How to respond to NP trainees seeking supervision

[tr]

I have gotten several emails from random NP trainees at other institutions asking if I will be their physician supervisor.

What is going on with these clinical training programs that don't provide clinical training? I guess they just throw a bunch of lectures at them and then tell them to go out there and find their own preceptors? How is this even legal? Isn't there some kind of accreditation system?

I'm trying to come up with a polite refusal that also somehow conveys how horrifying it is for a training program to take their money and then tell them to go find some random outside physician to train them.

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[calvnandhobbs68]

Nope pretty common. They all expect you to do it for free too. We had one of the RNs who was in NP school somehow carpetbomb our listserve during fellowship with one of these requests lol. Typical scammy NP schools.

Either 1) Don't respond or 2) "I don't supervise NP students. Hope you can work with your institution to find an appropriate supervisor for clinical training"

 

[nexus73]

I don’t have time to take on a student.

It’s annoying for us because nurses at our hospital going through part-time np school get to clinical rotations and expect us to provide them. Which we don’t.

 

[J ROD]

I take the good looking ones....lol

 

[splik]

We got flooded with requests a while back (not from randos, but students from our university system). I required them to formally apply with a cover letter, CV, 3 letters of reference, and suitable candidates were invited to interview. There was only one suitably qualified applicant (who had several years of acute psych nursing experience). We told the others they were not qualified. We never get requests anymore.

 

[PikminOC]

I have gotten several emails from random NP trainees at other institutions asking if I will be their physician supervisor.

What is going on with these clinical training programs that don't provide clinical training? I guess they just throw a bunch of lectures at them and then tell them to go out there and find their own preceptors? How is this even legal? Isn't there some kind of accreditation system?

I'm trying to come up with a polite refusal that also somehow conveys how horrifying it is for a training program to take their money and then tell them to go find some random outside physician to train them.

Yes this is the way they are able to churn out so many

 

[PikminOC]

Not all DO schools give fourth year rotations so those students have to find rotations on their own too.

 

[nexus73]

Not all DO schools give fourth year rotations so those students have to find rotations on their own too.

Doctors training doctors...is just more reasonable to me.

We recently had a np applicant for inpatient psych. Had ZERO psych experience. Got rn degree 4 years ago and has been working part time on psych np while working mix of PACU and ICU rn jobs the last 4 years. And now wants to work inpatient psych. You have no experience why would we ever hire someone like this.

 

[PikminOC]

Doctors training doctors...is just more reasonable to me.

We recently had a np applicant for inpatient psych. Had ZERO psych experience. Got rn degree 4 years ago and has been working part time on psych np while working mix of PACU and ICU rn jobs the last 4 years. And now wants to work inpatient psych. You have no experience why would we ever hire someone like this.

Hospitals don't care. They have "collaborating" psychiatrists

 

[alina_s]

Doctors training doctors...is just more reasonable to me.

We recently had a np applicant for inpatient psych. Had ZERO psych experience. Got rn degree 4 years ago and has been working part time on psych np while working mix of PACU and ICU rn jobs the last 4 years. And now wants to work inpatient psych. You have no experience why would we ever hire someone like this.

We had an applicant like that. HR had set up the interview without asking anyone from the department. Charming person, but awkward interview day. It’s appalling that the programs tell students it’s completely reasonable to train as a NP in a field completely different from their experience. The local program doesn’t set up rotations and it sounds like they often end up being more observerships than practicums. How is an outpatient doc supposed to add in teaching time to the day, much less get patients to be patient enough to work with a completely green student? It’s appalling that people are taking out loans for this “training” and that graduating lets them practice independently (in some states) on all ages. There’s going to be a correction someday, right?

 

[calvnandhobbs68]

We had an applicant like that. HR had set up the interview without asking anyone from the department. Charming person, but awkward interview day. It’s appalling that the programs tell students it’s completely reasonable to train as a NP in a field completely different from their experience. The local program doesn’t set up rotations and it sounds like they often end up being more observerships than practicums. How is an outpatient doc supposed to add in teaching time to the day, much less get patients to be patient enough to work with a completely green student? It’s appalling that people are taking out loans for this “training” and that graduating lets them practice independently (in some states) on all ages. There’s going to be a correction someday, right?

Yep it’s totally ridiculous. I’ve seen their “clinical hours” for NP school too. Which typically would involve an NP student showing up a few days a week on the inpatient unit in between their days working as an RN, and either basically shadowing or carrying like 1 patient to present because they were never there for longer than 2 days in a row. The hilarious thing was that they never actually seemed interested in doing more than that either…it was very clearly a “get my hours signed off on” thing.

And that’s apparently equivalent to a 3-4 year residency. The futures looking bright fellas!

 

[Alemo]

We got flooded with requests a while back (not from randos, but students from our university system). I required them to formally apply with a cover letter, CV, 3 letters of reference, and suitable candidates were invited to interview. There was only one suitably qualified applicant (who had several years of acute psych nursing experience). We told the others they were not qualified. We never get requests anymore.

This is incredible. If the schools themselves won’t create any standards, let’s do it ourselves. Not to mention that’s barebones standard application fare for any kind of medical training, leaving out the most difficult items for acceptance (MCAT, high GPA, medical experience).

 

[Alemo]

There’s going to be a correction someday, right?

Uh, yeah! R-right? Right? Right guys? Guys?

 

[dl2dp2]

I have gotten several emails from random NP trainees at other institutions asking if I will be their physician supervisor.

What is going on with these clinical training programs that don't provide clinical training? I guess they just throw a bunch of lectures at them and then tell them to go out there and find their own preceptors? How is this even legal? Isn't there some kind of accreditation system?

I'm trying to come up with a polite refusal that also somehow conveys how horrifying it is for a training program to take their money and then tell them to go find some random outside physician to train them.

I would supervise for the right price. LOL. Apparently, the number I quoted was a bit too high... Still, my experiences in life have taught me that no number is too high to ask. If you don't get a counter it means you are asking too low.

 

[comp1]

Yeah, this should be funded. I'm very confused. This is something a school should set up a collaborative agreement regarding. It shouldn't be single cases like this.

 

[tr]

I would supervise for the right price. LOL. Apparently, the number I quoted was a bit too high... Still, my experiences in life have taught me that no number is too high to ask. If you don't get a counter it means you are asking too low.

Good lord, there is no price that would convince me to entangle myself in this dumpster fire of a 'training program.'

I just am trying to figure out a way to convey, without being rude, how grossly inappropriate it is for their training program to take their money and then tell them to go out there and find someone else to train them.

 

[deleted1100659]

I take the good looking ones....lol

This is completely unprofessional and uncalled for.

Im just kidding, I was thinking the exact same thing. no shame.

I

 

[deleted1100659]

I just am trying to figure out a way to convey, without being rude, how grossly inappropriate it is for their training program to take their money and then tell them to go out there and find someone else to train them.

yep, they totally stole that concept right out of the osteopathic medical school playbook

 

[FlowRate]

Good lord, there is no price that would convince me to entangle myself in this dumpster fire of a 'training program.'

I just am trying to figure out a way to convey, without being rude, how grossly inappropriate it is for their training program to take their money and then tell them to go out there and find someone else to train them.

I'm a pretty straightforward person. If that's what you think and how you feel then just say it. Obfuscating with kind allusions to try and spare their feelings will also risk sparing the message. You could always ally with them against the school by saying "You deserve..."

 

[tr]

I'm a pretty straightforward person. If that's what you think and how you feel then just say it. Obfuscating with kind allusions to try and spare their feelings will also risk sparing the message. You could always ally with them against the school by saying "You deserve..."

Well I feel like just coming out and saying "your training program is a dumpster fire" isn't super professional.

I ended up going with "Thank you for reaching out. I don't believe [our institution] is affiliated with your training program but I presume your graduate program should be able to arrange appropriate in-house clinical training for you. Best of luck!"

Just trying to get the message across that if you're in a training program it should be their job to train you.

 

[littlefred]

Well I feel like just coming out and saying "your training program is a dumpster fire" isn't super professional.

I ended up going with "Thank you for reaching out. I don't believe [our institution] is affiliated with your training program but I presume your graduate program should be able to arrange appropriate in-house clinical training for you. Best of luck!"

Just trying to get the message across that if you're in a training program it should be their job to train you.

Passive-aggressive. I like it.

 

[Merovinge]

Uh, yeah! R-right? Right? Right guys? Guys?

Yes, at least certainly in America, a country with a rich history of putting patient/human care and outcomes ahead of corporate profits...

 

[AcronymAllergy]

Good lord, there is no price that would convince me to entangle myself in this dumpster fire of a 'training program.'

I just am trying to figure out a way to convey, without being rude, how grossly inappropriate it is for their training program to take their money and then tell them to go out there and find someone else to train them.

Psychology has a few programs like this; back when I was a training director, I would occasionally have students reach out to me to ask about the availability of a practicum experience. My response was similar to yours RE: not being affiliated in a training capacity with their institution and our program not offering practica to begin with, and that they should seek assistance and support from their program.

It's unfortunate, to put it lightly. And in Psychology at least, the programs doing this are also (not coincidentally, I'm sure) exorbitantly expensive.

 

[Cath Up]

Is there any benefit to adding into a contract "I will not train NP or PA students. I will train DO/MD students when I want and you cannot stop me from training up to 1 at a time". Do people do that kind of thing? I imagine at some institutions with NP/PA programs there is pressure.

 

[calvinhobbes]

It’s bad at my hospital. They are working as hospitalists on the medicine floors with little to no Attending supervision and are literally killing patients. I have numerous horror stories, we are often correcting their mistakes but patient harm HAS happened and continues to happen. We even have one DNP signing her notes as Dr. XYX, NP, DNP. I mean come on! Smh. She came to our Doctor’s Day lunch and expected praise and all the freebies too, like a hoodie that says “Doctor hero.”

Browsed on Reddit yesterday and yeah their education is a joke, they know it and complain about it too! (See attachments).

The problem is that some NPs think they are BETTER than residents and/or Attendings, but in reality they don’t want to admit their training is subpar or non-existent; they just want the title of doctor with little to show for it. They don’t want to learn medicine or work hard, they want to fast-track their education yet still be called doctor when in reality their egos are the worst I have ever seen!

And who is enabling them? Physicians. Please for the love of God OP, do not train them. It’s their problem, not ours. Their field is already over-saturated and hopefully will implode soon.

 

[calvinhobbes]

Some links where they acknowledge their education is garbage:



They have no idea how to practice psychiatry but are looking for jobs:



Docs charged 3k to supervise an NP:




And the link where they think they are better than resident physicians:




Attached are some highlights, oh man lol.

The Noctor thread on Reddit has some leisure reading if anyone is interested 😅

 

[psych_0]

I see this has took a spiral down to "ALL NPs SUCK" town, but I get students that ask to rotate with me as well. I treat them like med students. I have them get to work an hour before me, see all my new patients and focus on collecting past psych, substance, family and social history. Then I "teach" them how to collect an HPI by shadowing me. Makes my life easier because when I see the patient I just review the info that the NP student gathered "so I see you told Jimmy NP here you've never been in a psych hospital before but your PCP gives you Zoloft for depression, you don't do drugs or alcohol, you live in a dumpster, and your mom has depression." If they missed anything, I can add questions accordingly. Allows me to breeze through new intakes and allows them to get better at interviewing. Then I'll answer questions they have as we walk between units.

 

[birchswing]

I see this has took a spiral down to "ALL NPs SUCK" town, but I get students that ask to rotate with me as well. I treat them like med students. I have them get to work an hour before me, see all my new patients and focus on collecting past psych, substance, family and social history. Then I "teach" them how to collect an HPI by shadowing me. Makes my life easier because when I see the patient I just review the info that the NP student gathered "so I see you told Jimmy NP here you've never been in a psych hospital before but your PCP gives you Zoloft for depression, you don't do drugs or alcohol, you live in a dumpster, and your mom has depression." If they missed anything, I can add questions accordingly. Allows me to breeze through new intakes and allows them to get better at interviewing. Then I'll answer questions they have as we walk between units.

Most mothers would be depressed if their children lived in a dumpster.

 

[tr]

I see this has took a spiral down to "ALL NPs SUCK" town, but I get students that ask to rotate with me as well. I treat them like med students. I have them get to work an hour before me, see all my new patients and focus on collecting past psych, substance, family and social history. Then I "teach" them how to collect an HPI by shadowing me. Makes my life easier because when I see the patient I just review the info that the NP student gathered "so I see you told Jimmy NP here you've never been in a psych hospital before but your PCP gives you Zoloft for depression, you don't do drugs or alcohol, you live in a dumpster, and your mom has depression." If they missed anything, I can add questions accordingly. Allows me to breeze through new intakes and allows them to get better at interviewing. Then I'll answer questions they have as we walk between units.

I mean, I wouldn't/couldn't take an outside med student on my own initiative either, it's just not protocol. I'd redirect them to our training directors and have them set up a visiting rotation formally.

The thing that bugs me is the wild-West nature of the training. Zero vetting of preceptors by the school, just get out there and find your own. How does the program determine whether the preceptor is qualified to precept, or oversee anything about the actual content/structure of the precepting? Sounds like anyone with a pulse and an MD would fill the bill. SMH at how these 'training programs' have the gall to outsource the actual entire job of being a training program to their own students.

 

[Dharma]

yep, they totally stole that concept right out of the osteopathic medical school playbook

A bit of a stretch and a rare occurrence. Maybe for electives it holds true at some schools. Sounds more like the off-shore schools. Regardless, off-topic.

 

[Dharma]

My current employer (large health care system northeastern seaboard) forces them upon us. No extra chips, no perks, just more forms to fill out and being hassled by administration when said forms for half-a$$ed grades are incomplete. All so they can hire an APN instead of a physician to save their corporation $$$ which frustrates me.

I've had a number of NP's pushed through my door on the inpatient unit for their "residency" (absurd abuse of the word). Any of my attempts to push back against the system and decline taking them have been futile so I just go through the motions. I already have medical students who I need (ie want) to teach. For the NP's it's glorified shadowing (ie passive learning experience) at best. I take zero responsibility actually teaching them directly or allowing them to play any role in patient care. I think this worked because I have not had a new one in some time 🙂 Passive aggression for the win?

A good question to ask before being hired: will I be asked to train NP's? Didn't think of that one and should have. Assumed it was all residents and medical students given our residency and med school. Lesson learned.

EDIT: These NP's coming from some random program not ran/owned by our hospital system. Hospital's collecting ducats from said rando "school" while us monkeys don't see a dime.

 

[Cath Up]

My current employer (large health care system northeastern seaboard) forces them upon us. No extra chips, no perks, just more forms to fill out and being hassled by administration when said forms for half-a$$ed grades are incomplete. All so they can hire an APN instead of a physician to save their corporation $$$ which frustrates me.

I've had a number of NP's pushed through my door on the inpatient unit for their "residency" (absurd abuse of the word). Any of my attempts to push back against the system and decline taking them have been futile so I just go through the motions. I already have medical students who I need (ie want) to teach. For the NP's it's glorified shadowing (ie passive learning experience) at best. I take zero responsibility actually teaching them directly or allowing them to play any role in patient care. I think this worked because I have not had a new one in some time 🙂 Passive aggression for the win?

A good question to ask before being hired: will I be asked to train NP's? Didn't think of that one and should have. Assumed it was all residents and medical students given our residency and med school. Lesson learned.

EDIT: These NP's coming from some random program not ran/owned by our hospital system. Hospital's collecting ducats from said rando "school" while us monkeys don't see a dime.

This is what I am worried about. Have you considered adding a right to refuse NP/PA students into future contracts? Has anyone heard of that being done??

 

[Dharma]

This is what I am worried about. Have you considered adding a right to refuse NP/PA students into future contracts? Has anyone heard of that being done??

It's worth a try. Theoretically speaking, anything can be added. Whether they agree is another option. Lawyer up for the contract and ask for what you want. You already have 'no.'

 

[futuredo32]

Don't train your replacement

 

[Stagg737]

It’s common for NP programs to have awful training and completely dump the clinical education on the shoulders of the students. One of many reasons why a modern-day Flexner Report of NP programs should be initiated.