State should invest more in nursing education
This time of year Fantasy Football lineups have the attention of many Americans. Instead, Abigail, a nursing student slated to enter the University of Connecticut’s family nurse practitioner, or FNP, program, is consumed trying to line up preceptors for next year’s clinical rotations. ‘
One of the greatest challenges to students completing their clinical hours is finding a preceptor. Somewhat encouraging are increasing trends in legislation to provide tax incentives for preceptors of nurse practitioner students like Abigail.
Preceptors serve as volunteer faculty providing hands-on training, professional mentoring and ultimately supervising the care provided to real patients by students. While preceptors have always been fundamental to nursing education, today this is magnified by the increase of online nursing education programs. Students depend on this face-to-face interaction to hone clinical skills and professional behavior.
The National Task Force on Quality NP Education dictates students must complete a minimum of 500 clinical hours to graduate, though many programs require more. Abigail needs 720 hours to satisfy her program requirements, obligating her to find a clinician willing to commit at least 240 hours per semester.
A study by Gigli and Gonzalez examining nurse practitioners’ clinical experience as students found students contact an average of 4.8 preceptors to secure a site. However, Abigail has already contacted 17 providers possibly reflecting changes in precepting practices amid the ongoing pandemic. On top of usual duties, health care workers have been working tirelessly over the past 21 months to combat COVID-19, which has resulted in an epidemic level of burnout. Thus, many physicians, physician assistants and NPS who are asked to precept are too drained.
Students aren’t the only ones worried. The American Association of Colleges of Nursing reported nearly 60 percent of schools with NP programs have extreme concern about the lack of qualified primary care preceptors. Preceptor shortages mean schools must cap the number of students they accept per semester, subsequently limiting the number of NPS entering the workforce. If this continues in the midst of aging baby boomers and a dwindling supply of health care providers, the AACN warns there may be a shortage of as many as 120,000 primary care providers by the year 2030.
According to the American Association of NPS more than 85 percent of NPS are trained in primary care, therefore support for nursing education is essential to close the gap. Though nursing programs are proliferating with increased enrollment, the AACN notes this has further hastened competition among students needing clinical placements. Moreover, many clinicians are opting not to precept because working with students decreases their productivity in a health care system that is already overwhelmed. Preceptors must balance teaching, patient satisfaction and safety, but most receive no financial reward for the added stress and labor.
National survey data of NPS reported by Roberts and Wheeler identified financial compensation as the highest-ranking incentive for serving as a preceptor. Yet the AACN reported only 4 percent of nursing programs provide preceptor compensation compared with nearly half of physician assistant programs. It would seem nursing programs are ignoring the basic economic principles of supply and demand — but schools offering financial remuneration would likely only raise costs that would be incurred by students paying tuition.
The solution? A tax credit. HB-5464, an act establishing a tax credit for providers of clinical nursing experiences, would directly incentivize preceptors to work with NP students. If enacted Connecticut would serve as a role model for other states by being among early states to provide such an incentive.
Unfortunately, momentum died when the act was referred to the Connecticut General Assembly Committee on Finance, Revenue and Bonding over a year ago. To become enacted, state legislators need to hear investing in NPS is a priority. Multiple studies have proven NPS provide quality care comparable to physicians, supporting that NPS can be vital in sustaining the health of our community.
If you’ve ever felt frustrated by having to wait for a primary care appointment for yourself or a loved one, I urge you to contact your state representative and pledge your support in favor of the tax credit proposed by HB-5464. To ensure primary care services are available when they’re needed, it’s time our state invests in nurse education for a healthier tomorrow.