Nurse Practitioner Clinical Rotations – Top 30 FAQs
Written By: Andrea Mosher, CPNP, PMHS
Starting nurse practitioner clinical rotations can be intimidating. Other than taking care of patients, it isn’t comparable to nursing school clinical rotations. Many nurse practitioner students have many questions regarding their clinicals and don’t know where to turn to for information. Don’t worry. You aren’t alone! So, what are the most frequently asked questions about nurse practitioner clinical rotations? Fear not! Here are the 30 most frequently asked questions about nurse practitioner clinical rotations.
WHAT ARE THE MOST FREQUENTLY ASKED QUESTIONS ABOUT NURSE PRACTITIONER CLINICAL ROTATIONS?
(The following are answers to the 30 Most Frequently Asked Questions about Nurse Practitioner Clinical Rotations.)
1. Do I have to find my own NP preceptor?
It depends on your NP school. Some schools will set up your NP clinical rotations for you, and others rely on their students to find clinical sites. It is crucial to find out early whether or not your school will provide clinical sites for you. It can be challenging finding a clinical rotation depending on the specialty you are studying, so having as much time as possible to find your site and preceptor can be helpful. If it is an essential factor in choosing which NP school you attend, I suggest you ask before applying or during the interview process.
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2. When do I start looking for an NP preceptor?
If you are responsible for finding your own clinical site, you should be looking for preceptors as soon as possible. It can take several weeks to several months to get a clinical rotation arranged. It is vital to get your nurse practitioner clinical rotations set up as soon as possible. That way, you aren’t scrambling a week before clinicals start.
Honestly, it isn’t out of the question to get a site set up a year or more in advance isn't out of the question. Obviously, you should prioritize your first clinical site first, but then consider if there is a rotation that may be more difficult to find and work on finding that even if it isn’t your second clinical rotation.
3. Where do I start looking for an NP preceptor?How you find
a clinical rotation may be the most difficult part of your clinical rotations. You can ask your student advisor if they have clinics that they work with regularly. If those options don’t pan out, check with your colleagues, fellow students, family, and friends if they know any nurse practitioners and are willing to take students.
Another consideration is to see if the school accepts physicians as preceptors, broadening the spectrum of options. You can also find nurse practitioner clinical rotation sites in NP forums
, through nurse practitioner associations, and occasionally nurse practitioner Facebook groups.
4. How do I ask to be a student?
First and foremost, be professional! Whether or not you are acquainted with the potential preceptor, always use professional language on the phone, in your emails, and in any letters you send.
1. Introduce yourself and let them know you are a nurse practitioner student, which school you attend, and when you are looking for a nurse practitioner clinical rotation.
2. Offer your contact information and if there is a specific time that is best to contact you.
3. Thank them for their consideration
5. Can I travel to another state to complete my NP clinical hours?
You do have the option to complete your nurse practitioner clinical rotations across state lines. You must have either an RN license in that state or a compact RN license and are completing your clinicals in a compact state. As an NP student, you technically are practicing under the license of another NP, but you still must have a valid RN license in your clinical state.
Luckily compact RN licenses are recognized in 34 states, giving you several options if you live or go to school near state borders. Once you graduate and pass your NP boards, the compact license doesn’t carry over to your APRN license. To practice in multiple states as an NP, you must have a license for each state that you will practice in.
6. Can I complete primary care hours in an urgent care or hospital setting?
No. Typically, if you are completing primary care hours, the school requires that you are in a primary care setting, not an acute care setting. If you are responsible for finding your own nurse practitioner clinical rotations, you must clarify with the school what the requirements are. If you are struggling to find a clinical site, discuss with your school advisor any flexibility with clinical sites. A hospital rotation will likely not work, but they may be willing to work with an urgent care or a walk-in clinic.
7. How long does it take to get a new clinical site approved?
Getting a clinical site approved for your nurse practitioner clinical rotation takes a lot of paperwork and time. Some documents are necessary for the school and the clinical site to complete and sign for legal purposes. The time it takes to complete all of the documents and agreements can vary. It may be possible to finish it in a few weeks in an emergency situation, but I would not depend on that time frame. Most schools require that you have the information for your clinical site turned in a semester or two in advance!
8. How many NP clinical hours are required?
It takes a lot of preparation to be an advanced practice registered nurse, and you will be required to complete significantly more hours
than in your registered nursing program. Throughout your NP program, you will be required to complete approximately 500-600 hours of clinicals!
Each NP program has different requirements when it comes to the number of hours. Additionally, you will be expected to complete your clinical hours in a variety of clinical environments. Again, this requirement will vary based on your program and your specialty.
9. How many days per week are NP clinicals?
Nurse practitioner clinicals can be as many days per week that you and your preceptor agree upon. Typically you will need to attend clinical days multiple times per week to get enough hours throughout the semester. You may create a set schedule like Monday, Wednesday, Friday, or it may vary week to week depending on your schedule and your preceptor’s schedule.
Make sure to schedule extra days for your NP clinical rotations just in case you or your preceptor have to cancel a scheduled date. You don’t want to get to the end of the semester and have to ask for an extension or try to squeeze in extra clinical hours in your already busy schedule.
10. Do I need nursing experience before starting an NP clinical rotation?
This question is a real hot topic in the world of nursing, and honestly, the answer truly depends on who you ask. Technically, you do not need any nursing experience to start nurse practitioner clinical rotations. To clarify, you do not need any work experience as a nurse, but you do need to have a valid, unencumbered nursing license.
You may be thinking, “what is so dramatic about that answer, and why is it such a hot topic?” There is a school of thought that to become an advanced practice nurse you must first have experience as an RN. Thus, trying to complete NP clinical rotations or NP school, for that matter, without RN experience isn’t recommended.
Some nurse practitioner schools may require that you have a specific amount of experience before applying. However, it is solely based on how successful you think you will be without nursing experience if they don't.
11. Can prior work experience count as NP clinical hours?
Students can complete nurse practitioner clinical rotations at their place of work, but previous work experience cannot count as clinical hours. Your work experience is likely to be in the role of a registered nurse and most likely not supervised by an advanced practice registered nurse, physician assistant, or physician.
Because your roles as an RN and NP student are so different, it would be impossible to gauge how prepared you are to practice as an NP. On the other hand, it would not be appropriate for you to function as an NP while you are working as an RN, this is outside of your scope of practice.
12. What is necessary prior to starting an NP clinical rotation?
Clinical rotations for nurse practitioner students are different than those for registered nursing students in several ways. You must be an actual NP student to complete NP clinical rotations. In addition to being a student, you must also have a valid, unencumbered RN license.
Additionally, you will most likely have to complete some classes prior to starting your rotation, and most schools will require certain vaccinations or proof of antibodies prior to starting clinicals. Your clinical site will also have some necessary training and paperwork prior to you starting clinicals.
13. How do nurse practitioner clinical rotations work?
When starting nurse practitioner clinical rotations, consider them a prequel to a job interview for after graduation. The process of clinical rotations
is a basic version of what you will be doing once you graduate and become board certified. You will learn how to do appropriate assessments and the clinical decision-making process of patient care. Additionally, you will learn about administrative responsibilities and problem-solving that isn’t found in a textbook. You will see other providers' workflows to help design what works best for you in your future practice. Take this time to soak up as much information and as many tips and tricks that you can.
14. Can simulation replace traditional NP clinical rotations?
With the advances in technology that we see every day, nursing school simulation experiences can closely mimic what you would experience in real life. These incredible advancements are not to replace clinical rotations for nurse practitioner students. The nurse practitioner certifying boards recognize
that simulation experiences are a great addition to augment your clinical experiences, but they are not to replace them.
If you have the opportunity for simulation experiences in your NP program, it is strongly suggested that you attend. You may be able to walk through an experience without the high stakes of taking care of actual human life.
15. What should I expect from my NP preceptor?
It is appropriate to have certain expectations
from your clinical preceptor, and you should expect a good quality and safe, educational experience from your preceptor. The preceptor should show you how to appropriately practice within your scope while helping you reach the course objectives. It is important that they do not teach in a “do as I say, not as I do” manner.
Additionally, you should expect that your preceptor allows you to actively learn during your nurse practitioner clinical rotation. They should provide you with facts and information, but not just lecture you for the entirety of your rotation. Your preceptor should allow you to be hands-on in as many experiences as you can; you should not be shadowing throughout the entire experience.
Finally, you should expect feedback from your preceptor, whether it is good or bad. The only way you will learn to be a successful NP is through constructive feedback. You need to understand what you did wrong and how to fix it, and you need to know what you are doing right.
16. What if I can’t find an NP preceptor?
If you cannot find a preceptor for your nurse practitioner clinical rotations, the first thing you should do is contact your clinical advisor for your program. Let them know that you are having difficulty finding a clinical rotation and explain all your efforts in the search. Occasionally advisors may have contacts for previous clinical sites that were used. Advisors may also have contact information for clinical coordinators that can help set up a preceptor for you.
Additionally, you can contact your state’s board of nursing for contact information for clinical preceptors to try to make connections you may not have known about. You could also contact the education department of local hospital systems; they have contact information and connections to set up a student schedule. You may have to broaden your search and have a longer commute, but that beats postponing your graduation for a semester because your clinical hours aren’t completed.
17. How do I prepare for a nurse practitioner clinical rotation?
Preparing for a nurse practitioner clinical rotation can be very intimidating. If you are like me you may be worried that you will be expected to know everything, like you should be completely ready to take care of patients without any help. Well, I am here to tell you to relax because that is not the expectation of a nurse practitioner student.
When a preceptor takes on a nursing student, they understand that they will be teaching you, and their job is to help you connect the dots from your textbook knowledge to real-world patient care. You will miss things on your exams, you will have wrong diagnoses, you will forget what labs or diagnostics to order for particular concerns, but that’s okay. You are a student, and you are there to learn.
Before clinicals, get a pocket notebook and write standard information you may need for your clinical rotation, and don’t be afraid to use it when your preceptor is teaching you. Additionally, you will most likely be required to keep a log of the patients encounters throughout your rotation; it may be helpful to create a spreadsheet or form to keep it organized throughout the semester. Other than that, be open and prepared to learn!
18. What does the day-to-day of a nurse practitioner's clinical rotation look like?
As I mentioned before clinical rotations for nurse practitioner students are a prequel to what your days as an NP
will look like. You can expect the first day or two as an orientation period. Your preceptor should give a tour of the clinic and talk you through the flow of a patient appointment from all of the roles in the clinic. You must understand what everyone does in the clinic, and this is great background information in designing your workflow.
After you understand the workflow well, your preceptor will ease you into seeing patients to see where you are skill-wise. They may have you collect the HPI or do the physical assessments on a few patients to gauge where they need to focus first. After getting the HPI and physical examination down separately, they will likely have you do both parts on a patient and report back. After you have mastered this portion of a patient encounter, they will add in coming up with a diagnosis, discussing differential diagnoses, and what you would like to do for a treatment plan.
Finally, you will be putting it all together from the HPI to the assessment, diagnosis, and charting on the patient in the EHR. By the end of the clinical rotation, you should feel somewhat confident in your ability to see a patient from start to finish. Additionally, you will learn the follow-up process to ensure you understand how to provide complete care.
19. What is expected of me as a clinical rotation student?
One of the most nerve-wracking parts of nurse practitioner clinical rotations is not knowing what is expected of you or assuming that more is expected of you than you are ready for. As a student, you are expected
to be professional and prepared to learn. Preceptors typically do not get reimbursed for being a preceptor. They are expected to do their job on top of being a teacher, so the last thing they need is a student who is unprofessional and uninterested in being there.
Outside of being professional and ready to learn, you are expected to make progress throughout your rotation. You need to be willing to take on the experiences and tasks that your preceptor gives you within reason. If you have seen them do a simple procedure several times and allow you to try it, do not be scared! That is how you learn, grow, and get prepared to be a nurse practitioner.
20. Can I do more than the required NP clinical hours?
If you are enjoying your nurse practitioner clinical rotations or have a patient you would like to follow up on, and they don’t have an appointment until after your last day, you may do more than the required hours. You must first discuss with your preceptor and your clinical advisor to ensure that it is okay.
Additionally, you should consider that your next clinical rotation may be starting immediately after you complete the clinical rotation. You do not want to jeopardize your clinical hours moving forward.
21. What if a patient refuses to have an NP student?
Honestly, do not feel offended if you have a patient that refuses to have an NP student, it typically is nothing personal. There are a plethora of reasons that a patient may not want a student present for their appointment. Patients could be on a time crunch and not have time to be seen by a student and the licensed provider. Additionally, some patients may feel uncomfortable having too many people in the room when discussing their health, or they may want to have a private conversation with a provider they have a working relationship with. Take the time to follow a nurse and see what types of procedures they do or learn about the responsibilities of other roles in the clinic.
22. What if I make a mistake during my clinical rotation?
No one likes to make mistakes, but we are human, so it is inevitable. It is essential to try your hardest not to make a mistake. If you aren’t sure how to do something or don’t have the answer to something, ask your preceptor! That is what they are for. Your nurse practitioner clinical rotation is for learning. You will not be expected to practice as an independent practitioner.
If you make a mistake, the most important thing to do is to acknowledge that you made a mistake and let someone know. Your NP preceptor will most likely know how to fix it, and there must be a solution promptly. After your mistake is remedied, you shouldn’t focus on the fact that you made a mistake, just learn from this experience!
23. What if I disagree with my NP preceptor?
Disagreeing with your preceptor may happen, and it may be a disagreement in practice or a dispute in their opinion. Either way, you must remember, you are a guest in the clinic. Even though it is a nurse practitioner clinical rotation, you should approach it like a situation in the workplace by being professional. If it is a difference of opinion, you should honestly just let it go and not engage in a confrontation.
If it is a difference in practice versus what you have learned in school, you have to decide whether or not it is dangerous or a disservice to the patient. If the difference is just a normal variation of what is taught, let it slide. If it is something that could negatively affect the patient, contact your clinical advisor and discuss the situation. Your advisor will be able to direct you in how to handle the situation appropriately.
24. If I am in a specialty nurse practitioner program, does my preceptor need to be certified in the same specialty as me?
This question has a very situational answer, it isn’t “yes” across the board, and it isn’t “no” either. First, you must check with the clinical guidelines for your nurse practitioner clinical rotations. Some schools may have a strict policy regarding this, but others may allow your preceptor to be of a different specialty as long as they see the patient population of your specialty.
For example, suppose you are a family nurse practitioner student. In that case, you will have the opportunity to work with other specialties like adult nurse practitioners and pediatric nurse practitioners since they both see your target population. However, if you have a family nurse practitioner who works with pediatrics, then a pediatric nurse practitioner student should rotate with them. As always, discuss with your clinical advisor to ensure that the program will accept your rotations.
25. Can a physician, or physician assistant be my NP preceptor?
Yes! Most NP programs recognize DOs, MDs, PAs, and other NPs as appropriate preceptor candidates
. Due to the similarities in the roles between each healthcare provider, it may be good to have preceptors that are not all NPs. This may provide alternative approaches and schools of thought that you may not have been introduced to if you precept with just one type of healthcare provider. Don’t forget to double-check with your clinical advisor to ensure that there aren’t any policies concerning working with another type of healthcare provider.
26. Can I still work as a nurse during my nurse practitioner clinicals?
Academic classes and nurse practitioner clinical rotations will keep you very busy, but it is possible to work as a nurse
while completing your clinical rotations. It may take a little adjusting to be able to fit it all in. For example, you may have to work an alternative shift like second, third, or swing shifts, depending on your clinical hours. Additionally, you may have to work part-time and pick up full-time hours when you can.
It is important to remember that your roles and scope of practice are different when working and doing your clinical rotations. It can sometimes be difficult, especially toward the end of your program, not to step outside of your scope while you are at work.
27. What type of attire do I wear for my nurse practitioner clinicals?
As I have mentioned before, your nurse practitioner clinical rotations are a practice version of what it will be like when you enter the workforce as a nurse practitioner. So, before starting your rotation, ask your preceptor what the office dress code
is, especially if your program does not specify in their clinical policies. More often than not, the dress code will be business casual, but some schools or clinics will require that you wear scrubs. You may also be required to wear a lab coat over your clothing. Finally, you should always have your student identification badge on during clinicals to identify who you are and why you are there for patients and staff.
28. Is it appropriate to give a thank you gift to an NP preceptor?
It is appropriate to give a thank you gift to your NP preceptor within reason. You may also want to consider bringing in treats or something for the clinic staff or the unit that you were on to thank them for their help. Gifts are not a requirement or expected, but it is a nice gesture to show your appreciation for all of the teaching and guidance you have received throughout the clinical rotation.
29. What is in it for the NP preceptor?
While it is unlikely that your preceptor is getting financially reimbursed, they understand that nurse practitioner clinical rotations are imperative to the learning process since they have been in your shoes before. That doesn’t mean that your preceptor doesn’t get anything out of being a preceptor. There are several benefits
to being a preceptor.
It can be an opportunity for them to build their resume or curriculum vitae. They may have the chance to become adjunct faculty at the nursing school they precept for. Additionally, some nurse practitioner boards recognize precepting hours as continuing education hours toward licensure. Finally, they are providing a service to fellow nurses and sometimes give back to their alma mater.
30. Can I fail an NP clinical rotation?
Of course, you can fail your nurse practitioner clinical rotations! Schools provide clinical preceptors with a guide of objectives that you need to achieve during your clinical rotations. If you aren’t meeting those objectives within reason, you can fail your clinical rotations.
Typically, if you are not meeting them, you are not acting professionally while at your clinical rotation, you work in a clinically unsafe manner, or you are dishonest with your preceptor while practicing. I will say it one more time your clinical rotations are a practice run for you in the real world, and you must take them seriously!
My Final Thoughts
Whether you feel totally overwhelmed by nurse practitioner clinicals or you feel like you have everything under control, there will be questions that arise during your time in clinicals. Don’t feel alone! Most students have questions that they won’t ask or don’t know who to ask. You don’t have to wonder, “what are the most frequently asked questions about nurse practitioner clinical rotations?” This list of the 30 most frequently asked questions about nurse practitioner clinical rotations has got you covered.
Andrea Mosher, CPNP, PMHS
Andrea Mosher, CPNP, is a primary care pediatric nurse practitioner with a variety of nursing experience. She has worked in medical-surgical, emergency departments, urgent care and primary care pediatrics.