This month we are excited to feature Amy Jnah as our first guest blogger. I met Amy at the FANNP Symposium in 2008 and have always found her to be the ultimate professional. Amy has the unique blend of military and civilian nursing experience as well as a well-rounded nursing background of Staff Nurse, Nurse Manager and Research Nurse experiences from which to draw.
After graduating Magna Cum Laude with her MSN / NNP from Eastern Carolina University (ECU) in 2008 Amy began her NNP career in a large LIII NICU in Ohio before moving to North Carolina where she continues to function in a high acuity NNP capacity but is also the Faculty Head of the NNP program at ECU.
In light of her experience as well as numerous awards and publications, we are honored to present her insights about the value of the NNP preceptor and hope you enjoy it as well.
Neonatal nurse practitioners in today’s workforce provide a multifaceted, inter-professional approach to care. We provide direct patient care in addition to the provisions of collateral duties: teaching neonatal-specific courses such as NRP and STABLE, leading and participating in quality improvement initiatives, presenting at journal clubs, or authoring and contribute to the revisions of clinical practice guidelines (Witt, 2014).
We also provide a service unique to the nursing role, that of dedicated preceptor for NNP students. Advanced practice nursing is innovative in this respect, in that we devote countless meaningful hours of our time, intellect, and energy to the development of our own, the novice student nurse practitioner. More often than not, this is a 1:1 relationship. Does this focused preceptor-to-student relationship set us apart from our counterparts, the physician’s assistant or hospitalist? I would like to think that it does.
Recall that the NICU-specific hours for physician assistants and resident physicians amount to substantially less than the minimum 600 hours that student NNPs are required to amass to achieve eligibility to sit for the national certification examination. Some physician assistant programs do not include the NICU as a part of student rotations.
Furthermore, NICU rotations for resident physicians are now reduced to 2 months total, with a third month elective option for interested individuals. This amounts to a fraction of the time that a student NNP spends training in the NICU.
With NNP students logging hours primarily in Level 3 NICUs, with direct supervision by a qualified and dedicated preceptor, it is clear that the breadth, depth, quality, and quantity of training afforded to NNP students is truly remarkable and the most comprehensive NICU-specific training available to clinicians filling roles other than that of attending neonatologist. The lack of documentation of untoward outcomes by the provisions of care by the NNP demonstrates our value to the healthcare arena (Witt, 2014).
Additionally, one should note the uniquely differentiated approach that NNP preceptors and academic programs offer to students. NNP preceptors execute this differentiated teaching style almost instinctively.
Differentiated teaching strategies have been proven to optimize the learning potential for students. As stated by Hani Morgan (2013), “differentiated instruction is a way of recognizing and teaching according to different student talents and learning styles” (p. 34). The focused preceptor: student relationship provides the opportunity for mentoring behaviors to emerge. The consistency in assessment of the student coupled with the nursing-specific guidance (theoretical, ethical, and philosophical) afforded to student NNPs through these dedicated preceptorships further promulgate the differentiated approach.
Visual, auditory, or tactile approaches are often intertwined through a practicum semester, providing a multi-sensory, multimodal approach to teaching and learning, which further demonstrates the complex, comprehensive student NNP learning experience. This approach facilitates a seamless role transition from bedside neonatal nurse to a well-rounded emerging professional and novice clinician. This is the type of clinician leader we need in our NICUs today.
With the right preceptor/student partnership, a mentoring relationship may flourish which brings with it multiple downstream positive implications. Mentors are able to identify strengths and weaknesses of their prodigies, and customize strategies to reverse weaknesses while simultaneously enhancing the student’s self-confidence. A trusting relationship is formed, where the student feels comfortable asking questions and embracing his/her vulnerabilities while the mentor continually scans for learning opportunities for the student.
This type of relationship clearly serves to optimize self-confidence for all parties involved and is mutually beneficial. Many studies have been published related to the positive impacts of self-confidence in the workplace. A landmark 2008 study by the University of Florida published results of a self-confidence study from a cohort of 7,660 individuals who were studied over 25 years (Judge & Hurst, 2008). What were the results? To summarize, individuals with a higher self-confidence level started off with higher income levels that continued to rise over the next 25 years.
Furthermore, those with lower self-confidence had 3 times as many health problems as their counterparts (Judge & Hurst, 2008)! Gallup studied these same concepts, and found that “people who had the opportunity to use their strengths early on had significantly higher job satisfaction and income levels 26 years later” (Rath & Conchie, 2002).
Judge, T. A., & Hurst, C. (2008). How the rich (and happy) get richer (and happier): Relationship of core self-evaluations to trajectories in attaining work success. Journal of Applied Psychology, 93, 849-863