 I often find I can't turn off my clinical side. Recently, I had to take my three-year-old dog to the vet for decreased appetite. I watched the vet circle his hands around her abdomen to palpate her internal organs. I watched him pause... “Did he just hesitate as he palpated her? Did he feel something abnormal?" I remember thinking this to myself. Questioning his hesitation. But moments later, he completed his exam and said she was normal. I didn’t question him, and he said she looked great. He was a seasoned vet. He should know what he’s doing, right?
Turns out, I should have questioned him. He did feel something. Things were not normal, and her spleen was actually four times its normal size! He just questioned his physical exam and thought it wasn't possible in such a healthy-looking three-year-old dog. Darn! I should have listened to my gut and questioned whether he felt something. I didn’t listen to my intuition or observation skills. Trust Your Clinical Instincts As healthcare professionals, our clinical intuition, along with our assessment skills, can be a powerful tool. Our training, experience, and pattern recognition can help us to sense when something isn't right, even before lab results or imaging confirm it. There’s more to it, though. The Science Behind Clinical Intuition Research supports the role of intuition in clinical decision-making. Studies suggest that experienced clinicians often make faster, more accurate assessments based on subconscious pattern recognition. This doesn’t mean we abandon evidence-based practice. It means we acknowledge that intuition is a refined skill developed through exposure and experience. When Instincts Are Overridden How many times have you felt something was "off" but hesitated to speak up? Here are common reasons clinicians ignore their intuition:
Real-World Clinical Intuition in Action One case stands out to me: A patient had been coming into the practice for years with a diagnosis of TMJ. I was new to him, and he was asking for the same old treatment—pain meds. I dug a little deeper into his history, and one phrase he used caused me to pause. "It's a shocky feeling in my ear." I remember stopping, looking at him with a puzzled expression, and thinking, "Shocky does not sound like TMJ." I asked if he'd ever had HSV, and he had. A little further digging, and, on a hunch, I asked if he'd be willing to trial some Acyclovir. He was. Sure enough, it worked. His ear pain was not TMJ but recurrent herpes. He was forever grateful to me for listening to my gut. Another time, I saw a patient who had been repeatedly diagnosed with anxiety and prescribed medications accordingly. Something about their vague complaints, an uneasiness in their chest, a sense of "impending doom," made me reconsider. I ran a D-dimer, and sure enough, they had a pulmonary embolism. That gut feeling saved a life. Developing and Honing Clinical Intuition If intuition is a skill, it can be strengthened. Here’s how:
Takeaways for NPs, NP Students, and Clinicians
Clinical intuition is not a replacement for science; it’s a complement to it. As healthcare professionals, we owe it to our patients to balance data with instinct, ensuring the best possible outcomes. While Kira’s journey has come to a close, the lesson she left me with lives on: Trust your training. Trust your eyes. And above all, trust your gut. It just might be speaking the truth before anyone else can see it. Have you ever had a gut feeling that turned out to be right? Share your experience! About the Author Lynn McComas is the CEO and founder of PreceptorLink and a recognized expert in precepting nurse practitioners and advanced practice provider students. With over two decades in primary care, Lynn has served as a coach, advisor, mentor, and preceptor for countless healthcare professionals, including NPs, nurses, and medical assistants. She co-founded a successful skills and procedures business and speaks nationwide on NP-related issues. Lynn is also a regular contributor on LinkedIn, KevinMD, Facebook, YouTube, Instagram @preceptorlink, X @LynnMcComas, and her blog, where she addresses the growing NP and PA professions and the urgent need for preceptor sites. Her unique perspective, shaped by her business, clinical, and educational experiences, positions her as a key voice in tackling preceptor shortages. Lynn is committed to driving change—through a paradigm shift in NP education, reducing barriers, offering preceptor incentives, and advocating for reforms within the profession.
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Should Preceptors Be Paid? (Or get something for their time?!) Here’s Why We Think They Should7/9/2025  Preceptors are a mandatory and vital part of NP education. We honestly don’t understand why some in the profession still feel that precepting should be an expected and unrewarded “part of their role.” Imagine if school faculty were expected to work for free or receive a certificate of appreciation! In our opinion, there is value in precepting, and preceptors should receive something for their time and expertise. What exactly that might be is up to the preceptor and/or the school. For some, it might mean tickets to basketball games or access to library resources, but it also might include an honorarium. We do feel that schools should bear this cost. If they have to build it into student fees, then so be it. The cost would still be passed on to the student, but it would be the school’s responsibility, not the student’s. We love working with quality schools, by the way! No, I did not have to pay a preceptor way back when I got my Master’s NP degree. My school offered to find them nearby, or I could find my own if I wanted someone closer since I drove a couple of hours to school. I got my Masters back in the day when brick and mortar was the norm. I drove two+ hours twice a week to attend class. The expectation back then was that you drove to campus. When I got my doctorate at Duke University, I flew across the country from San Diego to North Carolina. The faculty at Duke acted as my DNP project advisors, but I definitely wanted my own preceptor site closer to home, so I found one on my own. But a lot has changed since then. It’s more complicated to precept today, which makes placement even harder. With nearly 500 NP schools across the nation, the competition is incredible to find a placement. Additionally, it’s more complicated for clinical sites due to malpractice, billing, affiliations, and the bureaucratic nature of the process. I dive into that more in my article on the shortage of nurse practitioner preceptors. Why Precepting Isn’t as Simple as It SeemsThere’s much more involved in precepting than simply supervising a student. Today’s preceptors take on added responsibilities that can directly affect their time, income, and even legal protection. Many clinicians are on RVU-based reimbursement models, where income depends on the number of patients seen. Taking time to teach can reduce productivity and lead to lost income. In addition, concerns about malpractice liability often arise, especially when there is no clear agreement outlining coverage for students. (I’d recommend ALWAYS have your own malpractice, and include a tail.) The administrative burden is also heavier than most expect. Affiliation agreements between schools and clinical sites can be time-consuming and difficult to navigate. Some agreements take months to finalize, adding stress to an already full workload. This can be hard on both the preceptor AND their site. Time, too, is a major factor. Between patient care, charting, and other responsibilities, most providers already work at capacity. Adding teaching into the mix can feel overwhelming, even for those who value mentoring. These challenges are real. And they are exactly why we believe preceptors should be compensated or recognized meaningfully for the essential role they play. Final ThoughtsPreceptors are essential to the future of nursing. Without them, NP students can’t complete their education—and yet, too often, they’re expected to work for free. That expectation simply isn’t sustainable.
We believe preceptors deserve to be compensated or meaningfully recognized for their time, energy, and expertise. Whether it's financial or material compensation, professional perks, or institutional support, their contribution should never be taken for granted. At PreceptorLink®, we’ve helped thousands of NP students find quality clinical placements. While we wish this process were easier (and less costly), we’re here to help you navigate it with confidence and support. 👉 Find or Become a Preceptor About Lynn Lynn McComas is the CEO and founder of PreceptorLink and a recognized expert in precepting nurse practitioners and advanced practice provider students. With over two decades in primary care, Lynn has served as a coach, advisor, mentor, and preceptor for countless healthcare professionals, including NPs, nurses, and medical assistants. She co-founded a successful skills and procedures business and speaks nationwide on NP-related issues. Lynn is also a regular contributor on LinkedIn, KevinMD, Facebook, YouTube, Instagram @preceptorlink, X @LynnMcComas, and her blog, where she addresses the growing NP and PA professions and the urgent need for preceptor sites. Her unique perspective, shaped by her business, clinical, and educational experiences, positions her as a key voice in tackling preceptor shortages. Lynn is committed to driving change—through a paradigm shift in NP education, reducing barriers, offering preceptor incentives, and advocating for reforms within the profession.  Deciding whether to pursue a Doctor of Nursing Practice isn’t just about adding another credential. It’s about looking at your future and asking, “What kind of impact do I want to make?” I remember sitting with that same question when I was an experienced nurse practitioner, unsure whether the DNP would truly change the way I practiced or open doors I couldn’t already access. Now, having completed my DNP at Duke University, I can tell you it reshaped how I think about healthcare, leadership, and my role in this profession. If you're exploring the possibility of a DNP, I want to share what I’ve learned, what to expect, and how to decide if this path makes sense for your goals. Let’s walk through what a DNP really involves and whether it aligns with where you see yourself going. What You Need to Know About the DNPA DNP is a practice-focused doctoral degree that prepares nurse practitioners (NPs), clinical nurse specialists (CNSs), nurse anesthetists (CRNAs), and nurse midwives (CNMs) to take on leadership roles in clinical care, healthcare policy, and education. Unlike a PhD, which focuses heavily on research, the DNP is all about applying evidence-based practice, improving healthcare systems, and driving quality improvement in real-world settings. There are two common ways to enter a DNP program:
Should APRNs with an MSN Get a DNP?If you’re already a nurse practitioner, clinical nurse specialist, CRNA, or nurse midwife with your MSN, you might be wondering whether a DNP would truly make a difference in your career. I had the same questions when I was at that stage, and here’s what I considered and what you might want to think about too. 1. Do You Need a DNP to Stay Competitive? Many APRNs still practice with an MSN, and that’s completely valid. But things are shifting. Some hospitals and academic settings are starting to prefer or require a DNP, especially for roles in leadership, education, or policy. For example:
2. Will a DNP Increase Your Salary? This varies. In clinical settings, a DNP doesn’t always lead to higher pay. But in leadership, administrative, or policy roles, the DNP is often expected and those roles tend to come with higher salaries. A colleague of mine transitioned from full-time clinical work into a director-level role in population health after completing her DNP. She wouldn’t have qualified for that position without the degree, and it came with both increased pay and a chance to lead large-scale initiatives. 3. Are You Drawn to Systems and Leadership Work? This was the deciding factor for me. I wanted to improve more than just individual outcomes. I wanted to tackle the systems behind them. DNP programs focus on quality improvement, population health, leadership, and finance. If those topics speak to you, this path can give you the skills to make a much wider impact. You might design a telehealth program for underserved communities or work within your hospital system to reduce readmissions. These are the kinds of projects that DNP-prepared nurses are trained to lead. For BSN-Prepared RNs: Is a Direct-Entry DNP the Right Move?More RNs are considering skipping the MSN and going straight into a DNP program. It sounds efficient, but it’s not always the best fit for everyone. Can You Handle the Academic and Clinical Demands? Direct-entry DNP students take on advanced practice coursework, clinical training, and doctoral-level projects all at once. It’s a heavy lift and a long road. I’ve seen nurses get through these programs, but I’ve also seen burnout. It takes strong time management, support, and a lot of grit. One former student I mentored told me that going directly from a BSN to DNP felt like “learning two languages at once.” She made it through, but she also admitted that having a year or two of NP experience first would have helped her feel more grounded during clinical rotations. Do You Have Enough Bedside Experience? Nurses who’ve spent time in direct patient care often adapt more easily to the clinical decision-making required of NPs. If you’re early in your career, you might feel like you’re playing catch-up, especially with complex diagnostic work. Some nurses prefer to earn their MSN, build some practice experience, and then return for their DNP when they’re ready for leadership. You can also check AACN’s guidance on DNP programs to better understand expectations for each pathway. DNP Pros and Cons Based on ExperienceAdvantages
Heavy academic and clinical workload, especially for direct-entry students How I Made My DecisionWhen I chose to pursue my DNP, I had already spent years in practice as an NP. I knew I wanted to go beyond individual patient care and influence the broader system. I also had an interest in mentoring and teaching future nurse practitioners. The DNP gave me the skills, credentials, and confidence to step into those roles. If you're on the fence, ask yourself:
There’s no wrong answer. Only what’s right for you. Final ThoughtsThe DNP isn’t for everyone, and that’s okay. You don’t need a doctorate to be an outstanding nurse practitioner. But if your vision includes teaching, leading, or transforming healthcare on a larger scale, the DNP can be a powerful step forward.
It was the right choice for me, and I’m proud to use what I learned every day to support students, patients, and the future of our profession. About Lynn Lynn McComas is the CEO and founder of PreceptorLink and a recognized expert in precepting nurse practitioners and advanced practice provider students. With over two decades in primary care, Lynn has served as a coach, advisor, mentor, and preceptor for countless healthcare professionals, including NPs, nurses, and medical assistants. She co-founded a successful skills and procedures business and speaks nationwide on NP-related issues. Lynn is also a regular contributor on LinkedIn, KevinMD, Facebook, YouTube, Instagram @preceptorlink, X @LynnMcComas, and her blog, where she addresses the growing NP and PA professions and the urgent need for preceptor sites. Her unique perspective, shaped by her business, clinical, and educational experiences, positions her as a key voice in tackling preceptor shortages. Lynn is committed to driving change—through a paradigm shift in NP education, reducing barriers, offering preceptor incentives, and advocating for reforms within the profession. |
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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