A Message to NP Schools of Nursing: An Open Letter from Lynn McComas, DNP, ANP-C, President & CEO of PreceptorLink®

Dear NP Schools of Nursing,

I have to be honest. Some schools of nursing (SON) are making it worse for students and for the profession. As a long-time NP, a subject expert on “The Preceptor Problem for the NP Profession,” and with ten years of experience in helping students find preceptors, I understand the many complicated factors around this issue.  However, we have been seeing some really concerning problems lately. I can no longer sit back and say nothing, so I want to speak directly to the SON. (And, of course, students, preceptors, the profession, patients, and NP-haters are listening, so please be thoughtful about any responses.) 

We know you’re working hard to meet accreditation standards and comply with evolving regulatory requirements, and we fully appreciate the importance of these standards. However, when preceptor requirements change abruptly, students and our team feel shocked and left scrambling. This sudden shift can frustrate preceptors who had cleared their schedules to take on students, leading to avoidable chaos. We see firsthand how these policy changes are creating significant, often unnecessary, obstacles for students and preceptors alike.

Let’s face it—you know how hard it is find preceptors for NP students. This difficulty is why many schools require students to find their own clinical placements. It’s also why placement coordinator roles within schools often see high turnover. Clinical placement coordination is a difficult, time-consuming task, and that is exaclty the reason I founded PreceptorLink® ten years ago. As an experienced NP in the trenches, I wanted to fill this critical gap for students who otherwise face this responsibility alone (or want options beyond what their school can offer). (YES! Some schools do place students. To those schools: Thank you and God bless you! We’re here for you too if you need help.) 

Not a day goes by that we don’t receive a call from a student in tears, frustrated by the barriers they’re facing. We owe it to these students—the future of NP care—to do better. When students are declined for rotations they’ve already secured due to sudden policy changes, it sends a message to students that their dedication and hard work don’t matter. It sends a message to the preceptors and sites that agreed to accept these students that they don’t matter. Accreditation standards may require updates, but if students have met prior standards, they should be allowed to complete their planned rotations without last-minute disruption. They trusted the process and invested time, energy, and resources—let’s honor that by “grandfathering” in students who’ve secured placements in good faith.

Additionally, communication about policy changes must be clear, timely, and accessible. Manuals students receive are dense, hard to follow, and constantly evolving. When policies change, students need a clear breakdown of how the changes impact their placements, with effective dates. Providing a concise, easily digestible format—a summary chart, FAQ, or simple checklist—can go a long way in helping students navigate requirements without combing through endless documents. Some manuals are 190 pages long! It’s no wonder students struggle to know their school’s requirements.

A recent policy change at one school to reduce the maximum number of students per preceptor from three to two per term might seem minor, but it has created a domino effect that leaves one in three students without a preceptor, even after months of planning. Students who thought they had a secure plan are now scrambling. This isn’t just inconvenient—it jeopardizes their education and strains relationships with preceptors feeling unsupported and dismissed. We’re seeing the results with sites. Many clinical sites are closing their doors to students from certain schools, and some have stopped accepting NP students altogether because they’re unwilling to handle constant, unpredictable changes. 

Here’s another recent change we’ve seen: The recent blanket decision to disallow Family Nurse Practitioners (FNPs) to precept Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) students in acute care settings. While we respect the need for alignment with regulatory and state guidelines, it should not be a blanket rule. Follow state BON guidelines and evaluate on a case-by-case basis. I read in one manual that made this change that an ANP, AGPCNP, or PA are allowed to precept an AGACNP in an acute care setting but not an FNP, even if they have years of experience, are hospitalists and the state BON allows it.

Again, if it’s a state requirement, that is one thing, but to make it a blanket requirement and decline excellent preceptors makes no sense. By making this a blanket rule, programs are losing out on qualified, willing preceptors who could be a tremendous asset in acute care education. Let’s respect the nuance and experience these preceptors bring instead of applying rigid standards across the board.

Declining non-board-certified physicians as preceptors is another extremely problematic and frustrating issue. Physicians are highly-educated providers who have met extensive training (well beyond an NPs) and continuing education (CE) requirements. Yet some NP schools deem them unsuitable for NP students due to administrative standards—not due to a lack of expertise or a state requirement. (If it’s a state requirement, that is different, but I have not found a state that requires physician preceptors to be board certified. Let me know if you know of a state that requires BC for physician preceptors. Not the school making the determinations, but the state BON making it.) Did you know that physicians have to retest for their Boards again? (Unlike NPs) Yes, physicians have to sit for the exam again every time they recertify. This is in addition to the CE they have to do for licensing.

Did you also know that most medical boards charge $1,000 to $2,000 for recertification every 10 years? And board certification is often not required by states or hospitals. As a result, many physicians choose not to renew board certification due to high costs, time burdens, and the perception that recertification exams don’t reflect real clinical practice.  By enforcing rigid standards, NP programs risk denying students access to seasoned mentors who could greatly enhance their practical training. Frankly, it’s embarrassing to tell a seasoned physician that the NP school has declined them because they did not renew their board certification.

If schools continue requiring students to find their own preceptors while raising placement standards, it may be time to revisit the admissions process to better align with the availability of qualified preceptors. Students are tasked with securing their placements but face an uphill battle with fewer preceptors and increasingly complex requirements. Programs should support—not hinder—student success by ensuring admission numbers reflect the reality of available preceptorships.

Phew! That’s my two cents. Thanks for allowing my vent!

At PreceptorLink®, we’re committed to guiding and supporting students, preceptors, and the schools themselves. We’re happy to help place your students and share the knowledge we’ve gained over a decade in this field. We stand side by side with you in the trenches. Our team isn’t only exceptional at what we do—we truly care about students, preceptors, schools, and the NP profession. We want this process to work for everyone involved, so please, don’t make it harder for students, for us, and for the profession we all serve. Let us work together to improve the situation for the sake of the profession, NP care, and the students who are giving their all to become skilled providers.

Let’s make it better. We owe it to the profession, to the students, and, ultimately, to ourselves.

Sincerely,

Lynn McComas, DNP, ANP-C President & CEO, PreceptorLink®