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Imagine paying thousands of dollars to attend college with the expectation that the education will provide you with the knowledge and skills needed to actually perform well in your profession.

What if you actually wanted to graduate and be the most educated and proficient nurse practitioner with the ability to do a job that only Doctors were trained to do which took them many years.

Here’s the problem, when you graduate from NP school after 2-3 years, you are very incompetent. When you start your first job, you barely know how to order labs or radiographic imaging or interpret them for that matter. Let’s not forget about medication’s or actually knowing how to write a detailed note. I personally didn’t even know how to write medications on a prescription pad.

But why not? Didn’t I go to school to learn how to become a NP?

The Problem:

The most important part of NP education would prove to be the clinical component. The main issue with this is that most NP schools require you to look for your own clinical site and preceptor to train you. There is a huge shortage of available preceptors that are willing to take a new NP student and some sites even expect you to pay $500-$600 to precept you for the semester.  The school doesn’t even try to reimburse you for this by the way.

What happens? You land yourself into a clinical site that is not able to provide you with the skills and knowledge needed, you don’t learn how to do the basic tasks associated with being a NP.

My first clinical was a pain management site; the only preceptor I could find and I was so grateful but can you tell me exactly what could I be learning as a primary care NP in a pain management clinic?

To make matters worse, I was paired up with another NP student who was assessing 1 patient for about 1 ½ hours, checking the patients’ ears, eyes,  tongue, toes, etc, for a back pain case managed with opioids. Is this strange or what? It’s even stranger now that I am an experienced NP.

I fought for my rights and begged my school to find me a better clinical site. I landed myself into an urgent care clinical, still not what a new NP needs but I learned so much in this setting, I completed my clinical hours and graduated.

The Solution:

Take a deeper look at how Physician assistants are trained, they have great clinical training alongside the medical students who will soon become Doctors.

Physicians have extensive and thorough training that takes them many years.

Not all NPs come from a medical surgical background and this doesn’t seem to be a pre-requisite for admission into any NP school. I have trained new NPs even with ER backgrounds and they struggle the same as any new NP, sometimes worse. This is a new role and you need experience with managing patients and many different disease states in order to be proficient; but the basic role should be taught in school/clinicals.

Schools need to have the ability to provide in depth learning clinical opportunities to prepare NPs for the real world, and the school should set this up for every student.

Clinicals should rotate through each specialty to gain basic knowledge of disease management such as cardiac, pulmonary, GI, hem/onc, neuro, Infectious disease, dermatology, ENT, ortho, Nephrology, vascular, etc.

NPs are expected to do the same job that Physicians do, therefore when we graduate, we should be able to function with the ability to make informed decisions on patient care and deliver high quality care from day 1 with confidence and comfort; alongside a collaborating physician.

Why should it be any less, clinicals should not be a choice of acceptance, you pay a lot of money for education, so it should be provided by the school.

This is a big issue, and it can prove to be frustrating when you start your first job.

On the job training, here we come!


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