Let’s talk about…… Nurse Practitioners and Double Standards


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Let’s say you are a medical student. You go to ISYS (I Stole Your Stethoscope) University. You pay your tuition and attend your classes.   You are expected to show up for your clinical experiences on time or early, prepared, and ready to go. Your school arranges them, and Physicians are compensated for your instruction. Then you are in Residency and you are paid to work and learn. And the facility actually bills for your time, and the Supervising Physician bills for hers.

Now let’s say you are a Nurse Practitioner student. You go to SMYS University. You pay your tuition and attend your classes. You are expected to spend untold hours locating a Provider to precept you, and possibly begging them to have you. You may be completely unable to find one; in which case, you will automatically fail. If you find one, awesome! If not, doom! Total crapshoot.

What is the difference here?Investment-in-Healthcare

The Supervising Physician is paid to teach.  The Supervising NP is not.  We have single handedly solved the mystery surrounding the difficulty of finding NP preceptors. It took us thirty seconds.

It is possible that we need to change this model.  We need NP’s. They are good, solid critical thinkers, and excellent within their scope of practice. Hospitals can afford to better staff their services when NPs are part of the provider pool. They are a lifesaver in a financial sense.  There are good outcomes with Nurse Practitioners as well as Physicians.  NP’s make a difference here and abroad. We can see they are especially necessary when events like the #JuniorDoctors strike happen.  Physicians and NP’s are both absolutely essential.

Both Physicians and NP’s are constantly pressured to see more patients, document more stuff, take less time, and make more money for their organizations. This is not a scenario in which it is optimal for anyone to take on a student.  However, the Physician will be paid to do it, so there is some incentive. The NP has to do it out of the kindness of his heart; and take on liability and extra work for the privilege.  I am all about students.  I do my best to give them a great experience, and if I were in that situation, I might not take students either.  No incentive, added liability and extra work? What could go wrong?

This seems to be a symptom of the disease pervasive in nursing….. “Dumped Upon” Syndrome.  This happens because it is the status quo, nobody else wants it to change, and we are allowing it to happen.  We want to help, our hearts are in the right place, and we take on ridiculous amounts of work for no added compensation.np

Because we are a profession of Martyrs.

Perhaps together we can fix this mess.





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Author Janie Garner

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Join the discussion 6 Comments

  • LeAnn says:

    So completely true! Being in the FNP program, it is like pulling teeth, actually worse, to find someone to precept! I will be traveling to three states in order to fulfill my clinical obligations, and it’s just wrong! Thank you for writing this!

  • LeAnn, thanks for putting that into perspective. There are many conversations online about NPs , yet I had not heard of this side of the story. Thanks for this. Twitter @RN_Solutions

  • Carol says:

    Thank you for writing this. I am a FNP who precepts students, and I hear over and over again from students how hard it was for them to find placements. They literally send out hundreds of letters, and maybe get a handful of responses. Things need to change.

  • Love what you guys are doing. Making people open their eyes and think.
    As a PA I would say although PA educational programs do find their students preceptors, they are generally PAs who are not paid and who also are getting more and more difficult to find. It will be a problem for all of us. Especially when large mega-institutions tell their NPs, PAs and physicians that they no longer can take patients as it “increases liability” or slows them up.
    Teaching is noble and we will have to find a way for clinicians in the field to be able to do it.

  • Barbara R. Kelley says:

    You all need to talk with your legislators. This $ for residents and to pay physicians to precept them is medicare pass-through money which legislators (federal) fight for. Residency programs are run through hospitals but NP/PA programs are not. The government money (yours and mine) goes to the hospitals not to schools. Nursing school deans are aware of this. So, what to do? We need to get the word out and get some parity with government (yours and mine) money. Good for you to bring this up.

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