 If you are a nurse practitioner student in Texas, whether FNP, PMHNP, AGACNP, or another track, clinical rotations are one of the most important and stressful parts of your program. Texas has dozens of NP programs and thousands of students competing for placements. High demand, evolving site expectations, and state-specific requirements make the process challenging. This guide covers what rotations are, how they work in Texas, where the challenges lie, and how to set yourself up for success.
Clinical rotations are not just a graduation requirement. They are where you sharpen your clinical judgment, learn how to manage patient care, and build professional confidence. Strong performance can lead to job offers or professional connections. They also prepare you for licensure by documenting required clinical hours. Treat every rotation as if it were a job interview because they often open doors to your first NP position. For specific tips on excelling during rotations, see what NP students should do and not do for clinical rotations. Here is how rotations usually work in Texas. Your program sets required hours and specialties. You secure a preceptor, sometimes with school assistance. An affiliation agreement must be signed between your school and the clinical site. You complete supervised hours, receive evaluations, and submit documentation for approval. A few schools such as TWU, UT Health San Antonio, and Cizik School of Nursing help with placements, but most students are responsible for finding their own preceptors. Rotations in Texas are challenging because of high competition for limited preceptors, provider burnout reduces the willingness to teach, affiliation agreements often take months to finalize, and geographic barriers add complexity in rural regions. Demand far exceeds supply, especially in major cities like Dallas and Austin. Texas is projected to need more than 13,000 additional nurse practitioners by 2036, yet over 60 percent of counties are designated shortage areas. But what I hear in the real world is that it is very hard for new grads to find jobs in certain cities. This will translate when it comes to a preceptor search. If it’s hard for a new grad to find a job, it will likely be hard for a student to find a placement. You may need to be more flexible if you are in an impacted area. Where you rotate matters. In large cities such as Houston, Dallas, Austin, and San Antonio, you may access specialists, high acuity cases, large health systems, and networking opportunities. The tradeoff is limited preceptor availability, long onboarding, and challenges with Affiliation Agreements. If your school doesn’t already have one in place with a large healthcare institution, the site is unlikely to add another school. Then you find you’re shut out of multiple options in the area. In rural regions, students often gain more responsibility, closer mentorship, and broader patient exposure. Many students report that rural placements become the best part of their program. Border and underserved regions such as South Texas or the Rio Grande Valley provide unique opportunities to serve communities in need, build cultural competence, and gain experience with interdisciplinary teams. These sites often welcome students and can offer stipends, housing, or future job opportunities. And, you’ll get to buff up on your Spanish, a skill that can make you more marketable. HRSA sites can be a great option. You can use this HRSA tool to find Health Professional Shortage Areas (HPSAs) across Texas. Preceptors in Texas must be an NP, MD, DO, PA, or other approved provider, practicing in the same specialty, in good standing with their board, and working in a clinical site that meets school requirements. There is no statewide list, so eligibility must be confirmed with your school. To secure a preceptor in Texas, start early, ideally 4 to 6 months in advance, and even earlier in cities. Ask your school for preceptor lists and information on approved sites. Use a professional matching service such as PreceptorLink® if you are short on time or struggling to find options. Tap into your network by asking classmates, coworkers, and local NPs, and use professional groups on Facebook or LinkedIn. When contacting a preceptor, be professional, include who you are, what you need, your school, your dates, and attach a polished cover letter and CV. See also Preparing for Clinicals: 13 Essential Questions To Ask Before You Start to help you get ready for each rotation. Affiliation agreements are often the biggest source of delay. These legal contracts can take 30 to 90 days or more to finalize. Always ask your school which sites are already affiliated, especially if you need inpatient or ER or are trying to secure a preceptor at a large facility. Your school knows where they have affiliations in place! It always frustrates me when students say their school won’t tell them. Really, this is the least they can do! If your chosen site is new, begin paperwork immediately and stay in close contact with your school coordinator. You may need to follow up directly to move things forward. At PreceptorLink® we help facilitate this process and reduce bottlenecks. The Texas Board of Nursing requires that all clinical placements follow strict standards. Sites must provide appropriate learning experiences, written agreements must be in place, preceptors must be credentialed, and faculty must retain oversight even if preceptors supervise. Students may only accept clinical tasks they are prepared for and must seek supervision when faced with new or unfamiliar situations. Clinical records and evaluations must be properly documented and retained by the school. In summary, NP clinical rotations in Texas are competitive, time-consuming, and often overwhelming, but they are also an opportunity to grow and launch your career. Plan early, keep an open mind about rural or underserved areas, and use every available resource, including your school, your network, and professional placement services. Treat rotations as job interviews, show up prepared, and build lasting professional relationships. If you need help finding a preceptor in Texas, PreceptorLink® connects NP students with vetted placements across specialties and supports you through paperwork, communication, and coordination with your school. Visit the PreceptorLink app to start your search today!
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 Finding a preceptor is one of the biggest challenges nurse practitioner (NP) students face today. If you’ve ever spent hours cold-calling clinics, emailing providers, and still come up empty, believe me, you’re not alone. One question I hear all the time is: “Why don’t schools help with preceptor placement?” The short answer is: sometimes they do. Some schools go above and beyond, building strong preceptor networks and actively securing sites. Others may promise help, but the reality is that students still do most of the legwork. A few programs, however, provide little to no assistance at all. This inconsistency leaves many students frustrated and unsure of what to expect. In this article, I’ll share what I’ve learned about how schools approach preceptor placement, where the gaps often are, and why this matters so much for NP students. What Accreditation Standards Actually SayMany students assume schools are going to find them preceptors. The truth is, accrediting bodies like the Commission on Collegiate Nursing Education (CCNE) do require schools to provide students with high-quality clinical experiences. CCNE’s 2024 Standards, effective January 1, 2025, require programs to ensure quality clinical experiences and clear policies around clinical requirements and placements, but they do not mandate that schools personally arrange every preceptor for every student. Some schools go above and beyond, helping secure sites, coordinating paperwork, and even offering school-linked clinics (most have med schools attached). Others place the responsibility almost entirely on students to track down their own preceptors. Do your research and ask for clarity in writing to find out the truth. Look on nursing and social forums to find out the truth as well. Just because they claim to help doesn’t necessarily mean they actually do. Schools That Do Offer Support A few universities stand out for actively assisting students. Some well-resourced or highly selective programs do usually place their students, or at least help. Students should expect to pay higher tuition or clinical fees, but many feel it’s well worth it. These schools generally have real faculty involvement and support as well. That said, even for the schools that “help,” students sometimes report that support is limited or inconsistent. It’s not unusual for programs to say they’ll assist, only for students to still end up making most of the calls themselves. Watch for an upcoming article on this subject as well! How Schools Can Help with Preceptor PlacementWhen schools take preceptor placement seriously, it shows. Quality programs don’t leave students to fend for themselves. They build systems that make the process smoother for everyone involved. Whether that means bringing outside help (like PreceptorLink®/AMO) or having their own team, they support students. Here are some of the most effective ways schools can support preceptorships: 1. Building Preceptor Networks Schools that invest in long-term relationships with hospitals, clinics, and community practices give their students a huge advantage. By keeping a list of trusted preceptors who have worked with the program before, schools can quickly connect students with providers who already understand the expectations. 2. Providing Administrative Support Anyone who’s gone through preceptor placement knows that paperwork can be a mountain. Site agreements, credentialing, background checks can be overwhelming. Schools that step in to handle these details remove a major burden from both students and preceptors. 3. Involving Faculty in the Process Good faculty support goes beyond the classroom. Some programs send faculty advisors to clinical sites to check in on students and preceptors. Others provide structured evaluation tools that make it easier for preceptors to give consistent feedback. These touchpoints help ensure quality and show preceptors they aren’t alone in guiding students. 4. Offering Incentives for Preceptors Let’s face it. Precepting takes time and effort. Schools that recognize this with small stipends, continuing education credits, or even formal recognition programs tend to keep their preceptors engaged. A little appreciation goes a long way. 5. Preparing and Supporting Preceptors Not every great clinician has been trained to teach. Schools that offer orientation sessions, workshops, or access to academic resources (like online libraries) help preceptors feel more confident in their role. This, in turn, creates a better learning environment for students. 6. Leveraging Technology Some schools are getting creative by using placement software to match students with available sites, reducing the back-and-forth. Others are even exploring telehealth preceptorships in rural areas, expanding opportunities for students while addressing access issues. When schools put these pieces in place, it doesn’t just make life easier for students. It also strengthens relationships with preceptors and improves program outcomes. Everyone benefits: students, faculty, preceptors, and ultimately, patients. The Challenges Schools FaceOf course, I want to be fair here. Schools don’t always withhold support out of neglect. In many cases, they’re navigating challenges that make preceptor placement more complicated than it looks from the outside.
The Challenges Students FaceFrom a student’s point of view, the struggle to secure a preceptor can feel overwhelming. You’re balancing coursework, deadlines, and family responsibilities. On top of that, you’re expected to find someone willing to precept you. Here are some of the most common challenges I hear from students:
How PreceptorLink® Helps Schools with Preceptor Placement Schools really should be helping their students secure clinical placements, but the reality is, not every program has the time, connections, or infrastructure to do it well. And when that happens, it’s the students who end up struggling. That’s why we created our Schools Program. At PreceptorLink®, we partner directly with nursing schools to strengthen their clinical placement process. Instead of leaving students to scramble on their own, we help schools:
When schools and PreceptorLink®/AMOpportunities work together, everyone wins: students, preceptors, faculty, and ultimately, the patients they will go on to serve. And since PreceptorLink® and AMOpportunities have joined ranks, we have even more preceptor options and better services and support! Final ThoughtsIf you’re a student, my advice is: don’t assume your school will handle everything for you. Ask early and clearly what support they provide. If you find yourself struggling, know that you’re not alone and that there are resources out there to help.
If you’re a faculty member or administrator, we know how hard this job is! We’ve been doing NP clinical placements for over a decade! If you need our help, we’re here to support you. Your students are counting on you, and there are proven ways to make this process smoother. Schools: Strengthen your clinical placement process with PreceptorLink®/AMO. Contact [email protected]. Together, we can make clinical education easier, more consistent, and more supportive for everyone involved. About The Author Lynn McComas is the Chief Nursing Officer at AMOpportunities and Founder of PreceptorLink. She is a recognized expert in precepting nurse practitioners and advanced practice provider students and has been matching preceptors since 2014. 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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