Choosing the Right Person for the Job
I have been a nurse since 1988 and an NP since 1997. I have precepted many NP students, but I have never considered altruism my reason for doing so. When I was an undergraduate nursing student, I had some very weak preceptors. I thought, When I become an expert in my field, I will do my best to teach the new generation everything I can in my allotted time with them. There have been many wonderful, sharp students who showed enthusiasm and humility; I would feel comfortable sending my family members to them.
There have, however, been barriers in precepting. The biggest, in my opinion, is that many students should not have made it to a clinical setting in the first place. There should be a screening process. If a student NP who has practiced as a nurse for a few years cannot do a simple RN-level physical assessment or differentiate between objective and subjective data, that student should not be sent to a preceptor. Also, in my program and many others, instructors do not practice; therefore, students are being taught by people who do not actively treat patients.
The electronic health record (EHR) has been another huge barrier. My students no longer document in charts, so I am limited in how much I can facilitate their documentation. I used to have them write the chart, read it, and sign it. Now, with the complex multitude of EHRs, it would take too long to teach students the system for them to document effectively and in a timely manner. Many students do not know how to write a prescription, and there is no opportunity to teach that, since everything is electronic. I do not know of a solution for this.
As far as compensation, I would love to see tax incentives. Another option, for those of us who have to pay for our own license, certification, and DEA privilege, could be a program that enables us to get credit from either federal or state government for direct practice expenses if we precept a certain number of hours. I also love your idea of complimentary CMEs or some sort of appreciation from society, not just individual students.
I will continue to precept and do my best to educate, because one of these people will be taking care of me or my family one day.
Luba Fry, ARNP
Boca Raton, FL
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