NP student cannot find pediatrician to agree to have her for 6 week preceptorship

[MPMD]

Terrible situation with plenty of blame to go around.

This problem seems pervasive in NP education and frankly the fact that whoever accredits NP schools hasn't strongly addressed it does untold damage to their quest for legitimacy.

I have been involved in many iterations of this problem. As I said at one point I offered to literally set up a site and be the site coordinator for a well-regarded NP school if they could buy some of my time from the uni. I would have done it for 4-5% of my salary. No interest whatsoever. Not only did they not have resources to help students find sites they didn't have any funds to develop an established training site.

[fatlittlepig]

Wow tough situation, that's really too bad. I can definitely understand the bewilderment and frustration of the young nurse, but I can also see the other side. Personally, having a student follow me for a single day would be enough. I just can't imagine 6 weeks, it's too intrusive, unless I could somehow leverage the student to make my life easier...

[Dilaudidopenia]

NP education is garbage.  I see the results of it in the ED everyday.  It's downright dangerous.  They don't "assist" me in any form of the word.  They create more work for me.  Somehow a PGY-4 EM resident has to be under the preview of an attending and make 65k but an NP fresh out can be quasi independent and make upwards of 100k.  Bull.

Physicians as a whole should be refusing these "opportunities" globally.  If they can't complete their rotations, they can't practice.

[EM-CCM MD]

FLP - clearly you don’t know the rules. Show me a medical student who only triples my work, and I’ll kiss his feet.

[jm129]

agree with dilaudidopenia.

the problem is pervasive.

This is not good for medicine.

I would not do that even for money!

I think this trend will also discourage medical students to pursue primary care specialties making the shortage even worse.

 

[Panscan]

Dilaudid you mean fully indepedent in a lot of states for the np. It's literally insane. A pgy2 resident has so much deeper and comprehensive knowledge than a typical mid-level who basically are masters of memorizing a workflow and doing jt over and over without much critical thought.

[jm129]

I would also like to add that professional nursing organizations can be way stronger and influential than any physician's organizations. This trend might change the landscape of medicine in the next few years.

 

am I too skeptical?

[southerndoc]

This is what happens when you go to an online nurse practitioner school.  Any halfway decent school would arrange for these rotations instead of asking the student to arrange for it.  There are quality issues that need to be monitored.  How many medical students are required to arrange their own rotations during third year?  Does the school even cover malpractice in these situations?

[Dilaudidopenia]

@panscan - yes that, and perhaps even scarier, in states where independent practice has not taken root, if they are in a busy ED, there is really no time to supervise them, making them effectively independent.

[Brains428]

I do something similar to @lordosis, but for radiology. There is a remote campus for state MD school and I've offered to help teach some. They've tried to get me to take 4 weeks blocks, but I've basically refused. Firstly, I don't work that many days in a row in 4 weeks. Secondly, in order to afford that, I work basically 2+ FTE of work on a shift. The days I take students are my days off that I can actually sit down and talk about a chest x ray for 15 minutes.

My only problem with extenders is that even though they are a big chunk of the over-ordering, they point at radiologists for the problem.

What are the requirements for said NP student to get a rotation? Do they have to be in-state. Can they shadow another NP (which seems to be appropriate so they understand the level of care their providing)?

[White.Beard.Doc]

One more thought... the NP2B could talk to established pediatric NPs to request a rotation?

[Lordosis]

I cannot remember if it was an NPor a pa but I was asked to have one shadow me to get peds experience for a week. This NP had been in Ortho the past ten years and never saw children and was changing to urgent care. I was flabbergasted that spending a week with me was all she wanted to do to be experienced with peds. I said no.

This is just one of the reasons I would rather squeeze my patients into my day then have them go to urgent care.

[gap55u]

I am at a medical center that has a hard time placing its own medical students- brick and mortar NP’s are therefore doing some of their own scrambling for rotations. It is hard work (and uncompensated and makes you inefficient) to precept.

I don’t have the right answer. I don’t like the idea of NP precepting NP. I had a patient who was a brand new nurse. She went directly to online NP school doing her clinicals with someone who did the same thing a year or two prior. Recipe for bad medicine!!

Nor do I want to train my own competition!

[MPMD]

southernerdoc wrote:

Any halfway decent school would arrange for these rotations instead of asking the student to arrange for it.

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Incorrect. See above. This happened at a university you would all recognize as being a quality institution of higher ed. The problem seems pervasive throughout NP education and somewhat idiosyncratically distributed. I know of another almost completely online NP program where the student I know has had no issue securing rotations.

 

southernerdoc wrote:

How many medical students are required to arrange their own rotations during third year?

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Some are especially those at Caribbean and/or for profit brand new (read: DO) schools. It's a travesty and scam perpetrated on vulnerable college students who didn't get into more established places and convinced by marketing departments that this new place for $75k/year is the path to their dream.

[HikingDO]

Let this scary thought sink in...in my area there are NPs taking NP students on clinical rotations. What could possibly go wrong???