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Appendix I FNP Site and Preceptor Guidance

FNP Site & Preceptor Guidance

 

FNP592 Focus:

Types of Patients: Across the lifespan in the primary care setting

Types of Services: Assessment and management of primary care.

Ideal Preceptor Choices: Primary care MD, DO, FNP, AGNP. Family practice MD, DO, FNP, AGNP. Internal medicine MD, DO, FNP. Pediatric primary care MD, DO, FNP or CPNP. The preceptor’s practice cannot have a specialty. 

Ideal Site Choices: Family practice, internal medicine (non specialty) practice, or primary care clinic. Primary care pediatrics. Additional sites that may be acceptable include health departments and retail clinics (e.g., CVS) that provide primary care. Home care that provides primary care across the life span. Sometimes acceptable: urgent care facilities that provide primary care.

Inappropriate Sites: Acute care facilities (hospitals, surgery centers, EDs, emergent or urgent care clinics), specialty clinics, long-term care facilities, university health services, hospice care centers, pain management centers, Inpatient Units ,Surgery Centers, Birthing Centers, Substance Abuse Centers/Clinics, Plastic Surgery, Inpatient Psychiatric Units, Telehealth (only), Inpatient Substance Abuse, Inpatient rehab, Acute care inpatient settings, Surgery, Chiropractor, Dialysis centers/offices, Neurosurgery, Covid Clinics, Interventional Radiology, Interventional Cardiology, and cancer centers. 

Notes: If the preceptor lists Internal Medicine on CV/Resume, and also has training listed in a specialty (fellowship, second residency, etc.) and the clinic’s website also lists a specialty, it is not likely a primary care practice appropriate for a first rotation. A letter from the provider confirming currently practicing in primary care may be required.

Family/Primary Care:

Types of Patients: Care of patients across the life span.

Types of Services: Assessment and management of acute and chronic health conditions of patients across the life span.

Ideal Preceptor Choices: Primary care MD, DO, FNP. Family practice MD, DO, FNP. Internal me

dicine MD, DO, FNP. The preceptor’s practice cannot have a specialty.

Ideal Site Choices: Family practice, internal medicine practice, primary care clinic. Additional sites that may be acceptable include health departments and urgent care facilities that provide primary care. Home care that provides primary care across the life span.

Inappropriate Sites: Acute care facilities (e.g., hospitals, surgery centers, EDs, emergent care clinics), specialty clinics, long-term care facilities, university health services, hospice care centers, pain management centers, and cancer centers

 

Pediatrics:

Types of Patients: Patients must be children or adolescents from newborn to 18 years of age.

Types of Services: Assessment and management of primary care of children and adolescents. Must see patients in a pediatrics practice and must see both well and sick infants/children/adolescents.

Ideal Preceptor Choices: Pediatrician MD or DO. FNP or PNP, in pediatrician’s office.

Ideal Site Choices: Pediatrician office, family practice, primary care clinic, or health department clinic.

Inappropriate Sites: Acute care facilities (e.g., hospitals, surgery centers, EDs, emergent or urgent care clinics), specialty clinics, long-term care facilities, university health services, hospice care centers, pain management centers, and cancer centers.

Hours: Generally the student should schedule at least 80 to get around 85 cases, but additional hours may be completed as long as it is in primary care peds and all other required specialty hours are completed by the end of the program. However, if the site is specialty-Peds (like Hem-onc peds, rheumatology peds, etc) this site would count as an optional specialty (up to 40 hours) and not toward your primary care peds requirement.

Notes: It is very important to check the age at which age the clinic or preceptor begins to see patients. Some family practice providers will only see ages 4 or 5 y.o. and up, and students are required to write SOAP notes on infants and young children during their program, and they need to gain experience at the younger ages. So if the site claims they are family practice but the site only sees 4 and up, the student should seek out another site for peds and should not count on doing their entire FNP program at the one site. Additionally, Peds urgent care should not be a students’ only Peds rotation. Urgent care rarely administers vaccines other than flu vaccine, and rarely do the primary care or full wellness visits that are an essential part of the training.You are responsible for obtaining all experiences outlined in the attestation form. Urgent care centers also do not often accept infants (< 12 mo old). ER should also not be considered for the Peds rotation. 


Women’s Health / OBGYN:

Types of Patients: Focused on the care of women. Focuses on the primary care services to women of all ages.

Types of Services: Provide obstetrical* and gynecological care. Focuses on women’s healthcare, family planning, and reproductive services.

*obstetrics is optional

Ideal Preceptor Choices: OB and/or GYN MD, DO, FNP, WHNP, CNM.

Ideal Site Choices: OB and or GYN practice, family practice, internal medicine practice, primary care clinic, or health department clinic that contains a minimum of 50% women’s care, including prenatal and postnatal care, GYN, pap smears, birth control, menopause, and STDs. 

Inappropriate Sites: Infertility clinics.

Note: Students are not to be involved in births or surgeries. 

 

Geriatrics:

Types of Patients: Age 65 and older with primary care issues.

Types of Services: Assessment and management of primary care, recommendation of appropriate immunizations for elders, medication management with focus on unique needs of the geriatric patient, assessment and facilitation of functional abilities in consideration of chronic and aging limitations.

Ideal Preceptor Choices: AGPCNP, ANP, FNP, GNP, MD, or DO working in Primary Care, Family practice or Internal Medicine.

Ideal Site Choices: Family practice with high number of gero patients, Internal medicine if patients meet the age requirements, long- term care, home health primary care if patients meet the age requirements

Specialty Gero Sites: Hospice, Alzheimers, SNF or other specialty geriatric sites will only be approved for 40 hours and count towards the 40 hour optional specialty limit, but the students may count them as geriatric (in the vast majority of of cases), but the student should not plan on a full rotation at these sites.

Inappropriate Sites: Surgery centers, EDs, emergent care clinics, and dialysis clinics.

Optional Specialty Rotations: (up to a total of 40 hours across ALL optional specialties). It is recommended to complete optional specialties only after meeting core/required specialty requirements (hours/journals) for family, women's health, pediatrics, and geriatrics. Unless already approved, effective July 2024, obtaining approval from the FNP Program Director is necessary if a student wishes to use an optional specialty prior to FNP597. 

Appropriate:


Inappropriate:

Note: If the optional specialty is not listed here, it must be sent to the PD to PD/OFE Director for review and determination of approval.

 

Telehealth for USU FNP Students

United States University’s (USU) College of Nursing and Health Sciences permits nurse practitioner students the ability to complete practicum hours via telehealth for select nurse practitioner practicum courses for limited hours.  Telehealth is defined as the provision of healthcare and health-related services by means of electronics and telecommunications technology. Students and preceptors must review the requirements and policies for telehealth outlined in the FNP Clinical Handbook.

Telehealth for this purpose is defined as synchronous services that occur when the provider and the patient are interacting with each other in a live real-time manner (e.g., video conferencing). Students may utilize telehealth as a method to deliver patient care under the supervision of their approved preceptor when approved for telehealth if they are physically present with their preceptor in a professional/business setting (not in a residential setting).

Teleprecepting is when the student and preceptor are not in the same physical location. This is not currently approved for USU NP students.

 

Telehealth Requirements

All students participating in telehealth must notify the Office of Field Experience on the Preceptor Nomination Form if they are completing a telehealth experience, even if they will be conducting telehealth with a previously approved preceptor. The preceptor must also inform the Office of Field Experience via the Preceptor Information and Acknowledgement Form if they are planning to see clients/patients via telehealth with a student.

Hours will not count if the preceptor is not approved for telehealth. 

Scenarios of what is permitted for telehealth: 

NOTE:  This does not count for an onsite direct patient care clinical experience since the patient is remote/virtual.   

 

Scenarios of what is NOT permitted for telehealth: 

 

State requirements include:

Students may only see patients that are within their state that is on file with USU. There are states where clinical experiences, including telehealth, are not approved.

 

Preceptor requirements include:

 

Student requirements include:

Hour Limits and Requirements for Telehealth

If approved, NP students may document up to 40 hours in Project Concert in telehealth. This limit applies for the entire program.