Welcome to Becoming a Stress-Free Nurse Practitioner, a show for new NPs and students that want to pass their board exam the first time and make that transition from RN to NP as seamless as possible. I’m your host Sarah Michelle. Now, let’s dive into today’s episode.

Hello my friends, this episode is going to be specifically for my future real deal nurse practitioners out there. We are going to be talking about all the ins and outs of clinical rotations, but also getting the very most that you can from your clinical experiences.

One of the most nerve wracking parts of nurse practitioner school for many of you is completing your clinical hours. And understandably so, because clinical rotations as a nurse practitioner student are a totally different feel and vibe than when you completed clinicals within your nursing program.

But that’s totally okay, this is just a new experience with a little bit of a learning curve. But after you’ve completed really that first 100 hours or so, you’re going to have figured yourself out a little bit more and you’re really going to be ready to go.

We are going to be talking about in this episode how I cried my way into my first clinical site, true story. The value of a learning mindset from day one of any clinical rotation that you begin. And also how to absorb and learn as much as you can in the clinical setting, even if you and your preceptor are not the perfect match for one another.

And so to jump right in, my very first tip when it comes to nurse practitioner clinical rotations speaks to those who have to set up their own clinical sites. If your school sets them up for you consider yourself very lucky. But for the majority of us, this is going to be a student responsibility.

So if you do not have to secure your own clinical site, definitely feel free to skip ahead a minute or two because I’m going to spend some time talking about this. For the rest of you, start the search for preceptors early, so early. Especially if you’re in a position, like me, where I didn’t have any contacts in the practitioner world when I was a student.

Seriously, I wish I had started looking as soon as I was accepted in the nurse practitioner school. Because what I found in my state is that the majority of clinical sites were reserved a year in advance at least. And so if you’re starting to look in the three months before your clinical is supposed to start, you’re likely to be in a pretty tough spot.

And if you start early, it will allow you to be a little bit more picky about where you end up too, which might be important. With my first clinical rotation I just had to get in the door somewhere. I was super struggling despite starting my search seven months in advance.

I had literally called 80 different clinical sites. And this is no exaggeration, I only secured my clinical spot, because when I called a clinic site number 81, I broke down in tears on the phone just out of sheer frustration when they told me no. That’s how desperate I had become. Because ultimately, if I didn’t find a clinical site, I might end up having my graduation delight.

And the site I called call felt so sorry for me crying on the phone, the preceptor ended up taking on three students at one time. And we all had to schedule and coordinate with one another so we wouldn’t overlap. It was a lot, but we did it. But I really wish I had started that year in advance so I wouldn’t have had to have been in that situation because that can be pretty limiting when you’re trying to arrange around other students.

And so, of course, being proactive, I set up my clinical site for the following semester way in advance so I won’t have to worry about it, right? Wrong. Literally a week before I was scheduled to start my second clinical site, I got a call that my preceptor was no longer going to be able to take a student.

Seven days, y’all. I literally had seven days to secure a new clinical site. And in that seven days was my first introduction to the beautiful world of networking. When it comes to clinical sites it is all about who you know and having those connections.

But if you remember, like I said, I didn’t have any connections. I was the first nurse in my family. I was also the first nurse practitioner. And while I didn’t have any connections, guess who did? My mom.

Of all the people to reach out to in order to find a clinical site my mom had never once crossed my mind. My mom though, is a retired schoolteacher, which means that she knows parents and families from all over the city. And she literally found me a last minute clinical site in 24 hours flat.

I couldn’t even believe it. I had spent months before this trying to find sites. And she had done it so quickly without even being in the healthcare field at all. And so never underestimate the value of your personal network when it comes to these clinical rotations.

If you’re struggling to find a clinical site, I’ve found so many people who have found preceptors by reaching out to their network through a simple social media posts. So it can really be that easy. I spent a lot of time overthinking it and a lot of time cold calling.

So we’ve discussed finding clinical sites if need be, now let’s talk about actual clinical sites. There are a vast variety of clinical sites and even specialties that you can shadow in, depending on your school’s policies. But I really like that I started my very first clinical in nurse practitioner school at an urgent care setting.

Now most people thought that urgent care would be a little overwhelming due to the pace. I mean, there were days we easily saw 50 patients in a day. But at the end of the day you see a lot of the same acute complaints over and over in urgent care. Which is excellent as a student because you get to figure out your groove and your routine.

And this also helps when it comes to charting as well, because you will be charting a lot of similar assessment findings between patients. And so you will get really good at knowing what to look for when you’re doing that physical assessment as well.

Primary care clinics on the other hand can definitely be more of a hodgepodge. Yes, you’re seeing those acute complaints, but you’re also seeing a lot of chronic complaints as well. There’s going to be a lot less repetition. And so when I went into a primary care clinic my second semester I just felt as if there was a little bit more of a learning curve.

And when you’re new and you’re nervous, and you’re going to be and that’s okay, the repetition is most definitely welcome. You want any advantage that you can get to build up those confidence levels.

Wherever you end up, though for clinicals it’s all about how you approach the clinical because that will determine what you are going to get from it. And so when it comes to your first clinical, and truly any clinical rotation that you do, you want to show up in the learning mindset from day number one. I always carried around a little notebook with me at all times so I could continuously jot notes throughout the day about the patients I was seeing.

I would also write down any little tips and tricks I learned along the way to try to make things easier to remember. And I think on day one of any new clinical it is also so crucial to have a true conversation with your preceptor about where you’re at as a student and any needs that you may have from that specific clinical rotation.

For example, at my first sight where she had three students, she would sometimes get me confused with the student who was at the end of her program and about to graduate. And therefore she expected my knowledge base to be a lot more developed than it was.

I really wish I had spent the time and had the courage to remind her a little bit more often of where I was at. Because due to the extra stress of being expected to know things that I just genuinely didn’t know yet, it made it a pretty miserable clinical experience for me. I very vividly remember telling my husband that I wasn’t sure if I was meant to be a nurse practitioner.

And so if you are ever in the spot of wondering, is this the right fit when you’re in school, always take a moment to be aware of where you are in the situation that you’re in. I spent that entire semester doubting myself. But when summer came and I had a new and a more relaxed preceptor, I was definitely sure that I was in the right place.

Which brings me to a separate point, tough preceptors. As you likely learned in nursing school too, you as a student will not perfectly match and click with every preceptor out there. Y’all, it’s okay. Everyone has different learning styles, and everyone has different teaching styles too on the flip side of that.

For example, my first preceptor very much enjoyed the Socratic teaching style and asking me questions upon questions in front of patients. And this made me so super stressed. But on the other hand, some students really respond to that style. And so if you’re not vibing with your preceptor it is always worth having an open conversation with them about things that you could do differently together.

Another example was in my third clinical rotation I had a preceptor who wasn’t accustomed to having a student. And so she didn’t even want to allow me to see patients on my own, even after she had already seen them. And so we had to have a lot of open conversations and dialogue.

And I had to work to build up trust with her so that she would let me see the patients without her. Being flexible and adaptable, but also asking for what you need will take you a long way in clinical rotations.

And as we close out this episode, I think it is so important to discuss being anxious when it comes to seeing patients on your own. I think that is really the fear factor behind starting and doing clinical rotations. Lots of thoughts start to run through your head of, what if I say the wrong thing? What if I’m unsure of the diagnosis? What if I diagnose wrong? Et cetera.

A great way to boost yourself up before walking in the clinical practice is to bare minimum have that physical assessment down pat. I went to an all online school where I practiced physical assessments live on Zoom with my instructor.

And so at first in clinical I was a little unsure of myself. And so I practiced on my husband at home all the time. I think he could easily do that physical assessment even today, just because I practiced so many times.

But what all that practicing did was give me a lot of confidence. And I even had a little page in my notebook of all the normal physical exam findings, so I could chart them correctly if need be. And I also want to let you know, you are never expected to know everything. Even seasoned nurse practitioners that have been doing this for decades still have questions. And they still need a little collaboration on those more complex cases. And there is nothing at all wrong with that.

But I do want to caution you about how you present yourself to the patient when you’re feeling unsure. We want to try our best, even during clinicals, to build rapport and trust but it’s going to be pretty difficult to do that if you tell the patient straight up that you are unsure of yourself.

And so my biggest tool was to have a line prepared for when I needed to gather more information from my preceptor or even a source like Epocrates or Medscape. There was one place I did clinicals where there was only Wi-Fi in one room. So you couldn’t take the laptop in the room with you and type as you were talking to the patient. So I would have to leave to get my source.

And so I would tell the patient something along the lines of, “I’m going to check out our sample cabinet to see if we have a sample medication for this condition.” Or I would say, “I’m going to run to the front desk really quickly, I see a flag on your chart, and just see if there’s any additional paperwork they need you to fill out.”

Whatever really just fit the moment is what I would use. And that way I could have time to get my bearings and ask questions to my preceptor while also not looking confused as a student.

And along those same lines, really push yourself in clinicals to be exposed to as much as you possibly can. You only get this learning experience once. And I remember being petrified in my urgent care clinical to suture. And when the opportunity finally presented itself, it was on a wound care physician.

My first suturing experience with on a seasoned wound care physician that have been suturing for years and years. And so it would have been super easy to bail out and say I was too nervous. But I pushed myself to do it anyways. And was it really rough? Absolutely. Did I learn a lot though? Absolutely.

And so don’t let that fear stand in your way of making the most of your clinical experience. Depending on your school, you only get 500 to 1000 hours to practice and then you’re doing it all on your own. You want to have as much of a variety of experiences as you possibly can before that solo day comes.

And so to tie all this up, start searching for those clinical spots early and try to get yourself a variety of different experiences and preceptors if at all possible. Whenever you’re feeling unsure of yourself, just know that it’s normal, and it’s to be expected, and you do still belong here.

And of course, always, always, always try to glean as much as you can from every single experience. You only get to do so many hours before you’re the real deal. And you want to make as many of those hours count as humanly possible.

And then, before you know it, you will be done with school. You’ll be preparing with me for your board exam to truly become the real deal. And that’s it for this week guys. I’ll talk to you soon.

As an extra bonus, friends, if you’re looking for support, no matter what phase of your nurse practitioner journey that you’re currently in, I have communities available for both students and new nurse practitioners, In these communities we work to uplift one another and grow this profession together every single day. Links to join will be included for you in the show notes.

Thanks for listening to Becoming a Stress-Free Nurse Practitioner. If you want more information about the different types of support we offer to students and new NPs, visit stressfreenp.com. See you next week.