Finding a Preceptor for Practicums

Sara: Hello everyone. It’s my pleasure today to introduce Rachel Borton, Director of the Family Nurse Online Program here at Bradley University and Rachel is here to discuss and share information and requirements for the FNP program practicums today and will talk a little specifically more about timelines, due dates, clinical requirements, preceptor packets, core competencies and tips and tricks for finding a preceptor. So we know this is a hot topic and we want to jump right in here and share as much information as possible so, without further ado, I’m going to turn it over to Rachel.

Rachel: Thank you, Sara. So I understand that, you know, one of the first probably challenges and nervous moments of a student returning to school is thinking about finding preceptors and just – it can be a little overwhelming and so Sara and I have worked together to create this webinar to hopefully kind of alleviate some of those fears. So first of all, how quickly should you find a preceptor? As soon as possible. I cannot emphasize that enough. You know, many students will start practicum in different rotations depending on your program so you will find they’re listed on the PowerPoint that if you’re in the DNP/FNP program you actually don’t start clinicals until the 8th semester in the program. But let me tell you that will arrive very quickly and if you are just reaching out to providers that you work with, different potential resources, it’s okay to say: “Hey, I’ve been – been accepted into this FNP program and this time next year I’m going to need a preceptor. What do you think? Would you be interested in letting me precept with you?” And just having that conversation, initiating that dialogue, will be so helpful.

The MSN/FNP students, they start in the 5th semester so you can see that’s a little quicker and probably the most accelerated rate is going to be the FNP certificate program – those students are actually starting clinicals in the 2nd semester. So for those students I often when I receive e-mails about potential applicants, I encourage them: “Have you already started talking to preceptors?” You will come into the program and 7 ½ weeks into the program you are going to have to already be turning in a preceptor packet so these packets – and we’ll talk about that in a couple more slides – but these packets are due 7 weeks prior to the clinical start date. So for FNP clinical, uh, the certificate students that means – let’s say they start in August, the end of August and fall, their first practicum begins in January – that preceptor packet with all of their potential preceptors information that they’ve identified is going to be due about mid-term during the semester. So it – it can happen fairly quickly.

So your next question is probably: “Well, which courses are practicums and how many hours are going to be completed for practicum?” And that’s a great question so the way that we have structured our practicums is that they align with theory courses so when you are in your Adult Health 1, you’ll have Adult Health practicum so that’s the first one you see listed there in UR639. And it goes throughout each theory course so you have five theory courses, two Adult Health, a Women’s Health, a Pediatric and a Gero and each theory course has a practicum, each of those you’ll be completing 150 hours with each practicum course. And this is definitely one of the strengths that Bradley has developed, you know, in order to sit for the National Certification exam you need a minimum of 500 hours. And as I attend meetings and, uh, just conversations about students sitting for board exams, there were some concerns brought forward about programs that are letting students attempt to test and they’re only meeting the minimum requirement of 500 hours; some students were attempting to test with 490 and they were not allowed to sit. And so Bradley has ensured that this is not going to be a problem for you in any way. With all of the hours wrapped in you’ll have 750 hours so it’s definitely a strength in this program.

So, what is required for clinical and when is it due? You know, I kind of talked about you’ll have that seven weeks where you’re going to be, uh, anticipating turning in a preceptor packet. Well, even before you turn a preceptor packet in, as you can imagine, working in health care, there’s going to be health requirements that you need to complete and as you can also imagine, I am sure you understand that every institution as is every university will have different requirements for you. So for Bradley in order for you to be in our program and prior to clinical start, you need to have these health requirements completed. There are certain immunizations that you need to have had or there are titers that you can get tested for. For example, um, hep B – you’ve probably had that 10, 12 years ago and so within the past year you have the choice of either getting the hep B series again or getting titers tested to showing that you have those antibodies present against the hepatitis B antigens. You need a physical exam just showing health and wellness. You need to have completed a certified background and drug screen. You will need to purchase malpractice insurance – and this is something that is purchased through Bradley – and you’ll also be setting up a Tyson account and Tyson is an electronic portal that we utilize for students to insert their clinical hours and their documentation in and then, of course, CPR is also a requirement.

So some other requirements to keep in mind: Every facility is going to have additional requirements. Let’s say for example you start at Bradley in fall, you’re a certificate student, we’ve required you to complete this physical immunizations, you’ve got your background and your drug screen and then let’s say your practicums don’t start for – you’re in the DMB/FNP program – they don’t start for eight semesters so you go to this facility and it’s been over a year since your last certified background check, there are some facilities that will require you to get another background check. They want one within a year and that is completely up to your facility or your preceptor so I always encourage students to just pay attention and ask ahead of time about any additional requirements and certainly you want to have your health requirements you’ve completed for Bradley at hand so that you can share with them: “This is what I’ve completed and when.”

Some other things that are required for you: You will have to watch an OSHA video, a HIPAA video, there is some information about Tyson and there will be a form that you sign indicating that you have watched those videos and you will be sending that in to our administrative support, Stephanie, and it may seem silly but I have someone with just their first name listed but every student comes to know Stephanie very quickly and she’s very easily accessible.

So, preceptor packets – where can you find these? We talked about you need a preceptor packet. This preceptor packet is on MyOnline, everything you need to know is on MyOnline so you want to get really comfortable and familiar with that. Keep that as a – a favorites tab on your computer. So in that preceptor packet you will find that there is an initial preceptor agreement form, there are preceptor tips and there is an evaluation form for your preceptor to complete on you. You will also work to complete a clinical agency agreement and this is completed with our credentialing coordinator, Miss Julie Schifeling and oftentimes certain facilities will have their own clinical agency agreement that they might already have in place. For example, students precepting at the VA – the VA has a very specific clinical agency agreement and that’s fine, and they will typically notify students of that immediately and then Julie and you would work together with completing that clinical agency agreement. So I think you can kind of see what’s going on that this – this is a process and there’s forms and there’s paperwork and so that’s why we encourage you “the sooner, the better.”

How do you submit that preceptor packet? So talking about submitting the preceptor packet what you want to do once you have it completed, your preceptor is going to sign it, you’re going to put in the address of where you’re going to be, what course you’re taking this for and this information can be sent to Stephanie and her e-mail is provided there or you may fax it to her and once your preceptor has been reviewed you will receive an e-mail stating whether they were approved or not approved. You will find out fairly quickly. I would – I would say at least within five business days.

So once you start thinking about your clinical location – you’ve got your preceptor packet, you’ve received approval, your clinically – your clinical agency agreement with Ms. Schifeling is completed and you start clinical. Now what kind of a schedule do you have? I get frequent e-mails from students asking, you know: “Which days can I attend practicum?” And I just cannot emphasize enough that this is specifically designed by you and your preceptor so you want to look at your schedule, look at your preceptor’s schedule and find out how you can best fit that 150 hours into your semester. I would say typically most students like to do 1-2 days a week. I do have those few eager-beavers students that want to get that 150 hours done in the first month and they have a flexible work schedule and they are able to do that. So that is completely up to you and your preceptor and when you are speaking with someone to, uh, you know, start that dialogue about precepting with them, that’s one of the first questions I would ask is: “What works best with your schedule? How can we make this work the best for the two of us?”

So then the next question you’re thinking is: “Okay, now I know how to turn my preceptor packet in but how can I find a preceptor? Contact all of your acquaintances, any friends, any providers – most of you are either working in a hospital, a nursing home, you might be working in home health care, you are coming into daily contact with providers and you really are just going to have to put yourself out there and you’ll be surprised how many people, number one, will be excited that you’re going back to school and number two, might possibly be interested in being a preceptor for you. So places that you can use, where can you complete your practicums in, hospitals, primary care – we have specialty hours, a total of 100 out of your 750 can be completed in specialty care. So such as dermatologists, GI/GU, cardiologists. Other areas for your regular hours, urgent care, quick care, prompt care, minute clinics – I will tell you that typically the VA seems to be very receptive to students, uh, underserved clinics and locations seem to be very receptive to nurse practitioner students as well. But you just really want to contact anyone that you come into contact with about precepting with you.

So some commonly asked questions. When I think about commonly asked questions here are some of the questions that come to mind. “Are there any organizations out there that can specifically help me find a preceptor?” Yes. Sigma Theta Tau is one. The national certification bodies that you will decide to test with, either the ANCC or the AANP, both of those have provider banks. So if you decide to join, for example, Sigma Theta Tau, you can go online and look at their provider database and see are there any providers in our area. “Uh, what if my clinical is not for one year but I found a preceptor. Should I complete the packet?” Yes, yes. I’m sure you’re not surprised after everything I’ve said that we do want you to complete it. Just keep in mind that in that preceptor packet your preceptor has to provide a copy of their malpractice insurance, their license, their most current vita – you know, I would imagine if you’re not completing clinical for awhile that perhaps some of those things will have expired and that’s okay. When you complete your clinical rotation you can send us updated documents.

A few other commonly asked questions, a couple more that I can think about: “Can I reuse my preceptor?” Sometimes it can be so challenging to find your first preceptor and before you know it you’re already into 643, your second practicum. Yes, you can absolutely reuse a preceptor but you can only reuse them twice and if you did reuse them what you would do is, instead of submitting that whole preceptor packet again, you are only submitting the initial preceptor form and that’s just a one page that’s part of that packet. So what if you’re preceptor’s approved, you started clinical but you can’t find the preceptor or agency in Tyson to document on. Okay, remember just a few slides back I talked about this electronic portal, Tyson. Tyson is fantastic. It is a quick, easy access for students, you can open it up on many different media devices, you can do it in clinical and real time but there’s a little bit of a trick. When you start your courses and your practicum, you will find in your syllabus very specific steps about how to – and if I were writing this in parens it would be, “How to request a preceptor and your agency within Tyson.” And basically you will put in your preceptor’s name and their address and you sen – you submit it and preceptor’s information as well and then your faculty for the course will get a little message e-mailed to them saying that they have had some submissions for their students in their course and then they go in and they okay those submissions. Once you’ve completed this, the faculty member approves it, then you will never enter it in Tyson again, it will always pre-populate for you to document on.

A couple of other questions that I can think of: “Do I need to have all nurse practitioners or are they all going to be doctors?” Well, here’s – here’s the, uh, rule for that. Based on our – our certification bodies, nurse practitioner students in a nurse practitioner program need to have the majority of their preceptors be nurse practitioners. And I think that kind of makes sense but I just kind of spell it out here, that out of your five preceptors, three of those need to be nurse practitioners. So who can be your preceptor? Advanced practice nurses, medical doctors and DO’s, doctors of osteopath. Who cannot be your preceptor? PA’s or physician assistants, CNS’s or CNL’s, so certified nurse leaders and the reason for that is because these are other midlevel providers that function in completely different roles than you will as a nurse practitioner. So if you precept with one of them it’s really going to blur the lines and make it very challenging for you to learn from them.

Now we have also, uh, uploaded documents in the resources list of this webinar platform that you will be able to access and amongst other things you will find the signature form for you to sign saying that you’ve looked at the OSHA and the HIPAA videos and you’ll also find an FNP clinical course competencies list and I think this is very helpful. When students start clinical, they start their practicum, often I will get an e-mail saying: “Uh, what am I supposed to do? My preceptor doesn’t know, uh, you know, I’m really concerned. Please let me know. You know, I haven’t done a Pap smear and I’m halfway through my semester.” You know, questions like that. So what this list does is it breaks out every theory and practicum corresponding course and it tells you. For example, your first Adult Health practicum, there’s a recommendation that says you should at least do three well visit physicals and you should at least do five episodic sick visits. You should at least do one sports physical. You should at least do two hospital follow-ups and two routine follow-ups. And then there’s one new consult. These are recommendations and I am completely aware that every preceptor, every patient’s going to be a little different. So this is not a, uh, must complete or will not pass the course. It’s just a recommendation about these are competencies that you want to keep your eyes out and when you have a patient come in and perhaps its not one you’ve been assigned to, you can tell your preceptor: “Hey, I need to do a sports physical and I haven’t done one yet. Would you mind if I go ahead and do that so I can get that off my competency list?”

And then there’s some other items that are encouraged but not required. For example, an I&D, sutures and removal, stapling, steroid injections, etc. So that’s just some information to help you really just set you up for success during your practicum rotation but I would encourage you to utilize those resources, print them off. If you have any questions or any concerns please contact your academic advisor and we’ll be help – we’ll be happy to elaborate on that for you.

Alright, well, thank you very much for spending your time with me today.