As I heard several times over, “Children are NOT little adults!” They were enthusiastic and earnest in their desire to increase their pediatric knowledge base and to connect with colleagues. Interspersed in the energy, however, I repeatedly encountered a recurrent theme I would like to share with you. These nurse practitioners are inundated with requests for preceptors. Most love to teach and want to share their knowledge and passion with the next generation of NPs. The problem they report is that the next generation of FNP students often appear apathetic and lackadaisical about learning pediatrics! This disinterest in learning pediatrics is causing these pediatric preceptors to feel disheartened and disinterested in teaching FNP students. Here are some of the comments they reported FNP students have said in their pediatric rotations: "I am only here to get my hours done and become an FNP.” "I am not going to do peds when I get out- I am only doing this because I have to do this to graduate." Even if the student doesn’t directly verbalize this, the disinterest is obvious to these dedicated practitioners (and the office staff). This attitude is unacceptable and troublesome, and it’s causing preceptors to quit precepting. These pediatric preceptors (whether NP, PA or MD) are dedicating their time to educate you! Precepting results in decreased productivity, which often results in less income. They spend their time and energy compiling educational material and carefully crafting teaching plans for you. They miss out on family and personal time so they can stay late and work with you! They want you to be excited and interested in pediatric healthcare! It is not fair to these dedicated professionals to act otherwise. We must train our FNPs well in pediatrics because children and their families deserve quality healthcare. FNP students, a disinterested attitude is NOT ok! FNP faculty, please counsel students that this is NOT acceptable. FNP schools, please carefully screen students. Regardless of the area in which you end up working, you must be respectful and appreciative of your preceptor and his/her specialty. Soak up every morsel of knowledge you can from every clinical rotation. Before you know it, you will be out and practicing, and lives will depend on you. (If nothing else, it will help you on Boards.) There is a serious preceptor shortage, especially for pediatric rotations, and this is only making the problem worse. I am dedicated to helping improve the preceptor problem for nurse practitioners, and I continue to search for ways we can help with this issue. Students, being gracious and interested in your clinical rotations will motivate preceptors. If preceptors don’t feel appreciated, they won’t precept! Compassion and passion are some of the characteristics that make nurses special. Demonstrate those behaviors at every clinical rotation. The profession and your future patients need you and are counting on you. About the Author: Lynn McComas, DNP, ANP-C, is an experienced nurse practitioner and an expert on the topic of precepting. Determined to make a difference in “the Preceptor Problem,” Lynn went on to obtain her Doctorate in Nursing Practice (DNP) at the esteemed Duke University, where she focused on finding solutions to the preceptor shortage. She is the owner and founder of PreceptorLink®. The company’s goal is to simplify and streamline the process of preceptor matching while maintaining quality and professionalism throughout. www.PreceptorLink.com Be sure to Like, Follow and Subscribe for future NP, APRN, and Preceptor related content!
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Introduction
The decision to become a Nurse Practitioner (NP) is a significant commitment that requires a substantial investment of time, money, and effort. As rewarding as the career can be, it's crucial for prospective NPs to understand the job market landscape before signing up for an NP program. This awareness can help avoid the disappointment and financial strain that may come from entering a saturated job market. The decision to become an NP should be informed by a thorough understanding of the current job market trends. While the demand for healthcare professionals generally remains robust, certain NP specialties and regions may experience saturation, making it difficult for new graduates to secure positions. Current Job Market Trends for NPs The NP job market in the United States varies widely. Some regions have a high demand for NPs due to physician shortages and an increasing focus on preventive care. However, other areas are saturated, making it difficult for new grads to find positions. Understanding these trends can help you make an informed decision about where and how to practice. How to Research the Job Market So, how do you go about researching the job market? Start with online job boards like Indeed, Glassdoor, and LinkedIn. These platforms provide valuable insights into the demand for NPs in different regions and specialties. Additionally, connect with professionals in the field through local NP associations. Ask local recruiters to be honest with you and let you know if there are new grad jobs, what they pay, and what type of job a new grad can get in your area. Don't underestimate the power of firsthand experiences shared by those already in the profession. Talking to New Grad NPs Talking to new grad NPs can provide invaluable insights. Ask on Facebook pages, but specify your location. They can share their experiences, challenges, and successes, helping you gauge the real-world scenario. Ask about their job search process, the demand for their specialization, and any advice they might have for someone just starting. Understanding Regional Differences The job market for NPs varies significantly by location. Urban areas MAY have more opportunities due to higher population densities and greater healthcare needs, but I have heard complaints from certain large cities, especially when they are close to excellent local NP schools. This is especially true if the new grad attended a less accepted online school over a popular, well-respected, and established local or state school. (Really think about this when you select your school too!) Conversely, rural areas might have fewer positions but can offer other benefits, such as a closer-knit community and potential loan repayment programs for healthcare providers. And there is often a higher need in rural areas. Specialization and Its Impact on Job Availability Your chosen specialization greatly impacts job availability. Family Nurse Practitioners (FNPs) are in high demand due to their broad scope of practice. There is also still a high need for Psych Mental Health Nurse Practitioners (PMHNPs), but as more and more schools graduate new grad PMHNPs, that may change as well. On the other hand, specialties like acute care or neonatal can be more competitive. Research the demand for different NP specializations to make an informed decision about your career path. Financial Considerations Becoming an NP is a significant financial investment. Tuition, books, and certification exams add up quickly. If your school does not find preceptors for you, you may have to find your own preceptor or use a company like PreceptorLink® to help you find a preceptor. It's essential to weigh these costs against potential earnings and job security. Ensure that your chosen specialization and region offer sufficient job opportunities to justify the investment. It’s Not Just a Financial Investment The journey to becoming an NP is not just financially demanding; it's emotionally and time-intensive. Balancing school, work, and personal life can be challenging. Make sure you're prepared for the commitment required and have a strong support system in place. Make sure this is a smart time to go back and take on this extra burden and responsibility. It kills me when I hear and see students literally in tears over how frustrating NP school is, and then to not be able to find a job. Oh boy! The Final Word Before enrolling in an NP program, do your due diligence. Research the job market, talk to current NPs, and understand the financial and emotional investments required. Stay informed about industry trends and be adaptable to changes in the healthcare landscape. Read our other articles to help you decide before you take the big step! We have lots of good info on our Blog! HOWEVER, I will add that if you show initiative and determination; if you work hard and are a great student and potential clinician; and if you are smart and dedicated to finding a job, even if it’s not the right job at first, you can get a job. Be savvy and put yourself out there. Network like crazy. Have a fantastic cover letter and resume. Be someone that the practice/site just HAS to take a chance on! But all of that can take a lot of work, especially in certain parts of the country, so if that’s not you, then make your decision accordingly. About the Author: Lynn McComas, DNP, ANP-C, is an experienced nurse practitioner and an expert on the topic of precepting. Determined to make a difference in “the Preceptor Problem,” Lynn went on to obtain her Doctorate in Nursing Practice (DNP) at the esteemed Duke University, where she focused on finding solutions to the preceptor shortage. She is the owner and founder of PreceptorLink®. The company’s goal is to simplify and streamline the process of preceptor matching while maintaining quality and professionalism throughout. www.PreceptorLink.com The PreceptorLink® Difference At PreceptorLink®, with nearly a decade of experience in preceptor matching, we go beyond simply connecting you with preceptors. We believe in QUALITY. For our NP profession to continue to have positive outcomes, we must ensure quality education. Our goal is to match quality students with quality preceptors to develop quality clinicians. Our founder, Lynn McComas, DNP, ANP-C, has leveraged her extensive experience and contacts as an NP to create our business, educate our team, and design our tech-enabled match-making App. We want to not only connect students with qualified preceptors but also equip them to make the most of this crucial learning phase. We also quant to provide education to help support preceptors. If you need a preceptor, want to become a preceptor, or have a burning question about the nurse practitioner profession, we’re here to help! Lynn and The PreceptorLink® team are experts in the area of precepting and the NP profession. Check out our App, review our How It Works page, or reach out to us at 888-418-6620. www.PreceptorLink.com Be sure to Like, Follow and Subscribe for future NP, APRN, and Preceptor related content! Today I spoke with a new preceptor who really sounds like a great clinician and preceptor! I thought I’d share this PMHNP’s precepting style and method.
A few details about the preceptor:
Interview with D.M, PMHNP: I see patients of all ages with all conditions. The top 5 conditions I treat are as follows:
Philosophy: I consider psychiatric care to be an art form that thrives on collaboration, interaction, and customization for each individual client. Precepting: Students will learn not only the clinical but also the business side of running a practice, including time management and CPT code selection. Medication management and psychotherapy occur with every appointment. Students sit adjacent to me as I interview clients, chart, diagnose, prescribe, and bill insurance companies. I do this mostly in person, but I can also do telepsych with students. The student reviews my charts in the morning. I give the student a brief synopsis, about a minute long, about the patient that he/she's going to see before I see the patient. I'll give the student a brief synopsis of the diagnoses, what's going on, and what medications they're on. My patients are back-to-back, and I see patients from 8:00 in the morning to 4:00 in the afternoon. I do synchronous charting, so I never take charts home. I’m done charting when I am done seeing a patient. If the student has any questions, I tell them to write them down during the patient visit. Then I will answer them either immediately after the appointment, or I will sit with the student and answer them later in the day. Also, anytime that we have a break or if a patient doesn't show up, I’ll answer questions. But I'll ask the students questions, too. I’ll ask things like, “What do you think about this? Do you have any experience with this? Why do you think I picked this medication? I really like to have that full feedback. It helps make them use their critical thinking skills. When I was a student I was with a preceptor where the students were just allowed to observe, and they didn’t provide feedback. Students just don't learn well that way. Students are just basically going off whatever their preceptor's favorite medications are, and then they adopt them as their own. And that's why I always tell people, I'm not going to give you any medication recommendations at all until I hear the full feedback. I'm going over what's going on, from sleep to anxiety to panic attacks to depression to whatever the case may be. You're not going to know all of that usually until towards the end of the interview. So I have the students do that for several encounters and usually the goal is, by the end of the rotation, that now they can do an Initial or a follow-up. Students should be able to take my notes from my last appointment and effectively do a follow-up because I write really good notes. That's one thing that I really train them to do as well. If any type of new medications or something that's kind of interesting shows up, I'll give them a little bit of homework. I might say, “Hey, teach me about X medication. That's a newer medication.” Or “Teach me about Rixalta. You don't hear that too often for bipolar patients. I give them a little useful homework. Preceptor’s choice for their EHR: So we use a system called Advanced MD EHR. It helps with practice management so I can focus on patient care. It even does marketing. It has about four tabs: 1) HPI 2) Mental Status exam 3) Patient vitals and current mood 4) Your medication recommendations, plan, and assessment. It's very user-friendly. Something that I always teach students is synchronous charting. I never bring charting home. I'm a very quick typer. I finish charting between each patient. I see a lot of patients in the day. A lot of people are going to have depression, anxiety, sleep problems. I pretty much see that across the board. So it's not good to get confused, and it's good to chart properly. That’s important. Overall, I love to teach, and I try to teach students how to do it right and do it efficiently. We think D.M., PMHNP, sounds like a fantastic preceptor and provider. We hope you found this Real World Precepting case helpful! Can you share how you like to precept? Let’s all learn from each other. (We generally don’t share names, so preceptors aren’t inundated with requests to precept!) About the Author: Lynn McComas, DNP, ANP-C, is an experienced nurse practitioner and an expert on the topic of precepting. Determined to make a difference in “the Preceptor Problem,” Lynn went on to obtain her Doctorate in Nursing Practice (DNP) at the esteemed Duke University, where she focused on finding solutions to the preceptor shortage. She is the owner and founder of PreceptorLink®. The company’s goal is to simplify and streamline the process of preceptor matching while maintaining quality and professionalism throughout. www.PreceptorLink.com Be sure to Like, Follow and Subscribe for future NP, APRN, and Preceptor related content! Time-Saving Tip for Preceptors: Empower Students as Scribes!
Hey there, fellow preceptors! I have a strategy that may help streamline your day and boost student learning. Consider having your students scribe for you! Double Duty with Scribing: Student scribes can be a fantastic asset. Here's why:
Beyond Time-Saving: Even if you already use a dictation service like FreedAI or DeepScribe, consider incorporating student scribes as well. Here's the bonus:
Let's Share the Knowledge! Student scribes can significantly enhance your day's efficiency while providing valuable learning experiences. Do you have any time-saving tips or success stories with student scribes? Share them in the comments! Let's build a supportive community of preceptors who learn from each other. About the Author: Lynn McComas, DNP, ANP-C, is an experienced nurse practitioner and an expert on the topic of precepting. Determined to make a difference in “the Preceptor Problem,” Lynn went on to obtain her Doctorate in Nursing Practice (DNP) at the esteemed Duke University, where she focused on finding solutions to the preceptor shortage. She is the owner and founder of PreceptorLink®. The company’s goal is to simplify and streamline the process of preceptor matching while maintaining quality and professionalism throughout. www.PreceptorLink.com The PreceptorLink® Difference At PreceptorLink®, with nearly a decade of experience in preceptor matching, we go beyond simply connecting you with preceptors. We believe in QUALITY. For our NP profession to continue to have positive outcomes, we must ensure quality education. Our goal is to match quality students with quality preceptors to develop quality clinicians. Our founder, Lynn McComas, DNP, ANP-C, has leveraged her extensive experience and contacts as an NP to create our business, educate our team, and design our tech-enabled match-making App. We want to not only connect students with qualified preceptors but also equip them to make the most of this crucial learning phase. We also want to provide education to help support preceptors. If you need a preceptor, want to become a preceptor, or have a burning question about the nurse practitioner profession, we’re here to help! Lynn and The PreceptorLink® team are experts in the area of precepting and the NP profession. Check out our App, review our How It Works page, or reach out to us at 888-418-6620. www.PreceptorLink.com Be sure to Like, Follow and Subscribe for future NP, APRN, and Preceptor related content! You searched and searched, and you finally did find a preceptor! Yeah! You recently started clinicals, but now you aren’t seeing enough patients or certain types of patients that you need! If it’s not one thing, it’s another!
I frequently hear nurse practitioner students complain about this, so I wanted to share some tips on how to increase your patient census, especially if you're an NP student struggling to fill your schedule. (This approach works for new grads or clinicians who are new to a practice as well!) Understanding the Challenge Many NP students find it challenging to get enough patient hours. Sometimes, students are just not getting enough hours in general, but frequently, they are short on patients in a specific area like pediatrics or women’s health. It’s important that students have quality clinical rotations and see all ages and as many types of patients. This is especially vital since fewer physicians are going into pediatrics anymore. Not seeing a diverse population of patients can prevent you from obtaining your necessary clinical hours, hinder your learning, delay your progress, and keep you from your goals: graduation, being prepared for clinical practice, and finding a nurse practitioner job! Whether it's a low census period, such as summer, or a need for more specialized cases like pediatrics, women’s health, or geriatrics, there are effective strategies to address this issue. Below, I outline practical approaches to help ensure you meet your clinical requirements. Communicate with Your Preceptor and Office Staff So what do you do? First, communicate with your preceptor. Make sure they understand your need for more patient interactions. Frequently, your preceptor can suggest people for follow-up, but sometimes they just don’t have the time to do this in their busy day. In this case, the Office Manager or the scheduler can often help you identify potential return visits. If they are willing to take the time with you (bringing them a cup of coffee from their favorite coffee place can help incentivize them!) and review potential patients together. Look for patients who have what you need for optimal learning (and clinical check-offs. Let’s keep it real!) Patients who are due for follow-ups – blood sugar checks, failure to thrive assessments, pap smears, breast exams, imaging, or lab work. Is there a diabetic or hypertensive patient due for follow-up? Use Electronic Health Records (EHR) to identify these patients efficiently too. Another approach is to bring up a follow-up with a patient you are currently seeing. “Kelly, it’s been a few years since we did a pap smear on you. Would you like us to schedule you for follow up on that?” “Mrs. Smith, did you ever get that follow-up breast exam.” “Samantha, I see that we see your kids here as well. Do you want to schedule their sports physicals now before it gets too busy?” Build the patients you need into your schedule. This approach works when you are a new hire and you are trying to fill your schedule, too! Create Follow-Up Visits So, you’ve identified some patients. Now, what do you say when you call? (Or, if it’s the scheduler, what can they say?) I suggest something like this, “Hi, Mrs. Jones. This is Lynn McComas, and I am an NP student working with NP Smith. She wants you to come in for a follow-up on your XYZ problem. We’d love to get you in for a visit. How does this Friday work for you?” Or, “Good morning, Mrs. Jones. I’m Lynn McComas, an NP student working with NP Smith. NP Smith mentioned that you are due for a follow-up breast exam. We have an opening on Tuesday. Would that work for you? Great! Let me hand you over to the scheduler!” Suggest days when you are in the clinic, of course, but you may even need to come in on a day that you weren’t planning on coming. (Again, get the ok from your preceptor on this! They may have other students on that day.) You have now “pre-introduced” yourself to the patient, which will make the follow-up introductions even easier. A friendly reminder call can go a long way in making patients feel valued and cared for. The clinic benefits, the patient benefits, and you can get your needed hours and experience! Plus, you can study up a bit on the visit before it happens. Win, Win! Create Visits with Existing Patients Sometimes, opportunities for the required patient encounters can be created during visits with existing patients.
Leveraging Technology Utilize patient portals to identify patients who are overdue for visits, labs, or imaging for easy scheduling and for automated reminders. These tools can significantly reduce no-show rates and keep your schedule full. Then, for best results, follow up with a phone call. Expanding Your Network to Other Providers Network with other healthcare providers in the practice or hospital. This can be especially helpful for Acute Care or inpatient settings, but really for any sites that have multiple providers. Let them know your needs and ask if you can see any [peds, women’s health, cardiac, etc.] patients with them. (Once again, be sure to get your preceptor’s permission for this first.) This not only helps you see the patients you need, but it also helps you meet other providers (for future clinicals or general networking). Conclusion Finding the types of patients that you need for clinical rotations can be challenging, but with proactive strategies and a positive attitude, you can turn this around. Communicate with your preceptor, take initiative, and utilize available resources to maximize your clinical experience. These strategies, grounded in practical experience, can make a substantial difference in achieving your clinical rotation goals. Remember, every challenge is an opportunity to learn and grow. Keep pushing forward, stay patient, and continue to build your skills. Keep on learning! About the Author: Lynn McComas, DNP, ANP-C, is an experienced nurse practitioner and an expert on the topic of precepting. Determined to make a difference in “the Preceptor Problem,” Lynn went on to obtain her Doctorate in Nursing Practice (DNP) at the esteemed Duke University, where she focused on finding solutions to the preceptor shortage. She is the owner and founder of PreceptorLink®. The company’s goal is to simplify and streamline the process of preceptor matching while maintaining quality and professionalism throughout. www.PreceptorLink.com Be sure to Like, Follow and Subscribe for future NP, APRN, and Preceptor related content! |
About Lynn:As a longtime NP with a desire to help and make positive changes to her beloved profession, Lynn often writes opinion pieces about the NP profession. Archives
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"Why NPs train on the backs of physicians"
from KevinMD |