A Shortage of APRNs Means a Shortage of Preceptors For APRN Students

Reviewed by Abbie Jacobs, RN, BSN

You’re already well aware of the fact that the medical industry is facing a dire shortage of providers. The Bureau of Labor Statistics expects we’ll see a shortage of somewhere around a million nurses by 2024. According to the Association of American Medical Colleges, things will be bad for MDs as well, with a projected shortage of around 100,000 trained doctors by 2030.

In fact, that might be exactly why you decided to become an APRN—there’s going to be a strong demand for someone with your skills for decades to come. Nurse practitioners and other APRNs have the flexibility to fill many roles in the industry at a far lower cost than doctors. It’s also a lot faster to train them up… 6-8 years of training and education to become an APRN versus 12 or more to become an MD.

But the system is already feeling the strain of too few professionals to fill too many positions, and that’s having an effect on the training pipeline for APRNs. Specifically, it’s getting really difficult for budding APRNs to find preceptors to supervise them during their required hours of clinical experience… because those potential preceptors are already slammed!

The Critical Role of Preceptors in Advanced Nursing

The role of preceptor is an old one in the field of medicine, harkening back to the days of apprenticeships. The only way to learn the intricacies of practice was at the feet of someone who had already built up experience and knowledge in the field.

Today, much of the knowledge that is passed along to budding nurse practitioners comes through schooling. Earning a master’s degree or post-graduate certificate in nursing is a classroom-intensive exercise. You’ll absorb information through reading and lectures and prove your competency with quizzes and tests.

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But there’s nothing like practical, hands-on experience when it comes to truly absorbing the lessons you learn on paper. That’s where the preceptor comes in: a supervisor to guide you, check your work, keep you from killing patients by accident.

Doctors Are Not Always The Best Option For Preceptors

In some ways, NPs have it easy when it comes to finding preceptors, because they can be supervised either by a currently licensed nurse practitioner ora physician or physician’s assistant. That opens up a wider pool than is available in other professions.

It might seem like a great idea to have a full MD as a preceptor. With all the additional training and experience they have, you might imagine their ability to teach and offer insight would dramatically exceed that of nurse practitioners.

But that perspective misunderstands some of the essential differences between the nursing model and the medical model of treatment. A nurse practitioner working with a physician preceptor misses out on a world of holistic patient care approaches that doctors actually have very little experience with.

Clinicals under a physician preceptor is like studying car repair with a NASCAR pit crew… the cars get fixed, but you get there with a completely different process than your neighborhood mechanic.

The Current Environment Makes it Difficult to Find Qualified Preceptors

For all the drawbacks of studying under physician and physician assistant preceptors, it’s sometimes the only option. Licensed and certified nurse practitioners have a raft of reasons that limit their availability to serve as preceptors today.

It’s not that practicing NPs don’t want to pass along their knowledge and expertise. Instead, it’s usually because they simply don’t have the time. Like other providers, they often are given only 15 to 20 minutes per patient to meet, diagnose, treat, and chart.

Hospitals and urgent care clinics encourage them to block as much of the day as possible for these visits and move patients through as quickly as possible in order to bill more procedures.

When a preceptor takes on a student, that workload explodes. The preceptor is responsible for not only helping to train the student, but also for reviewing their own charting and double-checking their diagnostic and treatment work. Ultimately, it’s the preceptor’s license on the line if mistakes are made.

It’s a lot of responsibility and a lot of time that is rewarded only with liability and expectations.

Making matters even worse, you may be required or at least encouraged to find clinical work inside your subspecialty. But lining up a pediatric nurse practitioner preceptor, for example, restricts your option to an even smaller number of possibilities.

As a student, you’re expected to overcome this by getting out and networking and making cold calls to line up your own preceptors. But this just makes life harder for those preceptors, who are overwhelmed with interns… not to mention for students, who are already slammed with important school work!

To help bridge the gap, services like PreceptorLink are stepping up to serve as matching services for willing preceptors and APRN students. And local and national associations are also trying to provide resources for both preceptors and students looking for them… the National Association of Pediatric Nurse Practitioners encourages students to get in touch with local chapters to help with the search.

Changing The Equation To Get More APRN Preceptors In The Field

Preceptors do get one small benefit out of taking on students, which is that they can typically count the time spent towards their professional development requirements for maintaining their certification. Both the ANCC and AANP award credits toward recertification for precepting students for at least 120 hours.

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This is something, but it’s not enough in today’s high-pressure environment. As students compete to be taken on for the limited number of APRN preceptors who are available, it not only makes the preceptor role more and more difficult, but limits the possible expansion of the field so that more people could fill that role.

Schools are now being encouraged to allow more flexibility in the timing of clinical rotations, to allow you to snag them when the opportunity comes up instead of on an arbitrary schedule. There are also some suggestions that clinical requirements generally be relaxed.

Until these problems are solved, expect a slog when it comes time to line up preceptors for your clinical hours. Getting ahead of the game and doing your networking well before you get to that phase will put you out front. And once you get your own license, don’t forget—up and coming students can use your expertise as a preceptor, too!