The model for staffing hospitals and the neonatal intensive care unit is changing, but is your hospital ready for that change? In a nurse’s journey to becoming a neonatal nurse practitioner, one of the final steps is working in the hospital under a preceptor. This is often a thrilling time for the student, but what about the preceptor? The declining numbers of NNPs wanting to precept is a concerning problem. It is not always exciting on the reverse end, and it is often dreaded. Why is this such a problem?


The State of the NNP

As of 01/01/2019, there are only 6,043 nationally certified NNPs in the US. The job market for more NNPs continues to be high and on the rise. More and more hospitals are adopting the Neonatologist – NNP staffing model to take care of the tiny, newborn babies. However, the average NNP is just under 50 years of age.

Many smaller facilities who have Pediatricians in-house 24/7 to cover for deliveries are starting to replace them with NNP’s. This is not only a cheaper way to staff a hospital, but it also increases the need to have NNP’s to rotate through the schedule. As such, the number of NNP job openings continues to exceed the number of new grad NNPs entering the workforce each year


The Need for NNPs

From 2008 to 2018, the US has averaged  275 new NNP grads per year. There are approximately 400 job openings each year, which has left a great need for more NNPs to be ready to work. So, as the need for more NNPs rises, hospitals are left with just a handful of options:

  • Hire more NNPs — a helpful idea, but this does not address the shortage.
  • Or hire other roles to do the NNP role.
    • Hire more PAs (Physician Assistants) to work in the NICU
    • Encourage Hospitalists to function in that role

So,  the most apparent NNP solution would be to send more NICU Staff Nurses to school to become NNPs….right? Well, yes and no.

Even if 400 registered nurses would leave their staff nurse position and go to school to train to become an NNP,  there would then be a shortage of preceptors. Preceptors are the educated, licensed, and practicing NNPs who teach the NNP students. The students are not paid during the clinical hours of their schooling. 


The Preceptor Dilemma

This shortage exists because not every hospital offers students to train at their facility. Some tiny hospitals may have very low staffing so they are unable to take the time to educate others while working.

If the facility does allow the NNP to precept, this does not immediately remove all hurdles. Here are some of the problems that preceptors face:

  • Not all experienced NNPs “want” to be a preceptor. 
    • It is a time-consuming role, and it increases the liability of the preceptor.
  • They are forced to do so.
    • No one wants to be “voluntold” to do a job they don’t like to do. 
    • A poor attitude of a forced preceptor can lessen the quality of training that they might receive. 
    • There are no financial or reasonable incentives given.
  • Precepting a student puts an additional burden not only on the preceptor but the rest of the team as well.


The Perks of Precepting

After reading the above, one might wonder why they should precept? Precepting is not a glorious position, and while it does look good on a future resume, there are many more reasons and perks of precepting: 

  • A way to give back in thankfulness to the preceptor that trained them.
  • The satisfaction of helping more hospitals have NNPs and seeing others succeed based upon their efforts.
  • The joy of helping students learn and be ready to work on their own.
  • A chance to train students who will (hopefully) stay on with them to work there after they graduate.
  • A positive demonstration of their commitment to the organization and upper management in hopes of getting a raise or some other perk in the future.



The preceptor role for NNPs is not only a great way to help train future NNPs, but it is also needed due to the shortage. As hospitals continue to supplement the neonatologist role with more NNPs, it is vital for new NNPs to have the right training in their final stages of education. The benefits of precepting are more than financial, but they are positive ways to give back to help those who brought them to this point in their career and pay it forward at the same time.


How does your hospital choose precepting for future students? Do you need to entice your existing NNPs to take on a preceptor role? What creative ways do you “compensate” them in thankfulness to them? Shout out in the comments, we’d love to learn together.


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