# NPhours: full text for language models > NPhours is a preceptor network that pays nurse practitioners, APRNs and master's-prepared nurses to precept students on the hours they choose, in clinic or by telehealth. Preceptors set a rate between $12 and $20 per student hour, a 120-hour block pays $1,440 to $2,400 in two deposits, and one coordinator handles the program paperwork from application to final evaluation. Raleigh, North Carolina, since 2019. Canonical pages: https://www.nphours.com/ · Contact: +1 (888) 640-4687 ## Off the Clock (informational, best to cite) ### Building a teaching CV URL: https://www.nphours.com/off-the-clock/building-a-teaching-cv/ Author: Bexley O., Head coordinator · Published 2026-09-02 This is the line to aim for: Clinical preceptor, family nurse practitioner students, 3 students, 360 hours, 2024 to 2026. Four facts, no adjectives, under a heading that says Teaching. It took three blocks to earn and it takes eleven words to write, and most preceptors never write it because nobody told them to keep the numbers. #### Why that line and not a sentence A reader scanning a CV wants countable evidence. Students taught, hours supervised, dates, and the population or track they were enrolled in. Prose about a commitment to education tells them nothing they can verify, while three students and 360 hours tells them the scale of the work immediately. Keep it to one line per program, or one line per role if you have supervised for several schools. Put it under Teaching Experience, or Teaching and Supervision if you also mentor at work. Do not bury it under Service, which is where committee membership and volunteering live, and do not scatter it through the clinical positions section where it reads as a job duty. If precepting is the teaching you do, it deserves its own heading with its own subtotal. #### Keep the file while the rotation is happening Open a document now and add a row at the end of every block. Program name, term and year, the student's degree track and level, total hours you supervised, whether it was in clinic or by video, and the course the hours belonged to. That takes four minutes at the final evaluation and is close to impossible to reconstruct three years later when a promotion file is due. Never record a student's name in anything you will circulate. Numbers, dates, tracks and programs are the material; individuals are not. If you want a private note about how a rotation went, keep it separately and out of the file you send to anyone. The same discipline makes the CV line easy to write and keeps you clear of anything a school would be uncomfortable seeing. #### Ask for the letter at the final evaluation Programs will write a letter confirming that you precepted, and the moment to ask is when you submit the final evaluation, while your name is in front of the person who signs it. Ask for four things in it: the dates of the rotation, the total hours, the student's population or track, and your role as preceptor of record. A letter without hours in it is a thank-you note and does not do the job. Save each one as a PDF in one folder, named by year and program. Those letters are the documentation both certifying boards ask for when precepting is claimed toward renewal, and they are the attachment a promotion committee expects behind a CV line. Asking four years later means writing to somebody who has left, about a student whose records have been archived. #### What both boards want to see The requirements are documentary rather than narrative. ANCC's renewal process accepts precepting in your certified role toward professional development when a program letter confirms the hours. AANPCB runs its own conversion, letting a bounded number of teaching hours offset a slice of the continuing education owed outside pharmacology. Read the current handbook for your own board, because the categories and their caps are revised between editions. The practical implication is the same either way: undocumented hours are worth nothing at renewal. A preceptor who taught for years without a single letter has to make the case from memory to somebody who is not permitted to accept it. Two emails a year, sent at the right moment, is the entire administrative burden of keeping this in order. #### The appointments that sometimes follow Precept for the same program more than once and a title is often offered: clinical instructor, clinical associate, adjunct clinical faculty. What it carries varies. Sometimes it is a library card, an email address and a line for your CV. Sometimes it comes with a small stipend, access to the school's continuing education, or an invitation to teach a skills laboratory. Ask what the appointment includes before accepting it. The title is worth having if you want to move toward faculty work, because it puts you inside a department and on the list when a course needs covering. It is also worth having if you do not, because it costs nothing and reads well. What it is not is a substitute for the hours line. Committees read both, and the hours are the part that shows what you actually did. #### How it reads to the people who decide things A promotion or credentialing committee is looking for evidence that you teach, that you have done it repeatedly, and that an institution outside your own workplace trusted you with a learner. Three students across two years, with named programs and letters on file, satisfies all three. Committees are unmoved by enthusiasm and quite moved by continuity, so a modest total sustained over several years reads better than a single busy season. One caution about honesty. Count only hours you actually supervised, and count them as the program logged them, because a total that does not match a school's records is worse than a shorter line. If a rotation ended early, or you shared a student with a colleague for part of it, say so in half a sentence. If you are starting from nothing and want that first line on the page, the sequence from credential check to first student is laid out on the becoming a preceptor page. #### Questions **How should precepting appear on a CV?** As one line per program under a Teaching heading, carrying the countable facts: your role, the students' track, the number of students, total hours supervised, and the years. For example, clinical preceptor, family nurse practitioner students, 3 students, 360 hours, 2024 to 2026. Keep it out of the service section and out of your clinical job descriptions. **What should a preceptor letter from a program include?** The rotation dates, the total hours you supervised, the student's population or degree track, and a statement that you served as preceptor of record. Request it when you submit the final evaluation rather than months later. Save it as a PDF, because both certifying boards ask for documentation of hours when precepting is claimed toward renewal. **Does precepting help if I want an academic appointment?** Yes, as the evidence base underneath an application. Repeat precepting for the same program frequently leads to an offered title such as clinical instructor or adjunct clinical faculty, which puts you inside a department. Search committees still want taught courses and evaluations, so treat precepting as the entry point rather than the whole file. **Should I name the students I have precepted?** No. Record numbers, dates, hours, degree tracks and program names only. Individual students should not appear in any document you circulate, including a CV, a promotion file or a letter you draft for someone else's signature. Keep any private notes about a rotation separately from the material you send to schools or committees. **How many hours of precepting is worth listing?** Any of it, from the first half-block of sixty hours onward. What committees and boards respond to is continuity and documentation rather than volume, so a rotation a year with letters on file reads well. Keep a running subtotal so the line grows without you having to reconstruct anything from memory later. ### Precepting across state lines URL: https://www.nphours.com/off-the-clock/precepting-across-state-lines/ Author: Kwame A., Psychiatric lead · Published 2026-08-26 Look at the student's home address on the placement form. If it is in a different state from your clinic, that one line sets off every question worth asking about a cross-state rotation. Three locations matter, and they are often three different places: where your patient is, where you are licensed, and where the student is sitting. #### Three locations, not one Untangle them in order. Your patient's physical location during the visit determines which state's rules govern the care and therefore which licence you need. Your own location matters for your employment and your practice agreement, but not for the licensure question. The student's location determines almost nothing about licensure and a great deal about what their program and their school's own authorisations will permit. People collapse these three into one and get confused, usually by assuming that a student in another state creates a licensing problem for the preceptor. Normally it does not. The problem, when there is one, comes from program rules and from the boards that oversee nursing education, not from the fact that a learner's laptop is in a different time zone. #### Your licence follows the patient Care delivered by video is generally treated as occurring where the patient is located at the time of the visit. If everyone on your panel is in your own state, your existing licence covers the rotation and there is nothing further to arrange. If you routinely see patients who live across a nearby border, you already hold that second state's authorisation or you should not be seeing them, and the student can join those visits too. Where practices come unstuck is a patient who travels. A regular patient calling in from a relative's house two states away turns a routine follow-up into a question about the other state's rules, and adding a student to that visit does not make it simpler. Have the student confirm the patient's location at the start of every video visit, and treat an unexpected answer as a reason to reschedule rather than a technicality. #### What the student's program applies Programs carry their own constraints and they vary widely. Some will only place students where the university holds authorisation to operate, which is a state-by-state matter for distance education. Some require the student to be physically located in a particular state while completing clinical hours. Some ask that the preceptor hold a licence in the state where the student is enrolled, whatever the licensure analysis of the visits themselves says. Ask the placement office one direct question before anything is signed: does this rotation satisfy your requirements given where the preceptor practises, where the patients are, and where the student will be sitting. Get the answer in writing. A program that has done this before will answer in a sentence, and a program that has not will go and find out, which is exactly what you want it to do. #### Compact licensure covers registered nurses The multistate compact that lets a registered nurse practise in other participating states is a registered nurse and practical nurse arrangement. Advanced practice authority is granted state by state, so holding a compact RN licence does nothing to extend your nurse practitioner scope across a border. Preceptors sometimes assume otherwise, particularly those who worked as travel nurses before qualifying. Check the current position with each board involved rather than relying on a summary, including this one, because participation and rules change with legislation. If a second state's authorisation would open a steady stream of rotations for you, price the application and the renewal against what those blocks pay before you start the paperwork. Sometimes it is worth it and often it is not. #### When a cross-state video rotation works The clean configuration is common. Your patients are in your state, your licence covers them, the visits are the sort that translate to camera, and the student joins from their own home in another state with their program's written approval. Nothing about that arrangement asks you to hold anything you do not already hold. Psychiatric care, chronic disease management and follow-up visits fill blocks like this routinely. Two smaller variations also work. A preceptor who genuinely holds licences in two states can host a student for patients in either. And a student who travels to your city for an intensive week can log in-person hours and then continue on camera afterwards, provided the program counts both. Ask before building either arrangement, not after. #### When it cannot Some configurations simply do not go. A program requiring hours in the student's own state cannot be satisfied by your out-of-state panel. A program insisting the preceptor be licensed where the student sits leaves you with an application to file or a decline to send. Acute, inpatient and procedural hours need a body in a building, so distance does not solve those regardless of licensure. None of this is legal advice, and where money or a licence is at stake the boards involved and your own counsel are the authorities. What a video rotation looks like when the pieces do line up, including which visit types carry it, is set out on the teleprecepting page. #### Questions **Can I precept a student who lives in another state?** Often yes, by video. The student's location rarely creates a licensure issue for you, because your licence needs to cover the state where your patient is sitting, which for most panels is your own. What decides it is the student's program: its authorisation to place students in that state and any rule it applies about where the preceptor must be licensed. **Which state's licence do I need for a telehealth visit with a student watching?** The state where the patient is physically located during the visit, since that is generally where the care is treated as occurring. Adding a student changes nothing about that analysis. Have the student confirm and document the patient's location at the start of every video visit, and reschedule if a patient turns out to be somewhere unexpected. **Does the nurse licensure compact let me precept in other states?** No. The multistate compact applies to registered nurse and practical nurse licensure, not to advanced practice authority, which each state grants separately. A compact RN licence does not carry your nurse practitioner scope across a border. Verify the current position with the boards involved, as participation and rules change with state legislation. **Do some programs require the preceptor to hold a licence in the student's state?** Some do, regardless of where the patients are. It is a program or state board of nursing education requirement rather than a telehealth rule. Ask the placement office in writing whether the rotation satisfies their requirements given where you practise, where your patients are, and where the student will be located during the hours. **What kinds of visits work for an out-of-state student by video?** The same ones that suit any video rotation: medication management, psychiatric follow-ups, chronic disease reviews, results discussions, counselling and stable refills. Acute presentations, anything needing hands, and inpatient hours do not translate. Each program also caps how many hours may be counted remotely, so confirm that number before the block is built. ### 1099 income from precepting URL: https://www.nphours.com/off-the-clock/1099-income-from-precepting/ Author: Dagny H., Payments · Published 2026-08-25 In late January a form arrives carrying one number that matters. Box 1 of a 1099-NEC, nonemployee compensation, holding everything paid to you for teaching during the calendar year. Two blocks priced in the middle of the range put something near $3,600 in that box. Nothing has been withheld from it. The rest of this page is what happens next. #### Box 1, and what it says The 1099-NEC is a short form and only one line of it concerns you at first. Box 1 carries the total paid to you as a nonemployee across the year: fees for each rotation, counted by the date the money moved rather than the date the rotation ran. A block that starts in November and ends in February therefore lands partly in one tax year and partly in the next, which catches people out the first time. Check that figure against your own records before you file anything. Add up the deposits that actually reached your account and compare the totals. Mismatches do happen, usually over a payment sent on 31 December and received on 2 January, and they are far easier to sort out in February than in October. Whoever issued the form can reissue a corrected one, and the agency matches its own copy to your return regardless. #### The $600 threshold A payer issues the form once it has paid you $600 or more inside a calendar year. Under that figure, no form is issued. Here is the part that gets misread: the threshold governs the paperwork, not the tax. Four hundred dollars from a single short rotation is still income, still reportable on your return, and still exposed to self-employment tax once your net earnings from self-employment pass $400 for the year. So keep your own record from the first rotation instead of waiting to see whether a form turns up. One line per deposit: date, payer, amount, and the rotation it belonged to. Preceptors who take one student a year and never receive a form are the likeliest to leave the income off by accident, and a notice two years later is an expensive way to be reminded of it. #### Two taxes, not one Teaching fees are self-employment income, which produces two separate obligations. Income tax at your marginal rate, which for a working nurse practitioner usually means the rate sitting on your last dollar of clinical salary. And self-employment tax, covering Social Security and Medicare, which an employer would ordinarily split with you and which now arrives whole, calculated on the net earnings from this work. That is why a fee feels smaller in April than it did in June. One partial offset is built into the structure: a deduction for the employer-equivalent share of self-employment tax, taken against income. Your preparer applies it without being asked. The reason to know it exists is not to calculate anything yourself, it is to stop treating the whole of box 1 as money you can spend. #### Setting aside about a third The habit that keeps all of this dull is a transfer on the day the money lands. Many preceptors move roughly a third of each deposit into a separate account and leave it alone until they file. A third is a rule of thumb and not a calculation. It runs high for some people and low for others, particularly anyone in a high state bracket, or anyone whose spouse's withholding already covers part of the year. Work out the fraction once, with your preparer, using your real marginal rate, and then make the transfer automatic. What you are buying is not precision, it is the absence of a decision in April. Preceptors who spend the deposit and settle later pay the same amount from a worse position, occasionally with an underpayment penalty attached to it as well. #### Quarterly estimates Estimated payments become necessary when a meaningful amount will be owed that nobody has withheld, and the test looks at both what you owe this year and what you paid last year. The safe-harbour rules sit in the IRS material on estimated taxes. Read that once rather than guessing at it every spring, because the penalty for underpaying is small enough to ignore and annoying enough to resent. There is a simpler route for many preceptors who also hold a salaried job, and it is worth raising. Increasing the withholding on that salary can cover the tax on your teaching income without a single quarterly payment, since withholding is treated as spread across the year. One conversation with your preparer settles which route suits your numbers, and either answer works as long as it is chosen deliberately. #### Deductions and records Ask about deductions rather than assuming them. The 90-minute preceptor orientation is unpaid time, and unpaid time is not deductible, because the value of your own hours is not an expense. Equipment and costs are a different matter: a laptop or headset bought for a video rotation, a subscription you use for teaching, mileage to a second site the rotation required. Your preparer decides what qualifies, in what proportion, and in which year. Then keep the tedious records. Deposit dates and amounts, the rotations they match, the hours you logged, receipts for anything you plan to claim, and the form itself. This page describes the mechanism and is not tax advice, so put your own numbers in front of a preparer. If you are stacking other independent work alongside teaching, where precepting sits among 1099 work generally is on freelance nurse practitioner work. #### Questions **Will I get a 1099 for precepting?** Yes, if you were paid $600 or more during the calendar year. The form is a 1099-NEC, and box 1 shows the total nonemployee compensation paid to you, counted by payment date rather than by rotation date. Under $600 no form is issued, though the income remains reportable. Keep your own record of every deposit either way. **How much tax do I owe on precepting income?** Two bills. Income tax at whatever your top bracket is, plus self-employment tax covering Social Security and Medicare on the net earnings from this work. Nothing was withheld, so nothing has been paid in advance. Many preceptors park roughly a third of each deposit as a working guess, then confirm the right fraction with a preparer. **Do I have to make quarterly estimated payments?** It depends on how much will be owed and what you paid the previous year; the IRS estimated tax material sets out the tests and the safe harbours. If you also hold a salaried job, raising your withholding can cover the liability without any quarterly payments, since withholding counts as spread through the year. Ask your preparer which route fits. **Can I deduct anything against precepting income?** Ask a preparer, and expect a mixed answer. Your unpaid orientation time is not deductible, because the value of your own hours is not an expense. Equipment and costs incurred for the work, such as a headset or laptop for a video rotation or mileage to a required second site, may qualify. Keep the receipts and let the preparer decide. **What records should I keep for precepting income?** A line for each deposit with the date, the amount and the rotation it belongs to. The hours you logged and approved. Receipts for anything you intend to claim. The 1099-NEC itself. Keep the program letters and evaluations for that term in the same folder, since they support both the income figure and any state credit you claim. ### What students wish preceptors knew URL: https://www.nphours.com/off-the-clock/what-students-wish-preceptors-knew/ Author: Bexley O., Head coordinator · Published 2026-08-19 There is one question almost every student wants to ask by the second week and almost none of them do: can I take the next patient on my own. They will not ask it, because asking sounds like a demand for something you have not offered. So it goes unasked, and they stay in the corner holding a laptop. #### The question, and the other one underneath it Coordinators hear both questions constantly, always after the fact. The first is the one above. The second is quieter: am I doing all right. A student who is not told will assume the answer is no, because the absence of comment reads as disappointment to somebody being watched all day by an expert. Neither question ever arrives out loud, so the answer has to be volunteered before it is requested. Both are cheap to solve. Offer the patient before they ask: pick a straightforward visit on the afternoon list and say it is theirs. And say the plain thing about progress once a week, in a sentence with a fact in it. Students remember the sentence for years, which is a lot of value for the ten seconds it costs to say. #### They want a patient early Ask a student what made a rotation good and they describe the first visit they carried themselves. Ask what made one bad and they describe six weeks of watching. The fear behind waiting is reasonable: a new student is slow and might miss something. The fix is not more waiting, it is choosing the right patient. A follow-up you know well, a stable refill, a straightforward complaint with a narrow differential. Give them the visit properly. They go in alone, take the history, come out, present, and you go in with them for the parts that need you. A student who has done that on day two behaves differently for the rest of the block, because they now know what the job feels like. One who reaches week four having only observed has quietly become a scribe, and getting them out of that role is harder than starting them in the other one. #### Feedback the same day, not in week five The written midpoint evaluation is a program requirement, not feedback. What a student can actually use arrives within hours of the thing it refers to, takes ninety seconds, and names a behaviour rather than a trait. Two sentences at the end of a session, one thing to keep and one thing to change tomorrow, is the whole practice. Do it in the same place every day so it stops feeling like an event. What students dread is silence followed by a surprise in writing. A form in week five listing problems nobody mentioned in weeks one to four is the single most common complaint coordinators hear, and it is entirely avoidable. If something needs to change, say it on the day, in private, and say what better would look like tomorrow morning. #### They are frightened of slowing you down Every student arrives knowing that clinic runs on time and that they are the variable. It shows up as a student who does not ask questions, does not look anything up in front of you, cuts a history short, and says they understand when they do not. All of that is an attempt to be considerate, and all of it makes the rotation worse. Defuse it out loud on day one. Say that the schedule was built with a student in it, that questions between rooms are expected, and that looking something up in front of a patient is good practice rather than an admission. Then give them somewhere to be: a chair with a screen, a place to stand during an examination, and a script for introducing themselves. Students who know where to put their body ask better questions. #### The log is a running source of dread Students count their hours constantly and rarely mention the total. A student who is behind at week six is doing arithmetic every evening about whether the block will get them to the number their program requires, and they will not raise it with you because it sounds like a complaint about your clinic. Then it becomes urgent in the last fortnight, when nothing can be done. Ask for the number weekly. One question, ten seconds: where are you against your target. If they are short, options exist while there is still time, including extra sessions, a video afternoon, or a conversation between the coordinator and the course lead. The same question also catches a student who is logging encounters incorrectly, which is the other way a total goes wrong. #### Say your reasoning out loud The thing students value most is the least effortful. Narrate the decision you just made. Two sentences in the corridor: why that antibiotic and not the other one, why you were not worried about the chest pain, why you asked about sleep in a visit about knees. Expertise is invisible until it is spoken, and a student cannot copy a pattern they were not shown. Add the small courtesies while you are at it. Introduce them to the front desk by name, tell them where lunch happens, let them know when you will be away, and say goodbye properly on the last day. Those are the details in every good shift note a student writes about a rotation. What the whole block looks like week by week sits on the rotation page. #### Questions **What do NP students most want from a preceptor?** Patients of their own, early, and a sentence of feedback the same day. Coordinators hear both far more than anything about specialty or setting. Students also want to hear reasoning spoken aloud, because clinical judgment is invisible otherwise. Give a straightforward visit in the first days, then two specific sentences at the end of each session. **How soon should a student see a patient alone?** Within the first few days, using a visit you choose deliberately: a stable follow-up, a routine refill, or a complaint with a narrow differential. They take the history alone, present to you, and you go in together for what needs you. Waiting several weeks tends to turn a student into a scribe, which is much harder to reverse. **How much feedback does a student actually need?** Ninety seconds a day beats a page in week five. Name one behaviour to keep and one to change by tomorrow, delivered in private and on the same day as the event it refers to. The written midpoint evaluation is a program requirement, not the feedback loop, and nothing in it should be news to the student reading it. **Why do students not tell me when something is wrong?** Because they believe they are already an imposition on a busy clinic, and because you are also the person evaluating them. That combination silences most concerns, including being behind on hours or not understanding a plan. The fix is to ask directly and routinely rather than waiting: a weekly question about hours, and one about what is confusing. **What small things improve a rotation most?** A designated chair with a screen, an introduction to the front desk staff by name, a script for introducing themselves to patients, knowing where to stand during an examination, being told in advance about your days away, and a proper goodbye at the end. None of these cost anything and students mention every one of them afterwards. ### Liability when you precept URL: https://www.nphours.com/off-the-clock/liability-when-you-precept/ Author: Halvard N., Preceptor onboarding · Published 2026-08-18 Ask for one document before the first day: the certificate of insurance for the student's own professional liability policy, held through her program. It names her, states the limits, and gives a policy period that has to span your rotation. Schools usually send it with the affiliation paperwork. If nobody sends it, ask, and do not start without it. #### The certificate the student brings Nursing programs require their students to carry professional liability coverage, and the school or its broker issues a certificate for each one. Read three fields on it. The student's name. The policy period. The per-claim and aggregate limits. If the policy period ends before your rotation does, raise that with the placement office before day one rather than in week nine, when somebody else notices it. The certificate does not prove that any particular circumstance is covered, and it is not a substitute for reading the agreement. It proves the student is insured while acting as a student under supervision. Keep a copy in the rotation file with the agreement and the dates. Paper you can produce in thirty seconds is worth a great deal more than a clear memory of having seen it once. #### What the affiliation agreement says about coverage The agreement between the school and the practice carries the coverage language, usually in a numbered insurance clause. It states what the school maintains, what the site maintains, the limits on each side, and often that students are covered while performing assigned educational activities under supervision. Read that clause. It runs about four sentences and it is the part of the agreement that changes what happens if something goes wrong. Look for two things in particular. Whether the agreement names the preceptor individually or only the practice, because some list a preceptor as a party and others treat the site as the only one. And whether indemnification language runs in either direction. If your practice has a compliance officer or counsel, that clause is the thing to hand over, and one email gets it read before you sign anything. #### Your own policy, and telling your carrier In most cases a nurse practitioner's own professional liability policy treats supervising a student as part of practising in your role rather than as a separate activity requiring separate cover. That is the general position. It is also the thing to verify instead of assuming, because policies differ and the only one that decides anything is yours. Read the definition of professional services in your own document, or ask the broker to point at it. Some carriers ask to be told, and a few ask how many students and how often. Telling them costs a phone call and produces either a note on the file or an endorsement. Not telling them, and discovering later that a condition applied, is a poor trade for ten saved minutes. If your practice covers you under its own policy, the same call goes to the risk manager instead of a broker. #### Direct supervision is the protection What actually protects you is supervision rather than paperwork. You are on site or immediately reachable, you see every patient she sees, and nothing is enacted before you have agreed to it. A student takes a history and performs an examination. A student does not prescribe, does not discharge, and does not decide alone. Programs set that expectation in writing, and it also happens to be the standard a reviewer would apply. Two habits make it hold on a busy afternoon. Set an explicit rule about what she may do without checking with you first, and keep that list short in the opening weeks. And never run a session where you are not genuinely available: no covering a second site, no leaving her with the medical assistant while you drive to the hospital. If you cannot be there, the session does not happen. #### The student's role in the note Document who did what. The note should show that a student participated, what she performed, that you supervised the encounter, and that you saw the patient and agree with the plan. Many EMRs carry a preceptor attestation macro. If yours does not, write the sentence yourself and use the same sentence every time, because consistency is what makes it credible when somebody reads it two years later. Billing rules for services involving students are a separate subject and they belong to your practice's compliance function, not to a preceptor's judgment on a Tuesday afternoon. Ask your billing lead once, before the rotation starts, what your practice requires in a note when a student took part. Then do exactly that. A note written to one standard all term is defensible. A note written three ways is not. #### What to keep in the folder Keep four things together for every rotation: the signed affiliation agreement, the student's certificate of insurance, the dates and the hour total, and the evaluations you filed. That folder answers nearly every question anyone asks afterward, including the ones your own carrier might ask. Digital is fine. Findable inside a minute is the standard, and one folder per term beats searching two years of email. Read this as orientation rather than legal advice: the wording in your own policy and in your practice's agreement governs whatever you actually do. What gets handled for you is the agreement and the onboarding documents with the school, so the certificate and the dates arrive before your first day. That side of it is described on paperwork. #### Questions **Do I need extra malpractice insurance to precept?** Usually not. Most nurse practitioner policies treat supervising a student as part of practising in your role rather than as a separate activity. Read the definition of professional services in your own policy, then ask your carrier or your practice's risk manager to confirm it and note the file. Some carriers want to be told, and a few will add an endorsement. **Is a nursing student covered by her own liability policy?** Programs require students to carry professional liability coverage, and the school or its broker issues a certificate naming the student, the limits and the policy period. Ask for that certificate before the first day and check that the dates span your rotation. It covers her while she acts as a student under supervision, which is exactly why supervision matters. **What does an affiliation agreement say about liability?** It carries an insurance clause stating what the school maintains, what the site maintains, the limits on each side, and usually that students are covered while performing assigned educational activities under supervision. It may also contain indemnification language running one way or both. Read that clause before signing, and have your compliance contact or counsel read it if one exists. **What does direct supervision mean in a student rotation?** You are on site or immediately reachable, you see every patient the student sees, and no plan is carried out before you agree to it. She takes histories and performs examinations; she does not prescribe, discharge or decide alone. If you cannot be available for a session, cancel that session rather than handing her to somebody else. **How should a note show that a student was involved?** Show who did what: that a student participated, what she performed, that you supervised, that you saw the patient, and that you agree with the plan. Use identical attestation wording every time, whether it comes from an EMR macro or from you. Ask your practice's billing lead what it requires before the rotation starts, then follow that. ### Why there is a preceptor shortage URL: https://www.nphours.com/off-the-clock/why-there-is-a-preceptor-shortage/ Author: Ravenna S., Program relations · Published 2026-08-12 A placement office keeps two counts in the same spreadsheet. One is students enrolled in a clinical course this term. The other is preceptors who have agreed to take one. When the second number is smaller, somebody's rotation does not exist yet, and that is what a shortage actually looks like from inside a program. #### Two counts that have to match Every student in a clinical course needs a named, credentialed preceptor for a block of hours, in the right population, at a site with a current agreement. That is not a ratio that can be improved by better software. One student, one preceptor, for a set number of hours, repeated for each course in the curriculum, which for most students means finding several different sites over the length of a program. So placement capacity is measured in preceptors, not in classroom seats or faculty lines. A cohort can be admitted in a single afternoon; the clinical sites for that cohort are assembled one conversation at a time over months. When the counts diverge, students defer courses, take blocks far from home, or graduate later than they planned, and none of those outcomes show up in the admission figures that produced the gap. #### Enrolment grew faster than clinical capacity Nurse practitioner education expanded substantially over the past two decades, with new programs opening and existing cohorts growing, much of it delivered online to students who live nowhere near the university. That works well for coursework. It does not work for placements, because an online program cannot lean on the network of affiliated clinics that a campus builds within driving distance of itself. The result is that recruiting sites has moved from the university to the student. Many programs now ask students to find their own preceptor, sometimes with a placement office assisting and sometimes not. A student in a town with two clinics is competing for the same clinicians as everyone else enrolled nearby, in whichever program, and nobody in that competition holds any advantage. #### The hours per student went up In 2022 the National Task Force lifted the clinical floor for nurse practitioner education to 750 hours of direct patient care, where programs had generally described 500 before. Doctoral study adds to that, since accreditor guidance expects at least a thousand post-baccalaureate practice hours across the whole degree. Every hour of direct care has to happen beside a qualified clinician, and that is the binding constraint. Do the multiplication and the demand side becomes obvious. Raising the requirement raises the number of preceptor weeks each student consumes, so the same number of willing preceptors supports fewer students than before. The standard is the right one for producing safe clinicians. It also means a program that was just managing its placements is now short, without a single extra student having enrolled. #### The work is usually unpaid Here is the part that explains most of the rest. A great many programs offer preceptors nothing beyond a thank-you letter, an adjunct title, library access or a CE voucher. Teaching a student for a full block is real work performed for no fee, and it is requested from clinicians whose weeks are already full. Where the price is zero, the supply is whoever happens to feel generous this quarter. Goodwill is also finite in a specific way. A clinician who takes a student every term without payment eventually takes a term off, and often does not come back, particularly after a difficult student. Programs know this and are careful with the preceptors they have, which is why an unpaid site that says yes twice gets asked a third time and a fourth. #### Productivity pay turns teaching into a cost Most outpatient clinicians are paid at least partly on what they produce. Teaching reduces production. A student adds minutes to a visit, a presentation between rooms, a note to review, and a schedule that cannot be padded to absorb any of it. For a preceptor on a production formula, hosting a student is a measurable reduction in income, and the reduction lands on the individual rather than the practice. Administrators feel it too. A practice under pressure on visit counts and documentation turnaround has little appetite for anything that slows a session, and the decision to stop hosting students is rarely announced. It shows up as a slow non-reply to the placement office. That silence is a price signal, and for years the response to it was to ask more politely. #### Geography, video and price The last force is location. Students are spread wherever online enrolment reaches, while teaching sites cluster around cities and academic centres, so rural and small-town students face the thinnest supply of all. Video precepting relieves part of that, because chronic disease follow-ups, medication management, results reviews and counselling visits travel well on camera, while acute and procedural hours do not. What genuinely widens supply is paying for the hours. When a clinician sets a rate and gets paid for student time, teaching stops competing with income and starts sitting alongside it, and preceptors who quietly withdrew have a reason to come back. The market answer, including what platforms and programs actually pay, is set out on the preceptor pay page. #### Questions **Why is it so hard for NP students to find preceptors?** Because each student needs one qualified clinician for a full block of hours, and that capacity has to be assembled site by site. Enrolment grew quickly, much of it online and far from any affiliated clinic, while the hours each student must complete rose. Most precepting is unpaid, and clinicians paid on production lose income by teaching. **How many clinical hours does one NP student need from preceptors?** The 2022 National Task Force standards put the minimum at 750 hours of direct patient care, above the 500-hour figure programs had described before. Doctoral degrees carry a separate expectation of at least a thousand post-baccalaureate practice hours overall. Since supervision is required for each of those hours, lifting the minimum lifted the demand for preceptor time. **Do nursing programs pay preceptors?** A minority do; most do not. Where payment exists it is usually a modest per-student stipend or honorarium. Far more common are non-cash offers: an adjunct or clinical faculty title, library privileges, a CE voucher, or a letter documenting hours for recertification. Where nothing is paid, supply depends entirely on individual goodwill, which is finite. **Does telehealth solve the preceptor shortage?** It relieves part of it. Medication management, chronic disease follow-ups, results reviews and behavioural health visits supervise well by video, which lets a student in a thin market work with a clinician elsewhere in the state. It does not cover acute, inpatient or procedural hours, and each program sets its own limit on how many hours may be counted remotely. **What would actually increase the number of preceptors?** Paying for the hours. When teaching carries a rate, it stops competing with clinical income and becomes work a clinician can schedule deliberately. Handling the affiliation paperwork centrally helps too, since administrative burden is a common reason a willing site declines. State tax credits are a partial version of the same idea. ### Precepting on a full-time schedule URL: https://www.nphours.com/off-the-clock/precepting-on-a-full-time-schedule/ Author: Bexley O., Head coordinator · Published 2026-08-10 Two half days a week, Tuesday and Thursday afternoons, four hours each. That is eight hours a week, so a 60-hour half-block closes in eight weeks with a session to spare. It is the pattern that survives a full-time job, because it never costs you a whole clinic day and it lands in the same two slots every week. #### The Tuesday and Thursday half-block Choose the two sessions in your week least likely to be pulled apart, and give the student those two, every week, in the same slots. Consistency does more work here than volume. A student who knows she is with you on Tuesday and Thursday afternoons builds her other coursework around it, and your front desk learns which visits to schedule into those hours without being reminded each time. Afternoons often suit a full-time clinician better than mornings, because mornings are where the acute add-ons and the running delays collect. If your practice is the other way round, invert it. What you are hunting for is the four hours where losing a patient from the schedule would not bring the day down, and nearly every schedule has two of those in it somewhere. #### Laying the hours over a real calendar Do this arithmetic on an actual calendar rather than in your head. Eight hours a week across eight weeks is 64, which covers a 60-hour half-block with one session left over. A 120-hour block at eight hours a week needs fifteen weeks, longer than many terms allow, so a full block on a full-time schedule usually means three sessions a week or one longer day. Then subtract reality before you commit to dates. Count the weeks you are away, the week of the system upgrade, the two days of mandatory training, the conference you already registered for. What remains is what you actually have to give. If the remainder falls short of what the program needs, take the half-block or a later term instead of promising hours you will spend the rotation apologising for. #### Protect the first two weeks The opening fortnight is the expensive stretch. She is learning your rooms, your EMR, your staff and how you like a patient handed to you, and your throughput sags while that happens. So start a rotation where your calendar is thin: the fortnight after a holiday, the weeks before a seasonal peak. Not the week you come back from leave with a backlog of messages and results. Two small moves help more than they ought to. Ask the front desk to leave one slot open in each of the first four teaching sessions. And give her the tour and the logins in a session with no patients in it, even if that is thirty minutes on a Monday. Time spent before the first patient is time you will not spend catching up during one. #### Blackout weeks Name the weeks you cannot teach before you agree to dates, and name them in writing. Your vacation. The week you cover a colleague's panel. The annual audit. The fortnight the practice migrates to a new system. School holidays, if your childcare depends on them. A rotation with two declared blackout weeks is straightforward for a program to plan around, and an undeclared one produces a missed session the student has to explain to faculty. Programs are entirely used to this. Terms get built with slack in them, and a student who knows in advance that weeks six and seven are off will plan another site or her own coursework into that gap. What a program cannot absorb is a cancellation on Monday morning for a week that has been on the calendar since June. #### One student at a time Take one. Two students in the same clinic session sounds efficient and is not, because both need presenting time and only one of them can have it while a patient sits waiting. You end up teaching sequentially at half depth, and both of them notice. If your practice wants to host a pair, the version that works is two preceptors, or two rotations that do not overlap in the same sessions. One exception is worth knowing. A student in her final block, running her own room under light supervision, can sit alongside a newer student for a fortnight, because the senior one asks almost nothing of you. That is an arrangement to plan on purpose with both programs, not something to discover in the middle of a term and hope works out. #### When to say no this term Say no when the hours are not there. When the first two weeks fall in your worst fortnight of the year. When you are covering somebody else's panel, or you are three months into a new job, or you are already carrying a resident or a newly hired nurse practitioner. None of those conditions is permanent. The honest answer is usually not no but not this term, and programs plan two and three terms out. Declining one rotation costs you nothing and takes two lines of email, and a coordinator would far rather read that on Tuesday than lose a week in October. You see dates, hours and mode before you accept anything at all, and the calendar side of that is described on scheduling. #### Questions **Can you precept while working full time?** Yes, with two half days a week in fixed slots. Eight hours a week completes a 60-hour half-block in about eight weeks. A 120-hour block at that rate needs roughly fifteen weeks, longer than many terms allow, so full-time clinicians usually take the half-block or add a third session. Consistent slots matter more than total volume. **How many hours a week should I give a student?** Eight hours in two half days is sustainable for a full-time clinician. Sixteen is possible if you are salaried and your panel is stable. Below four hours a week the student never builds any momentum and the rotation runs past the end of the term. Fewer, longer sessions teach better than a scatter of short ones. **Should I take two students at once?** Not in the same clinic session. Both need presenting time and only one can have it while a patient waits, so each gets taught at half depth. Two preceptors, or two rotations that do not overlap, works fine. The single exception is a final-block student running her own room, who needs very little from you. **What are blackout weeks?** Weeks you tell the program in advance that you cannot teach: vacation, covering another panel, an audit, a software migration, school holidays. Declaring two of them before you agree to dates is easy for a program to work around. Cancelling a week that has been on the calendar since June is what causes the real trouble. **When should a full-time clinician decline a rotation?** When the hours are not there, when the first fortnight lands in your busiest stretch, when you are covering another panel, when you are new in the job, or when you already supervise a resident or a new hire. Decline the term rather than precept badly. Programs plan two or three terms ahead and will come back with other dates. ### Precepting after retirement URL: https://www.nphours.com/off-the-clock/precepting-after-retirement/ Author: Halvard N., Preceptor onboarding · Published 2026-08-04 Look at the practice hours field on your renewal application. It asks how many hours you worked in your certified role during the cycle, and a clinician winding down is the person most likely to be short on that line. Precepting is one of the activities that can help fill it, provided you still hold everything the work requires. #### The line on the renewal form Certifying bodies differ, and some attach a clinical practice hour requirement to renewal alongside continuing education. The application asks for hours in the role your certification covers, and it is a number you enter and can be asked to document. A clinician who dropped to two days a week three years ago often discovers this on the form itself rather than in advance, which is the worst moment to find out. Precepting sits inside the same accounting. Under ANCC's renewal rules, hours you spend teaching a student inside your own certified population count within the professional development categories, with a letter from the school as the documentation, and 120 hours the figure named for a five-year cycle. AANPCB works by exchange rate instead: 120 teaching hours at most, traded against 25 of the non-pharmacology contact hours. Read the handbook your own board publishes, and if renewal is close, ask them which category your hours land in. #### What retirement does not remove Three things have to be current on the day a student starts, and stepping back from full-time work changes none of them. An active, unencumbered licence in the state where you practise. Current national certification covering whichever population the student has enrolled to learn. And two years in that population after the certificate date, which nearly every semi-retired clinician clears several times over. The order matters if anything has lapsed. Reinstating a certification takes longer than renewing one, and reactivating a licence can involve practice hours, refresher coursework or fingerprints depending on the state and how long it has been inactive. Start those before you talk to anyone about students. A rotation cannot begin against a pending application, and a credential that lapses mid-block ends the block that day. #### You still need patients That is the part people do not expect. Precepting clinical hours means supervising a student while you see patients, so a clinician who has stopped seeing patients altogether has nothing for a student to log. The usual solution is a small remaining panel: per diem days, one clinic a week, a telehealth shift, or covering a colleague's schedule. A modest amount of ongoing practice is enough to host a student for a half-block. If you have genuinely finished clinical work, the non-clinical routes are the ones to look at. Doctoral project mentoring, education practica for MSN students, and leadership practicum supervision all count hours that are not direct patient care. They need a different set of qualifications, generally a matching degree and a current role in that function, and they suit somebody whose expertise outlasted their clinic days. #### Video rotations fit this phase If your remaining practice is a telehealth panel, a student can join it. You host from wherever you work, the student joins the same visit, and the visits that suit this best are the ones a wound-down schedule tends to hold anyway: medication follow-ups, chronic disease reviews, results conversations and counselling. Acute care and anything needing hands rarely translates, and programs know it. The practical constraints are ordinary. A wired connection where possible, a room with a door, a second screen so the student is not hidden behind the chart, and a habit of introducing the student and confirming the patient agrees before the visit starts. Programs cap how many hours may be counted by video and the cap differs by school, so get the number before you commit to a pattern. #### Insurance and coverage Do not assume you are still covered. If your professional liability was employer-provided, it likely ended with the employment, and a claims-made policy without tail coverage leaves a gap for anything reported after it ended. A per diem or locum arrangement may cover you for its own patients and say nothing about teaching. Ask your broker two direct questions: am I covered for supervising a student, and is that in writing. Students carry their own coverage through their program and often an individual policy as well, and the practice hosting the rotation carries its own. Those do not substitute for yours. None of this is legal advice, and the person who should confirm the answer is the broker or counsel who knows your policy, before a start date rather than after an incident. #### Pacing it Start with one student and a half-block, sixty logged hours, spread across the days you already work. That is roughly seven or eight sessions a month for a quarter. It is enough to know whether you enjoy teaching at this stage of your working life, and short enough that a change of plan costs a student nothing serious. Add a second student later if the first one was good company. Semi-retired preceptors are often the best a program gets, because the reason for the visit is no longer throughput. If you want the version of this written around keeping a licence active and the practice hours a renewal wants, it sits on the semi-retired precepting page. #### Questions **Can a retired nurse practitioner still precept students?** Yes, provided the licence is active and unencumbered, board certification in the student's population is current, and you still see patients somewhere for the student to work alongside. Many semi-retired clinicians keep per diem days or a telehealth panel for exactly this reason. With no remaining clinical practice, non-clinical mentoring roles are the alternative. **Do precepting hours count toward my certification renewal?** They can, by different routes with each board. ANCC counts teaching a student in your certified role inside professional development, using a letter from the school as documentation, and names 120 hours for a five-year cycle. AANPCB trades a ceiling of 120 teaching hours against 25 non-pharmacology contact hours. Handbooks get revised, so confirm the wording that governs your own cycle. **Does the two-year experience rule still apply if I am retired?** Yes, and it is rarely a problem. The rule asks for two years working in the certified population, timed from the certificate date rather than from your most recent post. A long career satisfies it comfortably. What matters more at this stage is that the certification itself is current, not how recently you worked full time. **Will I still be covered by malpractice insurance if I precept in retirement?** Assume you are not until a broker says otherwise in writing. Employer-provided coverage typically ends with the job, and a claims-made policy without tail coverage leaves later claims uncovered. Student and program policies do not extend to your supervision. Ask specifically whether supervising a student is included, and settle it before a rotation starts rather than afterwards. **Is video precepting easier than in-clinic precepting after retirement?** Often, because it removes the commute and fits a small remaining panel. Follow-up visits, chronic disease reviews, results discussions and counselling all work well on camera. What it needs is a stable connection, a private room, a second screen, and a program that permits the share of hours you plan to deliver remotely. ### When a student is behind URL: https://www.nphours.com/off-the-clock/when-a-student-is-behind/ Author: Tamsin R., Clinical lead · Published 2026-08-03 The midpoint evaluation form is where this becomes real. A rating grid, a comment box, and an hour total that does not match the calendar. Before you write a word, work out which of two problems is in front of you. She is behind on hours, or she is behind on skills. They look alike on the form and they are handled differently. #### The midpoint form is the moment Schools put a midpoint evaluation near the halfway hour for precisely this reason. It is a checkpoint with a deadline attached, and it is the last point where a term can still be repaired without moving somebody's graduation date. File it on time even when the news in it is bad. A late form closes the only window the school has to act, and the student carries the cost of that, not you. Read the grid before you write in it. Most forms score domains: history, examination, assessment, documentation, professionalism, and then a summary judgment about whether she is progressing as expected for this point in her program. Faculty read that summary line first. If your honest answer is no, mark it no. Softening it now means the final evaluation has to carry a surprise, and by then there is nothing anyone can do. #### Hours behind is arithmetic Count the gap and divide it by the weeks that remain. Twenty hours short with five weeks left is four hours a week, which is one added half day. Forty hours short with three weeks left does not fit inside anybody's schedule, and pretending it does burns the time that is left. Do the division on paper before you open the conversation, because the number decides which conversation you are having. Then find the cause, because the cause picks the fix. A student who lost days to illness or childcare needs replacement dates. A student whose log is simply not filled in needs an afternoon with the software and your approvals, not more clinic. A student who has been arriving at ten and leaving at three needs to hear that described as a behaviour with a consequence, first in person and then in writing. #### Skills behind is a different problem Skills behind sounds like this: she cannot produce a differential in week eight, she keeps missing findings you have pointed out twice, she documents an examination she did not perform. Extra days will not touch any of that. Be specific about the domain and give examples with dates on them, because faculty cannot act on a report that a student seems unready. They can act on three dated instances. Sort the fixable from the rest. Presentation structure, examination sequence and note quality all respond to a fortnight of focused coaching, and most students who look hopeless in week six are only unstructured. A pattern of documenting things that did not happen is not a skills gap and does not belong in a remediation conversation at all. Report that one to the program on the day you see it. #### The calls, and who is on them Two calls, in this order. Your coordinator first, because she has seen this before, holds the program's contacts, and knows what that particular school does with a struggling student. Then the faculty member of record for the course, because remediation and dates belong to the school and to nobody else. Keep the student informed that both calls are happening. None of this should reach her secondhand. Put the substance in email afterward, briefly and without adjectives. Dates, hours logged, the domains at issue, two or three examples, and what you are willing to do. That last item matters: another four weeks, another twelve hours, a second review in ten days, or nothing past the original end date. Say which one, in writing, so the program can plan around a fact instead of a hope. #### Remediation belongs to the program You do not write the remediation plan. The school writes it, because it owns the course objectives, the grade and the consequences of failing. Your contribution is evidence and availability. A usable plan names the specific behaviours, sets a timeframe, says who observes what, and states what happens if the objectives are still unmet when the time is up. Ask for a copy and read it before you agree to anything. Extended dates are common and usually harmless. A 120-hour block can run four weeks past its original end without damaging anything, provided the affiliation agreement covers the new dates and your own calendar will hold them. Confirm both, in writing, with the program. An extension that nobody documented is exactly the sort of thing that surfaces months later while somebody reconciles hours against a signed agreement. #### When to say it should not continue Sometimes the answer is that the rotation ends. Say so when a student's presence is unsafe for patients, when her documentation cannot be trusted, when repeated feedback has produced no change across eight weeks, or when your practice cannot absorb the supervision she actually needs. That is a legitimate professional judgment and it is yours to make. Make it in writing, to the program and your coordinator, the day you reach it. Two practical points. Tell the student yourself, briefly and privately, before she reads it in somebody's email, and keep the reasons factual. And you are paid for the hours she logged and you approved, whether or not the term ran to its planned end; how each half is released is set out on the pay page. Ending early is not a punishment, and your coordinator takes the placement from there. #### Questions **What do I do if my student is behind on clinical hours?** Divide the gap by the weeks remaining before you speak to anyone. Twenty hours short with five weeks left is one extra half day a week. If the arithmetic will not fit your schedule, call your coordinator and the course faculty, because extended dates are the school's decision to make. Then confirm the new dates are covered by the affiliation agreement. **What goes in the midpoint evaluation when a student is struggling?** Mark the summary judgment honestly, name the specific domains, and give two or three dated examples instead of impressions. Add what you are willing to do about it. Say the same things to the student before you submit the form. A softened midpoint removes the school's only chance to act while the term can still be salvaged. **Who writes a remediation plan for a nursing student?** The program does, because it owns the course objectives and the consequences of not meeting them. You supply evidence and say what you can accommodate. A usable plan names the behaviours, sets a timeframe, says who observes what, and states what follows if the objectives are still unmet. Ask for a copy before you agree to an extension. **Can a preceptor end a rotation early?** Yes. Unsafe practice, documentation that cannot be trusted, no change after repeated feedback, or a practice that cannot absorb the supervision required are all legitimate reasons. Put it in writing to the program and your coordinator on the day you decide, tell the student yourself before she hears it elsewhere, and keep the explanation factual. **Do I still get paid if the rotation ends early?** You are paid for the hours the student logged and you approved, so an early end does not erase time you already gave. The release schedule for each half of the fee is described on the pay page. Approve any outstanding log entries promptly, because an unapproved backlog is the one thing that genuinely holds up a deposit. ### Saying no to a rotation URL: https://www.nphours.com/off-the-clock/saying-no-to-a-rotation/ Author: Bexley O., Head coordinator · Published 2026-07-28 Here is the whole message: "Thanks for sending this one. I can't take it, my autumn is already full." Two lines, no explanation, no apology, sent the same day it arrives. That is a complete and professional answer to a rotation that does not fit, and it is the one coordinators would rather have than silence. #### The message itself Write the decline the way you would write a colleague about a meeting. One line that acknowledges the offer, one line that closes it. If a date or a specialty would work better, add a third line saying so, because that sentence is worth more to a coordinator than any reason you could give. Then close the email. There is nothing further owed and nothing to justify. What slows people down is the belief that a no needs an argument behind it. It does not. Coordinators build rotations out of many small yes and no answers and expect most of the answers to be no. A same-day no is genuinely more useful than a maybe that resolves in eleven days, because a block with a start date has to be filled by somebody. #### Declining is quiet A card you turn down goes back to the coordinator and gets offered to another preceptor. That is the entire consequence. You are not moved to the back of a queue, you are not ranked, and you do not have to explain yourself to a school. The program is looking for a qualified site by a date; how many people said no along the way is not part of that conversation. This matters because the fear of looking unhelpful is what makes clinicians accept blocks they cannot carry. An accepted rotation you resent is worse for the student than a rotation you declined, and considerably worse for you in week four. Turning down four cards and taking the fifth is not a failure of commitment. It is how a working clinician ends up with a student in the right month. #### Reasons that are reason enough You do not have to justify a decline, but it helps to know how ordinary the good reasons are. None of the following needs softening, and none of them says anything about your commitment to teaching. Any one of them is a complete answer on its own. The one to watch for is a course that does not fit your panel. A student needing well-child visits in a clinic that sees three children a month will fall short of their objectives through nobody's fault, and the person best placed to see that coming is you. Saying so early is a service to the student, not an obstacle, and a coordinator can usually bring you a different course rather than a different student. - A quarter that is already busy, with or without a student in it. - A new hire, an EMR conversion, a site move or an inspection in the same window. - A course whose objectives your patient mix cannot honestly satisfy. - A student already with you, when one at a time is your limit. - A stretch of locum or extra shifts you have committed to. - A personal reason you have no intention of describing to anyone. #### One sentence of information changes the next offer There is a difference between a reason and information. A reason explains you. Information tells a coordinator what to send next. "Not this quarter, ask me in January" and "I can take psychiatric follow-ups but not intakes" and "Tuesdays and Thursdays only" are all information, and each of them shapes the next card you see. None of them is an obligation. If you would rather say nothing, say nothing. The two-line version is fine indefinitely. But if you find yourself declining most of what arrives, one sentence about why will usually fix the mismatch faster than another six declines. Coordinators are matching people to blocks, and they cannot match to a preference nobody has told them about. #### Declining a card is not withdrawing from a rotation These two things feel similar and are not. Before you accept, nothing has been built: no agreement signed, no student told, no term arranged. After you accept, a school has approved a site, an affiliation agreement has been signed or amended, and a student has planned their whole term around your address. Pulling out at that point can cost them a semester, because replacement sites are scarce and dated. If you truly must withdraw, do it the moment you know and do it in writing to your coordinator rather than to the student. Say what has changed, name the last date you can host, and offer whatever partial hours you can still supervise. A block that ends early with warning is recoverable. A block that ends on a Monday morning with no notice usually is not. #### Set a blackout instead of declining repeatedly If your calendar has predictable dead zones, hand them over once. December and January, the fortnight around a system upgrade, the summer you are covering someone else's panel. A coordinator who holds those dates stops sending cards into them, and you stop writing the same two lines every fortnight. The same applies to a standing pattern: two fixed days a week, mornings only, video after four. Update it when it changes and treat it as a working preference rather than a promise. Blackouts, day patterns and how far ahead blocks get built are handled on the scheduling page, and telling your coordinator once is faster than declining five times. #### Questions **How do I turn down a rotation politely?** Two sentences the same day: thank the coordinator for sending it, and say you cannot take this one. No reason is required. If a different month, specialty or day pattern would work, add one line saying which, because that sentence shapes the next offer you receive. A prompt no is more useful to everyone than a slow maybe. **Does declining rotations affect whether I get offered more?** No. A declined block simply goes to another preceptor, and there is no ranking or penalty attached to saying no. What does change future offers is information: telling your coordinator which months, specialties, modes or weekdays actually work means the cards you see are closer to what you would accept in the first place. **What if I need to cancel after I have already accepted a student?** Tell your coordinator in writing as soon as you know, not the student directly. Name what changed, the last date you can supervise, and any partial hours you can still cover. After acceptance a placement has been approved and an agreement signed, and the student has built a term around it, so early notice is the difference between a recoverable block and a lost semester. **Is it acceptable to decline because I am simply too busy?** Yes. A busy quarter is one of the most common and most legitimate reasons, along with a new hire, a records system conversion, a site move, or a student you are already teaching. A rotation you accepted reluctantly serves the student worse than one you declined, and nobody needs a fuller explanation than the one you choose to give. **Can I block out certain months in advance?** Yes, and it saves everyone time. Give your coordinator the dates you are unavailable and any standing pattern, such as two fixed weekdays or video-only afternoons. Blocks are then built around those constraints instead of being offered into them. Update the list whenever your clinical schedule shifts; it is treated as a preference, not a commitment. ### Giving feedback a student can use URL: https://www.nphours.com/off-the-clock/giving-feedback-a-student-can-use/ Author: Tamsin R., Clinical lead · Published 2026-07-27 A sentence she can use starts with something she did. 'You asked the mother about daycare before you asked about fever, so she told you three other children have it. Keep that question early.' What she did, what it produced, what to do next time. In that order, in the same session, with nobody else in earshot. #### Start the sentence with the behaviour The behaviour goes first because it is the part she can verify. She remembers asking the question, so there is nothing to argue about, and the rest of the sentence lands on solid ground. Then the effect, because a behaviour without a consequence sounds like a preference of yours. Then the instruction, in the form of something she can do on Tuesday morning rather than something she should become over the next year. Sentences that open with a judgment fail, and they fail predictably. Telling her she needs to be better organised gives her nothing to change. Telling her the history was scattered invites a defence instead of a change. The test is whether a stranger reading your sentence could say what the student actually did. If not, you have described an impression, and impressions are what evaluations are for. #### Say it in the same session Feedback ages badly. Twenty minutes after the visit she still holds the room, the patient and her own thinking in mind, so a correction attaches itself to a specific memory. Four days later she remembers only the correction, which turns it into a remark about her character. So say it before you both go home, and if you can find sixty seconds, before the next patient goes in. Privacy is the other half, and private means out of hearing of patients, staff and any other learner. A workstation in an open corridor does not qualify. Neither does the doorway of a room with a patient sitting in it. If nothing else is available, use the walk to the lab, or your own office with the door shut. Correcting a student where a medical assistant can hear costs more than the seconds it saves. #### Feedback and evaluation are different documents Feedback is informal, private and aimed at the next patient. An evaluation is written, goes to the nursing school, and records whether she met the objectives of a course. Preceptors get into difficulty by mixing the two: saving observations for the form, or writing a form that contains something she is reading for the first time. Nothing on a midpoint or a final should arrive as news to the student. The working rule is short. Anything you intend to write on an evaluation should have been said aloud a fortnight earlier, with a chance to act on it. If you notice you are holding a serious concern you have never raised, raise it first, then write it. A student who is failing an objective has a right to know while there is still time in the term to fix it. #### The comment box on the midpoint form The rating grid takes two minutes and communicates almost nothing. The comment box is what a coordinator, a course faculty member and the student herself will actually read. Use the same structure you use out loud: two things she does that work, written as behaviours, one change written as an action rather than a trait, and a closing line about where she should be by the final evaluation. Some wording that carries weight. She takes a complete medication history without prompting, including over-the-counter products and supplements. She presents in a clear order and commits to an assessment before asking for mine. The area to work on is the examination: she should examine before presenting rather than going back afterward. Concrete enough that faculty who have never met her can picture her on a Tuesday morning. #### When it is not landing Sometimes you say it three times and nothing moves. Check three things before deciding she is not listening. Was it a behaviour or a trait. Did you say what to do instead, in words she could repeat back to you. And did you ever confirm she understood it the way you meant it, by asking her what she is changing this week. Most feedback that fails, fails at the third one. If it is genuinely not landing, escalate on paper and early. Put the concern in the midpoint comment box, tell her you are putting it there, and ring the faculty contact before the halfway mark rather than after. A student short of hours or short of skills is a different problem, handled in when a student is behind. If you have never filled in one of these forms, the onboarding walks through them: preceptor orientation. #### Questions **How do you give feedback to a nurse practitioner student?** Open the sentence with the behaviour, say what it produced, then say what to do next time. Deliver it in the same session and out of earshot of everyone else. Keep it to one or two items rather than a list. Feedback naming something she can remember doing gets acted on, and feedback about traits or general impressions does not. **What is the difference between feedback and evaluation?** Feedback is private, informal and aimed at the next patient. An evaluation is written, goes to the nursing program, and records whether the student met a course objective. Nothing on a midpoint or final form should be new information to her, so anything you plan to write should have been said out loud with time left to act on it. **What should I write in the midpoint comment box?** Three or four concrete sentences: two behaviours that are working, one change written as an action rather than a trait, and a line about where she should be by the final. Write it so a faculty member who has never met her can picture her in clinic. Then say the same things to her before you submit the form. **When should I give a student feedback?** In the same session, ideally within twenty minutes of the encounter, while she still remembers the room and her own reasoning. Waiting several days turns a technical correction into a remark about her character. Give it away from patients, staff and other learners, even when that means walking to your office and closing the door behind you. **What if a student keeps making the same mistake?** Check whether you named a behaviour or a trait, whether you said what to do instead, and whether you ever asked her to repeat back what she is changing. Most repeated errors survive because that third step never happened. If it continues, write it in the midpoint comments, tell her you are writing it, and call the faculty contact. ### Precepting PMHNP students by video URL: https://www.nphours.com/off-the-clock/precepting-pmhnp-students-by-video/ Author: Kwame A., Psychiatric lead · Published 2026-07-21 The visit that teaches most is a new psychiatric evaluation with the student leading it. You are on the call with your camera on, introduced by name and role in the first thirty seconds. For the next forty minutes the student asks the questions. You watch, you write nothing down for them, and you wait. #### The intake the student runs Set the shape before the patient joins. The student opens, confirms identity and location, states who is present on the call and why, and works through the presenting concern, the psychiatric and treatment history, substances, medical history and medications, a sleep and appetite review, and a risk screen. You stay quiet unless one of your agreed triggers appears. Forty minutes of an unbroken history is where a psychiatric interview actually gets learned. Then take the last stretch yourself. Ask the two or three questions the student missed, close with the patient, and let them see how you land a plan inside a fixed appointment length. New evaluations are the slowest visits in the week and the ones a student should own earliest, because the skill being built is structure under time pressure rather than knowledge of a drug list. #### When to step in Agree the triggers out loud before the first patient. Four are enough: any disclosure of suicidal or homicidal thinking, any sign the patient is in acute distress on camera, a medication decision the student is not yet ready to make, and a patient who directly asks for the supervising clinician. Anything else waits until the student has finished, however much you want to correct a phrase. Agree the mechanics too. A private chat message that says one word, a soft unmute and a short sentence, or a hand signal if the student can see you in a corner of their screen. Entering cleanly matters: name what you are adding rather than taking the visit over. Handing a visit back to a student after you have spoken is a skill worth practising on easy visits so it works on hard ones. #### Safety concerns on a video call Video removes distance, not risk. Before every new visit the student confirms and documents the patient's physical address for that appointment, a direct callback number, an emergency contact where the patient consents to one, and the local emergency number for that location. Those four fields exist so nobody spends a bad minute searching for them. Have the student read them back into the note while the patient is still on the call. When a risk disclosure comes, you take the interview and the student stays on the call and watches. Afterwards, walk them through what you did and why, in order, and have them write the plan into the note in their own words for your review. Your practice's crisis pathway and local resources should already be written down somewhere the student can open in one click. If they are not, that is the first thing to fix. #### Medication follow-ups fill the block Intakes teach the most and occupy the least of the calendar. The hours in a psychiatric video block come from follow-up visits: a titration check three weeks into an antidepressant, a side effect complaint, a refill with a screening scale repeated, a stable patient who needs eight minutes and a script. A student who runs a dozen of those in a day learns pattern recognition no single intake can teach. Sequence it deliberately. The student observes a handful, then runs the structured parts under your ear, then carries the whole visit with you listening and joining at the plan. Because psychiatric follow-ups are short, a video afternoon can produce a lot of logged encounters, which is one reason psychiatric rotations are the easiest to fill remotely and the fastest to reach a hundred hours. #### Writing the mental status exam from a screen The mental status exam by video is narrower and it should read that way. You can describe appearance in frame, grooming where visible, eye contact with the camera, psychomotor activity within the shoulders and hands you can see, speech rate and volume, prosody, thought process and content, insight and judgment, and observed affect. You cannot comment on gait, tremor below the frame, or anything about smell or handshake. Teach the student to write what was observed and to leave out what was not. The note should also carry the modality, the patient's location during the visit, who else was present, and that consent for a video visit and for a student's participation was obtained. Students write the first draft of that block, you check it, and after a week they stop forgetting the location line. It is the single most commonly missing element in a telepsychiatry note written by a learner. #### The permitted share and the presentation Programs set their own limit on how many hours a student may count by video, and the limit differs by school and sometimes by course. Ask for the number in writing before the block is built, because a student who discovers in week six that only part of their hours count has lost weeks they cannot replace. Psychiatric programs tend to be the most accommodating on this point. Keep the presentation ritual even without a hallway. Move the student to a breakout room or a second call for ninety seconds, take the summary and the proposed plan, decide, and bring them back. That pause is what turns a watched visit into a decision the student made. If psychiatric rotations are the ones you want, the specialty detail sits on the PMHNP precepting page. #### Questions **Can PMHNP students complete clinical hours by video?** Many can, and psychiatric rotations suit video better than most specialties because the examination is largely conversation. The limit is set by the student's program, not by the platform, and it varies by school and course. Ask for the permitted share in writing before the rotation is built so the student is not left with hours that cannot be counted. **What does the preceptor do while a student runs a psychiatric intake?** Stay on the call with your camera on, introduced by name and role, and stay quiet. Watch structure, timing and what gets missed rather than intervening on wording. Step in for risk disclosures, acute distress, a medication decision beyond the student's level, or a direct request for you. Take the final minutes to close the visit and set the plan. **How do you handle safety planning during a video visit with a student present?** Confirm the patient's physical location, a callback number, an emergency contact and the local emergency number at the start of every visit, documented in the note. If risk is disclosed, the preceptor leads the rest of the interview while the student observes, then debriefs the sequence afterwards and drafts the plan for review. Keep your crisis pathway one click away. **What can you document in a mental status exam done by video?** Appearance and grooming as visible in frame, eye contact with the camera, observable psychomotor activity, speech rate and volume, thought process and content, insight, judgment and observed affect. Leave out gait, lower-body tremor and anything requiring physical presence. Note the modality, the patient's location, others present, and that consent for the visit and the student's participation was obtained. **How do you replicate a hallway presentation on a video rotation?** Use a breakout room or a second call. The student leaves the visit for ninety seconds, gives a short summary with a committed assessment and plan, you decide, and both of you return. Keeping the pause short protects the appointment length, and requiring a commitment is what separates a student who watched a visit from one who took part in it. ### SNAPPS for busy clinics URL: https://www.nphours.com/off-the-clock/snapps-for-busy-clinics/ Author: Tamsin R., Clinical lead · Published 2026-07-20 The student stands at the workstation and takes 90 seconds without being interrupted. Two sentences of summary, a differential narrowed to two or three, her reasoning for and against each one, a question she could not answer alone, the plan she proposes, and the single topic she will read tonight. That is SNAPPS, and she runs it. #### The 90-second summary The S is a summary, and its whole discipline is length. Two or three sentences: who the patient is, what brought her in, and the findings that bear on the decision. Not the full history in the order it was collected. A student summarising a fatigue visit gives the age, the duration, two positives and two relevant negatives, and then stops. If she runs past four sentences, hold up a hand and ask for the short version. You will hear the difference between a student who has thought and one who has transcribed. The transcriber narrates: the whole review of systems, every negative, a cousin's family history. The thinker selects. Selection is the skill you are building, and the summary is where it first becomes visible, which is why you can judge a presentation in its opening fifteen seconds and know what the rest of it will need from you. #### Narrow, then analyse N is narrowing: two or three possibilities said out loud, not a list of nine. A is analysing: she weighs them against her own findings and says which way each finding points. Ask for that explicitly. Fatigue in a 34-year-old could be anaemia, thyroid disease or depression, and the analysis is the sentence where she says the heavy periods pull her toward the first while the flat affect keeps the third in play. This is the pair students dodge, because it is where being wrong becomes visible. A summary is safe and a plan is safe, but narrowing commits her to something. Expect hedging in week two and ask for a number: give me two, and tell me which one you would treat today. Once she does that reliably, most of what you were teaching in the corridor she has started teaching herself. #### Probe with her question, not your quiz P is the probe, and the direction of traffic reverses here. She asks you about what she could not work out alone. Not a question with an obvious answer, and not a request for the answer to the case. Something closer to whether the pattern in a set of thyroid results changes the interval before repeating them. Her question shows you exactly where her knowledge stops, which you would otherwise spend a fortnight guessing at. Insist on a real question. New students ask nothing, either because they think the question exposes them or because they have rehearsed something safe. Say plainly that you expect one uncertainty per presentation and that it costs her nothing with you. Then answer briefly: two sentences and a rule of thumb, not the lecture the question deserves, because there is another patient waiting and she can read the rest this evening. #### Plan, then select The second P is her plan, said in the order she would carry it out: what she orders, what she prescribes, what she tells the patient, and when she wants the patient back. Concrete enough that you can agree with it or change it. 'A CBC and a TSH, talk about her sleep, back in three weeks' is a plan. 'Some labs and reassurance' is not a plan, and you should hand that one back. S is select: she picks one issue out of the case to read about and names it before she walks away. That is the entire step, and it does two useful things. It closes the encounter with her own learning question instead of homework you assigned, and it hands you an opening line for Thursday. Ask her what she found. A student who knows the question is coming actually does the reading. #### When it beats the one-minute preceptor The two methods answer different problems. The corridor method is yours to drive: you ask, she answers, and the exchange stays on rails you are holding. SNAPPS hands her the rails. That is better once she can structure a case, because you see her reasoning without your own questions shaping it. It is worse in week one, when an unstructured student handed the floor will talk for four minutes and arrive nowhere in particular. Read the day as well as the student. SNAPPS suits the visit with five minutes of slack in it: follow-ups, chronic care, the back half of a rotation. The five microskills suit the walk-in you are already late for. Most preceptors use both in one afternoon, and the students who do best are simply told which is happening. Say 'give me the full version on this one' and she will. #### Teaching it in week two Introduce it as a format, on paper, at the start of week two. Write the six steps on an index card and give her the card. Tell her that from Monday you want the first patient of each session presented this way, then the first two, then every follow-up. Starting with one patient a session is deliberate. A student practising a new structure on every case will drop it by Wednesday. Then coach the format rather than the medicine for a fortnight. If she skips the analysis, name the step and ask her to take it again from there. If she asks you nothing, wait her out. By week four the shape is habit and you can go back to teaching clinically. If her presentations are not improving and you cannot see the reason, your coordinator has watched this go sideways before and support is one call. #### Questions **What does SNAPPS stand for?** Summarize, Narrow, Analyze, Probe, Plan, Select. The student summarises the case in two or three sentences, narrows the differential to two or three possibilities, analyses them against her findings, probes the preceptor with a question she could not answer herself, proposes a plan, and selects one issue to read about. The whole thing takes about 90 seconds. **How long should a SNAPPS presentation take?** About 90 seconds, and the limit is the point of it. Two or three sentences of summary, two or three items in the differential, a sentence on each, one question, one plan, one reading topic. A student running four minutes is narrating the visit rather than reasoning through it, and the format needs coaching before the case does. **When should I use SNAPPS instead of the one-minute preceptor?** Use SNAPPS once the student can structure a case unaided, usually from week two or three, and on visits with some slack in them such as follow-ups and chronic care. Use the preceptor-driven microskills with a new student and with the walk-in you are already behind on. Plenty of preceptors use both in a single afternoon. **How do I teach a student to use SNAPPS?** Hand her the six steps on a card at the start of week two and ask for one patient per session presented that way. Add patients as she steadies. Coach the structure rather than the medicine for the first fortnight: when she skips the analysis, name the step and ask her to take it again from there. **What if the student has no question to ask me?** Tell her the question is part of the format and that you expect one uncertainty per case. New students stay quiet because they believe a question reveals a gap, so say out loud that finding the gap is the purpose. Then answer in two sentences and a rule of thumb, and leave the rest for her evening reading. ### How much do NP preceptors get paid URL: https://www.nphours.com/off-the-clock/how-much-do-np-preceptors-get-paid/ Author: Dagny H., Payments · Published 2026-07-14 Start with one block. A student needs 120 hours with you, and at $15 an hour of student time that block pays $1,800, in two deposits of $900. That is the figure to hold in your head while you read about everything else, because most of what is written about preceptor pay never gets as far as a number. #### The three ways money reaches a preceptor There are three sources and they rarely overlap. The first is the program itself. Some schools pay a stipend or an honorarium per student, though many pay nothing and lean on goodwill, adjunct titles and library access. The second is a matching network, where a fee per rotation is paid by the network on behalf of the student or the program. The third is the state, through an income tax credit that a handful of legislatures have enacted for uncompensated precepting in shortage areas. Networks publish their fees more often than programs do. Across the ones that disclose figures, a rotation of about 120 hours has clustered around $1,200 to $1,440 in recent years, which is $10 to $12 for each hour the student is with you. NPhours sets the band at $12 to $20 and lets the preceptor choose within it, so the same block pays between $1,440 and $2,400 depending on the rate you set. #### Doing the hourly math honestly The student hour is not a clinic hour, and the two get confused. A student who is with you for a nine-hour day logs nine hours. You were paid for nine hours of student time while you also saw your own panel and earned whatever your practice pays you for that. Precepting income sits on top of clinic income; it does not replace it. That is why $15 an hour, which would be a poor clinical wage, is a reasonable teaching fee. The cost that offsets it is throughput. Most preceptors lose about one patient an hour for the first two weeks while the student learns the clinic, and less after that as the student begins to carry the history and the note. For a preceptor on productivity pay that loss is real and should be counted against the fee. For a salaried preceptor it is time, not money, and the fee is closer to pure income. #### What tax credits add, and where A few states pay preceptors through the tax code rather than in cash. Maryland allows $1,000 per rotation, capped at $10,000, but only for uncompensated precepting in designated shortage areas. Georgia pays $375 for each of the first three rotations and $750 for the fourth through the tenth, which reaches $6,375 for an APRN who precepts ten in a year. Alabama's figure is $425 per 160-hour rotation with a $5,100 cap. Colorado's rural credit is $2,000 per preceptorship, up to three. Two things matter about credits. First, several require the precepting to be unpaid, so a network fee can disqualify the rotation; read the statute or ask your preparer before assuming both. Second, a credit reduces your state tax bill and is worth nothing beyond that bill. The state table, with the conditions attached to each, is kept on one page and updated when a legislature changes something. #### The recertification trade Precepting also pays in a currency that is not money. Under the ANCC renewal handbook, precepting hours in your certification role count toward the professional development categories, documented by a letter from the program, with 120 hours over the five-year period the described minimum. AANPCB allows a maximum of 120 precepting hours to replace 25 of the non-pharmacology continuing education contact hours in a recertification cycle. Put a value on that if you like. Twenty-five contact hours of CE bought at conference or online prices is a real expense, and one block of precepting can remove it. It is not the reason to precept, but it belongs in the arithmetic, and the letter that documents it is something to ask your program contact for at the end of every rotation rather than four years later. #### What a year of precepting looks like on paper A preceptor who takes one student per term at $15 an hour, three terms a year, earns $5,400 in fees and receives a 1099-NEC in January showing that figure. Tax is owed on it at your marginal rate plus self-employment tax, less any deductions your preparer allows, which is why many preceptors set aside roughly a third. Two students a term doubles the figure and, for most clinics, doubles the throughput cost as well. The rate you set changes the picture more than the number of students does. At $20 the same three blocks pay $7,200. Preceptors in high-demand specialties and states set the top of the band and are still matched, because the fee is small against what a program spends to place a student who cannot find a site. If you are deciding whether the number is worth it, the rate card shows what each rate pays per block and per term. #### Questions **Is $15 an hour a typical preceptor rate?** It is in the middle of the NPhours band of $12 to $20 per student hour and above what most matching networks have paid per rotation, which has clustered around $10 to $12 an hour when a 120-hour fee is divided out. Programs that pay stipends directly vary widely, and many pay nothing at all. **Do NP preceptors get paid by the school?** Some do, most do not. A minority of programs pay a per-student stipend or honorarium; a larger number offer adjunct or clinical faculty titles, library access, or CE vouchers instead of money. Where a school pays nothing, a matching network or a state tax credit is usually the only cash route. **Can I take a network fee and a state tax credit for the same rotation?** Often not. Several state credits, Maryland's among them, apply only to uncompensated precepting, so a paid rotation is excluded. Others do not say. Read the statute for your state or ask your preparer, and keep the rotation's dates and hours in a form that lets you claim whichever applies. **Is precepting income taxed?** Yes. Network fees are paid to you as an independent contractor and reported on a 1099-NEC if they reach $600 in a year. You owe income tax at your marginal rate and self-employment tax on the net figure. Many preceptors set aside about a third and make a quarterly estimate if the total is large enough to require one. **Does precepting count toward NP recertification?** Yes, under both major boards, with different mechanics. ANCC counts precepting hours in your role toward professional development, documented by letter, with 120 hours over five years the described minimum. AANPCB allows up to 120 precepting hours to replace 25 non-pharmacology CE contact hours. Confirm the current handbook before you rely on either. ### Clinical logs: Typhon, Exxat and Medatrax URL: https://www.nphours.com/off-the-clock/clinical-logs-typhon-exxat-medatrax/ Author: Ravenna S., Program relations · Published 2026-07-08 Here is one encounter as a log entry: 9 July, outpatient primary care, female, 63, type 2 diabetes and hypertension, no procedure, student took the history and presented the plan, 35 minutes, preceptor Ravenna S. Multiply that by a few hundred and you have a rotation as the program sees it. Your part is one click. #### The fields in a single entry Logging platforms ask for the same core facts, whatever the interface looks like. The date and the site. The setting or type of visit. The patient's age and sex, never a name or a record number. One or more diagnosis codes, usually chosen from a picker rather than typed. Any procedure or skill performed. The student's level of involvement. The minutes spent. And the supervising preceptor, selected from a list the program maintains. Two of those fields do most of the work in an audit. Involvement separates watching from doing, and programs grade the difference: observed, assisted, performed with guidance, performed independently. Minutes decide whether the encounter counts toward direct patient care hours at all. A student who records forty minutes for a visit that took twelve is not padding on purpose, but a term of that produces a total nobody can defend. #### The 48-hour habit Most programs require encounters to be logged within forty-eight hours, and the ones that do not still expect the same discipline. The reason is simple. Detail evaporates. A student who logs on Thursday for a Monday clinic remembers the interesting case and forgets four medication reviews, so the log understates the day and the diagnosis mix looks thinner than the clinic actually was. Make it visible rather than nagging about it. Ask on the Monday of each week whether last week is fully logged, and once, early, ask to see the screen. Students who batch a whole term into the final weekend nearly always find gaps they cannot reconstruct, and those are the hours that get argued over at the end when there is no time left to fix anything. #### What your attestation actually says At some point in every week the system sends you something to approve: a time sheet, a batch of encounters, or a link that opens a list with a confirm button. What you are confirming is narrow and specific. That the student was with you on those dates for roughly those hours, that the work described is the work they did, and that you supervised it. Nothing more, and nothing less. Read before you click. An attestation that turns out to cover a Friday you were away is the kind of finding that ends a placement and follows the program into its next accreditation visit. If the batch contains something you cannot place, send it back to the student and ask them to correct the entry. That conversation takes four minutes now and saves an investigation later. #### The log is what pays, not the calendar This is the part preceptors underestimate. Payment for a rotation follows the hours the program's system shows as logged and approved, not the hours sitting in your practice schedule. A day the student attended and never recorded is a day nobody can see. NPhours will not pay for hours the log does not carry, because the program will not certify them and the student cannot count them either. So treat the log as part of the teaching. Check it at the midpoint, when the first half of a block is due for payment anyway, and again a week before the final evaluation. Two glances at a running total across a nine-week block is the whole discipline. The order and timing of the two deposits is described on the pay page. #### The errors that show up again and again Almost every logging dispute traces back to a handful of mistakes, and none of them involve dishonesty. They involve a tired student clicking through a form at nine in the evening. Point them out in week one and most of them never happen. One more worth naming separately: shadowing recorded as direct care. In the first days a student watches, and watching is legitimate orientation, but it is not the same category of hour. Programs define the boundary and the student should ask their faculty rather than guess. If a student is unsure how to classify a session, the answer belongs in an email to the course lead, not in the log. - Hours attached to the wrong supervising clinician, usually the practice owner instead of you. - Duplicate entries created when a form is submitted twice on a slow connection. - Involvement level left at the default, so independent work reads as observation. - Minutes that add to more hours than the clinic was open that day. - A diagnosis typed as free text where the program expects a coded selection. - A whole week logged from memory after the deadline, missing the routine visits. #### How the three systems differ Typhon, Exxat and Medatrax are all web platforms for tracking student clinical experience, and any of them may be what your student uses. They differ in interface, in how time sheets and encounter logs relate to each other, and in how preceptor approval arrives: some send an email with a link, some issue you a limited login, some ask faculty to reconcile totals on the student's behalf. The important point is that the program, not the vendor, decides most of what you see. Required fields, deadlines, involvement categories and whether you approve weekly or at the end are configuration choices made by the school. So do not take a colleague's description of a system as authoritative, and ask the coordinator for the one-page version of your student's setup before day one. #### Questions **What do NP students record in a clinical log?** Each patient encounter with the date, site, setting, patient age and sex, diagnosis codes, any procedures, their level of involvement, the minutes spent and the supervising preceptor. No identifying information about the patient goes in. Totals from these entries become the evidence that the student met the direct patient care hours their program requires. **What am I attesting to when I approve a clinical log?** That the student was present with you on the dates listed, for approximately those hours, doing the work described, under your supervision. It is not a judgment of clinical quality and not a countersignature of documentation. Read each batch before confirming, and send anything you cannot place back to the student for correction rather than approving it. **How quickly should a student log an encounter?** Within forty-eight hours, which is the deadline most programs set. Beyond that, routine visits are forgotten and the recorded diagnosis mix stops resembling the actual clinic. Ask at the start of each week whether the previous week is complete, and look at the screen once early in the block so you know what the running total looks like. **Does precepting pay depend on the log?** Yes. The hours the program's system shows as logged and approved are the hours that get paid, so an attended day that was never recorded cannot be counted or paid. Checking the running total at the midpoint evaluation and again shortly before the final evaluation is enough to keep the figures matching your schedule. **Which log system will my student use?** Whichever one the school licenses; Typhon, Exxat and Medatrax are the common ones and a student rarely gets a choice. What differs for you is how approval reaches you, either as an emailed link or through a limited preceptor login. Ask the coordinator for the specific setup and the approval schedule before the rotation starts. ### The one-minute preceptor URL: https://www.nphours.com/off-the-clock/the-one-minute-preceptor/ Author: Tamsin R., Clinical lead · Published 2026-07-06 You are in the corridor between room four and room five. The student has seen the sore throat and wants to tell you about it. Before she offers one more physical finding, ask her what she thinks it is and what she would do about it. That question, asked first, turns the next ninety seconds into teaching instead of a report. #### Ask her to commit The first microskill is a commitment, and it comes before your own opinion. What do you think is going on. Then what would you do about it. A student who is never asked to commit will hedge for two minutes, list findings in the order she happened to collect them, and hand the decision back to you. A student who has to name a diagnosis exposes her reasoning, and reasoning is the only part of her you can actually teach. Hold the silence after you ask. Four seconds feels long in a corridor, and that is where the answer comes from. If she says she is not sure, narrow the question rather than answering it: what are the two most likely, and which do you favour. Do not rescue her with the diagnosis. A commitment you supplied teaches nothing, and by week three she will stand there waiting for it every time. #### Probe for the evidence Second microskill: ask what supports the answer she just gave. What made you land there. On the sore throat, the useful probe is what she considered and set aside. If she says viral pharyngitis, ask what moved her away from a bacterial cause and what she would need to see to change her mind. You are not quizzing her on criteria she can look up. You are asking her to show the path she walked. The probe catches two different problems, and it matters which one you have found. Sometimes the reasoning is sound and the data is thin, which means she needs to go back and ask two more questions. Sometimes the data is complete and the reasoning skipped a step, which means she needs a rule rather than more history. The teaching that follows differs in each case, so probe before you decide what to say. #### Teach one rule, not five Third microskill: give her one general rule she can carry into the next patient. One. Not a differential, not a paper, not the whole topic. Make it portable and short enough to repeat back: which cases need a score before a test, when a negative rapid test still earns a culture, how to word a return precaution so the patient actually hears it. The rule works precisely because it is small. Preceptors overrun this step more than any other, and it is understandable. You know a great deal, and she is standing right in front of you. But a rule delivered inside a four-minute lecture arrives at the same moment as the next patient's chart and does not survive the trip. Say the rule, ask her to say it back in her own words, then open the door. She will still have it on Thursday. #### Reinforce, then correct Fourth microskill: reinforce something specific she did. Specific means the behaviour and its effect, in one sentence. You asked whether she could swallow fluids, and that answer is what told you she is not dehydrated. That sentence teaches. Good job teaches nothing, and students discount it inside a week because they can hear that it is filler rather than observation. This is the step that gets skipped when the clinic is running behind, and the ten seconds it saves cost more than they are worth, since a student who never learns which moves worked is guessing about what to repeat. Fifth microskill: name the error and the fix in the same breath, in private. You did not ask about the rash on her trunk. On a sore throat with fever, ask about rash every time, because it changes what you are looking at. Behaviour, correction, reason. No preamble and no compliments stacked around it. Timing beats gentleness here: an error named thirty seconds after it happened is a technical note, while the same error raised at the midpoint is a verdict, because by then she has repeated it thirty times. #### The exchange, start to finish Here is the whole thing in the corridor, on the sore throat, at about ninety seconds. Read it as five moves rather than a script, because the words change with the case and the order does not. Notice that you speak four times and none of your turns runs longer than two sentences. Two habits make it hold. Ask for the commitment before you say your own answer out loud, and keep the rule to a single sentence. Then let her write the note while it is fresh. For the other format worth learning, the one where the student runs her own presentation and you mostly listen, see SNAPPS. If you are still weighing whether teaching fits your clinic day, the rotation itself is laid out on precepting NP students. - You: What do you think this is, and what would you do about it? - Student: Viral pharyngitis. Supportive care, fluids, and a note for work. - You: What moved you away from a bacterial cause? - Student: No exudate, the nodes are soft, and she has a cough. - You: The rule is that fever with a sore throat gets a rash question every time. - You: Asking about swallowing fluids is what settled the dehydration question. Add the rash next time. #### Questions **What is the one-minute preceptor?** A five-step teaching method for the short exchange between patients. Get the student to commit to a diagnosis, probe for the evidence behind it, teach one general rule, reinforce something specific she did well, and correct one error. The whole sequence fits in about ninety seconds, which is why it survives in a full clinic where longer teaching does not. **Why ask a student to commit before giving your own opinion?** Because the commitment is the only clear view you get of her reasoning. A student who hears your assessment first will present the findings that support it and quietly drop the ones that do not, and you learn nothing about how she thinks. Asking for a diagnosis and a plan first shows you where the actual gap is, which decides what you teach. **What if the student says she does not know?** Narrow the question instead of answering it. Ask for the two most likely possibilities and which she favours, or ask what she would need to know in order to choose. If she still cannot commit, that itself is information: she is short of data, short of a framework, or short of nerve. Supplying the answer removes your only chance to find out which. **How is the one-minute preceptor different from SNAPPS?** The one-minute preceptor is driven by the preceptor, who asks the five questions in order. SNAPPS is driven by the learner, who summarises, narrows the differential, analyses it, asks her own questions and proposes a plan. Use the first with a new student, and move to the second once she can structure a presentation without help. **Does teaching this way slow the clinic down?** Less than you would expect once the first fortnight is over, because the exchange is bounded. Five moves and one rule take roughly ninety seconds, and a student who knows the shape of it arrives with an assessment and a plan rather than a narrative. The expensive part of precepting is the opening two weeks, not the method you choose. ### Student access to your EMR URL: https://www.nphours.com/off-the-clock/student-access-to-your-emr/ Author: Halvard N., Preceptor onboarding · Published 2026-07-01 The item to request first is a named read-only login for the student. Their own username, view rights to the schedule and the chart, no ability to sign anything. It takes an administrator ten minutes to create and it takes your organisation two weeks to approve, which is why it goes in before everything else. #### Requesting the login Whoever administers your record system needs six facts to build the account: the student's legal name, their program, the rotation start and end dates, the supervising clinician, the access level, and confirmation that HIPAA training is complete. Send all six in one message. A request that arrives in pieces sits in a queue, and access granted in week three of a nine-week block wastes the part of the rotation where a student learns the most about your documentation. Ask for the account to expire on the last day of the block. Automatic expiry is safer than a note in your calendar, and it saves the awkward audit finding where a student from last spring still has an active login. If your system offers a training environment, ask for that too. A student who has clicked through the templates once arrives on day one able to find the problem list. #### Why shadow logins are the wrong shortcut The tempting alternative is to sit the student at your open session and let them work under your credentials. Do not. Every action taken in that session is attributed to you in the audit log, including anything entered while you were in another room. If a note or an order is later questioned, there is no record separating your work from a learner's, and the person holding the credential answers for all of it. Credential sharing is also prohibited by most organisations' own access policies and by the terms your practice signed with its vendor, so the exposure is not only clinical. Where a system genuinely offers no student role, the alternative is supervised viewing: the student reads the chart with you present, on your session, and documents nothing. That is slower than a real login and it is still the correct answer. #### What a student may write and what you must sign A student's note is a draft until a licensed clinician takes responsibility for it. In most configurations the student types into an unsigned encounter and you review it line by line, correct it, add your own findings, and sign. Your signature is not a countersignature on someone else's work; it is your attestation that you saw the patient, that the record reflects what you found, and that the plan is yours. What may be reused for billing is a separate question with organisation-specific answers, and it is one to put to your compliance or coding lead rather than to settle from an article. The practical rule that keeps you safe is to document your own history, examination and decision-making in your own words, and to treat the student's text as material you have verified rather than as a shortcut. #### The audit trail is watching both of you Every chart a student opens is logged with a timestamp and a user. That is a feature, not a threat, but it means a curious student who looks up a neighbour or a former colleague creates a permanent record of doing so. Say this out loud on day one, in one sentence: open the charts on today's schedule and nothing else. Students almost never breach deliberately; they browse because nobody told them not to. Set the panel boundary explicitly. If your clinic shares a database with an urgent care or a specialty group, the student's account may reach far beyond the patients you are teaching with. Ask the administrator to scope access to your department if the system supports it, and check the log once in the first fortnight so any misunderstanding is corrected while it is still small. #### Systems differ, so ask rather than assume Record systems handle learners differently. Some ship a student role template with view rights and unsigned documentation already configured. Some have only a generic read-only role, which means no note practice at all. Some require a training module or a course completion before an account is issued, and some restrict outside network access, which matters if any of the block is delivered from your home office by video. Because these behaviours change between versions and between local builds, treat any general claim about a named product with suspicion, including a claim made by a colleague at another clinic. Ask your own administrator two questions: what learner roles exist in our build, and what does the request process require. The answers to those, in writing, are the only reliable version of this section. #### When no access is possible Sometimes the answer is no. A hospital-owned system with a hard policy, a rotation too short to justify the account, a video-only block on a network that does not permit outside logins. The rotation still works. The student documents on a structured worksheet you provide, presents from it, and records the encounter in the program's own clinical log, which is where the hours are counted anyway. You lose the documentation teaching, so replace it deliberately: read one of your own signed notes aloud with the student at the end of a session and explain why each line is there. For video blocks, the question of what the student can see and from where is worth settling before day one, and the setup sequence sits on the teleprecepting setup page. #### Questions **Do NP students need their own EMR login?** They need one to practise documentation, and their own named account is the only safe way to provide it. A named read-only login with unsigned documentation rights keeps the audit trail honest and lets the student draft notes you review and sign. A rotation can proceed without access, with the student using a worksheet and the program's clinical log instead. **Can a student use my EMR login if the system has no student role?** No. Every action in that session is recorded as yours, which removes any record separating your work from a learner's, and credential sharing generally breaches both organisational policy and vendor terms. The alternative is supervised viewing: the student reads the chart while you are present and documents nothing in the system. **Who signs the note when a student writes it?** You do, and your signature attests to your own work rather than approving someone else's. Review the draft line by line, correct what is wrong, add your history, examination and decision-making in your own words, then sign. What portions of student documentation may support billing varies by organisation, so ask your compliance or coding lead. **How long does it take to get a student EMR account?** Plan on two weeks from a complete request. Administrators need the student's legal name, program, rotation dates, supervising clinician, access level and confirmation of HIPAA training. Incomplete requests wait in a queue. Ask for the account to expire automatically on the last day of the block so nobody has to remember to close it. **What HIPAA training does the student need before access?** Programs train students on privacy and confidentiality before placement and can send an attestation confirming completion, which is usually what an administrator wants on file. Many practices also require their own onboarding module, badge or safety training. Ask early which local modules apply, because a missing module is a common reason an account request stalls. ### Teleprecepting consent and documentation URL: https://www.nphours.com/off-the-clock/teleprecepting-consent-and-documentation/ Author: Kwame A., Psychiatric lead · Published 2026-06-29 The video visit opens and the student speaks first. Her name, that she is a nurse practitioner student working with you today, that you will be on the call and will review everything, and then a direct question asking whether the patient is comfortable having her take part. She stops and waits for an answer. The answer goes into the chart. #### The line the student reads aloud Write the line out and hand it to her before day one, because a student improvising consent on camera produces something vague, and vague consent is what gets a rotation stopped. A version that works: 'My name is Dana Okonkwo. I am a family nurse practitioner student, and I am working with your nurse practitioner today. She will be part of this visit and will go over everything with you. Are you comfortable having me participate?' Three features make that line do its job. She identifies herself as a student and not as a member of staff. She names you and says you will be on the call, so nobody thinks the visit has been handed off to a trainee. And she asks a closed question the patient can answer with a no. A request that leaves no room for refusal is not consent, and on camera a patient has fewer cues telling her that refusing is permitted. #### Where the consent goes in the chart Document it the way you would document any verbal consent: in the note for that encounter, in one sentence, naming who obtained it and what the patient said. Something like this does the work. Nurse practitioner student introduced at the start of the visit, patient gave verbal agreement to student participation, preceptor present throughout the encounter. Put it above the history, so a later reader sees the visit was set up properly before reading anything clinical. If your EMR carries a telehealth consent template, add the student sentence into that template rather than keeping a separate list somewhere. The note is the document that survives. Your recollection of an agreeable patient does not survive, and neither does a message in a chat window. When a program audits a rotation, or a patient rings the practice asking who else was on that call, the note is the thing that answers. #### When the patient declines the student Some patients say no, and a few say it at the least convenient moment, after the visit has already begun. Take the refusal immediately and without negotiating it. The student drops off the call, you carry on alone, and you do not start explaining nursing education to a patient who has just said no. Tell the student afterward what happened, because a first refusal lands hard and she will assume she caused it somehow. Refusals gather in predictable places. A first appointment for a sensitive complaint. A psychiatric intake with a frightened patient. An established patient who waited three weeks for time with you specifically. If you can see that a visit is likely to be a no, keep the student off it. Reading through tomorrow's schedule the evening before costs five minutes and protects both the patient and the student's nerve. #### The breakout where you actually teach In clinic you teach in the corridor. On video you have to build the corridor. Set up a second channel before the rotation starts: a separate meeting the two of you leave open, a phone line, or the platform's breakout function where it has one. When the student is ready to present, she tells the patient plainly that she is stepping away to review the visit with the nurse practitioner, then mutes and leaves rather than whispering with a live microphone. What follows is a corridor exchange, compressed. Ninety seconds for her summary, her assessment and the plan she proposes. You ask for her commitment, correct what needs correcting, decide what happens next, and the two of you return together. Warn the patient at the start that this pause is coming and roughly how long it will last, because two minutes of silence on a video call feels a great deal longer to the person sitting there. #### Logging the encounter and attesting to it A video encounter enters the clinical log like any other, with one extra field. The student records the date, the length of the visit, the patient's age and sex, the diagnoses addressed, her own level of participation, and she marks the encounter as telehealth. Most logging systems carry that flag now. Where hers does not, she writes it into the encounter comment, because a program that limits video hours has to be able to count them. Your part is the attestation, and it makes a specific claim: that you supervised the encounter, that the student's described role is accurate, and that the hours are right. Approve entries weekly rather than in one batch at the end of the term. A month of unapproved video encounters is hard to reconstruct honestly, and the one thing you must not do is attest to a visit you cannot actually remember. #### What varies by state and by program Two sets of rules sit above everything here, and neither is yours to set. Boards of nursing differ on supervision by video, on whether a preceptor has to be physically present in certain circumstances, and on what a student may do when the patient is sitting in another state. Programs differ on the share of hours a student may earn by video and on whether particular visit types are excluded outright. So ask two questions before the first call and get both answers in writing. What does this program cap video hours at, and what does the board in the patient's state require of the supervising clinician. Your coordinator collects both during onboarding. The technical side, the second channel, the consent wording and the EMR view, is set up once and described on teleprecepting setup. #### Questions **What does a student say to get consent on a video visit?** She gives her name, states that she is a nurse practitioner student, names the preceptor who will be on the call, says the preceptor will review everything, and asks directly whether the patient is comfortable with her taking part. Then she waits for the answer. Written out in advance the line takes about twenty seconds and avoids the vagueness of improvised consent. **How do you document student consent for a telehealth visit?** In the note for that encounter, in a single sentence: that the student was introduced, that the patient verbally agreed to her participation, and that the preceptor was present. Place it above the history so a later reader sees it first. If your EMR has a telehealth consent template, add the student line into that template instead of keeping a second record. **Can a patient refuse to have a student on the call?** Yes, at any point, including after the visit has started. Accept the refusal at once, have the student leave the call, and continue alone without explaining her training to the patient. Debrief her afterward so she does not read the refusal as her own failure. Screening tomorrow's schedule for likely refusals prevents most of these moments entirely. **How does a student log a telehealth encounter?** The same way as an in-person visit, with the encounter flagged as telehealth: date, duration, patient age and sex, diagnoses, and her level of participation. Programs that limit video hours need that flag in order to count them. The preceptor then approves the entry, which attests that the encounter was supervised and that the hours and the described role are accurate. **Which visits work by video and which do not?** Medication management, follow-up for stable chronic disease, behavioural health and counselling visits translate well to a camera. Anything that turns on a hands-on examination translates poorly, and acute inpatient hours rarely count at all. Each program decides what its own students may claim by video, so confirm the cap and any excluded visit types before the rotation starts. ### What programs verify before you precept URL: https://www.nphours.com/off-the-clock/what-programs-verify-before-you-precept/ Author: Ravenna S., Program relations · Published 2026-06-24 Two documents open a preceptor file: your CV and a licence lookup. The CV goes to a placement coordinator who reads it for dates rather than achievements. The lookup happens in Nursys, the national licensure database, usually before anyone emails you back. Everything else in the approval follows from what those two things show. #### The CV, read for two dates A placement coordinator is looking for the date you were certified in your population and the date your current clinical role began. Those two dates decide eligibility, and on most CVs they are the hardest facts to find. Put certification on its own line with the month and year and the credential spelled out. Put each clinical position with a start month, an end month, the population you see and the setting. Trim what does not answer a question. Committee work, poster sessions and continuing education lists do not affect approval and push the dates onto a second page. What does help is a plain line for each previous student you have hosted, with the program and the hours, because coordinators read prior precepting as evidence you know what a rotation involves. One page is enough for most files. #### The Nursys lookup Nursys is the database boards of nursing use for licence verification, and a search returns your licence number, type, status, expiry date and any public discipline on record. A program checks it because primary source verification is the standard; a photograph of your wallet card is not. Nothing about the check requires you to do anything, but it does mean the record has to match the name and state you gave. The common failure is a name. A licence issued under a maiden name, a hyphenated surname entered without the hyphen, or a middle initial in one place and not the other will return nothing and the file goes into a queue for a human. Search yourself once before you apply. If the record is stale or the name is wrong, fixing it with your board takes days, and it will not fix itself later under time pressure. #### Certification verified with the board that issued it Licence and certification are separate checks. The program goes to ANCC or AANPCB, or the relevant specialty board, and confirms that your certification is current and that its population matches the student's track. Family, adult-gerontology, pediatric, psychiatric-mental health, women's health and acute care are not interchangeable for this purpose, however broad your actual practice has become since you qualified. That is the check that surprises people. A clinician who has worked in family practice for a decade but holds an adult-gerontology certification cannot be approved as the preceptor of record for a pediatric course, no matter how many children pass through the clinic. Population match is set by the certifying credential and the course objectives, not by the patients in your waiting room. #### The two-year rule and the expiry window The years of practice a program wants are counted from the date on the certificate, not from graduation and not from your first nursing job. Two years in the certified population after certification is the usual floor and the one NPhours applies. A clinician certified eighteen months ago is eligible soon, and the sensible move is to note the date you become eligible and open your hours then. The other date is your expiry. Many placement offices will not approve a preceptor whose certification lapses during the rotation, and a good number apply a wider margin, asking for proof of renewal when the credential expires within about ninety days of the block's end. Renew early and send the new certificate the day it arrives. A lapsed credential ends a rotation immediately, mid-block, and the hours after the lapse are not counted. #### Your practice description, read against course objectives The third document is a short description of your site. Coordinators use it to decide whether the rotation can satisfy a specific course, so write it with numbers: patients seen in a typical day, the age spread, the mix of well visits and episodic care, the chronic conditions you carry, procedures available, the record system, and how much of the week is video. Four or five sentences is plenty. A placement office then lays that beside the objectives for the course the student is enrolled in. A women's health course needs contraception and prenatal visits in real volume. A pediatric course needs well-child checks on the schedule. When a description is vague, the coordinator has to ask, and the file waits. When it is specific, the file matches or it does not, and either answer arrives faster. #### What stalls an approval Approvals rarely fail outright. They stall, and they stall on a short list of the same things, most of which are clerical rather than clinical. A file that clears in one exchange usually looks different from a file that takes three only in the details below. Read the list before you send anything, and check your own paperwork against it while there is still time to correct something. None of this is meant to be a hurdle. The checks exist because a program has to prove to its own accreditor that every student was supervised by someone qualified in the right population, and the paper trail is how that is proven. The eligibility rules themselves, including what disqualifies, are set out on the requirements page. - A name on the licence record that does not match the name on the CV or the application. - Certification in one population and a student enrolled in the course for another. - A CV with no month-and-year dates, so eligibility cannot be calculated. - A credential expiring inside the rotation window with no renewal evidence attached. - A missing certificate of insurance or an out-of-date HIPAA or safety module. - A site description too general to map onto the objectives of a named course. #### Questions **What is Nursys and why is my licence in it?** Nursys is the national database boards of nursing use to publish and verify licence records. A search returns the licence number, type, status, expiry and any public discipline. Programs use it because accreditation requires primary source verification rather than a copy you send them. Your record is there because your board reports to it; you do not add yourself. **How many years of experience do I need before I can precept?** Two years of practice in the population you would teach, counted from the date on your certification rather than from graduation. NPhours applies that floor, and most programs use the same or similar language. For MSN education and leadership practica the equivalent is an MSN or higher plus a current role in that function. **Does my certification population have to match the student's track?** Yes, for the preceptor of record. A program has to show its accreditor that supervision came from someone certified in the population the course covers, so an adult-gerontology credential cannot anchor a pediatric rotation. Your day-to-day patient mix does not change that. Broad practice does help you host students from adjacent tracks for portions of their hours where a program allows it. **What happens if my certification expires during a rotation?** The rotation stops. Hours supervised after a credential lapses are not accepted, and the student loses them. Many placement offices screen for this in advance and will ask for renewal evidence when a certification expires within roughly ninety days of the block's end date. Renew early, then send the updated certificate to the coordinator the day you receive it. **What should my practice description include?** Numbers a coordinator can match to course objectives: patients in a typical day, the age range you see, the balance of preventive and episodic visits, common chronic conditions, procedures available on site, the record system, and how much of the week runs by video. Four or five specific sentences beat a paragraph of general description every time. ### How many clinical hours NP students need URL: https://www.nphours.com/off-the-clock/how-many-clinical-hours-np-students-need/ Author: Ravenna S., Program relations · Published 2026-06-22 The number is 750. The 2022 National Task Force Standards for Quality Nurse Practitioner Education, sixth edition, set 750 hours of direct patient care as the minimum for an NP program. Your student's own total will be higher, cut across courses and populations, and your 120 hours are one slice of it. Here is the arithmetic from the school's side of the desk. #### Where the 750 came from The National Task Force writes the standards accreditors apply to NP programs, and the sixth edition, published in 2022, put the direct patient care minimum at 750 hours. That is a floor and not a target. Schools build above it, because a floor written for every population has to be reachable by the program with the thinnest clinical sequence. So a student who tells you her degree requires more than 750 is telling you the truth. One number does more work than it appears to. It sets how many rotations a student needs, which sets how many preceptors a school has to find each term, which is why a placement office is emailing you in July about a January start. The hours are the school's accreditation obligation. Your signature on a log is the only evidence that the obligation was actually met. #### The 500 you will still hear Before the sixth edition the widely quoted floor was 500 hours, and 500 still turns up in program handbooks, in older articles and in the memory of anyone certified a decade ago. Both figures are genuine. They belong to different documents and different years. A student who says her program asks for 500 direct care hours may be reading a handbook written before the current standards, or she may be describing one course rather than her whole degree. This matters to you for one practical reason. When you take a block, you are meeting a course requirement, not a degree requirement, and the two get mixed together in conversation. Ask which course your rotation satisfies and how many hours that course needs. The answer sits on her syllabus. A student who cannot answer it is a student whose log will surprise you both in week ten. #### Where the 1,000 hours belongs DNP programs carry a separate total. Under CCNE guidance a DNP requires at least 1,000 post-baccalaureate practice hours, counted across the whole program rather than in direct patient care alone. A post-master's DNP student can therefore arrive with most of that total already banked from her MSN, and the hours she still needs may be project or systems work instead of clinic sessions with patients in front of her. Which is why two students who both say they need hours can need entirely different things from you. One needs patients, in a population your certification covers. The other needs a mentor for a quality improvement project and a signature on a practicum agreement. Ask which kind you are being offered before you accept, because the second is a real commitment and it is not a clinical rotation. #### How a program splits the hours Nobody hands a student 750 hours and wishes her luck. The total gets cut into course-level pieces: an adult course, a pediatrics course, a women's health course, a primary care course running over two terms. Each piece has its own hour requirement, its own log, its own evaluation form, and sometimes a rule about setting or patient mix. A family NP student has to spread hours across the lifespan, which is why she needs several different sites. Two consequences follow for you. Hours are not interchangeable, so a student who over-logs in your family practice cannot slide the surplus into her psychiatric course, and an extra fortnight with you may buy her nothing at all. And when a student asks to stay longer, the useful question is which course she is trying to fill. If it is one your practice cannot serve, the real help is a call to her coordinator. - Each clinical course carries its own hour minimum, often 120 or 180 for a term. - Population requirements can force a set number of pediatric or older adult encounters. - Some courses specify a mix of wellness and problem visits. - Hours logged under the wrong course usually cannot be moved to another one. - Video-eligible hours are set by the program, and no two programs set them identically. #### Why a rotation is 120 hours The standard block runs 120 hours because that shape fits both sides of the arrangement. It divides neatly into a term: two nine-hour days a week for seven weeks, or one day a week for fourteen. It lasts long enough that the student stops costing you throughput before she leaves, since the expensive stretch is the opening fortnight. And it is short enough that a clinic can commit without deciding anything about next year. The 60-hour half-block exists for the same reason in reverse. It suits a clinician who can give one day a week for seven weeks and nothing beyond that, and it suits a course with a smaller requirement or a student topping up one population. The trade is that a larger share of the rotation is spent in the slow part, and she leaves at roughly the point where she was becoming useful. #### What counts as direct patient care Direct patient care means the student, inside a patient encounter, doing the work of an advanced practice nurse: history, examination, assessment, plan, counselling, and the note for that encounter. It counts with the patient in the room, and it counts on a video visit where the program accepts video. It counts while you are supervising, and it stops counting the moment nobody is. What does not count is much of what a student would like to count. Simulation, beyond whatever share her program permits. Skills labs. Observation with no participation in it. Chart review, staff meetings, and watching a procedure she takes no part in. The line shifts slightly by school and the school is the authority. When you accept a rotation you see the program, dates, hours, specialty and mode first, which is what matching is for. #### Questions **How many clinical hours do NP students need?** The 2022 National Task Force standards, sixth edition, set a minimum of 750 direct patient care hours for nurse practitioner programs. Most schools require more than that floor. DNP students carry a separate total of at least 1,000 post-baccalaureate practice hours under CCNE guidance, and the older 500-hour figure still appears in handbooks today. **Is the minimum 500 hours or 750 hours?** Both numbers are real and they come from different documents. 500 was the widely described floor before the sixth edition of the National Task Force standards; 750 is what those 2022 standards require. Programs working under the current standards start at 750 and usually exceed it. Ask your student which course your rotation satisfies and what that course requires. **Do DNP students need 1,000 clinical hours?** A DNP requires at least 1,000 post-baccalaureate practice hours in total under CCNE guidance, which is not the same thing as 1,000 hours of direct patient care. Hours earned during an MSN can count toward the total, and some of what remains may be project or systems work. Ask a DNP student whether she needs patients or a project mentor. **What does not count as direct patient care?** Simulation beyond the share a program allows, skills labs, observation with no participation, chart review outside an encounter, and time in meetings. Watching a procedure the student takes no part in does not count either. Programs draw the line a little differently and the program decides, so ask the coordinator before questionable hours go into the log. **Why are rotations usually 120 hours long?** Because 120 hours fits a course requirement and a term calendar at once. Two nine-hour days a week gets there in roughly seven weeks; a single weekly day takes the full fourteen. It also puts the slow opening fortnight behind you while the student is still there to be useful. The 60-hour half-block suits clinicians who can spare one day. ### How affiliation agreements work URL: https://www.nphours.com/off-the-clock/how-affiliation-agreements-work/ Author: Ravenna S., Program relations · Published 2026-06-17 Scroll an affiliation agreement to the last page and read the signature block before anything else. Two lines sit there: an authorised officer of the nursing program, and an authorised officer of the practice. Your name is usually not one of them. It appears further up, in an exhibit, as the designated preceptor for a named student. #### Who is actually bound An affiliation agreement is an institution-to-institution contract. The university agrees to send prepared, insured, background-checked students; the practice agrees to host them under qualified supervision. A preceptor is the person the practice designates to do the supervising, named in a schedule or a placement letter attached to the agreement. That distinction protects you. Personal obligations, personal indemnities and personal insurance requirements do not belong in a document signed by two organisations. It matters most when a practice manager forwards the file and asks you to sign it. If you are not the person with authority to bind the practice, you are the wrong signatory, and signing anyway can put an individual clinician behind a promise the organisation should be making. Send it to whoever signs contracts where you work. If you are in solo practice you are both parties at once, which is exactly when a lawyer's read is worth the fee. #### The clauses that decide whether a rotation happens Most of the document is standard. Six clauses are the ones that actually change what happens in clinic, and they are worth reading in full rather than skimming. Programs write them differently, and a placement office will usually tell you which of them they are allowed to modify and which come from university counsel. Read the supervision clause against how your day really runs. Some programs require the preceptor to be physically present in the building at all times; others allow immediate availability by phone or video for parts of a visit. If your practice moves you between two sites in one day, that clause has to accommodate it before the rotation starts, not after a site visit finds the mismatch. - Supervision: how present you must be, and who covers the student when you are out sick. - Permitted mode: whether any of the hours may be delivered by video, and under whose licence. - Liability and insurance: who carries what, and the certificate each side must produce. - Term and renewal: the start date, the end date, and whether it renews on its own. - Student conduct and removal: the practice's right to end a placement, and how notice is given. - Records and confidentiality: what the student may see, document and take away from the visit. #### Liability, insurance and the certificates The insurance clause names limits for each side and asks for proof. Programs typically carry professional liability for enrolled students and will send a certificate of insurance on request; students often carry an individual policy as well, which the placement file should already hold. The practice supplies its own certificate showing that it and its clinicians are covered while teaching. Read whether teaching activity is named or merely assumed. Indemnification is where the negotiation happens. A mutual clause, in which each party answers for its own negligence, is the ordinary shape. A one-way clause that asks the practice to indemnify the university for the student's conduct is worth pushing back on. This is not legal advice, and the practice's own counsel or insurance broker should say yes before that language is accepted. #### Whose template gets used Most programs arrive with a standard template that has already been through their own counsel, and most placement offices strongly prefer it. Larger practices and health systems arrive with a template of their own and a policy that says outside paper is not signed. When two institutions each hold a template, one of them yields or a redline moves back and forth. Neither side is being difficult; both are following an internal rule. The quickest route is to ask early which template will be used and who reviews it. A university legal office and a health system contracts office both work in queues measured in weeks. A small independent practice can often sign the school's template in an afternoon because there is nobody upstream to consult. Knowing which situation you are in tells you how far ahead the paperwork has to start. #### How long signing takes Plan in weeks. A solo practice signing a school template can be done inside a few days. A system with a contracts office, a risk review and an insurance certificate to issue can take a month or longer, and the clock only starts when a complete package reaches the right inbox. Rotations that fall apart late almost always fall apart here, not over the teaching. You can shorten it by gathering the pieces before anyone asks. A current CV, the licence and certification numbers a program verifies, the practice's legal name and address exactly as they appear on its registration, the certificate of insurance, and the name and title of whoever signs. That package turns a three-week exchange into a two-email exchange more often than any other single thing. #### When the practice already holds one Many clinics are already affiliated with the local university, sometimes from a rotation four years ago that nobody remembers. Check three things before assuming it covers you: whether the term is still current or renewed automatically, whether the agreement names your discipline and population rather than only medical or registered nurse students, and whether it permits any of the hours to happen by video. An existing agreement with the wrong scope needs an amendment, which is faster than starting over. Where one is in force, the paperwork for a new student is usually a short placement addendum naming the student, the dates, the hours and you. On NPhours a coordinator handles that exchange with the program and tells you what is outstanding, and the sequence is set out on the paperwork page. #### Questions **Do I sign the affiliation agreement myself?** Usually not. The parties are the nursing program and the practice, so the signatures belong to people authorised to bind those organisations. A preceptor is named in an exhibit or placement letter as the designated supervisor. If you own or run the practice you do sign, in that capacity, and it is worth having your own counsel read the indemnification language first. **What is in an affiliation agreement?** Definitions of the parties, the purpose of the placement, supervision requirements, insurance limits and certificates, indemnification, the term and renewal dates, student conduct and removal rights, confidentiality and records handling, non-discrimination language, and a notice clause. Student names, dates, hours and the designated preceptor generally sit in an attached schedule so the master agreement can cover future students unchanged. **How long does an affiliation agreement take to sign?** Anywhere from a few days to more than a month. A small independent practice can sign a program's template quickly. A health system with a contracts office and a risk review works in queues, and the clock starts only when the complete package arrives. Gathering the CV, licence numbers, legal entity name and insurance certificate in advance is what shortens it. **Can a rotation start before the agreement is fully signed?** No. Until both institutions have signed, the student has no authorised placement and the insurance arrangements the document describes are not in force. Programs will not count hours logged before the effective date, and a practice that hosts a student anyway is exposed. If the start date is close, ask the placement office for the current status in writing. **Our clinic already has an agreement with that university. Is that enough?** Often, but check three things: that the term is current or renews automatically, that the scope names nurse practitioner or advanced practice students rather than only medical students, and that it allows any hours you plan to deliver by video. If the scope is wrong, an amendment is faster than a new agreement. A short placement addendum then covers the individual student. ### Your first student, week by week URL: https://www.nphours.com/off-the-clock/your-first-student-week-by-week/ Author: Tamsin R., Clinical lead · Published 2026-06-16 Before you see a single patient together, sit down for ten minutes. That huddle is the whole first day: how you want her to present, where she stands in the room, what she may examine, what she may never do, and when the two of you will talk. A 120-hour block runs eight to fourteen weeks. Here is what each stretch looks like. #### The day-one huddle Ten minutes, in your office, before the first chart opens. Cover six things: how the clinic day is shaped, how you want a patient presented to you, what she says when she walks into a room, which parts of the exam she may perform this week, what she documents and what she leaves alone, and the signal you will use when you need her to stop talking. Then walk her to the front desk and introduce her by name. Say the uncomfortable part out loud while you are there. You will interrupt her. You will take over an encounter without warning when a patient needs you to. None of that is a verdict on her ability, and you will explain each instance afterward rather than in front of the patient. A student who hears this on day one stops reading interruption as failure, which spares you both a hard conversation in week three. #### Weeks one and two: shadowing and the history Expect the first fortnight to cost you roughly one patient an hour. That is the true price of teaching and it is front-loaded, so put the block in a stretch of calendar that can absorb it. In week one she shadows. She watches how you open a visit, where you type, how you close, what you say to a patient who wants one more thing. She takes histories on cases you choose for low complexity and reports back in the hall. By the second week the history belongs to her on most visits. Send her in first on the straightforward ones, give her six minutes, and take the story from her before you go in yourself. You are not teaching diagnosis yet. You are teaching her to gather an accurate history quickly and hand it over in a form you can use, because every other skill in the rotation stands on top of that one. #### Weeks three to six: she sees first and presents Now set the pattern that carries the rest of the term. She goes in, takes the history, performs the exam elements she is cleared for, forms an impression, and presents to you at the workstation. Ask for her commitment before you offer yours: what does she think this is, and what would she do about it. Then you both go back in, and you confirm, adjust or redirect in front of the patient without dismantling her in front of the patient. Two teaching methods fit the ninety seconds you actually have between rooms. The five microskills of the one-minute preceptor work when you are driving the exchange. A learner-driven format like SNAPPS works once she is ready to run her own presentation. Pick one and use it the same way every time, because a student who knows the shape of the exchange comes prepared for it. #### Week four: read the log Open her clinical log at week four and read it against your own schedule. Three things matter: that the hours entered match the days she was actually in the building, that each encounter carries a plausible visit type and diagnosis, and that nothing is sitting unapproved while it waits on your signature. Schools watch these logs closely, and a backlog of unapproved entries discovered in week ten turns into everybody's problem at once. Week four is also the last point where a shortfall is cheap to fix. Thirty hours behind at week four is one extra half day a week for the remainder. Thirty hours behind at the midpoint means the program has to extend her end date and reshuffle her next placement. Ten minutes with the log prevents that. Logging systems differ from school to school, and your coordinator can show you where the approval button hides. #### The midpoint: the form and the first half of the fee Near hour sixty the program sends a midpoint evaluation. It is a rating grid with a comment box, and the comment box is the part that does any work. Write two behaviours she does well and one specific change she can make by Tuesday, in words she can act on without interpreting them. Complete it before you meet, then read it to her with the door shut and hand her the copy. The midpoint is also the money marker. The first half of the block's fee is released by direct deposit once that evaluation is filed, and the balance follows the final one. Say nothing about any of that to the student. Her evaluation and your invoice are separate documents and should stay separate. The only thing she needs to hear from you that week is what is working and what changes next. #### Weeks eight to fourteen, and the final In the back half she should carry most of a visit: history, exam, an assessment she can defend, a plan with a reason behind it, and a note you edit rather than rewrite. Your work narrows to confirming findings, adjusting plans and signing. Supervision does not loosen because she has become competent. You are in the building, reachable in seconds, and you lay eyes on every patient she sees. That line does not move in week twelve. The final evaluation closes the rotation: the same grid, a summary comment, your signature, and the hour total reconciled against the log. Sign the last entries that week rather than next month. Then ask the placement office for a preceptorship letter while she is still on somebody's active roster. For the full arc of a rotation, including what you sign and when, see precepting NP students. #### Questions **How long does a 120-hour rotation take?** It depends on the days per week. Two nine-hour days finish 120 hours in about seven weeks, and one day a week takes fourteen. Programs set the term dates and usually let the site and the student agree on the pattern inside them. Fewer, longer days generally teach better than many short ones, because the student sees whole clinic sessions rather than fragments. **What should a student do in the first week?** Shadow and take histories. She watches how you open a visit, document it and close it, then takes histories on patients you pick for low complexity and reports back to you before you go in. She is learning clinic flow, the staff and where supplies live. Assessments and plans start from about week three, once her histories are reliable. **How much does a student slow me down?** About one patient an hour in the first fortnight. It eases from week three, when she starts taking the history and drafting the note herself. If your pay is productivity-based, count that cost against the fee honestly. If you are salaried, it costs time rather than money. Choosing a term with no vacation or audit in it helps more than anything else. **Do I have to be in the room with the student?** You have to be immediately available, and you have to see every patient she sees. Programs describe that as direct supervision. In practice you are often not in the room while she takes a history, but you go in before any plan is acted on, confirm the findings that matter, and sign the note. Nobody gets seen unsupervised. **When does the midpoint evaluation happen?** Around the halfway hour, so near hour sixty of a 120-hour block. The program sends a rating grid with a comment box, you complete it, and you go through it with the student in private. It is also the marker for the first half of the fee, so filing it on time serves the program's deadline and your deposit at once. ### Telehealth side work compared URL: https://www.nphours.com/off-the-clock/telehealth-side-work-compared/ Author: Dagny H., Payments · Published 2026-06-11 Take one Saturday, eight in the morning to noon. Four hours, a laptop, a quiet room. Four kinds of remote work will take those hours from you, and only one of them will tell you in advance exactly what the four hours pay. Here is the arithmetic for each, and what you have to do before you can start. #### The one figure you can know beforehand A video precepting half-day is priced per hour of student time. Four hours with a student on camera is four logged hours, and the rate is the one you picked when you opened your hours. At the floor of the NPhours band those four hours come to $48; at the ceiling they come to $80. Sixty of those hours make a half-block. Nothing about that number depends on how many patients turn up. The other three pay by output, not by clock, which is why nobody can quote you a Saturday figure for them without seeing the contract. What you can do is read the pay clause and convert it into an hourly estimate yourself. In each case below, the sentence to hunt for in the agreement is named. Write the estimate down before you accept, because the estimate is what you are actually agreeing to. #### The telehealth panel shift Direct-to-consumer and payer-sponsored panels usually pay per completed visit, sometimes with an hourly floor for a scheduled block, sometimes with a bonus above a visit threshold. Look for three lines in the contract: the fee for one completed encounter, whether a no-show or an incomplete intake pays anything, and whether the hourly floor survives a slow queue. Multiply the visit fee by the number of visits the queue realistically delivers in an hour. The setup is the heaviest of the four. Expect credentialing, payer enrolment where claims are billed, malpractice coverage in the states you cover, a training module on the vendor's own record system, and separate licences for every state the panel serves. Weeks can pass between signing and your first shift. Compact status covers registered nurses, not advanced practice, so each state where a patient sits wants its own APRN licence. #### Asynchronous chart review Store-and-forward work pays per chart or per case: intake questionnaires triaged for refills, utilisation and coverage reviews, e-consults answered in writing. The clause to find is the fee per completed review, the turnaround window attached to it, and whether a case you decline or escalate still pays. Then time yourself on ten charts. Reviewers routinely find that a fee which looked fine per chart becomes thin once the harder cases are averaged in. Onboarding is lighter than a live panel but not light. There is a platform to learn, a documentation standard to match, and often a quality audit on your first batch. Licensure still follows the patient: the state where the person receiving the advice is located governs, so a reviewer working a national queue is buying and renewing licences as a cost of doing business. Ask which states the queue actually feeds you. #### Health content writing Writing pays per word, per piece, or occasionally per hour of review. The contract lines that matter are the fee, how many revision rounds are inside it, whether a spiked draft is paid at all, and who owns the byline and the copyright. A per-word rate is easy to compare and easy to misjudge: a clinically accurate piece with citations takes far longer per word than a listicle, and the fee rarely reflects that. No licence is required to write, which cuts both ways. Nothing stops you starting on Saturday, and nothing stops anyone else either, so the rate is set by a wide market rather than by your credential. Expect an unpaid sample, a slow first month, and a real rate that only climbs once an editor stops sending changes. Of the four, this is the one where your hourly return depends most on repetition. #### What four hours of video precepting looks like The student joins your video room at eight. You take the first patient together, then hand over the second: the student takes the history on camera, leaves the room to present, and you go back in for the pieces that need you. Follow-ups on stable medication, results review, chronic disease check-ins and counselling visits all work by video. At noon the student logs the hours and you attest to them. The setup is credential work, not credentialing. An active unencumbered licence, board certification in the population you teach, and two years of practice in that population since you were certified. After that it is the program's paperwork and a 90-minute orientation. Because the patient is your own patient in your own state, no new licence is bought and no payer enrolment is opened. #### Setting the four side by side Rank them on how many weeks pass before the first dollar arrives. Writing is fastest to start and slowest to pay well. Chart review sits in the middle on both. A panel shift pays reliably once you are through credentialing, which is the longest runway of the four and the one most likely to stall on a licence application. Precepting starts when a program signs, and the figure never has to be estimated. Then rank them on what happens when Saturday gets taken by something else. Visits and charts simply do not get done and do not pay. A writing deadline moves once, politely. A rotation is a commitment to a student, so it is the one to think hardest about before saying yes. If you want the four sitting in a single ranked list with the setup time attached, that comparison lives on the income options page. #### Questions **What does a four-hour video precepting session pay?** Four hours of student time at the rate you set. Inside the NPhours band that is $48 at the low end and $80 at the high end for the morning, paid as part of the rotation total rather than per session. Sixty logged hours make a half-block and 120 make a full one, released in two deposits tied to the evaluations. **How do I estimate an hourly rate from a per-visit telehealth contract?** Find the fee for one completed encounter, then ask the recruiter how many encounters a provider typically closes in an hour on that queue. Multiply. Check whether no-shows and incomplete intakes pay, and whether an hourly floor applies when volume is low. That floor, not the headline per-visit figure, is what protects a quiet Saturday morning. **Which remote NP work has the lightest onboarding?** Health content writing, because no licence or credentialing is involved; you can start the week you find a client. Precepting is next, since the checks are on credentials you already hold plus program paperwork. Chart review needs platform training and state licences. Live telehealth panels are heaviest, with credentialing, payer enrolment and a licence for every state served. **Do I need a licence in the student's state to precept by video?** Your licence has to cover the state where the patient is sitting, which for most video rotations is your own state and your own panel. The student's location matters to their program's rules rather than to your licensure. Programs differ on how many hours they will accept by video, so ask before the block is built. **Is telehealth panel work better paid than precepting?** Per hour it often is, because you are the one seeing patients rather than teaching someone else to. It is also the only one of the four that competes with your clinical day rather than sitting on top of it. Precepting pays a smaller hourly figure for hours that would otherwise be unpaid teaching, which is a different trade. ### Does precepting count toward recertification URL: https://www.nphours.com/off-the-clock/does-precepting-count-toward-recertification/ Author: Tamsin R., Clinical lead · Published 2026-06-09 The thing that makes precepting count is a letter. One page on program letterhead, carrying your name, the student's name, the dates and the hours. ANCC counts precepting inside its professional development categories and wants that letter as proof. AANPCB does something different: it converts precepting hours into continuing education contact hours. Both boards need the same page from you. #### The letter is the whole artifact Nothing about teaching a student documents itself. Your board never sees the clinical log, the evaluation form, or the eight Tuesdays you gave away. It sees one letter that you either attach at renewal or hold in case of audit. So the first thing to know about this credit is clerical rather than clinical. Get the letter, name the file after the term, and keep it beside your license renewal and your CE certificates. Preceptors lose the credit for one reason, and it is timing. A placement office that would sign a letter in November has forgotten your student by March, changed staff by the next academic year, and cannot verify hours it no longer holds. Ask while the rotation is closing and the coordinator still has the file open on her desk. That is one email, and it separates a documented category from something you merely remember doing. #### How ANCC counts precepting hours ANCC renewal runs on a five-year cycle and asks for continuing education plus a set of professional development categories. Precepting is one of the options inside that structure, and it counts when the hours sit in the role and population your certification covers. The renewal handbook puts the floor at 120 preceptorship hours over the five years, which means one standard block can satisfy the category by itself, and two half-blocks reach the same place. Two limits deserve stating plainly. The hours have to be yours as the preceptor, not hours you spent being oriented or observed by somebody else. And the category does not replace the pharmacology or contact-hour requirements sitting next to it on the same renewal. Read the handbook in force on your own renewal date, because the requirements get revised between cycles and the only version that governs you is the current one. #### How AANPCB converts hours into contact hours AANPCB comes at it from the other direction. Instead of treating teaching as a development category, it allows precepting hours to stand in for continuing education. The ceiling is 120 hours of precepting, and what those hours buy is 25 contact hours on the non-pharmacology side of the requirement. Your pharmacology hours are untouched and still get completed the ordinary way, and the substitution applies within the recertification cycle where the hours were earned. Price the trade if you want to see what it is worth. Twenty-five contact hours purchased through conference registration or a paid CE library is a line item you can look up in about a minute. A single block of teaching erases that line, and you were paid for the block as well. That is not why you take a student, but it is a good reason to file the letter instead of shrugging at it. #### What the letter has to say A letter that gets rejected is nearly always a letter missing a number. What the boards want is verification that a named clinician precepted a named student for a countable number of hours during a stated period, signed by somebody at the school with authority to say so. Programs usually have a template. When a coordinator asks what you need, sending her the list below is faster than describing it and saves a second round of email. One thing the letter cannot do is cover work that is not precepting. Committee service, guest lecturing and your own reading belong in other categories with their own evidence. And the 90-minute preceptor orientation you complete before your first student is training rather than accredited continuing education, so it earns no contact hours from either board. Keep it filed separately so nobody reviewing your renewal has to guess what it was. - Your full name, credential and certification, spelled as they appear on your board record. - The student's name, degree program and population focus. - The day the rotation opened and the day it closed. - Total precepting hours, matched to the figure in the student's clinical log. - A statement that you served as clinical preceptor of record for those hours. - Signature, title and date from a faculty member or the placement office, on letterhead. #### Ask at the end of every rotation Build the request into how you close a term. On the final day you sign the last evaluation, confirm the hour total in the log, and send one message to the placement office asking for the preceptorship letter for that student. Put the dates and the hour figure in your own message so the office only has to confirm what you wrote. Schools usually turn that around inside a week when it arrives already filled in. Then file it somewhere you will find it in year four. A preceptor who takes two students a year passes the documented minimum quickly and then cannot prove a single hour of it, which is the only real failure mode in this whole subject. If you have not seen the onboarding side yet, the training that comes before your first student is described on the preceptor orientation page. #### Questions **Does precepting count toward ANCC recertification?** Yes. ANCC treats precepting in your certification role as one of the professional development categories in the five-year renewal cycle, and the handbook describes 120 preceptorship hours as the minimum for that category. You prove it with a letter from the nursing program rather than a CE certificate. Check the handbook in force on your renewal date, since requirements change between cycles. **How many precepting hours will AANPCB accept?** Up to 120 hours. AANPCB allows that maximum to substitute for 25 contact hours on the non-pharmacology side of the continuing education requirement in a recertification cycle. Pharmacology hours are unaffected and still have to be completed separately. The board asks for documentation from the program, and its CE page carries the current conditions, so read that before counting on the substitution. **What does the preceptor letter have to include?** Your name and credential, the student's name and program, the day the rotation opened and the day it closed, the total hours you precepted, and a statement that you were the clinical preceptor of record. It needs a signature, a title and a date from a faculty member or the placement office, on program letterhead. Request it during the final week. **Does a preceptor orientation count as continuing education?** Not as accredited CE. The 90-minute orientation you complete before your first student covers supervision, documentation and the logging system, and it is training rather than a board-approved contact-hour activity. Neither board will accept it toward a CE requirement. The precepting hours themselves are what count, through the professional development category or the contact-hour substitution. **Can the same precepting hours count with two boards?** Some nurse practitioners hold certification from both ANCC and AANPCB, with separate cycles and separate rules. Neither board describes precepting hours as exclusive to it, so keep one well-documented letter per rotation and submit according to each handbook. Ask both boards directly before you plan a whole cycle around a single set of hours. ### Precepting vs adjunct teaching URL: https://www.nphours.com/off-the-clock/precepting-vs-adjunct-teaching/ Author: Dagny H., Payments · Published 2026-06-03 Open the adjunct offer letter and find the one number in it. It is a flat fee for the course, paid whether the section carries eight students or twenty, and the contract prices your teaching contact hours only. Preparation, grading and student email sit outside that number. Divide before you compare it to anything. #### Find the per-course figure first Adjunct contracts in nursing are written per course, not per hour. The letter names a fee for the term and lists what you owe against it: a set number of class or clinical contact hours, a syllabus, posted office hours, grades filed by a deadline. Nothing in the document prices the work that happens between those hours. To get a rate you can use, write the fee at the top of a page and list hours underneath it until you run out of duties. Then do the division with your own numbers. A fifteen-week course meeting three hours a week is forty-five hours in the room. Add two hours of preparation for every contact hour the first time you teach it, less the third time. Add grading, which rises with enrolment. The fee over that total is your real adjunct rate, and it is normally a fraction of what the contact hours alone would suggest. #### The hours a course fee leaves out Four kinds of hours live outside the fee. Preparation, heaviest the first term and lighter after. Grading, which scales with the roster and arrives in bursts at midterm and finals. Student email and office hours, which show up on the student's clock rather than yours. And the administrative tail: loading a syllabus, entering grades in a system you use twice a year, answering a coordinator about a student who stopped submitting anything. Ask the department two questions before you sign. What has enrolment in this section run over the last three terms, and does the fee move if enrolment doubles. A flat fee against a growing roster means your hourly rate falls and you hold no lever. Some schools add a per-student increment above a threshold. If that clause exists, it is worth more to you than a small rise in the base figure. #### What a student hour pays and what it costs Precepting prices the unit differently. One hour of student time is the unit, logged by the student and attested by you, at a rate you set once instead of per course. A standard rotation runs 120 logged hours. At the bottom of the NPhours band that rotation pays $1,440 and at the top it pays $2,400, released in two deposits across the block. Nothing is charged for preparation because there is none to charge: you are seeing your own patients. The cost here is throughput rather than evenings. Reckon on one fewer patient in each hour while a student learns your rooms and your rhythm, and less of a dent once they begin taking histories and drafting notes. On production pay, subtract that honestly. On salary it shows up as a longer day rather than a smaller deposit. Either way the subtraction happens once, at the front of a rotation, not weekly for a whole term. #### Schedule control and whether either stacks An adjunct course is pinned to an academic calendar. It meets when the catalogue says it meets, the term opens and closes on dates you did not pick, and stepping away mid-term leaves a department scrambling. Clinical adjunct assignments are harder still for a working clinician, because they land inside weekday clinic hours and often ask you to drive between student sites in the same afternoon. Rotations bend. You name the days and hours you will host a student and the block is built around them, two-day weeks and video-only afternoons included. Both forms of work stack with a clinical job in the sense that neither is your main income. Only one of them stacks on your own calendar. If your schedule shifts twice a quarter, a flat course fee is the harder promise to keep. #### Recertification credit under each The two boards buy teaching in different currencies. ANCC's renewal handbook treats precepting in your certified role as professional development, evidenced by a letter from the program, and names 120 preceptorship hours across the five-year cycle. AANPCB runs a conversion instead, letting a maximum of 120 precepting hours stand in for 25 non-pharmacology contact hours. Read the current handbook before you count on either, because categories get renumbered between editions. Adjunct teaching is less tidy here. A course load is not a stack of contact hours, and the categories that credit academic work are narrower than they look, so hold the handbook next to your contract before assuming a taught section earns renewal credit. What the title reliably buys is a line on a CV, a faculty email address and sometimes library access. Set that against a letter you can file with an application. #### Which one suits which clinician Take the course if you want the title, the classroom and a place in a department, and if your clinical week is steady enough to hold a fifteen-week promise. It is the better move for someone heading toward faculty work, because that path is built out of course evaluations, committee time and department relationships rather than out of student logs. Take rotations if you want paid hours that move when your clinic moves, and if the teaching you enjoy happens in a room with a patient in it. The two are not exclusive; plenty of clinicians hold an adjunct line in spring and host a student in July. If you are weighing either against per diem shifts or a telehealth panel, the hours-per-dollar comparison sits on the part-time work page. #### Questions **How do I work out what an adjunct course really pays per hour?** Take the flat fee in the contract and divide it by every hour the course will cost you, not only the contact hours. Count class or clinical time, preparation at about two hours per contact hour the first time through, grading that rises with enrolment, office hours and administrative work. Then ask whether the fee changes if the section grows. **Does precepting pay better than adjunct teaching?** Per hour it usually does, because precepting bills hours you were already at work. A 120-hour rotation through NPhours pays $1,440 to $2,400 once your chosen rate is applied, and your own panel keeps moving alongside it. An adjunct fee is fixed per course while the uncounted hours pile up at home. Divide each by its true hour count before deciding. **Can I hold an adjunct appointment and precept at the same time?** Yes, and many clinicians do both. The obligations rarely collide, since one sits on an academic calendar and the other on your clinic calendar. Check your adjunct contract for an exclusivity or outside-employment clause, and tell each side about the other so nobody is surprised. Precepting fees are independent contractor income even when the same school employs you as faculty. **Does an adjunct appointment count toward NP recertification?** Not automatically. Precepting has a defined route with both boards: ANCC accepts preceptorship hours as professional development when a program writes the letter, and AANPCB exchanges as many as 120 precepting hours for 25 contact hours outside pharmacology. Academic teaching is credited under narrower categories, so check your board's current handbook against your contract rather than assuming the course qualifies. **Which is better if I want to move into faculty work eventually?** The adjunct course, though precepting helps. Search committees read taught courses, student evaluations and department references, and an adjunct line puts you inside the building where those get written. Precepting builds the other half of the file: named programs, dates, student numbers, logged hours, and letters you can request at the close of each rotation. ### Preceptor tax credits by state URL: https://www.nphours.com/off-the-clock/preceptor-tax-credits-by-state/ Author: Dagny H., Payments · Published 2026-06-03 Six states pay preceptors through the tax code. Maryland and Hawaii each allow $1,000 per rotation. Alabama allows $425. Georgia scales from $375 to $750. Colorado pays $2,000 for a rural preceptorship. South Carolina sets conditions instead of a flat figure. Here is the table, with the strings attached to each line. #### The table, state by state Start with what each state actually pays an advanced practice nurse. These are the figures in current statute, and every one of them carries conditions that matter more than the dollar amount does. Maryland allows $1,000 for each rotation, up to $10,000 in a year, and only where the precepting is uncompensated and the site sits in a designated shortage area. Hawaii allows $1,000 per rotation with a $5,000 ceiling, and its credit is shared with physicians and pharmacists. Alabama pays $425 for every 160 hours of precepting and stops at $5,100, with nurse practitioners, nurse midwives, nurse anesthetists and physician assistants all named. Georgia sets $375 apiece for rotations one through three and $750 apiece for rotations four through ten, holds APRNs and PAs to $6,375, and is scheduled to sunset at the end of 2026 unless the legislature extends it. Colorado pays $2,000 for a qualifying rural preceptorship and allows as many as three in one year. - Maryland: $1,000 for each rotation, $10,000 annual cap, uncompensated precepting in a shortage area only. - Alabama: $425 for each 160-hour rotation, $5,100 annual cap, open to NPs, CNMs, CRNAs and PAs. - Georgia: $375 for rotations one to three, $750 for rotations four to ten, $6,375 cap for APRNs and PAs, scheduled to sunset 31 Dec 2026. - Hawaii: $1,000 for each rotation, $5,000 annual cap, shared with physicians and pharmacists. - Colorado: $2,000 for a qualifying rural preceptorship, no more than three in a tax year. - South Carolina: two or more rotations required, at a practice where at least 30 percent of patients are Medicaid, Medicare or self-pay. #### Why several of them require unpaid teaching The legislatures that wrote these credits were trying to buy something money was not already buying: teaching in places where nobody is paid to teach. So the statutes often say the precepting has to be uncompensated. Maryland says it plainly. Others say nothing about it, and silence is not the same as permission. If you accept a fee for a rotation and then claim a credit that assumes the rotation was free, that is a problem your preparer will find in April. It is a real fork if you want both. One way through is to separate them by student: take a fee for one rotation and precept the next one unpaid in a qualifying county, where the state's rules allow the split. Another way is to skip the credit and take the fee, which for most preceptors is the larger figure anyway. What you cannot do is assume the two stack because no line on the form says otherwise. #### A credit is not a deduction The two words get used as if they were interchangeable. A deduction reduces the income your state taxes, so its value depends on your rate: deduct $1,000 at a 5 percent rate and you keep $50. A credit reduces the tax itself. A $1,000 credit against a $1,400 state bill leaves you owing $400. That arithmetic is why a $425 preceptor credit is worth more than a $425 write-off, and why the small figures on this page are less small than they look. The next question is what happens when the credit is bigger than what you owe. Some states carry the unused part forward to a later year, some let it lapse, and some pay it out. That line lives in the state's filing instructions rather than in the headline figure, and it decides whether Colorado's $2,000 is worth $2,000 to you or worth only as much as your state liability that spring. Read it before you plan around the money. #### The federal bill that has not passed You will see the PRECEPT Nurses Act quoted as though it were already law. It is not. The bill proposes a $2,000 federal credit for nurses who precept without compensation, it has been introduced, and it has not been enacted. Bills die far more often than they pass. Until this one moves, there is no federal preceptor credit on any return, and any page that treats one as available is describing a proposal in the present tense. It is still worth knowing for one reason. The condition attached to the proposal is the same condition the states use, which is that the teaching be unpaid. A preceptor who is paid per block would sit outside it. That is not an argument for working free. It is a reason to notice that so far the tax code has chosen to reward the unpaid version of this work and has left the paid version alone. #### What to keep, and who to ask Each of these credits is a documentation claim, and the documentation is thin: the opening and closing dates of the rotation, the hours the student spent with you, the student's name and school, the address of the site, and a letter from the nursing program confirming that you served as preceptor. Ask the placement office for that letter during the final week, while your name is still in front of somebody. Four months later the same request takes three emails. Then confirm the current figures before you file. Caps change, professions get added, and credits expire, which is exactly what Georgia's is scheduled to do after 2026. Your preparer can tell you what your state allows this year, whether a fee disqualifies the rotation, and which form the credit lands on. If you are still deciding whether the credit or the fee is the better route for you, the wider market answer is on what preceptors actually get paid. #### Questions **Which states give nurse practitioners a preceptor tax credit?** Six of them: Maryland, Alabama, Georgia, Hawaii, Colorado and South Carolina. The amounts range from $375 for a first Georgia rotation to $2,000 for a rural Colorado preceptorship. Each state sets its own annual cap, its own definition of a qualifying rotation, and its own list of eligible professions. Confirm this year's rules with your preparer before you file. **Can I claim a preceptor tax credit if I was paid for the rotation?** Often no. Some of these credits, Maryland's being the clearest, exist specifically to reward teaching that nobody paid for, so a fee can disqualify the rotation entirely. Other states are silent, and silence is not approval. Have your preparer read your state's statute, and document paid and unpaid rotations separately so you can claim whichever one qualifies. **Is the PRECEPT Nurses Act law yet?** No. It is a proposed federal credit of $2,000 for nurses who precept students without compensation. The bill has been introduced in Congress and has not been enacted, so there is nothing to claim on a federal return today. Check the bill's status yourself rather than trusting an article that describes the credit as though it already exists. **How is a tax credit different from a deduction?** A deduction reduces the income that gets taxed, so what it saves you depends on your rate. A credit reduces the tax you owe, close to dollar for dollar. So a $425 preceptor credit takes roughly $425 off a state bill, while a $425 deduction saves you only the tax on that amount. Carry-forward rules differ by state. **What records do I need to claim a preceptor credit?** Keep the rotation dates, the total student hours, the student's name and program, and the clinic address. Add a letter from the nursing school confirming that you precepted that student, which states either require or accept as proof. Request it in the final week of the rotation. Some states also want the shortage-area or county designation for your site. ## Guides for prospective preceptors ### Becoming an acute care NP preceptor URL: https://www.nphours.com/acute-care-np-preceptor/ Acute care is the hardest population to precept part-time, and worth saying so first. The hours have to happen at the bedside, the credential match is strict, and a hospital adds a credentialing office to the paperwork. If you work inpatient or critical care shifts and your employer accepts students, a 120-hour block is roughly ten shifts with a learner beside you. #### The credential match is strict for this population Programs will not bend on this one. An adult-gerontology acute care student needs an acute care preceptor, and a primary care certification does not substitute even when the practice is genuinely inpatient. Some courses also accept an intensivist or a hospitalist physician, and a few accept a PA in the same service, but the population and the acuity have to line up with the certificate on your wall. The same logic runs the other way. If your certification is acute care, you are usually not the right preceptor for a family or adult primary care student, whatever your clinic experience was five years ago. Check the course name in the request before you get attached to the dates. A mismatch found in week one is a lost term for the student and an afternoon wasted for you. #### Hours accrue in shifts, not in clinic days Do the arithmetic in shifts and the block gets easier to picture. Ten twelve-hour shifts, or fifteen eight-hour ones, comes to 120 student hours. Most acute care preceptors run it as two shifts a week for five weeks, or one a week across a term, and the student follows your rota rather than a fixed weekday. That is a real advantage of the setting: nobody has to invent extra time. Nights and weekends are worth asking about rather than assuming. Some courses count them fully, some want a share of daylight hours because rounds, family meetings and consultants only happen then, and some limit consecutive shifts. Get the answer in writing before you offer a rota. It is the single most common source of a log dispute at the end of an inpatient rotation. #### Procedures and the supervision rule Students want procedures and hospitals control them. Your unit's student policy decides whether a learner may hold a probe, thread a line, place an arterial catheter or manage an airway, and it usually requires you at the bedside with your hands free. Nothing changes about who is responsible: you are, and a student never performs unsupervised, however capable they look on the third attempt. Build the ladder deliberately. Watch you twice, set up the kit, do the ultrasound survey, then perform the step you have agreed while you talk them through it. Have them log the procedure the same shift, with the supervision level recorded honestly, because faculty read that field. Debriefing while the tray is still open teaches more than a conversation the next morning. #### Why video almost never counts here The examination is hands-on, the patient is in a bed, and the reasoning happens on rounds with the chart, the monitor and the nurse in the same corridor. There is no version of that on a laptop. Programs know it, and inpatient courses generally require the hours in person, which is why acute care sits outside the telehealth part of this network. The exceptions are small and rarely enough on their own. A student can join a family meeting remotely, review imaging with you on a shared screen, or sit in on a tele-critical care service if that is genuinely how the unit works. Treat those as additions to a bedside block rather than a way to build one, and let the program rule before you count anything. #### What this network can and cannot arrange for you NPhours can match you with a student whose course fits your credential, handle the agreement between the program and your employer, run the onboarding paperwork, pay you and keep one coordinator on the rotation. What it cannot do is open a hospital that has closed its doors to students, shorten a credentialing queue, or place you where your manager has not agreed. Ask your service line first. That one conversation decides everything else. Pay does not vary with acuity. The block is 120 student hours, the half-block is 60, and your hourly figure sits anywhere from $12 to $20, so ten shifts return $1,440 at the lower end and $2,400 at the upper. It is released in two parts, at the midpoint and at the close, and it is self-employment income you will see on a January 1099-NEC. #### In order 1. Ask your service line: Whether the unit takes NP students at all, and who signs off. Everything else waits on that answer. 2. Confirm the certification fit: Acute care student, acute care preceptor. Read the course title on the request, not the student's degree. 3. Offer a rota, not a weekday: Ten twelve-hour shifts across five to twelve weeks, with the nights question settled in advance. 4. Agree the procedure ladder: What the student may attempt under direct supervision, per your hospital's own student policy. 5. Open your hours: Certification, unit, state and shift pattern. A coordinator will tell you honestly what is placeable. #### Questions **Can an acute care NP student do any hours by telehealth?** Very few. Inpatient courses expect bedside hours because the examination, the monitor and rounds cannot be reproduced on a screen. A family meeting joined remotely or a genuine tele-critical care service may be accepted as part of a block, never as the whole of one. Assume in person unless the program tells you otherwise in writing. **Does a primary care certification let me precept AGACNP students?** No, in almost every case. Acute care courses require supervision by someone certified for that population and acuity, and placement offices verify the certificate rather than the job description. If you work inpatient with a primary care certification, ask a coordinator which courses will accept you. Some hospitalist and subspecialty rotations have wider rules. **How is a block scheduled around twelve-hour shifts?** Count hours, not days. Ten twelve-hour shifts add up to the full 120 student hours, and five of them make a half-block. Preceptors typically take a student for one or two shifts a week and let them follow the rota, including the weekend shifts if the course permits them. The schedule is agreed before the rotation opens. **What does an inpatient rotation pay a preceptor?** The same hourly range applies as everywhere else on the network: you name a figure of $12 through $20 for each student hour and the total follows the hours logged. Ten twelve-hour shifts therefore earn $1,440 to $2,400. The first deposit follows your midpoint evaluation, the second follows the final one, and the whole of it is 1099 income. **Do I need hospital credentialing paperwork for a student?** Usually the student does, not you. Most hospitals require a learner to complete onboarding, health records, background screening and system access before a first shift, and that can take several weeks. Start the request early and tell the coordinator what your institution needs. Nothing about it is charged to you or to the student. ### Becoming an AGNP preceptor URL: https://www.nphours.com/agnp-preceptor/ Adult-gerontology primary care students need continuity: the same patients with the same four or five chronic conditions, seen more than once. If you hold AGPCNP certification and run a panel in internal medicine, geriatrics or long-term care, your ordinary Tuesday is already the curriculum. A 120-hour block is roughly one clinic day a week for a single academic term. #### The chronic panel is the curriculum Adult-gerontology courses are built around the conditions that fill your afternoon: type 2 diabetes, hypertension, COPD, heart failure, chronic kidney disease, hypothyroidism. What a student cannot get from a textbook is the second visit. Let them own eight or ten patients for the whole term. They read the last note they wrote, they see whether the change worked, and they learn that titration is a series of small decisions rather than one clever one. Give them the numbers to work with before the room. A student who has already pulled the last three A1c values, the home blood pressure log and the weight trend can present in ninety seconds and spend the visit on the patient instead of the chart. That habit also fixes the most common weakness faculty flag in adult-gero students, which is a plan that ignores what was tried in March. #### The Medicare annual wellness visit as a teaching case The annual wellness visit is close to a purpose-built student encounter. It has required elements, it is not driven by a presenting complaint, and it rewards a methodical learner: the health risk assessment, the medication list reconciled line by line, a cognitive check, immunisation status, screening due dates, and advance care planning if the patient wants it that day. A student can run all of it with you in the room. It also teaches documentation discipline, because the elements have to appear in the note or the visit was not that visit. Have the student read your last completed wellness note first, then draft one of their own for you to edit against the same checklist. Two of these in a term and they understand structured visits better than any lecture on billing could manage. #### Geriatric syndromes a student will not meet elsewhere Falls, polypharmacy, cognitive change, incontinence, frailty, weight loss: these are the presentations adult-gero students are examined on and the ones an urgent care rotation never surfaces. Pick one syndrome a week. Have the student do the gait observation, the orthostatic readings, the timed cognitive screen, the home hazards questions, and then say out loud which medication on the list is contributing. Deprescribing is the teaching set-piece here. Take a patient on eleven medications and ask the student to propose one to stop, with the reasoning, the taper and the follow-up interval. Then let them tell the patient. Most students have never watched anyone remove a drug from a list, and the conversation is harder than the pharmacology. Debrief it while the chart is still open. #### Care coordination counts as clinical time Half of adult-gero practice happens between visits, and students are allowed to log that time when it is patient care under your supervision. The home health order and the reason it will be rejected. The call to a daughter in another state. The medication reconciliation after a hospital discharge. The prior authorisation that decides whether your plan is real. Put the student on speaker for these instead of doing them after they leave. The skinny transitional care visit after a hospital stay is worth building a whole afternoon around. Discharge summary read aloud, medication list compared against the pre-admission list, follow-up appointments confirmed, red flags written down for the family. Students who have done four of those become the new graduates who catch the duplicate beta blocker on day one of their own job. #### Settings that fit, and the ones that mostly do not Internal medicine, family practice with an older panel, geriatric clinics, long-term care, assisted living rounds, home-based primary care and PACE programs all place adult-gero primary care students without argument. What tends not to work is urgent care and retail clinics: single visits, no continuity, and none of the syndrome work the course requires. Subspecialty clinics can take part of a block when faculty want that exposure, rarely the whole thing. Watch the credential line too. Adult-gerontology comes in two flavours, primary care and acute care, and a program will not accept the wrong one for its course. If you are AGPCNP certified, your students are the primary care ones. Inpatient and critical care students belong with an acute care preceptor, which is a different page and a different problem. Pay is unaffected by any of this. #### In order 1. Pick the teaching panel: Eight to ten patients the student will follow for the entire term, chosen in week one. 2. Book two wellness visits: Schedule them where the student can lead, mid-morning rather than at the end of a long list. 3. Choose a syndrome a week: Falls, medications, cognition, continence. One focus, one screening tool, one conversation to observe. 4. Name your rate and hours: Pick a number in the band, twelve dollars up to twenty, for time the log records. 5. Open your hours: Certification, state, setting and weekly availability. A coordinator answers the next working day. #### Questions **Does AGPCNP certification let me precept family NP students?** Sometimes, for the adult and geriatric portion of their log, and not for the pediatric or women's health columns. Programs decide this case by case and write the limit into the placement approval. If a family student is offered to you, ask which categories the course expects you to cover before accepting, so nobody is short of hours at the end. **Can adult-gerontology hours be done by video?** Part of them, usually. Chronic follow-ups, medication reviews, post-discharge check-ins and some cognitive screening work on camera with the student leading and you listening. Anything needing a gait assessment, an examination or vital signs measured in front of you stays in clinic. The program sets how much of the block may be virtual. **What does an adult-gero rotation pay a preceptor?** You choose an hourly figure inside a band that starts at $12 and stops at $20, then it applies to every hour the program's log shows. A full block of 120 hours works out at $1,440 to $2,400. It is paid in two halves by direct deposit, tied to the midpoint and final evaluations, and reported on a 1099-NEC. **Is long-term care an acceptable primary care site?** Often, and it is one of the better ones for this population. Facility rounds give a student polypharmacy, cognitive decline, functional assessment and family conversations in volume. Some courses want a share of hours in an ambulatory clinic as well, so a mixed placement with a colleague solves it. Ask the coordinator to check the syllabus first. **Do precepting hours help with my own recertification?** They can. ANCC treats teaching inside your own certification role as professional development, and its handbook sets a floor of 120 preceptorship hours over the five-year cycle, evidenced by a letter. AANPCB takes another route, converting a ceiling of 120 taught hours into 25 contact hours outside pharmacology. Confirm the current rules with your own certifying body. ### Becoming a DNP project mentor URL: https://www.nphours.com/dnp-project-mentor/ A DNP project mentor is the person at the site who makes a doctoral project possible: access to the unit, the data and the people, plus judgement about what can actually be finished. You are not supervising patient care, so these hours sit on the non-clinical side of the student's total. Most programs want a doctorate and always want a real role at the site. #### A project mentor is not a clinical preceptor The two roles get confused constantly, including by students. A clinical preceptor watches a learner assess and treat patients and signs for that care. A project mentor sponsors a piece of implementation work: you agree the aim, open the doors, tell the student which committee has to approve the change, and say when a plan will not survive contact with the unit. Nobody is being supervised in a room. The reporting line differs too. The student's faculty chair owns the academic standard, the methods and the grade. You own the site: feasibility, permissions, data access, and whether the intervention can run without disrupting care. When a student is caught between the two, your part of the answer is what the site will allow, and the chair settles the rest. #### Where these hours sit in the student's total Doctoral degrees work to a bigger number than master's degrees do. CCNE guidance puts the floor at 1,000 practice hours accumulated after the baccalaureate, and an NP course sitting inside that degree still has to reach the direct patient care minimum in the 2022 National Task Force standards, which is 750. Project and immersion work feeds the larger figure without counting as direct care. That distinction matters when the student asks you to sign a timesheet. Hours you mentor are logged under project or immersion headings, not under a patient care category, and faculty check which column they landed in. Ask to see the log format in week one. It takes five minutes and it prevents the conversation where forty hours have been entered against the wrong requirement. #### What you actually sign Expect four documents across the project. A letter or form from the site agreeing to host the work, usually signed by you and sometimes countersigned by an administrator. A mentor agreement naming your role, your credential and your hours. A determination form for the review board, since most quality improvement projects are classified as not-research and someone at the site has to say so. Then the evaluations. Evaluations come at the midpoint and at the end, and they are about the student's conduct of the work rather than their clinical skill: engagement with staff, follow-through, response to obstacles, quality of the final presentation. Write them plainly. If a student has not been on the unit since February, the form is where that gets said, not the exit meeting. #### Who qualifies to mentor a doctoral project Two conditions turn up on almost any mentor checklist. A terminal degree, usually a DNP or a PhD, though some schools accept a master's-prepared director when the faculty chair is closely involved. And a current position at the site where the project will run, with enough authority to grant access. A retired mentor with no current role rarely clears the second condition even with the right letters after their name. You do not need to be an NP, and you do not need board certification in any population, because no patient care is being supervised. Quality directors, nurse executives, informatics leads, pharmacy directors and physician medical directors all mentor projects. Pay follows the same band as clinical teaching: name your rate between $12 and $20 an hour, and 120 mentored hours comes to $1,440 or $2,400 or a figure in between. #### Project shapes that finish on time The projects that get done are small, measured and attached to something the unit already wants. A screening tool added to one clinic's intake with before and after rates. A discharge teaching protocol implemented on one floor. A handoff checklist with an audit at four weeks and twelve. A staff education intervention with a pre-test and a post-test. One aim, one unit, one measure, two academic terms. The ones that stall share a cause: no access to the data that would show whether it worked. Before you agree, find out who runs the report, whether the student can be given it, and how long the request takes at your institution. If the answer is nobody or six months, say so in the first meeting and help them pick a different measure. #### In order 1. Confirm your standing: Doctorate or an equivalent the program accepts, plus a current role and authority at the site. 2. Read the aim before agreeing: One sentence, one unit, one measurable outcome. Ask for a rewrite if it names three. 3. Check the data path: Who pulls the report, whether the student may see it, and how long the request takes. 4. Set the meeting rhythm: Thirty minutes every fortnight beats an hour that gets cancelled. Log the time as you go. 5. Open your hours: Credential, role, institution and availability. Say clearly that you mentor projects rather than clinical rotations. #### Questions **What is the difference between a DNP project mentor and a preceptor?** A preceptor supervises patient care and signs for direct clinical hours. A mentor sponsors the doctoral project at the site: access, permissions, feasibility and progress. The student's faculty chair remains responsible for methods and the grade. Many DNP students need both people during the same year, and one person occasionally fills the two roles at a single site. **Do I need a DNP or PhD to be a project mentor?** Usually yes. Most programs ask for a terminal degree because the mentor is guiding scholarly work, and some will accept a master's-prepared director when the faculty chair stays closely engaged. What no program waives is a current role at the site with the authority to approve access. Ask the coordinator which standard the specific program applies. **Do project hours count as clinical hours?** They count toward the doctoral total but not as direct patient care. The doctoral floor described by CCNE is 1,000 practice hours after the baccalaureate, and project work is logged inside that figure under a non-clinical heading. Direct care minimums are met separately, in supervised patient encounters with a clinical preceptor. **How many hours does mentoring a project take?** Less than a clinical rotation and spread further. A fortnightly half-hour meeting, a few hours reading drafts, some time opening doors internally, and the two evaluations. Many mentors log between 40 and 120 hours across two terms. You are paid on the hours the student's log records, at the rate you chose when you joined. **Can I mentor a project at a site where I no longer work?** Rarely. The value of a mentor is current standing: you can get the meeting, the data and the permission. Programs know it, and site approval forms usually require a signature from someone employed there. If you have retired from the site but still hold a role elsewhere, a project can often be reframed around your current organisation. ### Do NP preceptors get paid? URL: https://www.nphours.com/do-np-preceptors-get-paid/ Sometimes, and it depends entirely on who arranged the rotation. Money for precepting comes from three places: a stipend paid by the nursing program, a fee paid by a matching network, or a credit against your state income tax. Plenty of preceptors are paid from none of the three and teach for free. #### Why the answer is not a simple yes Precepting grew up as an unpaid professional duty, the way attending physicians taught residents. Most nursing programs still budget nothing for it and rely on goodwill, alumni loyalty and clinicians who remember their own student year. That model held while cohorts were small. It stopped holding when enrolment grew and the same clinicians started getting four requests a term for the same clinic day. So payment appeared unevenly, from different directions, and nobody publishes a rate. Two nurse practitioners in the same city can teach identical rotations in the same month, one for nothing and one for a four-figure fee, purely because of who arranged the placement. If you want to know what a specific rotation pays, the only reliable move is to ask the party requesting it before you agree. #### Source one: a stipend from the program Some schools pay preceptors directly, usually a flat honorarium per rotation rather than an hourly figure. It tends to appear where placements are hardest to fill: psychiatric courses, rural sites, and terms where a cohort is short of hours. The amount is set by a department budget, so it varies from token to substantial, and it is often available only on request rather than advertised. Many programs offer non-cash compensation instead, and it is worth knowing what to ask for. Library and database access. An adjunct or clinical instructor title you can put on a CV. Continuing education vouchers. A letter documenting your teaching hours for recertification. None of that pays a mortgage, and some of it has real value. Ask the clinical placement coordinator what the school can offer, in writing. #### Source two: a matching network Networks contract with programs to find and support preceptors, then pay the preceptor per rotation. Most platforms report per-rotation figures clustered around $1,200 to $1,440 for roughly 120 hours, based on 2024 figures. That works out to roughly the price of a long weekend, spread across a term, for one day a week of teaching alongside work you were doing anyway. On NPhours you choose your own rate inside the band, so a 120-hour block pays $1,440 to $2,400, arriving as two direct deposits at the midpoint and final evaluations. The network route also carries the paperwork, which matters more than it sounds: an affiliation agreement negotiated by somebody else is several hours of your life you keep. The rate card has the detail. #### Source three: a state tax credit A dozen or so states let preceptors claim a credit against state income tax for qualifying rotations. The mechanism is worth understanding because it is unlike a paycheque. You precept, the program certifies the rotation, and you reduce what you owe your state when you file. Credits are usually capped per year, often restricted to shortage or rural areas, and several require that the rotation was uncompensated, meaning you cannot take a fee and the credit both. Rules change yearly and one state's credit is scheduled to expire, so confirm the current statute with your tax preparer before you count on a figure. A federal bill proposing a $2,000 credit for precepting has been introduced and has not been enacted. The state by state table lives in the tax credit piece, which is the one place we keep it current. - Ask whether your state's credit requires uncompensated precepting before accepting a fee. - Ask whether the site has to sit in a designated shortage or rural area. - Ask how many rotations a year you may claim and what the annual cap is. - Keep the program's certification letter with your tax records, not in your inbox. #### The return that is not money Certification renewal counts teaching. ANCC's renewal handbook describes 120 preceptorship hours over a five-year cycle as one route through a professional development category, documented by a letter from the program. AANPCB lets precepting substitute for part of the non-pharmacology continuing education requirement, at 120 hours for 25 contact hours. One block, documented properly, can cover a renewal requirement you would otherwise buy. There is a professional return as well. A teaching line on a CV opens doors to faculty work, and students who trained with you become colleagues who refer. Neither replaces a fee. Both are reasons a preceptor keeps saying yes after the first rotation. Do not accept a promise of continuing education credit for a preceptor orientation, though: an orientation is preparation, not accredited education. #### In order 1. Ask the program first: Does it pay a stipend, and if not, what non-cash compensation exists. Get the answer in writing. 2. Check the network rate: Compare the per-rotation figure against the hours it actually asks of you, not the calendar length. 3. Read your state's credit rules: Amount, cap, location requirement, and whether payment disqualifies the claim. 4. Count the recertification hours: Decide whether one rotation could replace continuing education you would otherwise pay for. 5. Then decide the price of your day: A single clinic day each week across the term is the real cost. Weigh the fee against that. #### Questions **Do nursing programs pay preceptors?** Some do and many do not. Where a stipend exists it is usually a flat honorarium per rotation, offered most often for hard-to-fill psychiatric or rural placements. Other schools compensate with library access, a clinical instructor title, or continuing education vouchers. Ask the clinical placement office directly, because the answer is rarely published anywhere. **How much does a preceptor get paid for one student?** Where a fee is paid at all, the common range across matching platforms is $1,200 to $1,440 for about 120 hours, using 2024 figures. On this network the total follows the hourly rate you picked, so a full block lands somewhere from $1,440 to $2,400. Unpaid rotations remain the most common arrangement nationally. **Can I be paid and still claim my state's preceptor tax credit?** Often not. Several state credits are written specifically for uncompensated precepting, so accepting a fee disqualifies the claim for that rotation. Other states impose no such condition. Because statutes change and annual caps differ, confirm the current rule with your tax preparer before choosing between a fee and a credit. **Does precepting count toward recertification?** Yes, in both major certification systems, with documentation. ANCC treats preceptorship hours as one route through a professional development category over the five-year renewal cycle. AANPCB permits precepting hours to take the place of some non-pharmacology continuing education. Either way you need a letter from the program stating the hours and dates. **Is preceptor pay taxable?** Yes. Fees paid by a network or a program are self-employment income, not wages, so no tax is withheld and you owe income tax plus self-employment tax on it. A 1099-NEC arrives each January when the year's payments reach six hundred dollars. Quarterly estimates are the usual way people handle it. ### Becoming an FNP preceptor URL: https://www.nphours.com/fnp-preceptor/ An FNP student cannot finish a rotation in one narrow slice of practice. The program wants hours across the lifespan: children, adults, older adults, and women's health, usually logged and counted separately. If your schedule covers most of that in a week, one clinic day for a term will close a 120-hour block, and you set the rate you are paid for it. #### The age groups a family log tracks separately Look at your own week before you answer a match. An FNP course usually splits the clinical log into pediatrics, adult, geriatrics and women's health, and the student has to show entries in each column. That is why a practice seeing adults only can clear the credential check and still fail the placement review. Your student is not asking for 120 hours of whatever walks in. They want 120 hours that land in four buckets. Ask for the log's category headings in week one and keep them next to your screen. When a four-year-old with an ear complaint hits the schedule, that room goes to the student even though you would be quicker. When the pediatric column looks thin at the halfway mark, hand over the well-child slots and the sports physicals for a fortnight. Watch the buckets from day one and no faculty adviser emails you in week ten. #### Well visits and episodic visits teach different skills A well visit is where a student learns structure. The history has a fixed shape, the screening is protocol-driven, and the counselling can be rehearsed and corrected. Give a new student two of these in a morning and you hear their whole method out loud without risking the pace of the day. It is also the visit type where improvement is visible week over week, because the task barely changes and their fluency does. Episodic visits test reasoning instead. A sore throat, a rash, a knee that gave out on a stair: the student has to commit to something and defend it. Keep these short at first. Two minutes of history from them, your own quick confirmation in the room, then the plan discussed at the door. Handing over the episodic mix usually gets easier around week four, once you know how their differential tends to fail. #### A family practice day with a student in it Budget the first two weeks honestly. A learner costs you roughly one patient an hour while they work out your rooms, your EMR and your staff. Most family preceptors absorb that by staging: the student takes the first patient of each hour, presents in the hallway, and you both walk back in. You are present for every plan, and the student drafts the note you edit and sign. By week five the arithmetic flips. A capable FNP student carries four to six visits a session, and your part shrinks to two questions at the door. Teaching between rooms is its own skill, and the one-minute frame is the version that survives a full schedule. Read the method in Off the Clock and try it on a single afternoon before committing to it for a whole term. #### What converts to video and what stays in the room Follow-ups are the part of family practice that travels. A blood pressure recheck against home readings, a diabetes titration, a depression follow-up, a medication review after a hospital stay: the student can lead any of those on camera while you listen, and you hear every word they say. Rashes, ears, abdomens and anything needing a hand on the patient stay in the building. Pediatric well visits mostly do not convert, because growth measurements, immunisations and the exam all need the room. So a mixed family rotation tends to look like adult chronic care by camera and everything pediatric in clinic. Programs set the ceiling on video hours, not preceptors, and that figure sits on the match card before you accept. The teleprecepting page covers how the video half actually runs. #### Why a family rotation gets declined: the setting is too narrow The most common rejection has nothing to do with your credential. The clinic simply cannot produce the mix. Urgent care is the classic case: high volume, good pathology, no continuity and almost no well visits, so a primary care course will often refuse it or accept part of the hours. Aesthetics, occupational health, weight clinics and single-organ subspecialties hit the same wall. Describe your week accurately in the application and the problem goes away. Say what your youngest and oldest patients look like, whether you do women's health yourself, and how much of your schedule is booked ahead. A coordinator can match a narrow setting to a course that wants exactly that, or add a second site for the age group you lack. Guessing on the form is what produces a decline. #### In order 1. Audit your age mix: One month of your own schedule, sorted into children, adults, older adults and women's health. 2. List your visit types: Well versus episodic, booked versus same-day, and which of them you already do by camera. 3. Pick the day: Eight or nine hours a week for a term closes a full block; half that closes a 60-hour half-block. 4. Open your hours: Credential, state, weekday and the rate you want. A coordinator answers inside one business day. #### Questions **What does an FNP student need from a family preceptor?** Encounters across the lifespan, supervised and countersigned. Most FNP courses divide the log into pediatric, adult, geriatric and women's health categories and expect entries in each, plus a mix of well and episodic visits. They also need you present for every plan, since no student sees patients alone, and your signature on two evaluations. **Can a family practice preceptor cover women's health hours?** Often yes, if you do contraception counselling, cervical screening or menopause care yourself. If all of it goes out by referral, that column stays empty and the student needs a second site. Say so at the start rather than the midpoint, and a coordinator can place the remaining hours elsewhere in the same term. **Does urgent care count toward FNP clinical hours?** Sometimes, and rarely for a whole block. Urgent care gives a student volume and undifferentiated complaints, which faculty do value, but it offers little continuity and few well visits. Many programs cap how much of the primary care requirement an urgent care site can supply, and some decline it outright. The course syllabus settles it. **How many FNP students can I take at the same time?** One, in practice. Two learners in a family clinic means two logs, two evaluation cycles and a schedule with no spare rooms. Programs also tend to prohibit stacking students on one preceptor for the same hours. If you want more volume, take one student a term back to back instead. **What does precepting an FNP student pay?** You set a rate between $12 and $20 per student hour, so a 120-hour block returns $1,440 at the bottom and $2,400 at the top. It arrives as two direct deposits, one after the midpoint evaluation and one after the final. Anything at or above $600 in a year comes with a 1099-NEC in January. ### Freelance nurse practitioner work URL: https://www.nphours.com/freelance-nurse-practitioner/ Freelance means you are a business, not an employee. Nobody withholds your tax, nobody insures you by default, and a contract rather than a handbook sets the terms. The upside is real: you choose the work, the volume and the price. The paperwork that comes with it is the part people underestimate. #### What changes the day you stop being an employee Four things change at once. Nothing is withheld from what you are paid, so the tax bill arrives whole and on your own schedule. There are no benefits: no health plan, no paid leave, no retirement match, no disability cover unless you buy it. Your protection against a claim depends on a policy somebody has to name you on. And the terms live in a document you sign rather than a personnel policy you inherit. The kinds of work available are wider than most nurse practitioners expect. Locum and per diem clinical shifts. Telehealth panels billed by visit. Chart and utilisation review for insurers. Medical writing. Expert witness work. Adjunct teaching. Precepting students. Each carries a different contract, a different insurance answer, and a different amount of chasing to get paid. #### Read the contract for six things Scope first: what exactly you are being paid to do, and what falls outside it. Then the unit and the rate, because per hour, per visit, per chart and per rotation are not comparable until you convert them. Then payment timing, in days, with a named trigger. Then termination: how either side ends it and with what notice. Then indemnification, which is the clause that decides who pays if something goes wrong. Sixth, and most missed, is insurance. The contract should say plainly whether you are covered under someone else's policy or expected to carry your own, and if your own, at what limits. Ask for the certificate rather than the assurance. A one-page contract that answers those six questions is safer than a long one that leaves insurance vague. - Scope of work, with the tasks that fall outside it named. - Rate and unit, converted to a comparable hourly figure before you agree. - Payment trigger and payment window, in days rather than adjectives. - Termination notice on both sides, and what happens to work in progress. - Indemnification, and the insurance certificate that backs it up. #### Malpractice, and who is actually carrying it For clinical contract work the usual answer is that you carry a policy of your own, either occurrence based or claims made with a tail bought when you leave. Check whether the contracting entity's cover reaches you or only its employees, because the second is common and is not always said out loud. Limits should match what your specialty and state expect. Precepting is a narrower question. Nursing students carry their own liability policy through the school, and the program supplies a certificate as part of the placement paperwork. You remain the treating provider and your existing cover for your own patient care is what applies to the visit. Ask your carrier whether supervising a student is included, and read the liability piece before your first rotation. #### Getting paid, and paying tax on it Most freelance work runs on invoices. You submit, somebody approves, and thirty or forty-five days later the money moves, occasionally after two reminders. Keep a simple numbered invoice log, note the date each one was sent, and follow up in writing at the payment window rather than a week after. Precepting on this network is the exception: no invoice exists, and the two deposits are triggered by the evaluations rather than by anything you send. Set money aside as it arrives, because self-employment tax and income tax both land on the same figure. Most freelancers pay quarterly estimates and reconcile at filing. The 1099-NEC that shows up in January covers any payer who crossed six hundred dollars with you, and anything under that threshold is still taxable income. Confirm your own numbers with a preparer rather than with a forum. #### Where precepting sits among the options Judged as freelance work, precepting has three unusual features. Setup is short: four documents and a 90-minute orientation, with the school agreement negotiated for you. There is no marketing, no bidding and no client hunting, because demand comes from nursing programs on an academic calendar. And the fee is paid for hours you were already working, so the income does not cost you free time. The limits are just as clear. Demand is seasonal, arriving in waves before January, May and August terms. The hourly figure is a teaching rate rather than a clinical one, floored at twelve dollars and capped at twenty. And you cannot scale it far: one student a term is comfortable, two is a strain. It works best as one steady line in a mixed freelance year. #### In order 1. Separate the money: A dedicated account for contract income makes quarterly estimates and record keeping much easier. 2. Write your own rate sheet: One figure per unit: per hour, per visit, per chart, per rotation. Then stop negotiating from nothing. 3. Settle the insurance question in writing: Your own policy or theirs, with the limits named and a certificate in your files. 4. Reserve tax as each payment lands: Self-employment tax plus income tax on the same amount. A preparer names the fraction. 5. Keep the licence and certification current: Practice hours and continuing education have to keep accruing, or the work ends with them. #### Questions **Is precepting 1099 income or wages?** It is 1099 income. You are contracted one rotation at a time, nothing is withheld, and no employment relationship is created with the network or the school. Expect a 1099-NEC from any payer that crossed the six hundred dollar mark with you. Treat it like your other contract income and reserve tax as it arrives. **Do I need malpractice cover of my own to teach a student?** You need cover for your own patient care, which you almost certainly already have through your practice. The student carries a separate liability policy through their school, and the program provides proof of it in the placement paperwork. Ask your carrier to confirm that supervising a student is within your policy, and keep the reply. **Do I have to invoice for precepting hours?** Not on this network. Payment is triggered by the two evaluations rather than by a document you send, so half arrives once the midpoint form is in and the balance after the final. What you do have to do is confirm the student's hour log, because the log is the record the payment is calculated from. **What can a freelance nurse practitioner deduct?** The mechanism is that ordinary and necessary business expenses reduce self-employment income: licensure and certification fees, continuing education, professional insurance, a home office used only for the work, mileage between contract sites. What qualifies in your case depends on facts a preparer needs to see. Keep receipts as you go rather than reconstructing them in April. **Do I need an LLC to work as a freelance NP?** Many nurse practitioners contract as sole proprietors without one, and precepting requires no entity at all. An LLC or S corporation can change liability exposure and tax treatment, which is a conversation for an accountant and a lawyer rather than a web page. Start the work, then decide with real numbers in front of you. ### How to become a preceptor URL: https://www.nphours.com/how-to-become-a-preceptor/ You become a preceptor by proving three things to a nursing program: an active license, board certification in the population you would teach, and at least two years of practice since certification. After that it is paperwork, an orientation, and a start date. On NPhours the whole sequence takes about three weeks from application to a signed affiliation agreement. #### Check that you qualify before you fill anything in Programs verify four things, and they verify them in the same order every time. Your license has to be active and unencumbered in the state where you see patients. Your national certification has to match the student's track: an FNP student needs an FNP or a physician in family practice, a PMHNP student needs a psychiatric provider. Most programs then ask for a minimum period in practice after certification, and two years is the common figure. The fourth check is your setting, because a student in a primary care course cannot bank hours in a subspecialty clinic even if the preceptor is credentialed for it. If you are an RN with a master's degree and no NP certification, the path is different but real. MSN education and leadership tracks need preceptors in teaching and management roles, not prescribers. The requirement there is the degree plus a current position in that function. Read the eligibility page before you go further, because a mismatch on any one of the four points is the most common reason an application stalls. - Confirm your license shows no restriction, probation or pending action on the state board lookup. - Pull your board certification card and note the expiry date; programs will not accept one inside 90 days of lapse. - Count the months since your certification date, not since graduation. - Write down the visit types your clinic sees in a typical week; a coordinator will ask. #### Decide how many hours you can give, and in what form A standard block is 120 student hours, and most students need to finish it inside one academic term of 14 to 16 weeks. That works out to eight or nine hours a week, which for most preceptors is one clinic day. A half-block of 60 hours fits a preceptor who can give one half-day a week or a full day every other week. Decide this before you apply, because the number drives which students you will be shown. Then decide the mode. If your practice already runs video visits, a share of a student's hours can usually happen by telehealth, and psychiatric and primary care follow-ups convert well. Acute care and procedural specialties mostly do not. The program, not the preceptor, rules on what its students may count by video, and the ruling is written into the agreement, so nobody is guessing later. #### Apply, then let the program verify you The application on NPhours takes about ten minutes: credential, specialty, state, the hours you can give, and whether you precept in clinic, by video or both. A coordinator replies within one business day with any gaps. Once you are on the roster you upload a current CV, a copy of your license and certification, and a short description of your practice. Those four documents are what a program's clinical placement office reads before it approves you. Approval runs on the program's clock, not ours, and typically takes one to two weeks. During that time the affiliation agreement between the program and your practice is drafted or, if one already exists, confirmed. You do not chase any of it. When the agreement is signed you are eligible to accept students from that program, and the next one that matches your specialty, state and hours appears in your queue. #### Take the orientation and accept your first student Before a first student, every preceptor on NPhours completes a 90-minute orientation covering the teaching frameworks, the log the student keeps, the two evaluations you sign, and how the clinic day changes with a learner in it. It is not accredited continuing education and is not sold as such. It exists so that the first week goes the way the fifth week does. Your first match arrives as a card: program, course, dates, hours, specialty, mode, and the student's stated interests. You accept or decline, and a decline costs you nothing. When you accept, the coordinator confirms the start date with the program, sends the student your clinic's onboarding list, and stays on the rotation until the final evaluation is in. Pay lands at the midpoint and at the end. #### In order 1. Verify eligibility: License active, certification matching the student's population, two years since certification, and a setting the course accepts. 2. Set your hours and mode: A block, a half-block, or a custom count; in clinic, by video, or a mix your program partner approves. 3. Apply and upload four documents: CV, license, certification, practice description. A coordinator answers within one business day. 4. Program approval and agreement: One to two weeks on the program's side while the affiliation agreement is drafted or confirmed. 5. Orientation, then your first match: Ninety minutes of preparation, then a student card you can accept or decline. #### Questions **How long does it take to become a preceptor?** About three weeks on NPhours, most of it waiting on the program. The application takes ten minutes, the document upload another ten, and program approval one to two weeks. If your practice already holds an affiliation agreement with the program, approval is faster. The orientation is 90 minutes and can be done while approval is pending. **Do I need a doctorate to precept NP students?** No. A master's-prepared NP with current board certification and two years of practice in the population meets the rule most programs set for clinical precepting. DNP project mentors are the exception: programs usually ask for a doctorate there because the mentor is guiding scholarly work rather than patient care. **Can I precept if I work part-time?** Yes, if you can give a student eight to nine hours a week for a term, or roughly half that for a half-block. What matters is that the student's hours are with you seeing patients in the population the course requires. A two-day-a-week clinician can precept one student a term without changing their schedule. **Does my employer have to agree?** Usually yes, because the affiliation agreement is signed between the program and your practice, not with you personally. Most practices already hold such agreements or are glad to sign one. If you own the practice, you sign it. A coordinator handles the drafting and the back-and-forth either way. **What if a program rejects my application?** It happens most often when the certification does not match the student's track or the setting does not fit the course. Neither is a judgment on you. A coordinator will tell you the reason, and you stay eligible for other programs on the network whose rules your credential meets. Nothing is charged to you at any point. ### Becoming a nurse educator preceptor URL: https://www.nphours.com/msn-nurse-educator-preceptor/ An MSN education practicum has nothing to do with prescribing. The student needs supervised hours teaching nurses or nursing students, so the preceptor is a nurse who already teaches. If you hold an MSN or higher, an active license, and a current instructional role, you qualify without any population certification. A 120-hour practicum is one teaching day a week for a term. #### The credential here is your teaching role This is the one track where board certification in a patient population is beside the point. What programs check is the degree, the license, and whether you currently teach. Full-time faculty, adjunct clinical instructors, simulation coordinators, staff development educators, residency program leads and nurse educators in a hospital learning department all qualify. A master's degree earned in education, leadership or a clinical specialty is equally acceptable. What does disqualify is the absence of a current teaching assignment. A practicum student needs to be somewhere teaching happens on a schedule, with learners, objectives and evaluations already in place. If you taught two years ago and now work a clinical role, wait until you are back in front of a class rather than trying to build a practicum out of one guest lecture. #### Where the hours come from Three venues cover most practicums. The classroom, where the student plans and delivers content. The simulation lab, where they run a scenario and lead the debrief. And clinical instruction, where they supervise a group of undergraduate nurses on a unit while you keep the responsibility. A student who touches all three finishes with an honest picture of what the job involves, including the parts nobody mentions. Add the invisible work, because it counts and it is the part new educators underestimate. Writing objectives. Building a rubric. Marking twenty papers and defending the marks. Sitting in a curriculum meeting. Answering an email from a student who failed. Let them do a share of that beside you and log it. The teaching load is not the contact hours. #### The simulation lab is the best place to start Simulation gives you a controlled room, which is exactly what an inexperienced teacher needs. Let the student run a scenario you have already used: they set the objectives, brief the participants, operate or direct the case, then lead the debrief while you sit outside the circle. Debriefing is the skill worth the whole practicum, and it is the one most students have never attempted. Watch two specific things and tell them afterwards. Whether they asked a question and then waited long enough for an answer, and whether they let the group find the error instead of announcing it. New educators fill silence and give the answer away. Naming those two habits in the first fortnight changes the rest of the term. #### The teaching project and how it gets evaluated Nearly every education practicum includes a built artefact: a lesson or module the student designs, delivers and then assesses. Measurable objectives, a teaching strategy that matches the content, materials, and an evaluation instrument that tests what the objectives claimed. Review the draft before delivery, sit in the room while it happens, and then make them look at how the quiz questions performed rather than only at the scores. Your evaluation form asks about teaching, not about clinical judgement. Preparation, clarity, classroom management, use of evidence, responsiveness to learners, quality of feedback given. Grade it as you would want yours graded: one strength described concretely, one behaviour to change, and a sentence on whether they are ready to teach a group alone. Faculty read the midpoint form closely, so write something usable in it. #### Why the queue for these preceptors grows every spring Education practicums bunch at the end of a program, and cohorts finish in spring, so requests arrive in clusters between February and May. There are also fewer qualified hosts than for clinical rotations, because the pool is nurses who teach rather than every certified NP in a state. If you can host in that window, you will not wait long for a match. The schedule is friendlier than a clinical block too. Teaching happens in evenings, in intensive simulation days, and online, so a practicum can run on hours that would never work for a patient rotation. Pay uses the same band as every other role on this network: your hourly number sits somewhere from $12 up to $20, which puts a 120-hour practicum between $1,440 and $2,400, released in two deposits. #### In order 1. Confirm the two requirements: An MSN or higher plus a current teaching assignment. No population certification is needed. 2. Map your teaching term: Which weeks hold lectures, simulation days and clinical groups. That calendar is the practicum. 3. Choose the project slot: Pick the session the student will design and deliver, early enough to revise the plan twice. 4. Set your rate and hours: Your hourly figure inside the network band, and the number of hours you can genuinely supervise. 5. Open your hours: Degree, license, teaching role and institution. Mark the education practicum box on the form. #### Questions **Can an RN with an MSN precept nurse educator students?** Yes, and that is exactly who these programs want. The requirements are a master's degree or higher, an active unencumbered license, and a current role in teaching. Nurse practitioner certification is not part of it, because no patient care is being supervised. Hospital educators and adjunct clinical instructors are placed as often as full-time faculty. **What do nurse educator practicum hours involve?** Supervised teaching work: planning and delivering content, running simulation and debriefs, supervising a clinical group, writing objectives and rubrics, marking, and taking part in course administration. Programs usually want a spread across those rather than one activity repeated. The hours are logged as education practicum time, separate from any clinical category. **Can an education practicum be completed online?** Often a large part of it. Online courses, virtual simulation, recorded lectures and remote grading are all normal teaching work now, so the practicum can follow. What the program decides is how much may be remote and whether some in-person teaching is required. That is agreed in writing before the term starts. **How much does precepting an MSN education student pay?** The same rate structure as clinical precepting. Preceptors name an hourly figure inside the band, apply it to the hours the log shows, and a full 120-hour practicum lands between $1,440 and $2,400. Money arrives in two transfers, one after the midpoint evaluation and one at the close. Totals of $600 or more bring a 1099-NEC. **Do I need to hold a teaching certification?** No. Certified nurse educator credentials are welcome and never required. Programs ask for the degree, the license and the current role, and some also want a short teaching CV showing the courses you cover. If a specific school has an extra condition, a coordinator will tell you what it is before dates are discussed. ### NP preceptor jobs URL: https://www.nphours.com/np-preceptor-jobs/ An NP preceptor opening is a request from a nursing program for one student to spend a set number of hours in your clinic during one academic term. You are not hired and you do not change employers. You add a learner to days you already work, and you are paid per hour of student time. #### What an in-clinic opening asks of you The request is specific: this course, this student, these dates, this many hours, in your practice. Most preceptors fill it with one clinic day a week for a term. You need somewhere for the student to sit and write, a way for them to see the chart, and the willingness to run a slower clinic at the start. Plan on one fewer patient each hour for the first two weeks. The gap closes around week four. Mixed rotations are common now. A student spends most hours in your exam rooms and the rest on your telehealth afternoons, with the split written into the placement before it starts. Read-only student access to your record system is usually the only technical item to sort, and the piece on student EMR access covers how practices handle it. #### How openings break down by specialty Family practice generates the largest raw number of requests, because family tracks enrol the most students and their hours have to be spread across ages. Psychiatric mental health generates the greatest shortage, which is a different thing: fewer requests than family in absolute terms, far fewer preceptors available to take them. Adult-gerontology primary care sits third and is steady, driven by chronic disease and Medicare wellness visits. The smaller tracks are limited by setting rather than by interest. Pediatric requests need a well-child schedule. Women's health requests need contraception, prenatal or menopause volume. Acute care requests need an inpatient service and a preceptor rounding on it. Education and leadership practica need no patients at all, only a master's-prepared nurse doing that work today, which is why an RN with an MSN can take them. - Family: highest volume of requests, widest range of acceptable settings. - Psychiatric: highest ratio of students needing hours to preceptors offering them. - Adult-gerontology: reliable demand in internal medicine, geriatrics and long-term care. - Pediatrics and women's health: fewer requests, tighter setting requirements. - Acute care: inpatient only, and almost never by video. #### Why rural clinics see more requests than city ones Urban teaching practices are already crowded with learners. Medical residents, PA students and NP students compete for the same exam rooms, and a placement office that has been told no three times looks further out. Rural and small-town clinics have the opposite problem: plenty of undifferentiated volume, very few clinicians available to teach it. A single family NP in a county of nine thousand people can be the only option for a whole cohort. That imbalance shows up in the queue. If you practise outside a metro area, you will be offered more students than a colleague in the same specialty downtown, and you will be offered them earlier. Federally qualified health centres and community clinics see the same effect. Several states also run tax credits aimed squarely at rural precepting, which the tax credit piece in Off the Clock lays out state by state. #### Term starts, and how a request reaches you Nursing programs start clinical courses in January, May and August, so requests land in waves. Placement offices begin looking six to ten weeks ahead, which means October and November for spring, March for summer, and June for autumn. Apply in one of those windows and cards appear quickly. Apply in September and you may wait for the new year, then see three inside two weeks. You are not searching listings. Your credential, population, state, weekly hours and mode sit on file, and a request that fits them is sent to you with a window to answer. Nothing goes to a program until you accept. Matching covers how that works and scheduling covers blackout weeks, so two weeks away in June costs you nothing. #### How this differs from an adjunct faculty post An adjunct appointment is employment by a university. You are given a course, a syllabus, a roster, grading deadlines and a semester contract, and you answer to a department. Precepting has none of that. There is no course to build, no lecture, no exam to write, and you do not assign a grade. You sign two evaluations describing what the student can do, and faculty convert those into a grade. The pay structures differ too. Adjunct work pays a fixed amount per course regardless of the hours it eats. Precepting pays for measured student time: your own hourly figure, set once somewhere from twelve to twenty dollars, applied to the hours the log shows. Half arrives at the midpoint evaluation and half at the final. The part-time comparison puts both against per diem shifts. #### In order 1. File your profile once: Credential, population, state, clinic days available, and whether you would take mixed hours. 2. Time it to a term: October, March and June are the busy windows for spring, summer and autumn starts. 3. Read the request: Course, dates, hours, student year, and what the program expects you to sign at the end. 4. Accept or decline: Either answer is fine and neither is negotiated. A decline keeps you in the queue for the next one. #### Questions **Are NP preceptor jobs employment or contract work?** Contract work, one rotation at a time. You stay employed wherever you are employed now and take a student on days you already see patients. No benefits, no title, no new manager. The income is reported on a 1099-NEC each January when the year's total reaches six hundred dollars, so set something aside for tax. **Which specialties have the most preceptor openings?** Family practice by volume and psychiatric mental health by scarcity. Adult-gerontology primary care follows both. Pediatrics, women's health and acute care produce fewer requests because the setting requirements are narrower. Nurse educator and leadership practica are the quiet exception: they need no clinical setting, only a master's-prepared nurse currently teaching or managing. **Do I need to work in a large practice to take a student?** No. Solo and two-provider practices take students constantly, and small clinics often teach better because the student is not competing with residents for the interesting cases. What you need is space for the student to write, chart access, and a schedule with enough of the visit types the course requires. **When should I apply if I want a student in the spring?** October or November. Placement offices work six to ten weeks before a term begins, and January courses are largely settled by mid-December. Applying later still works, it just means waiting for the following wave. Approval and paperwork take a couple of weeks on the program's side, so early is genuinely better here. **Can I precept in a specialty clinic?** Yes for students whose course matches your setting, and for elective rotations where a program wants focused exposure. A primary care practicum is the case that usually fails, because it needs undifferentiated visits your schedule may not contain. Describe your typical week when you apply and coordinators will only send requests that fit it. ### NP preceptor requirements URL: https://www.nphours.com/np-preceptor-requirements/ Eligibility comes down to four checks. An unencumbered license. Certification from a national board covering your student's population. Two years of practice since that certification. A clinical setting the course will accept. Fail one and the program declines the placement, no matter how strong the other three look. This page covers only those rules. #### License status, checked on the state board site A placement office looks you up before it reads anything else you sent. Active is the floor, not the finish line. Probation, a consent order, practice restrictions or an open complaint all read as encumbered, and an encumbered record ends the review. The license also has to cover the state where the student stands next to you, which matters when you hold a compact license and a single-state one. Expiry dates carry the same weight as status. If your renewal lands inside the rotation window, finish it before the start date instead of during week eight, because the student's clinical log names a supervising provider for every date on it. A resolved action from years back is not automatically fatal. Say what it was and when it closed when you apply, and let a coordinator take it to the program in writing. #### Certification has to match the population, not the job title Programs match on population. A family track student needs a preceptor certified across the lifespan. A psychiatric track student needs a psychiatric provider. Adult-gerontology, pediatric and women's health tracks follow the same logic. Which body issued the card, ANCC or AANPCB, is not the question anyone asks. What the card covers is the question, and a placement office reads it literally off the certificate you upload. Dual certification widens the range of students you can take. Hold family and psychiatric credentials and you are eligible for either track. A card sitting inside 90 days of its expiry usually gets held until you renew, because the program has to keep an unexpired copy on file for the full length of the rotation. Renew first, then apply, and the wait disappears. #### Two years of practice, timed from your certification date The common floor is two years of practice in the population after certification. Fellowship or residency time inside that population counts. Time you logged as a registered nurse does not, and the months between graduation and passing the exam do not either. Part-time practice counts as long as it is genuine patient care in the population the student is being trained for. Two clinic days a week for two years satisfies the rule. Change populations and the clock restarts on the new credential. A family NP of nine years who certified in psychiatry last spring can take family students now and psychiatric students two years from that certification date. Some programs set a shorter minimum, and a few ask for three years in specialty courses. A coordinator tells you which floor a specific program uses before you accept anything. #### Setting and course match, where good credentials still fail A primary care course needs primary care volume: undifferentiated complaints, chronic disease follow-up, screening, refills, the ordinary week. If your schedule is entirely bariatric post-ops, aesthetics or one organ system, your credential can be flawless and the hours still will not count. The call belongs to course faculty, and they make it from the visit types you describe rather than the words on your badge. Mode is decided by the program too. Some courses accept a share of hours by video, others want every hour in the room. Pay sits outside eligibility altogether: your hourly figure is yours to choose within a twelve to twenty dollar range, and the rate card explains the arithmetic and the deposits. - An encumbered or lapsed license in the state where the student would see patients. - Certification in a population the student's course does not cover. - A setting whose visit mix the course faculty will not accept for the required hours. - A certificate that expires before the rotation's final evaluation. #### Routes that do not run through NP certification Nurse educator and leadership practica need a different kind of preceptor. For those, the bar is a master's degree or higher in nursing plus a current role in the function being taught: a faculty appointment, a simulation lab post, a nurse manager or director title. An RN with an MSN and no prescriptive authority qualifies for these, and demand is steady. The MSN educator route lays out what those hours look like. Physicians and physician assistants precept NP students where the program's handbook allows it, most often in family and psychiatric courses, and the handbook language is what governs. Doctorally prepared nurses are needed for DNP project mentoring, which is scholarly rather than clinical. If you are not sure which category you fall into, apply and say what you hold. Sorting credentials is a coordinator's daily work. #### In order 1. Pull your license record: Confirm active status, no restrictions, and an expiry past the term you would teach in. 2. Read your certification card: Note the population it covers and the date it was first issued. Both numbers get used. 3. Count from the certification date: Two years of practice in that population, part-time included. RN years do not count here. 4. Describe your week honestly: Visit types, ages, payer mix, procedures. Faculty decide from this whether your setting fits. 5. Apply and let a coordinator check the rest: Gaps get named within one business day. Several are fixed by paperwork, not time. #### Questions **Can I precept with a compact multistate license?** Yes, if the privilege covers the state where the student will see patients with you. Programs accept a compact license as long as the home state record is unencumbered. If the student's program sits in a state outside the compact, the placement office may ask for a single-state license instead. **Do I need to be an NP, or does an MSN count?** Both routes exist. Clinical rotations need board certification in the student's population. Education and leadership practica need a master's in nursing plus a current role in teaching or management, so an RN with an MSN qualifies there. The two paths lead to different students, not to different pay. **How many years of experience do preceptors need?** Two years of practice after certification is the figure most programs use for clinical rotations. A handful accept one year, and some specialty courses want three. The years must sit in the population you would teach, so switching populations resets the count. Fellowship time in the same population counts. **What disqualifies a preceptor application?** Four things, in rough order of frequency. A license with any restriction or pending action. A certification that does not cover the student's population. Not enough practice time since certification. A clinical setting whose visit mix the course will not accept. The last two are temporary; the first is the only one that closes the door outright. **Does my specialty clinic count for a primary care student?** Usually not, and the credential is not the reason. A primary care course requires a spread of undifferentiated and chronic visits, which a single-subspecialty schedule cannot supply. You may still fit specialty electives or tracks that match your setting. Describe your week and a coordinator will say which courses work. ### Becoming a nurse leadership preceptor URL: https://www.nphours.com/nurse-leadership-preceptor/ An MSN leadership or administration practicum needs a manager, not a prescriber. The student spends the term inside your operational week: the huddles, the staffing decisions, one metric they are trying to move, and a project you would use anyway. If you hold an MSN or higher and currently run a unit, a service or a department, you qualify to host one. #### The qualification is the chair you sit in Programs look for a graduate degree and a current leadership position. Charge nurses with a formal management remit, unit managers, service line directors, quality and safety leads, informatics managers, chief nursing officers: all are hosted regularly. Board certification in a patient population is irrelevant here, because you are not supervising care. Your license does still have to be active and clear, and most schools ask for a CV showing the scope you actually control. A few programs will accept a director whose master's degree is in business or health administration rather than nursing, and others insist the preceptor holds a nursing degree. That is decided by the school, not by us, and it is checked before dates are offered. If you sit in an interim post or have just changed employer, say so, because the site named on the paperwork has to be the site where the student turns up. #### These hours are project hours, not patient hours Nothing the student logs here is direct patient care, and the log knows it. Leadership practicum time is entered under administrative or project headings: meetings attended, analysis done, interviews conducted, documents drafted, presentations given. You confirm the total, usually on a timesheet you sign at the midpoint and again at the end alongside a short evaluation of their performance. That changes how you supervise. A clinical preceptor is in the room for every decision, and you are not. You give the student a defined piece of work, agree what done looks like, and check in on a fixed rhythm. Half an hour a week held firmly, plus whatever meetings they attend with you, is the pattern that works for a manager with a real job. #### Give them a project you were going to do anyway The best practicum projects are ones your unit already needs. A staffing model reworked for one shift pattern, with the assumptions written down. One quality indicator taken from the dashboard, traced to its cause, and given a plan with a measurement date. A supply or capital line examined with a variance explanation. An onboarding schedule rebuilt after four new hires said the same thing about week one. Say no to projects that need a decision you cannot make. If the aim depends on a budget you do not own or a policy set two levels up, the student spends the term chasing permission and finishes with nothing to present. Scope it to your own authority and a single unit. A small piece of work that got implemented beats an elegant proposal that sat in a folder. #### Meetings are the curriculum Take the student to the meetings you would attend without them. The morning huddle, the staffing call, the quality committee, a family complaint review, a capital request presentation, a difficult conversation with another department. Almost nobody learns management from a textbook chapter on conflict styles. They learn it from watching a director hold a position politely while a room pushes back. Brief and debrief around each one, briefly. Two minutes before on who is in the room and what is at stake, five minutes after on what they think just happened. Their reading will be wrong in interesting ways. Correcting it is the highest value teaching you will do all term, and it costs less time than reviewing a draft. #### Operational data has rules and a student is not exempt Decide up front what the student may see. Individual performance records, disciplinary matters, salary detail, labour relations discussions, named incident reviews and identifiable patient information stay closed. Aggregate metrics, de-identified dashboards, published policies and the unit's own numbers are usually fine. When a meeting turns to a personnel matter, the student steps out, and you say why afterwards rather than leaving them to guess. The practicum agreement between the program and your organisation covers confidentiality, and many employers add their own form before granting access to systems. Ask your HR contact early, since that permission takes longer than anything else in the process. Pay is straightforward: set your hourly figure inside the $12 to $20 band, so a 120-hour practicum comes to $1,440 at the base and $2,400 at the top, sent in two instalments. #### In order 1. Check the degree and the post: MSN or higher, a current leadership role, and authority over the area the project touches. 2. Pick the project before the student arrives: One aim, inside your own remit, with a measure you can already see on a report. 3. Choose the meetings: List the recurring meetings the student may attend and the ones they cannot, with reasons. 4. Clear the access question: Ask HR and information security what a student may open, and start that request early. 5. Open your hours: Degree, title, organisation and weekly availability. Flag that you host leadership practicums. #### Questions **Do I need to be an NP to precept a leadership student?** No. Leadership and administration practicums are supervised by managers, and no patient care is involved, so population certification plays no part. Programs verify the graduate degree, a clear license, and a current post carrying real decision-making scope. Directors, managers and quality leads are the usual hosts for these students. **How many hours does a leadership practicum run?** Commonly a block of 120 hours across one term, sometimes 60 in a shorter course, and occasionally more when a program combines two practicum courses. Spread across a fifteen-week term, 120 hours is roughly eight a week, most of it meetings you already attend plus project work the student does between them. **What can a leadership student be shown of confidential data?** Aggregate and de-identified information, published policy, and the operational numbers for the area they are working in. Individual performance files, pay detail, disciplinary and labour matters, and identifiable patient records stay out. Your organisation may require its own confidentiality form before system access is granted, which is worth requesting in the first week. **What does hosting a leadership practicum pay?** The same hourly band as every other role here, applied to the hours you supervise. Across 120 hours the total sits between $1,440 and $2,400, according to the figure you picked, and it arrives as two transfers keyed to the midpoint and the final evaluation. Earnings of $600 or more in the year are reported to you on a 1099-NEC. **Can a leadership practicum be done remotely?** Partly, and more easily than a clinical rotation. Meetings held on video, analysis, document work and check-ins all travel well. Programs generally want some presence on the unit, because seeing how a department actually operates is the point. Agree the split with the coordinator before the term starts so nothing is disputed later. ### Nurse practitioner side hustle options URL: https://www.nphours.com/nurse-practitioner-side-hustle/ Rank any side hustle on two numbers: the hours you spend before the first dollar, and the dollars per hour once it runs. Most lists ignore the first number entirely. Six options are worth a working nurse practitioner's attention, and they sort very differently depending on which of the two you care about. #### Sort by the hours before the first payment Every option has an unpaid front end, and it is where most attempts die. Chart review wants an application, references and a training module. A telehealth panel wants licences in the states you cover. Writing wants samples nobody pays for. Expert work wants a CV somebody found. Count those hours before you compare rates, because a high figure you reach in nine months is worth less than a fair one you reach in three weeks. The second number, return per hour, only matters once the work exists. Judge it on hours you actually give up, including the unpaid ones: preparation, chasing invoices, reading a manuscript, waiting for a case to settle. A rate that sounds strong halves once you count the two hours of unpaid reading behind each billed hour. #### The quick starters Chart and utilisation review is the fastest genuine entry. Insurers, review vendors and case management firms contract nurse practitioners to read records against criteria, paid per chart or per hour. Setup is an application, a background check and a training module, so weeks rather than months. The work is quiet, screen based, and dull in a way that suits some people perfectly. Volume rises and falls with the contract. Telehealth panels come next. Companies pay per visit or per hour for asynchronous or scheduled care, and demand is steady. The cost of entry is licensure: each additional state means an application, a fee and a renewal cycle to maintain. Reckon on a month or two before your first shift, plus platform training. Income scales with how many states you hold and how odd the hours you will accept. #### The slow starters, including the highest paid Health writing pays per piece or per word and takes months to build, because clients hire from a portfolio and the first samples are unpaid. Rates spread enormously. Clinical accuracy is your advantage over general writers, and the work is genuinely flexible once a client list exists. Expert witness work has the highest hourly figure on this page and the longest runway to reach it. Attorneys find you through a CV, a specialty and a record of testimony, so the first case is the hard one. Cases arrive unpredictably and deposition dates move. Adjunct teaching is slower than it looks too: a faculty appointment can take a full semester, and the pay is fixed per course whatever the hours. - Chart or utilisation review: weeks to start, paid per chart or per hour, volume set by contract. - Telehealth panel: a month or two, paid per visit, income tied to how many licences you hold. - Health writing: months of unpaid portfolio work, then per-piece rates with wide variation. - Expert witness: the highest hourly return and the longest wait for a first case. - Adjunct teaching: a semester of paperwork, then a fixed sum per course you teach. #### Precepting, ranked honestly On setup time, precepting is at or near the front. Four documents go in: your CV, your licence, your certification and a note on what a typical week in your clinic contains. Add a 90-minute orientation, and someone else handles the agreement with the school. Reckon on three weeks from applying to a confirmed start date. Nothing to market, no clients to chase, because the demand comes from programs that need hours filled. On hourly return it sits in the middle, and the number is teaching money rather than clinical money: you name your own figure, no lower than twelve dollars and no higher than twenty, for every hour of student time. A full block runs 120 hours across a term, paid in two deposits at the midpoint and the final evaluation. It will not replace clinical income. It does pay for hours already on your schedule, which nothing else here does. #### Choosing, and what to avoid Pick by the constraint that actually binds you. If you need money this quarter, chart review or a telehealth panel starts soonest. If you want the biggest hourly number and can wait, build toward expert work. If you want income from days you already work, precept. If a teaching line on a CV is the goal, precept first and let an adjunct application follow it. Two warnings. Never rent your signature: any arrangement asking you to sign charts or prescriptions for care you did not supervise puts your licence in front of a board, whatever it pays. And treat upfront fees as a red flag, since legitimate contract work does not charge the clinician to start. Precepting on this network costs the preceptor nothing at any stage. #### In order 1. Write down your two numbers: Hours available each week, and the earliest date you need income to land. 2. Count each option's unpaid front end: Applications, licences, training modules, portfolio samples, appointment processes. In hours, not in vibes. 3. Convert every rate to the same unit: Per chart, per visit, per word, per course and per student hour do not compare until you convert them. 4. Start one thing, not three: Three half-built income lines return less than one that is finished and running. 5. Reserve tax from the first payment: It is self-employment income and nothing is withheld. A preparer will name the fraction. #### Questions **What is the most profitable extra work for a nurse practitioner?** Expert witness work pays the highest hourly figure, but cases are irregular and the first one can take a year to find. Measured across a year rather than per hour, a steady telehealth panel or regular chart review usually earns more than an occasional high-rate case. It depends whether you value the rate or the reliability. **Which option can I start the fastest?** Chart review and precepting are the two quickest. Review work needs an application, a background check and a training module. Precepting needs four documents, a short orientation and a program's approval, which together run about three weeks. Telehealth is slower only because extra state licences take time to issue. **Can I do extra work with a full-time clinical job?** Yes, and most nurse practitioners who do this are employed full-time. Check your employment agreement for outside-work clauses first. The options differ in how much of your free time they consume: telehealth and chart review add hours to your week, while precepting uses hours you already spend in clinic. **Do I need more state licences to earn on the side?** Only for work that involves treating patients in another state, which mainly means telehealth panels. Chart review, writing and expert work generally do not require it, though individual contracts may. Precepting requires a licence valid where your own patients are seen, so a single active licence is usually enough. **What should I refuse outright?** Any arrangement that asks you to sign for care you did not supervise, any that charges you a fee to begin, and any that will not put the scope and the rate in writing. Those three rules eliminate most of what circulates in nurse practitioner groups online, and none of them costs you a real opportunity. ### Part-time nurse practitioner jobs URL: https://www.nphours.com/part-time-nurse-practitioner-jobs/ Part-time work for a nurse practitioner comes in four shapes: per diem clinical shifts, a telehealth panel, adjunct teaching, and precepting students. They pay in different units and cost different amounts of your calendar. Precepting is the only one of the four that pays you for hours you were already going to work. #### Four options, four units of payment A per diem shift pays for a block of clinical labour, usually eight to twelve hours, at an hourly clinical wage. A telehealth panel pays per visit or per hour logged, with volume you do not fully control. Adjunct teaching pays a fixed sum per course for a semester, no matter how many hours the course consumes. Precepting pays for each hour a student spends learning beside you. That last unit is the one people misread. You are not paid for a shift, a visit or a course. You are paid for measured student time, at a figure you choose between twelve and twenty dollars an hour, half of it after the midpoint evaluation and the rest after the final. A standard block of 120 hours is the usual size, and 60-hour half-blocks exist for tighter schedules. #### The comparison that matters is marginal, not gross Per diem work pays the highest hourly figure of the four, and it should, because you are seeing patients and carrying the risk. No teaching arrangement competes with a clinical wage per hour, and anyone telling you otherwise is selling something. If your goal is maximum income from a free Saturday, take the shift. Precepting works differently. The hours you give a student are hours you are already in clinic and already being paid for by your employer. The teaching fee sits on top of that, for the same eight hours. What it costs is throughput rather than time: roughly a patient per hour early on, and very little of that by week four. That is the honest trade. - Per diem: highest pay per hour, but every hour is a new hour away from home. - Telehealth panel: moderate pay, flexible blocks, income that moves with patient volume. - Adjunct teaching: a fixed sum per course, and the course decides how long it takes. - Precepting: teaching income layered onto clinic days you already committed to. #### Who controls the calendar Per diem gives you the choice of shifts and no choice inside them. Once you pick up Saturday, Saturday is gone, and popular shifts are claimed early. Telehealth panels offer the finest control, sometimes down to two-hour blocks, at the cost of income that rises and falls with demand. Adjunct work looks flexible until the third week, when grading deadlines arrive on the university's calendar rather than yours. Precepting sits in the middle and behaves predictably. You name the days, you name the weeks you are away, and a rotation lasts one academic term before you decide again. A holiday in the middle is planned around rather than apologised for, and the scheduling page explains how blackout weeks are handled. Declining a student costs you nothing at all. #### Setup time, which nobody counts and everybody pays Credentialing for a per diem post takes weeks: applications, references, payer enrolment, sometimes a hospital privileging committee. A telehealth panel wants licences in each state you cover, platform training and often a background check. An adjunct appointment goes through university human resources plus a faculty appointment process, and can take a full semester to complete before you teach anything. Precepting is the lightest of the four. You send a CV, a licence, a certification card and a description of your practice, and somebody else negotiates the school agreement with whoever owns your practice. Add a 90-minute orientation before your first student. From application to a signed placement is usually about three weeks, and the paperwork page lists what gets signed. #### Whether it stacks with a full-time post It stacks better than the other three, because it does not compete for the same hours. Your employer keeps its schedule, you keep your salary, and the teaching fee is separate income for work done inside those days. Two things to check before you say yes. Your employment agreement, for any clause covering outside professional work. And your practice's willingness to sign an affiliation agreement with a school, which most practices do readily. Be realistic about capacity in the first year. One student a term is plenty. Two at once is a mistake most people make only once, because the second student halves the attention each one gets and doubles the documentation you review. If you want teaching income without a clinical schedule at all, education and leadership practica are the version that needs no patients. #### In order 1. Count the hours you actually have free: Not aspirational hours. The ones that exist after the job, the commute and the family. 2. Price each option per hour you must give up: A per diem hour costs a free hour. A precepting hour costs throughput on a day you were working anyway. 3. Add the first-year setup: Credentialing, licences, platform training or faculty appointment. Some of it takes a whole term. 4. Read your employment agreement: Look for outside-work clauses. Teaching is rarely restricted, but read it once rather than assuming. 5. Start with the smallest version: One half-block, sixty hours, one term. Decide about the next one when that one ends. #### Questions **Is precepting a good part-time job for a nurse practitioner?** It is good part-time income and a poor substitute for a part-time clinical post. The fee is paid for teaching during hours you already work, so it adds money without adding shifts. If you need to replace a salary, per diem or a telehealth panel will do it faster. If you want to earn more from the days you already give, precepting is the efficient choice. **Does precepting pay as much as a per diem shift?** No, and it is not trying to. Per diem pays a clinical wage for clinical work you perform yourself. Precepting pays a teaching rate for hours a student spends with you, which is a different unit and a lower one. The gain is that those hours were already on your schedule, so nothing new is subtracted from your week. **Can I precept while working full-time?** Most preceptors do exactly that. A standard rotation works out to eight or nine hours weekly across a term, which fits inside one regular clinic day. Nothing is added to your working week. Check your employment agreement for outside-work language first, and confirm your practice will sign an agreement with the school. **How much of my week does a rotation take?** One clinical day, plus about fifteen minutes of feedback at the end of each session and a few minutes weekly to confirm the student's hour log. Two evaluation forms fall due across the term, one at the midpoint and one at the end. Each takes twenty minutes and there is nothing else to prepare. **Which part-time option has the lowest setup burden?** Precepting, by a distance. Four documents, an orientation of ninety minutes, and an agreement somebody else negotiates. Per diem credentialing and telehealth licensure both take longer and involve more of your own paperwork. Adjunct teaching is the slowest, because a faculty appointment moves at a university's pace. ### Becoming a PMHNP preceptor URL: https://www.nphours.com/pmhnp-preceptor/ Psychiatric mental health is the track our coordinators chase hardest. Demand for PMHNP preceptors runs ahead of every other population on the roster, and it is also the track that works best on camera, because the examination is the conversation. If you prescribe psychiatric medication and hold current PMHNP certification, you can teach a student from wherever you already see patients. #### Why psych students are the ones coordinators call about Enrolment in psychiatric NP programs has grown faster than the pool of certified psychiatric providers willing to teach, so the queue for these placements is long and it moves slowly. Practically, that means you will be offered students more often than a primary care preceptor, and you can be choosy about term, weekday and format. Half-blocks of 60 hours get filled here too, because faculty would rather split a student across two psychiatric preceptors than leave them without one. Pay does not change by specialty. Name any figure from $12 to $20 against each logged student hour, and 120 of them comes to $1,440 at the low end or $2,400 at the high end. Money moves twice: once the midpoint evaluation is filed, again when the final is in. The rate card covers the mechanics, including a student who withdraws mid-term. #### The initial evaluation the student runs while you watch The diagnostic interview is the centre of this rotation. Once a student has sat through three or four of yours, hand them a new patient and take the observer seat. They open, they gather the history, they screen for risk, they attempt a formulation. You say nothing unless safety requires it, and you write down the two things you will teach afterwards rather than correcting in the moment. Then make them document a mental status examination in their own words before they see yours. Appearance, speech, mood and affect described separately, thought process, insight, judgement, and a cognitive screen when the presentation calls for one. Students arrive able to recite the categories and unable to write them about a real person. Reading your version next to theirs, in the same chart, teaches faster than any correction you could say out loud. #### Medication management by video A follow-up prescribing visit is mostly listening, and a camera does not degrade listening. A student can run the whole thing: what changed since the last visit, sleep, appetite, adherence, side effects, the screening scale repeated, then a proposal for the dose. You stay on the call, ask your questions at the end, and enter or approve the prescription yourself, because the prescribing decision never belongs to the student. This is why programs permit a larger share of video hours for psychiatric rotations than for any other population. There is no physical examination to lose. What you do lose is the waiting room, so build in the checks that a room gives you free: confirm where the patient is sitting, note anyone else present, and watch for the movement findings a camera can hide. Kwame walks through the whole method in Off the Clock. #### Safety planning, and the moment you step in Risk assessment is the one part of the visit with a hard rule attached. Let the student ask the questions, including the direct ones, because avoiding them is the habit you are trying to break. Let them draft the safety plan with the patient: warning signs, coping steps, who gets called, what leaves the house. Then you review every line before it is signed and before the visit ends. You step in the moment disposition changes. A patient who needs an urgent evaluation, a hospital, a call to a third party, or a change to a controlled prescription becomes your visit, out loud, with the student watching. That is not a failure of the teaching. It is the teaching. Debrief it the same day and write the note yourself, with the student's part clearly attributed. #### Therapy hours and prescribing hours are counted apart Most psychiatric NP curricula ask for exposure to psychotherapy as well as to medication management, and many log them under separate headings. If your practice is a med management panel with twenty-minute slots, you can supply a great deal of one and almost none of the other. Say that plainly when you open your hours, so faculty know from the start where the rest has to come from. If you do carry longer appointments, a student can sit in on brief supportive work, motivational interviewing, or a structured therapy series with the patient's agreement. Consent for an observer matters more here than anywhere else in practice, and it is asked before the appointment rather than at the door. A patient who declines is a patient the student does not see, with no discussion and no note about it. #### In order 1. Confirm the credential match: A PMHNP student needs a psychiatric provider. Two years of psychiatric practice since certification is the usual bar. 2. Decide clinic, video or both: Fully remote psychiatric rotations run on this network. Mixed weeks are common too. 3. Set the weekly hours: Eight hours a week for a term is a block. Four hours a week is a half-block. 4. Plan the consent script: Decide how patients will be told a student is present, and who asks, before the first appointment. 5. Open your hours: State, certification, format and rate. A coordinator writes back inside a business day. #### Questions **Can I precept a PMHNP student entirely by telehealth?** Frequently yes. Psychiatric rotations carry the largest video allowance of any track, because the assessment is verbal and no hands-on examination is lost. The ceiling still belongs to the program, and some courses require a portion of hours in person. You will see the permitted split on the match card before you accept a student. **Do I need to offer psychotherapy hours to precept psych students?** Not always, but say what you have. Programs usually track therapy exposure and prescribing separately, so a twenty-minute med management panel covers one column well and leaves the other thin. Faculty can pair your hours with a therapist or a longer-session site. Problems only start when nobody knew until the midpoint review. **What happens if a patient becomes unsafe during a student visit?** You take the visit. The student stays and observes while you complete the risk assessment, decide the disposition, make any calls and write the note. Then you debrief the same day, naming what you did and why. Students learn escalation from watching it done once, and no program expects a learner to own that decision. **How much does precepting a psychiatric NP student pay?** The same band applies as for every population: pick your hourly figure inside it and multiply by the hours logged. A full block of 120 hours lands between $1,440 and $2,400. Half arrives after the midpoint evaluation, half after the final, by direct deposit. Preceptors paid $600 or more in a calendar year get a 1099-NEC. **Does a psychiatric practice need to be prescriber-only to qualify?** No. Community mental health, integrated primary care behavioural roles, addiction medicine and private psychiatric practice all place students. What the program checks is your certification in the psychiatric population, your active license, and whether the setting sees the diagnoses the course lists. Inpatient psychiatric units are treated differently and are usually assigned to acute care courses. ### Becoming a PNP preceptor URL: https://www.nphours.com/pnp-preceptor/ Pediatric primary care students learn on a schedule that already exists. The well-child series gives them the same visit at rising ages, so the structure repeats while the content changes, and you can hear them improve. If you hold pediatric primary care certification and see children weekly, one shared clinic day for a term covers a full 120-hour block. #### The well-child schedule is the teaching backbone Give the student the visit series and let them run it in order. The two-week weight check, the four-month feeding conversation, the nine-month development screen, the eighteen-month language check, the four-year school readiness visit, the adolescent annual. Each one has a shape they can prepare for, which means they arrive knowing what to ask instead of improvising. Repetition is why a pediatric rotation makes a competent history-taker in six weeks. Anticipatory guidance is where they need the most correction, and it is easy to coach. Have them pick two topics before the room, appropriate to the age, and deliver them in plain language to the parent. Sleep, car seats, screens, safe storage, dental, feeding. Then tell them afterwards which one landed and which one sounded like a handout being read aloud. #### Growth and development, the parts students get wrong Make the student plot the point themselves and say what it means before they open your last note. Weight, length, head circumference, body mass index for the older ones, and the trend rather than the single dot. The common error is reporting a percentile as a verdict. Ask them what changed since the previous visit, whether the curve is following its own line, and what they would want measured again in a month. Developmental assessment needs the same discipline. The student runs the screening tool, watches the child in the room rather than reading the form to the parent, and states the age-normal expectation out loud before deciding whether it is met. Then have them practise the referral sentence, because saying an evaluation is needed without frightening a parent is a skill nobody teaches in class. #### Immunisation counselling is a conversation you can teach Every pediatric student needs to have said these words to a real parent, badly, with a preceptor listening. Start with the routine visit where nobody objects: what is due today, why it is due now, what to expect tonight. Then let them handle a delayed schedule and work out the catch-up plan on paper before you check it. The hesitant parent is a different exercise, and you should agree the rules first. The student listens, asks what the specific worry is, and answers only what they know. You take over the moment the conversation moves toward a decision, and you do it without contradicting the student in front of the family. Correct anything they got wrong afterwards, in the workroom, with the schedule in front of you. #### Why pediatrics is harder to precept remotely In every other population the patient is the one on camera. In pediatrics the parent is, and the parent is also holding a toddler, answering a sibling and moving the phone. There are no measurements, the examination is limited to what the caregiver can show you, and consent belongs to a guardian who may not be the person on screen. Students find the visit harder, not easier, than being in the room. Some pediatric visits do work by video. A stimulant medication follow-up, an asthma control check with the action plan on the table, an eczema review, a lot of adolescent mental health. Well visits and immunisation visits do not, which caps how much of a pediatric block can be virtual. Programs decide the split, and it is stated in writing before the rotation begins. #### Adolescent confidentiality and the forms The teen visit is where a student learns to run a room in two parts. Guardian present for the history, guardian out for the confidential portion, and a clear sentence about what stays private and what does not. State law varies on that boundary, so tell the student your rule for your state on day one and have them say it aloud the way you say it. What they must not do is promise more privacy than the law gives them. School forms, camp forms and sports clearances look like paperwork and are actually good teaching. The student does the cardiac history, the musculoskeletal screen, the vision check and the concussion questions, then fills the form and hands it to you to sign. Six of those in a term and they can do a pre-participation examination without prompting. #### In order 1. Map your well-child slots: Count how many age-specific well visits a typical week gives you. That is the student's spine. 2. Set the teen rule: Write down your confidentiality practice for your state before the student meets a first adolescent. 3. Choose the day and the mode: Mostly in clinic for this population, with a video afternoon if your practice already runs one. 4. Pick your rate: Twelve dollars an hour at the floor, twenty at the ceiling, applied to hours the log shows. 5. Open your hours: Certification, state, weekday and how many children you see. A coordinator handles the rest. #### Questions **Can a family nurse practitioner precept a pediatric NP student?** Sometimes. Some pediatric programs accept an FNP preceptor whose practice is largely children, and others insist on pediatric certification for the whole rotation. It depends on the course and the placement office, not on your confidence with children. Ask before accepting, because a decision reversed after week two costs the student the term. **How much of a pediatric rotation can happen by video?** Less than in psychiatry or adult chronic care. Growth measurements, immunisations and the physical examination all require the room, so most pediatric blocks are largely in clinic with a video share for medication follow-ups, asthma reviews and adolescent behavioural visits. The exact ceiling comes from the program and appears in the placement agreement. **What does precepting a pediatric NP student pay?** Preceptors set their own hourly figure between the band's floor of $12 and its ceiling of $20, so 120 hours brings $1,440 to $2,400. Payment comes as two bank transfers, the first once the midpoint evaluation is signed and the second at the end. Anyone paid $600 or more across the year receives a 1099-NEC. **Do parents have to agree to a student being in the room?** Yes, and it is asked at the front desk or at the door rather than after the student is seated. A parent who declines gets the visit with you alone, without explanation or apology. Most agree. Introduce the student by name and role, say who is supervising, and the question rarely becomes a problem. **Is an urgent care or school-based clinic acceptable for pediatric hours?** School-based health centres often are, because they carry well visits, sports forms, chronic asthma and adolescent care. Pediatric urgent care usually covers only part of a block, since a course wants the well-child series and continuity too. A coordinator can check the syllabus against your setting before you commit to any dates. ### Precepting NP students URL: https://www.nphours.com/precept-np-students/ A rotation runs fourteen to sixteen weeks and follows the same arc every time. The student watches, then sees patients and reports back, then carries a small panel with you behind them. You sign two evaluations. Money arrives twice. Here is the whole thing in order, with the paperwork attached to each part. #### Before day one: the list you send A week ahead, the student needs practical detail and nothing more: start time, address, where to park, what to wear, which door is unlocked at seven in the morning. Your practice will want its own items in return, usually a signed confidentiality attestation, immunisation and tuberculosis records, and proof of the liability policy the school carries. The coordinator gathers all of that so it never lands in your inbox. Chart access is the one item worth starting early, because information technology departments move at their own speed. A read-only student login is the usual answer, with your credentials used for anything that gets filed. Two weeks is not too early to ask. The agreements underneath the placement, between school and practice, are handled without you, and the paperwork page lists each document. #### Week one: fifteen minutes that set the term Start with a short conversation before the first patient. Tell the student where to sit, how you want to be interrupted, and what to say to a patient when they do not know an answer. Give them one sentence to use out loud: they are a nurse practitioner student, you will be in shortly. Agree on where presentations happen, whether that is the corridor, the workroom or a chair beside yours. Then let them watch. Two or three sessions of shadowing while you narrate your reasoning aloud is enough for most students, and thinking out loud is the most useful thing you do all term. Your schedule will run behind at first. Book fewer patients if you can, and tell the front desk why the morning is slower. #### Weeks two to six: they see, then they tell you Move the student into rooms as soon as they can take a history without help. One patient an hour to begin with, chosen by you: a follow-up, a rash, a refill with a question attached. They gather the story and come out to present. Ask for a diagnosis, not a list of findings, because committing to an answer is the skill being built. Then walk in together and confirm or correct in front of the patient. Documentation is the part people forget to teach. Have them draft the note, read it, and show them the two lines you would change. Hours go onto the program's log inside forty-eight hours, while both of you still remember the session, because the log is what your fee gets counted against. A late log is the commonest source of a payment question. - Pick which patients the student sees rather than letting the schedule decide. - Ask for an assessment and a plan, in that order, every single time. - Enter the room together afterwards so the patient hears one consistent plan. - Review the draft note, name two specific changes, and move on. - Confirm the hour log within two days of each session. #### The midpoint: one form, one conversation, half the fee Around week seven the program sends a midpoint evaluation. It is a short competency form with room for comments, asking what the student can do unaided, what needs support, and what has to improve before the final. Fill it in honestly. A midpoint saying everything is fine, followed by a final that fails somebody, is unfair to the student and useless to faculty. Sit with the student for ten minutes and say the same things aloud that you wrote down. Most students have never been told directly how they are doing, and the midpoint is the moment to fix that. Once the form reaches the coordinator, the first half of your fee is released by direct deposit. Nothing has to be invoiced or requested. #### The last weeks, the final evaluation, and closing out By week ten a capable student should be running two or three patients an hour with you supervising rather than leading. Hand over continuity: the diabetic seen in week three comes back to them, not to you. You still see every patient, sign every note and make every decision. No student sees a patient unsupervised at any point, in any setting, and that rule has no exceptions. The final evaluation is longer than the midpoint and takes about half an hour. Submit it, check the total hours against your own count, and the balance follows the way the first half did. Then ask the program for a letter stating your hours and dates, because certification renewal will want it years from now. #### In order 1. Confirm the placement: Dates, hours, course, mode. A coordinator owns the rotation from that moment until it closes. 2. Sort access before week one: Read-only chart login, a desk, and a printed clinic list. Start the request two weeks out. 3. Hold the day one huddle: Interruptions, seating, presentations, and the sentence the student says to patients. 4. Shadow, then see, then present: Two or three sessions watching, then one patient an hour, then two or three. 5. File the midpoint evaluation: Week seven or thereabouts. Honest comments, a spoken version for the student, half the fee released. 6. Close with the final evaluation: Reconcile the log, submit the form, take the second deposit, request the letter for your records. #### Questions **How much time does precepting add to a clinic day?** Very little after the first two weeks, and a noticeable amount during them. Early on you lose roughly a patient per hour while the student learns your rhythm. By week four most preceptors are back to normal volume, because a student who can take a history and draft a note is useful rather than only slow. **What do I have to sign as a preceptor?** Usually four things: a preceptor agreement or data form naming you for the course, an acknowledgement that you received the syllabus and objectives, the midpoint evaluation, and the final evaluation. The affiliation agreement between school and practice is signed by whoever owns the practice, and it is negotiated for you. **When does a preceptor get paid during the rotation?** Twice. The first half of the fee is released once the midpoint evaluation is filed, around week seven, and the balance once the final evaluation is in. Both arrive by direct deposit and neither requires an invoice. The amount is calculated from the hours the program's log shows, which is why confirming the log matters. **Can a student see patients without me in the building?** No. A student is never unsupervised, in clinic or on video, and there is no version of the rotation where that becomes acceptable. You remain the treating provider on every encounter, you see each patient yourself, and you sign every note. The student's role is to gather, reason and propose, and yours is to decide. **What does the coordinator actually do during the term?** Collects the student's compliance documents, confirms dates with the program, answers you within one business day, chases the evaluation forms, and sorts out anything that goes wrong with logs or schedules. One named person handles the whole rotation, so you never explain the situation twice. ### Remote preceptor jobs URL: https://www.nphours.com/remote-preceptor-jobs/ A remote preceptor opening is a single telehealth rotation with a named program, fixed dates and a set number of hours. You see all of it before you say yes. It is contract work rather than a post with a title: you take one rotation, you get paid for it, and you decide whether to take another. #### The nine fields on an open listing Every opening arrives as a card with the same fields filled in. The program and the state it teaches from. The course and the track, for instance a psychiatric practicum or an adult-gerontology primary care course. Start and end dates. Total hours required. The permitted video share, written as a number rather than a hope. Weekly cadence, which is usually one day or two half-days. The student's year, their prior clinical experience and what they have asked to work on. Two more fields matter as much as the rest. The rate is shown as your own figure, the one you entered when you applied, multiplied out across the hours so you can see the total before you commit. And the card carries a coordinator's name and direct line, because one person owns the rotation from acceptance to final evaluation. Nothing is hidden until later. Matching explains how the cards are built. #### Hours, dates and the money on a remote block Most telehealth openings run a standard block: 120 student hours inside a 14 to 16 week academic term. That averages eight or nine hours weekly, which is one telehealth day. Half-blocks of 60 hours exist for preceptors who can offer a single half-day, and a few courses ask for smaller counts to finish a student who fell short elsewhere. Dates are the program's, and they cluster at the start of January, May and August. The arithmetic is plain. A 120-hour block pays $1,440 at the bottom of the band and $2,400 at the top, and where you land is your own choice made once at application. The money reaches you in two direct deposits keyed to the two evaluations, and a 1099-NEC follows each January if the year's total reached six hundred dollars. See the rate card for the mechanics. #### Where remote openings actually are Psychiatric mental health is where remote demand concentrates, and it is not close. Medication management visits work through a camera, psychiatric programs have grown fast, and preceptors in that population are scarce everywhere. Family and adult-gerontology primary care come next, mostly for chronic disease panels and results visits. Women's health has fewer remote hours because of exams, and acute care has almost none. Geography works differently than job seekers expect. The student's home city is close to irrelevant, since they join a call. What matters is that you are licensed where your patients are. Programs running distance cohorts place students across many states, so openings follow preceptor licensure rather than campus location. States with large distance enrolments and thin provider supply, which in practice means much of the South and Mountain West, produce the most listings. - Psychiatric mental health: the largest volume of remote openings, in every term. - Family and adult-gerontology primary care: steady demand for follow-up and chronic disease hours. - Nurse educator and leadership practica: fully remote, no patients involved at all. - Acute care, women's health exams and procedural specialties: little to no remote availability. #### Claiming one, and what you are signing up for When a card matches your credential, state, hours and mode, you have 72 hours to accept it. That window exists so a student is not left waiting while three preceptors think it over. Declining costs you nothing and does not push you down any queue. Once you accept, the coordinator confirms with the program and the paperwork moves, which the paperwork page describes in order. Understand the shape of the arrangement. This is independent contractor work billed per rotation, not employment. There is no salary, no benefits, no manager and no minimum commitment beyond the block you accepted. You keep your day job and your own schedule. You owe your own tax on the income. In exchange you can teach one student this term, three next year, or none at all. #### In order 1. Set your filters once: Population, states you are licensed in, weekly hours, and video as your preferred mode. 2. Read the card: Program, course, dates, hours, video share, student background, your total for the block. 3. Accept inside 72 hours: Or decline in one click. A decline is not a mark against you and costs nothing. 4. Let the agreement finish: The coordinator confirms with the program while your documents go to its placement office. 5. Start on the program's date: First video visit, first consent line, first hours on the log that same week. #### Questions **Is a remote preceptor job an actual job?** Not in the employment sense. Each rotation is a contract for a set number of student hours, paid at your rate, with no salary or benefits attached. People search for it as a job because that is how job boards are worded. Think of it as paid teaching work you add to a clinical schedule you already have. **Which state license do I need for remote precepting?** The one covering the state where your patients are, because you are the treating provider on every visit. The student's location matters much less; they are joining your call. If a program teaches from another state entirely, that is normally fine, and a coordinator confirms the requirement before you accept the placement. **How many hours a week does a remote rotation take?** Eight or nine for a standard 120-hour block spread across a term, which is one telehealth day. Four or five for a half-block. Add fifteen minutes at the end of each session for feedback and a few minutes each week to confirm the student's log. The teaching time overlaps your clinical time rather than adding to it. **What does a remote preceptor earn per rotation?** Between fourteen hundred and twenty-four hundred dollars for a full 120-hour block, depending on the hourly figure you chose. A half-block earns half of that. Video hours are paid identically to in-clinic hours; there is no discount for teaching from a desk. Payment arrives in two deposits rather than one lump at the end. **How quickly do remote openings fill?** Psychiatric openings can be claimed within a day of posting during term-start weeks in December, April and July. Primary care openings sit longer. Volume is seasonal rather than steady, so a preceptor who joins in October may see nothing until the new year and then several cards in two weeks. ### Precepting as a semi-retired NP URL: https://www.nphours.com/retired-nurse-practitioner-jobs/ Precepting is the most common way NPs stay in practice while winding down. A student needs your judgement rather than your panel size, the hours are yours to choose, and much of it can be done from a desk at home. The catch is that you still need current certification and somewhere patients are actually seen, so plan the wind-down in that order. #### What renewal actually asks of you Read your own handbook before you decide anything, because the rules differ by certifying body and by state board. Continuing education is universal. Beyond that, some certifying bodies attach a practice-hour requirement to renewal, and a few state boards do the same for an advanced practice license. The number depends on which body holds your certificate and which renewal pathway you choose, so look it up rather than relying on what a colleague told you. Teaching does earn credit toward some of these requirements. ANCC counts precepting toward its professional development category, with a 120-hour minimum across a five-year renewal cycle documented in a letter. AANPCB permits a maximum of 120 precepting hours to stand in for 25 contact hours of non-pharmacology continuing education. Neither replaces a practice-hour rule if your body has one, and that distinction is worth confirming in writing. #### You still need somewhere patients are seen That surprises people more than it should. A clinical rotation happens where care happens, so a preceptor who has closed the office entirely has nowhere for a student to log direct patient hours. Two arrangements solve it. Keep a small clinical commitment: a per diem day, a locum block, a shift at a community clinic, or a telehealth panel you still work. Or run your own remaining practice at reduced volume. If patient care is genuinely finished for you, the non-clinical roles remain open. DNP project mentoring, education practicums if you hold a current teaching post, and leadership practicums if you still direct something. Those need a role and a site rather than a patient list. What none of them tolerate is a mentor with no current position anywhere, because the paperwork asks where the student will be. #### The certification rules do not soften with seniority Thirty years of practice does not substitute for a current certificate. Your board certification has to be active in the population you would teach, your license has to be unencumbered, and the two-years-after-certification rule applies to everyone, including someone recertifying in a new population late in a career. A retired-status or inactive license generally will not satisfy a program's placement office. So handle the sequence deliberately. If you intend to precept for a few more years, renew the certification before you reduce your hours, not after, because a lapse is far harder to reverse than a renewal. If it has already lapsed, tell a coordinator plainly; there are non-clinical roles that do not require it, and pretending otherwise wastes a term. #### The video-only rotation For a preceptor who has left the building, a camera is the whole answer. Psychiatric follow-ups, chronic disease reviews, medication management, results conversations and post-hospital check-ins all teach well on screen, and you hear every word the student says, which is harder in a clinic corridor. One afternoon a week from a quiet room at home can carry a substantial share of a student's block. Two practical things decide whether it works. Your equipment and connection, which the teleprecepting setup page covers, and how much video the student's program will count, which they state in advance. Do not buy anything before a coordinator confirms both. Most preceptors in this position run a half-block first, then decide whether to take a full one next term. #### Be honest about energy, not just hours A student is company and a student is work. The first fortnight costs you time you did not spend before: reading their notes, correcting a plan, explaining something twice. If your reason for stepping back was fatigue rather than boredom, take 60 hours rather than 120 and see how it sits. One student a year, done properly, is worth more to a program than two abandoned in October. The money is modest and real. Your rate is a number you choose, no lower than $12 and no higher than $20 for each logged hour, which makes a standard block worth $1,440 up to $2,400 and a half-block half as much. Two deposits arrive, one on the midpoint evaluation and one on the final. It is 1099 income against a pension, so ask your tax preparer what that does to your return. #### In order 1. Read your renewal handbook: Find out whether your certifying body and state board require practice hours, and how many. 2. Renew before you slow down: Certification and license first, reduced hours second. A lapse is expensive to undo. 3. Keep a clinical foothold: A per diem day, a locum week or a telehealth panel gives a student somewhere to log hours. 4. Try one half-block: Sixty hours across a term tells you honestly whether you want a full one next time. 5. Open your hours: Certification, state, format and the afternoons you can give. A coordinator suggests what fits. #### Questions **Can I precept if I have fully retired from clinical practice?** Not for direct patient care hours, because a student has to see patients somewhere. Keeping a per diem day, a locum block or a telehealth panel solves it. If clinical work is over for good, DNP project mentoring, education practicums and leadership practicums are available to anyone holding a current role and site, without any patient list at all. **Does precepting help me keep my certification current?** It contributes. Preceptorship hours are accepted within the professional development portion of an ANCC renewal, subject to the handbook's 120-hour minimum and a letter confirming them. AANPCB runs its own conversion, trading a capped number of taught hours for part of the non-pharmacology requirement. If your pathway also demands practice hours, check whether teaching counts there. **Does the two-year experience rule apply to an older NP?** Yes, and it is measured from your certification date rather than from graduation or from total years in nursing. A very experienced NP who certified in a new population last year has to wait, in most programs, until two years have passed in that population. Long service in another specialty does not shorten the wait. **How many hours a week does precepting take when semi-retired?** A half-block of 60 hours is around four hours a week across a term, and a full block is roughly double. Add an hour or two weekly at the start for reading notes and giving feedback. Many semi-retired preceptors settle on one student a term, one afternoon a week, and stop there deliberately. **What does a rotation pay a semi-retired preceptor?** The same as anyone else on the network. You pick an hourly figure inside the band, and it applies to each hour the student's log records, which puts a full block somewhere in the $1,440 to $2,400 range. Payment lands in two halves, after the midpoint evaluation and after the final. Anything from $600 upward in a year is reported on a 1099-NEC. ### What an RN preceptor is URL: https://www.nphours.com/rn-preceptor/ Two different jobs use this title. One is the unit preceptor who takes a new hire through orientation, chosen by your manager and paid by your employer. The other is the academic preceptor who supervises a nursing student's practicum hours for a school. NPhours places the second kind and cannot place the first. Work out which one you are before reading further. #### The unit orientation preceptor This is the nurse who takes the new graduate for twelve weeks. The unit educator or manager picks you, usually because you are reliable and your documentation is clean. The work is competency checklists, gradual handover of a patient load, weekly progress notes and a difficult conversation if the orientee is not keeping up. It is a genuine skill and hospitals depend on it entirely. Pay comes from your employer, if it comes at all. Most systems attach a small hourly differential to precepting shifts, some pay a flat stipend per orientee, and some pay nothing and call it part of a senior nurse's role. The figure is set in your contract or your policy manual, not by any outside network, so the person to ask is your unit educator. NPhours has no part in that arrangement and cannot pay you for it. #### The academic preceptor for nursing students The other role belongs to a school. A nursing student needs supervised practicum hours signed off by a qualified nurse, and the hours are logged against a course requirement rather than a hiring plan. RN-to-BSN students bring community health, leadership and capstone hours. MSN students bring education, administration, informatics or public health practicums. What they all bring is a syllabus, a log and two evaluations. This is the work this network arranges. A coordinator matches the request to your degree and role, handles the agreement with the school, and pays you for the hours the log records. You see the course, the dates, the hour count and the format before you say yes to anything, and a decline has no consequence beyond the next request arriving later. #### Which degree fits which student The rule is that a preceptor holds at least the degree the student is working toward. A BSN-prepared RN can usually supervise RN-to-BSN practicum hours, including community health and capstone work. An MSN-prepared nurse is needed for MSN practicum students, and the school will also want you to hold the relevant role: teaching for an education course, management for a leadership course. Nurse practitioner students are a separate matter. Those hours require a certified NP or a physician in the same population, because prescribing and diagnosis are being supervised. An experienced RN, however good, cannot sign for them. If that is the request in your inbox, it was sent to the wrong person and a coordinator will re-route it. #### The practical side of hosting an RN student Expect the same three checks as any preceptor: an active unencumbered license, the degree the course requires, and a couple of years working in the role you would be teaching. Then expect the school's paperwork. A community health student needs a site that lets them do outreach, home visits, screening events or education sessions, and someone has to authorise their presence there. The teaching itself is less about clinical skill than about how a system works. Let them plan a session, run a screening table, sit in on a case conference, or write the referral and then follow it to see whether anything happened. RN students arrive expecting tasks and leave understanding process, which is the point of the practicum. #### Where you belong, honestly Read the four lines below and take the one that fits. Most people who search for this page want the first, and the answer to it lives inside their own organisation. It is worth asking anyway, because unit differentials often go unclaimed by nurses who did not know the policy existed. If it is the academic side you want, the money is simple. Pick your rate somewhere from $12 to $20 for each hour a student logs with you, which puts a full 120-hour practicum at $1,440 to $2,400. Half is released at the midpoint evaluation, half at the final, and anything reaching $600 across the year arrives with a 1099-NEC in January. - Precepting a new hire on your unit: ask your educator about the differential; this network cannot pay for it. - BSN-prepared with a community, public health or leadership role: you can take RN-to-BSN practicum students. - MSN-prepared and currently teaching: the nurse educator practicum page describes that work. - MSN-prepared and managing a unit: the leadership practicum page is the one to read next. #### In order 1. Name the role you mean: Unit orientation or academic practicum. They pay differently and are arranged by different people. 2. Check your degree against the course: At least the credential the student is studying for, plus the role the syllabus assumes. 3. Confirm your site will host: Community and public health placements need someone to authorise a student's presence. 4. Open your hours: Degree, license, role, state and availability. A coordinator routes you to the courses that fit. #### Questions **Do RN preceptors get paid for orientating new nurses?** Usually through their employer, not through a network. Many hospitals add an hourly differential to shifts worked with an orientee, some pay a stipend for each new hire precepted, and some treat it as an expectation of the role with no extra pay. The amount and the rules sit in your own contract or nursing policy manual. **Can NPhours place me as a hospital orientation preceptor?** No. Those assignments are made inside the unit by a manager or educator, tied to your own employment, and paid by the hospital. This network works with nursing schools, so the placements it arranges are academic ones with students who need supervised practicum hours. The two systems do not overlap at any point. **What qualifications does an academic RN preceptor need?** An active unencumbered license, a degree at or above the level the student is pursuing, and current practice in the relevant role, commonly two years of it. A BSN covers RN-to-BSN practicum students. An MSN is required for master's students, along with a teaching or management post depending on the course. **Can I precept nurse practitioner students as an experienced RN?** No. NP practicum hours involve supervised diagnosis and prescribing, so programs require a board-certified nurse practitioner or a physician in the same population to sign for them. Years at the bedside do not substitute. If you are studying toward an NP or completing certification, revisit this once you have both the credential and two years in it. **What do academic RN precepting hours pay?** You choose an hourly figure within the band this network uses, and it applies to every hour the school's log shows. A 120-hour practicum therefore returns between $1,440 and $2,400, paid in two direct deposits after the midpoint and final evaluations. It is contract income, so set some aside for tax and speak to your own preparer. ### Being a virtual preceptor URL: https://www.nphours.com/virtual-preceptor/ A virtual preceptor supervises a nurse practitioner student during telehealth visits. Three people are on the call: the patient, the student, and you. The student takes the history and proposes a plan, you step aside to hear the reasoning, then you come back on camera and close the visit. The chart entry and the medical decision stay yours. #### What teleprecepting is, and what it is not Teleprecepting means a student joins your telehealth schedule as a learner while you remain the treating provider. The student may sit in your office or at home in another city. Either way the patient sees two clinicians on screen, hears who each one is, and agrees to the arrangement before anything clinical starts. Nothing about the encounter itself changes: you examine what can be examined, you decide, you document, you sign. It is not remote chart review, and it is not a student watching a recording. Live participation is the whole point, because the hours a school counts are direct patient care hours. Whether a given course will accept them by video is the program's ruling, not yours and not ours, and that ruling is written into the placement before a start date is set. #### Visit types that convert to video, and the ones that do not Psychiatric medication management is the strongest fit in the whole catalogue. The encounter is conversation, mental status observation and a prescribing decision, all of which travel intact through a camera. Primary care follow-ups come next: hypertension and diabetes checks with home readings, results review, titration visits, contraception counselling, insomnia, refills with a real reassessment attached. Behavioral health intakes work when the student has been taught to run one at a slower pace. Procedures do not convert. Neither does acute care, where the value of the hour lives in the bedside exam and the pace of a deteriorating patient. Sensitive exams belong in a room with a chaperone. Well-child visits with growth measurements and immunisations need hands. If your week is mostly those, a mixed rotation makes more sense than a video one, and coordinators will say so plainly. - Converts well: psychiatric med management, chronic disease follow-up, results calls, titration, counselling visits. - Converts sometimes: new primary care complaints where the exam is limited and history carries the diagnosis. - Does not convert: procedures, wound care, sensitive exams, inpatient rounds, urgent same-day illness. - Never counts anywhere: watching recorded visits or reviewing charts without a live patient. #### A video half-day, hour by hour Eight o'clock, ten minutes with the student before the first patient: today's list, who is complicated, what you want them to attempt. Eight fifteen, the first visit. You open, name the student, ask the patient's permission, and hand over the history. The student takes twelve minutes. You stay on camera and mostly silent. At the point where a plan is needed, you tell the patient you are stepping away briefly to confer. You move to a private breakout room while the patient waits in the visit. The student gives you a short assessment and a plan, you ask one question, you agree or correct, and the two of you return together. That whole exchange runs two to four minutes and is the part where teaching happens. Repeat across five or six visits, close with fifteen minutes of feedback, and the morning has produced four countable hours. #### Consent, the share your program allows, and pay The consent moment is one spoken sentence at the top of the call: a student clinician is with you today, they will take part in the visit, and you may decline. Patients rarely refuse. When one does, the student leaves the call and rejoins for the next, and you note the refusal the way you would note a declined chaperone. Document that the permission was asked and given in the encounter note itself. Programs cap how much of a rotation may happen by video, and the caps differ by course and by year. Some allow a quarter, some allow half, some require every hour in person. You will know the number before you accept a placement. Video hours pay what clinic hours pay, at the rate you set inside the twelve to twenty dollar band. For cameras, platforms and the room setup, read teleprecepting setup. #### In order 1. Ask permission out loud: Name the student, say what they will do, offer the patient a way out. Then note it in the chart. 2. Hand over the history: Stay visible, stay quiet, and let the student work for ten or twelve minutes. 3. Step out to hear the plan: A private breakout for two to four minutes. Assessment, plan, one question from you. 4. Return and close on camera: You confirm or adjust the plan with the patient present, so nobody leaves confused. 5. Sign the note, approve the hours: Your documentation, your decision. The student logs the encounter and you confirm it that week. #### Questions **Can a student count telehealth hours toward clinical requirements?** Often yes, up to a limit the program sets. Courses vary widely: some accept a quarter of a rotation by video, others accept half, and a few accept none. The cap is stated in the course handbook and confirmed in the placement paperwork, so you are told the number before you agree to teach the student. **Where does the student sit during a video rotation?** Either in your office or in their own home, joining the same visit link. Remote students work fine for medication management and follow-ups. If a program wants some in-person hours, a hybrid arrangement puts the student in your clinic one day and on video the other, which also solves the exam problem. **Do I need my own telehealth platform to be a virtual preceptor?** You need a platform that supports a third participant and a private breakout, which most clinical video tools already do. If your practice runs telehealth today, you are equipped. If it does not, a coordinator walks through options during setup. Nothing about a preceptor's own equipment is expensive: a camera, a headset, a quiet room. **What happens if a patient refuses to have a student present?** The student drops off the call and waits for the next patient. That is the whole procedure. Refusals are uncommon and are almost never about the student personally. Note in the chart that consent was requested and declined, and carry on. A student who watches two or three refusals learns something useful about consent. **Which specialties have the most virtual precepting demand?** Psychiatric mental health leads by a wide margin, because the visits are conversational and the shortage of psychiatric preceptors is the sharpest in nursing education. Family and adult-gerontology primary care follow next, mostly for chronic disease and results visits. Acute care and procedural specialties have almost no video demand, for reasons that are clinical rather than administrative. ### Becoming a WHNP preceptor URL: https://www.nphours.com/whnp-preceptor/ Women's health rotations are in short supply because the visits are intimate and the pool of certified preceptors is small. If you hold women's health certification and see contraception, prenatal, screening or menopause patients each week, you can teach a student on hours you already work. Expect most of it in clinic, because the examination is the part that cannot move. #### Contraception counselling is the first visit to hand over This is the visit a student can run early and safely. There is a history to take, a set of options to lay out, and a decision that belongs to the patient. Have them cover effectiveness, what the first three months feel like, bleeding changes, what to do about a missed dose, and what happens when the patient wants to stop. No leading, no ranking methods by their own preference. Then check two things in the note. First, that the counselling is documented as a discussion rather than a prescription. Second, that the follow-up interval is stated. A student who has led fifteen of these conversations has learned more about shared decision making than any module will teach, and the visit type recurs often enough that they can practise on Tuesday what you corrected on Monday. #### Prenatal visits follow a rhythm a student can learn Routine antenatal care has a schedule, which makes it teachable. Monthly early, fortnightly in the middle, weekly at the end, with a known task list at each stop. Let the student take the return visits first: weight, pressure, fundal height, fetal heart tones, symptoms, the questions the patient wrote in her phone. The intake comes later, once you have heard them handle a return visit without missing the dating or the medication review. Be clear with the coordinator about what your practice actually does. Some women's health courses want antepartum hours specifically, some want gynaecology only, and a practice that refers all obstetrics out cannot supply the first. That is not a disqualification. It just decides which students are shown to you, and it is better settled before dates are booked than at the midpoint review. #### Menopause and cervical screening are underused teaching visits Students see far fewer menopause visits than they need. Give them the full history to take: vasomotor symptoms, sleep, mood, genitourinary changes, bone risk, cardiovascular risk, and what the patient has already tried. Then have them present the options and their trade-offs to you before entering the room again with a plan. Most arrive having read about therapy and never having watched anyone discuss it with a real patient. Screening visits teach a different thing: intervals, results and follow-up. Have the student state when this patient is next due and why, then let them deliver an abnormal result and arrange the next step. Watching one colposcopy referral conversation done well is worth more than the guideline table they memorised, because the difficult part is the patient's reaction, not the interval. #### Sensitive examinations, consent and the chaperone Ask before the appointment, never at the door. A learner in a pelvic or breast examination requires the patient's clear agreement in advance, and the front desk asking when the visit is booked gets an honest answer more often than you asking with the student already in the room. Patients decline routinely, and a decline needs no discussion, no persuasion, and no note beyond the fact of it. Keep your chaperone practice exactly as it is. The student does not replace the chaperone, and a student performing an examination changes nothing about who else is present. Build them up in the usual order: observe, then examine with you guiding, then examine while you confirm. None of this converts to a camera, which is why women's health rotations run mostly in the building. History-only visits, contraception follow-ups and results discussions are the parts that travel. #### CNM students, and where a women's health preceptor fits Nurse-midwifery students sometimes land in the same inbox, and the answer is partly yes. Midwifery programs commonly accept a women's health NP for well-woman care, gynaecology, contraception and antepartum visits. They generally do not accept one for intrapartum, birth or newborn hours, which have to be supervised by a midwife or a physician in that setting. So read the course name on the request rather than the credential of the student. If the request is for a gynaecology or primary care women's health course, your certification usually fits. If it is the birth course, it does not, and NPhours will not put you forward for it. Declining a mismatch costs you nothing and keeps you eligible for the terms that do fit. #### In order 1. List your visit types: Contraception, prenatal, screening, menopause, infertility, gynaecology. Say which ones you personally handle. 2. Sort the consent question: Agree with your front desk how patients are asked about a student before intimate visits. 3. Decide the mix: A clinic day plus a short video session for results and follow-ups suits this population well. 4. Choose your figure: The band runs from $12 up to $20 for every student hour, and you pick the point on it. 5. Open your hours: Certification, state, visit types and the weekday you can share. A coordinator takes it from there. #### Questions **Can women's health hours be completed by telehealth?** Only a portion. Contraception counselling, results discussions, menopause follow-ups and medication reviews work on camera with the student leading. Pelvic and breast examinations, cervical screening, insertions and antenatal checks require the room, so most of a block stays in clinic. The program decides how many virtual hours it will accept and records the number in advance. **Do patients often refuse a student for intimate examinations?** Some do, and it is unremarkable. Ask at booking rather than at the door, take the first answer, and give that patient the visit with you alone. Over a full term a student still accumulates plenty of supervised examinations, because most patients agree once they know who the student is and that you remain in the room. **Can a WHNP precept a nurse-midwifery student?** For part of the curriculum, usually. Midwifery programs often accept women's health NP supervision for well-woman, gynaecology, contraception and antepartum visits, and they require a midwife or physician for labour, birth and newborn hours. The course, not the student, tells you which one you are being asked for. A coordinator confirms it before any dates are agreed. **What does a women's health rotation pay a preceptor?** Preceptors on this network name an hourly rate inside a band with a floor of $12 and a ceiling of $20. Apply it to a standard block of 120 student hours and the total falls somewhere from $1,440 to $2,400. Half of it is released once you file the midpoint evaluation, the remainder after the final, and the money is 1099 income. **Is a family practice with a lot of women's health enough?** It can be, for some courses. What programs check is your certification against the student's track and whether your schedule genuinely contains the visits the syllabus lists. A family practice doing contraception, screening and menopause care may cover a gynaecology course but not an obstetric one. Send your visit mix and let the placement office rule on it. ### Work from home nurse practitioner jobs URL: https://www.nphours.com/work-from-home-nurse-practitioner-jobs/ Four kinds of nurse practitioner work are genuinely done from a spare room: telehealth clinical panels, chart and utilisation review, nursing education roles, and precepting students by video. Most other postings that say remote mean partly remote. The difference matters, because it decides whether your week has a commute in it. #### The work that really happens at a desk Telehealth panels are the largest category. You hold a schedule of video or asynchronous visits, you prescribe, you document, and no building is involved. Chart and utilisation review is the quietest of the four: reading records against a set of criteria, paid by the chart or by the hour, with no patient contact. Nursing education roles include course facilitation and, for master's-prepared nurses, supervising education and leadership practica that contain no clinical hours whatsoever. Precepting by video is the fourth, and it differs from the others because the patients are yours. A student joins your telehealth schedule to learn while you keep treating. The mechanics of that are on the virtual precepting page. What puts it on this list is that everyone involved, including the patient, can be sitting at home. #### Postings that say remote and mean something else Read any remote listing for the sentence that undoes it. Common ones: quarterly onsite meetings that turn out to be monthly. Home-based care, which means driving to patients' houses rather than staying in yours. Triage roles that require a facility for the phone system. Industry and liaison posts with heavy travel written as remote because there is no office. None of these are dishonest exactly, but they are not desk jobs. Three questions settle it before an interview goes far. How many days on site per month, in writing. Whose equipment and whose internet, and who pays if it fails. And whether the hours are fixed, on demand or self-scheduled, because a remote job with mandatory evening coverage is not the flexible arrangement it appeared to be. - Ask for the number of required onsite days per month, as a number. - Ask who supplies hardware, licences, secure connection and technical support. - Ask whether scheduling is fixed, on demand, or chosen by you each week. - Ask which states the role requires you to be licensed in, and who pays those fees. - Treat any posting that charges you to begin as one to walk away from. #### What a video-only preceptor can and cannot count The hours a student banks have to be direct patient care, and each program decides how many of those may happen through a camera. Some courses allow a quarter of the rotation on video, some allow half, and some allow none. You are told the permitted share before you agree to the placement, so a fully remote clinical rotation is realistic in psychiatric care and in primary care follow-up, and unrealistic almost everywhere else. Two hard limits are worth stating. Procedures, physical examination skills and sensitive examinations do not transfer to a screen, so those hours need a room. And hours that never appear on the program's log do not get paid, however much teaching you did. Education and leadership practica are the exception to all of it: no patients, no cap, entirely remote. #### Licensure, which is the real constraint For anything clinical, you need to hold a licence valid where the patient is sitting, not where you are. The compact simplifies that for member states if your home state participates. Every additional single-state licence is an application, a fee and another renewal to track, so telehealth income tends to follow how many licences a clinician is willing to maintain. Non-clinical remote work is lighter. Review work, writing and education roles usually ask only for one active unrestricted licence. Precepting by video sits with the clinical group, because you are still treating your own patients: one licence, valid where they are, is normally all it takes. A student attending from another state does not change that. #### The room, the kit and the money The equipment list is short and unglamorous. A camera at eye level. A headset rather than laptop speakers, so nobody is overheard. A wired connection if you can manage one. A second screen, because holding a conversation and a chart on one display is how documentation errors happen. And a door that closes, which is a clinical requirement rather than a comfort. For precepting you need one more thing: somewhere private to hear a student's assessment while the patient waits in the visit. A breakout room in your video platform does it. Teleprecepting setup covers the configuration. Pay does not vary by mode: an hour of student time on camera earns the same as an hour in your exam room, at whichever figure between twelve and twenty dollars you chose. #### In order 1. Decide clinical or non-clinical: Patient-facing remote work needs licences by state. Review, writing and education work usually does not. 2. Count the licences you hold: That number, more than your CV, sets how much telehealth work is open to you. 3. Set up the room once: Camera, headset, second screen, closing door. An afternoon of work that lasts for years. 4. Ask the onsite question early: Days per month, in writing, before you invest hours in an application process. 5. Add a rotation to your video days: If you already run telehealth, a student is the cheapest income you can add to it. #### Questions **Are there genuine work from home jobs for nurse practitioners?** Yes, in four groups: telehealth clinical panels, chart and utilisation review, nursing education roles, and precepting students by video. All four can be done without leaving the house. Postings outside those groups that advertise remote work usually include site visits, travel or home visits, so ask for the onsite requirement as a number before applying. **Can I precept a student entirely from home?** In some populations, yes. Psychiatric medication management and primary care follow-up rotations can run fully by video where the program allows it. Education and leadership practica are remote by nature because they involve no patients. Courses requiring physical examination or procedural skills will insist on in-person hours, and the program states its cap before you accept. **Do I need licences in several states for remote work?** Only for treating patients. You must be licensed where the patient is located, so multi-state telehealth means multiple licences or compact privileges. Chart review, writing and education roles usually accept one active licence. Video precepting also needs just one, because the patients are yours and they are in your state. **What equipment does a remote preceptor need?** A camera at eye level, a headset, the fastest connection available to you, a second monitor for the chart, and a room with a door. Your video platform needs to support a third participant and a private breakout so a student can present without the patient hearing. Nothing on that list is expensive. **Does remote work pay less than in-person work?** For clinical work it varies by employer and by how visits are counted, and remote roles sometimes pay per visit rather than per hour. For precepting there is no difference at all: the rate you set applies to student hours whether they happen on camera or in an exam room, and payment timing is identical either way. ## What NPhours does ### For clinics: hosting students under one agreement URL: https://www.nphours.com/for-clinics/ If you run the practice rather than the exam room, precepting is an administrative question. One agreement can cover every qualifying clinician on your staff. The onboarding list, the chart role and the point of contact are written once and reused. This page sets out what the practice signs, plans for, and controls. #### One agreement, several preceptors A school's affiliation agreement runs between the school and your practice as an entity, not between the school and one clinician. So a single signed agreement can cover every qualifying clinician you have. Program relations lists the named preceptors in a schedule attached to it, and adding a fourth nurse practitioner in March is usually a short amendment rather than a fresh contract. Two things still multiply. Each new school needs its own agreement, because each has its own template and its own counsel. And a multi-site group has to decide whether the agreement names the practice or specific locations, which matters when a student rotates between two of your offices. Say which you want at the start and program relations drafts to it. #### Written once, reused every term Your practice writes one onboarding list and it goes to every student who ever comes. Parking and which door. Badge, dress code, arrival time. Which policies they read before day one. The EMR training you require. And who lets them in on the first morning. Coordinators keep the current version and send it, so the same email is not rewritten four times a year. Chart access is built once as well. Your administrator creates a student role, read-only or drafting with mandatory cosignature, and reuses it, with each account expiring on the rotation's last day. Then nominate one person as the contact for student logistics, usually the office manager. Everything scheduling-related routes to them rather than to whichever clinician is nearest. #### The cost in patients, and the cap you set Precepting costs throughput before it returns any. For the first two weeks, plan on about one visit an hour fewer on the days a student is present. On a nine-hour clinic day that is real money for a practice that budgets by visit count. From week three most students are close to neutral, and by the second half a competent one is useful in a room. That is why the practice, not only the individual, gets a ceiling. You can cap how many students are in the building at once across all your preceptors, so three clinicians do not each take one in the same fortnight. You can also block practice-wide weeks: an EMR conversion, a survey, an accreditation visit. - A cap on concurrent students across every preceptor at the practice. - Blackout weeks that apply to the whole building, not one clinician. - A named contact who owns arrival, badging and chart access. - One onboarding list, kept current by your coordinator. - A student role in the EMR, built once and reused. #### Signatures, and who receives the money The practice signs the affiliation agreement and any site addendum, and nothing else. Each preceptor separately signs their own onboarding form with NPhours and, during the rotation, the midpoint and final evaluations. The student signs the school's supervision, privacy and conduct forms. The school signs its side and issues the certificate showing the student carries liability coverage. Payment goes to the preceptor. The rotation total is paid to the named clinician as an independent contractor, and the 1099-NEC is issued in that person's name rather than the practice's. If a practice and a salaried clinician would rather handle it another way, that is an arrangement the two of them make between themselves. #### In order 1. Name your signer: The owner, administrator or contracting office who signs agreements for the practice. 2. Sign once per school: One agreement, with your qualifying clinicians listed in a schedule attached to it. 3. Write the practice list: Parking, badge, dress, policies, EMR training and who meets the student. 4. Build the chart role: A student login your administrator can reissue, expiring on each rotation's last day. 5. Set the cap and the contact: How many students at once across the practice, and one person who owns logistics. #### Questions **Does every preceptor here need a separate agreement?** No. The agreement is between the school and the practice, so one signature covers the clinicians named on its schedule. Adding a clinician later is an amendment your coordinator handles. What does repeat is the credential check: each preceptor's license, certification and practice history is confirmed individually before that school approves them. **What does hosting a student actually cost us?** Mostly throughput in the first fortnight, at roughly a visit an hour on the days a student is in. After that the drag falls off quickly. There is no fee to the practice for placement, no charge for the agreement work, and no cost for the orientation your clinician takes beforehand. **Who does the student's chart access come from?** Your own IT or EMR administrator, because it is your system and your patient records. NPhours specifies what the student needs, which is read-only access or drafting that cannot be filed without a cosignature, limited to the preceptor's schedule and expiring on the last day. Build the role once and reissue it. **Can we limit how many students are here at once?** Yes, and most practices do. Set a ceiling that applies across all your preceptors, and coordinators schedule inside it, so two students never arrive in the same week unless you want them to. You can also close whole weeks for the practice, which is what an EMR go-live or a survey week calls for. **Can the practice receive the payment instead of the preceptor?** NPhours pays the individual preceptor named on the rotation and reports that income in their name. Whether a salaried clinician passes any of it to the practice, or waives it, is for the two of you to settle in writing. We are not a party to that arrangement and do not split payments. ### Matching: the student card, and your yes or no URL: https://www.nphours.com/matching/ Matching on NPhours is a queue of cards, not a phone call from a stranger. Each card describes one student's rotation in six fields, you accept or decline it, and nothing about you is shown to a program until you have accepted. This page describes the card, the clock on it, and what follows either answer. #### What is on the card A card carries the program name and the course, the rotation's start and end dates, the hours required, the population and setting the course demands, the mode the program permits for its students, and a short note from the student about their background and what they hope to see. It does not carry the student's name or contact details until you accept, and it never carries their grades. You are deciding whether the rotation fits your clinic, not interviewing the person. Cards only reach you when five things already line up: your state, your certification, your setting, your available hours, and a program that has approved you. A card that fails any of the five is never generated. This is why a preceptor in a rural family practice in Kansas sees FNP rotations from programs approved in Kansas and nothing else, and why a psychiatric prescriber who only works by video never sees an inpatient card. - Program and course, so you know whether it is an early or a final rotation. - Dates and total hours, so you can lay them against your own calendar. - Population, setting and permitted mode, straight from the program's rules. - The student's note, in their own words. #### The clock, and what each answer does You have 72 hours from the moment a card lands to accept or decline it. Two preceptors can be shown the same card in that window; the first acceptance takes it and the other is told within the hour. If you do neither in 72 hours the card leaves your queue and your standing is unchanged. A decline is silent: the program is not told who declined, and your queue continues. An acceptance does three things in the next business day. Your coordinator confirms the dates with the program's placement office and asks for the student's onboarding packet. The student receives your practice's own onboarding list, which you wrote once when you joined. And the rotation appears on your NPhours schedule with its midpoint and final evaluation dates already calculated, because those dates are also your pay dates. #### Preferences you can set, and what they do to your queue Your preferences page has four controls. A cap on concurrent students, which nearly every preceptor sets to one. A blackout calendar for weeks you are away, which suppresses cards whose dates cross it. A list of programs you prefer, which moves their cards to the top without hiding others. And a mode setting: in clinic, video, or both. Change any of them at any time and the next card obeys. One thing you cannot set is a guarantee. NPhours does not promise a card in a given month, because cards come from programs' rotation calendars, and those cluster around January, May and August starts. A preceptor with common hours in a common specialty in a populous state will see more cards than one with none of those. Your coordinator can tell you what the last term looked like for preceptors with your profile. #### In order 1. You are approved by a program: Your documents clear the program's placement office and an affiliation agreement covers your practice. 2. A card lands: Six fields describing one rotation, generated only when state, certification, setting, hours and program all match. 3. You answer inside 72 hours: Accept and the coordinator confirms dates; decline or let it lapse and nothing changes. 4. The student is onboarded: They receive your clinic's list, you receive their packet, and the evaluation and pay dates go on your schedule. #### Questions **Can I see the student's name before I accept?** No. The card shows the program, course, dates, hours, population, setting, permitted mode and the student's own note. Names and contact details are released when you accept, at which point the coordinator introduces you both. This protects students from being screened by name and protects your details from programs you have not agreed to work with. **What if two students would fit at once?** Your concurrent-student cap decides. Most preceptors set it to one, so a second card is held until the first rotation ends. If you set it to two, both cards can be accepted, but coordinators will ask you to confirm that your patient volume supports two learners, since programs count hours seeing patients, not hours in the building. **Why have I not received a card yet?** Usually because no program that has approved you has a rotation starting in the next eight weeks in your state and specialty. Rotations cluster at term starts, so a quiet October is normal. Check that your availability and blackout calendar are current, and ask your coordinator what the previous term looked like for a profile like yours. **Can I decline a student after accepting?** Before the start date, yes, by telling your coordinator, who reassigns the rotation and tells the program. It is not held against you once; a pattern of it is. After the start date a withdrawal strands a student's hours, so coordinators will first try to resolve whatever caused it, whether schedule, fit or clinic volume. **Do programs choose me, or do I choose them?** Both, in sequence. A program approves your documents first, which puts its rotations in reach of your queue. Then you choose the individual rotation by accepting a card. A program can also ask for you by name for a returning student, and that request arrives as a card marked as such. ### Paperwork: four documents, one agreement, one packet URL: https://www.nphours.com/paperwork/ You upload four documents once. Program relations checks each one against the body that issued it, then drafts the affiliation agreement your practice signs. The student's own file lands before the first day. Once a program has cleared you, later rotations reuse what is already on record, and you never sign the same thing twice. #### The four documents you upload once Four files go on your profile the week you join. A current CV with employers, dates and the population you saw in each role. A copy of your active state license, both sides if your board issues a card. A copy of your national certification showing the issuing body, the role and the expiration date. And a short practice description: setting, patient mix, daily volume, the EMR you work in, and the days a learner could sit with you. Program relations reads all four before any school does. The license number goes into the state board's own lookup, so status and expiration come from the board rather than from your scan. The certification is confirmed with ANCC, AANPCB or whichever body granted it, by number and by name. Your CV supplies the dates that show two years in the population after certification. If anything has lapsed, your coordinator tells you before a program sees the file. #### The affiliation agreement, and whose clock it runs on No hour counts until the school and your practice hold a signed affiliation agreement. It sets out insurance, supervision, medical records, student conduct and how either side ends the arrangement. Schools nearly always want their own template, so that is where drafting starts. If your practice already holds an agreement with that school from an earlier student, program relations pulls it, confirms it covers your population, and drafts nothing at all. Program relations completes the template, names you as supervising preceptor, and sends it to the person who actually signs for your practice. That is an owner in a small clinic, a practice manager in a mid-sized group, or a contracting office inside a health system. From there it sits with the school's placement office. One to two weeks is normal and term starts run longer. You do not chase it. Your coordinator does, and sends you the date it comes back countersigned. #### The student's packet, and who signs what The school assembles the student's file and sends it before the first day rather than on it. Inside are immunisation records, a criminal background check, signed HIPAA and confidentiality training attestations, and the certificate showing the student is covered by the school's professional liability policy. You read it, your practice keeps a copy, and none of it is yours to gather. If your clinic wants its own confidentiality form signed, hand it to your coordinator. Signatures divide cleanly. Your practice signs the affiliation agreement. The school signs its side of it and issues the liability certificate. The student signs the school's supervision and privacy forms. You sign one onboarding form with NPhours at the start, then the midpoint and final evaluations during the rotation, and those two signatures are also what release your deposits. Nobody asks you to sign an indemnity, a non-compete, or anything that binds your practice beyond the agreement itself. #### In order 1. Upload the four files: CV, license copy, certification copy and your practice description, once, from your profile. 2. Program relations checks them: State board lookup for the license, certifying body for the credential, CV for the practice years. 3. The agreement is drafted or confirmed: The school's own template if it has one, or an existing agreement pulled and confirmed current. 4. Your practice signs and the school countersigns: Sent to whoever signs for the practice, then back on the school's clock. 5. The student's packet reaches you: Immunisations, background check, training attestations and the liability certificate, in hand before day one. #### Questions **Do I need a new agreement for every student?** No. The agreement binds your practice to a school, not to a person. Once it is signed, every later student from that school arrives under it, and only the dates and the named preceptor change. A second school means a second agreement, which is why the first rotation carries most of the waiting and the fifth carries almost none. **My practice has no legal office. Who reviews the agreement?** Whoever signs contracts for your practice, which in a solo or small clinic is usually the owner. Program relations sends the template with a short note of what it commits the practice to and what it does not. If your signer wants a clause changed, the redline goes back through your coordinator to the school. **What is actually confirmed about my license and certification?** Status, number, population role and expiration date, taken from the state board's lookup and from the certifying body's own records. An encumbrance, a lapse, or a certification in a population you are not going to precept stops the file there. You get told what it is, and the file resumes when the underlying document is current again. **How long does this stage take from upload to first day?** Document checks usually finish inside a few business days. The agreement is the long pole at one to two weeks on the school's clock, and longer in the weeks before a term starts. The student's packet arrives once the agreement is signed. Plan on three to four weeks total for a first rotation with a new school. **What if my certification expires part way through a rotation?** Tell your coordinator as soon as you know the date. Most schools require the credential to be current for every hour a student logs, so the renewal has to land before the expiry. Upload the new certificate the day it arrives and the file updates. Nothing already logged is affected. ### Pay: your rate, the log, two deposits URL: https://www.nphours.com/pay/ You name your own rate on your preferences page, the school's log decides how many hours you are paid for, and the money arrives in two direct deposits tied to the two evaluations you sign. This page shows the arithmetic at four rates and says what lands on your tax return in January. #### Setting your rate Your preferences page has one dollar field. You pick any figure between $12 and $20 per student hour and it travels with every card you are shown from that moment on. Nobody negotiates it down. Schools see the total for a rotation, not a list of preceptors sorted by price, so a higher figure does not push you to the back of a queue. You can change the number whenever you like, and a change applies only to rotations you accept afterwards. A card you already accepted keeps the figure it carried on the day you said yes. Raise your rate in June and the student you took in May is still paid on May's number, with no mid-rotation adjustment for anyone to explain. #### What a block pays, in dollars A block is 120 student hours. Multiply 120 by your figure and you have the rotation total. A half-block is 60 hours, so halve it. Three blocks in a calendar year comes to 360 hours, which is where a preceptor taking one student per term usually lands. The list below is the whole calculation, with nothing deducted at either end. There is no fee to you at any point. NPhours does not charge preceptors to join, to be listed, to be matched, to be paid, or to sit the orientation. Nothing is subtracted for the student's onboarding either. Programs carry the cost of placement, so what the arithmetic says is what reaches your account. - At $12: $1,440 a block, $4,320 across three blocks. - At $15: $1,800 a block, $5,400 across three blocks. - At $18: $2,160 a block, $6,480 across three blocks. - At $20: $2,400 a block, $7,200 across three blocks. - A 60-hour half-block pays half the block figure at your rate. #### The two deposits, and what releases them Payment follows the hours in the school's own clinical log, not the hours on your calendar. Half the rotation total is released when you sign the midpoint evaluation. The other half is released when you sign the final. Both arrive by direct deposit into the account you gave at onboarding, and your coordinator tells you the date each was sent. A rotation that stops early pays for the hours already logged. If a student withdraws at 74 logged hours, you are paid for 74 at your figure, and your coordinator asks the school to close the log so the total is final. Hours nobody logged are not paid, however many days a student sat in your clinic, which is why week four carries a log check. #### Tax, and what NPhours reports This is independent contractor income. NPhours withholds nothing: no federal or state income tax, no Social Security, no Medicare. You receive the gross figure and you owe the tax on it, self-employment tax included, which for many preceptors means quarterly estimated payments. Ask your own preparer what that means for your return before you set money aside. Each January, NPhours issues a 1099-NEC to every preceptor paid $600 or more in the previous calendar year. Box 1 totals the deposits that cleared inside that year, so a final evaluation signed in early January falls on the next form rather than the last one. Keep your address and taxpayer details current so the form reaches you. #### In order 1. Name your rate: One dollar field on your preferences page, changeable whenever you want. 2. Accept a card: The figure locks to that rotation on acceptance, whatever you do to the field later. 3. The student logs hours: The school's log is the record your payment is calculated from. 4. Sign the midpoint: Your signature releases half the rotation total by direct deposit. 5. Sign the final: The balance goes out, trued up to logged hours if the rotation ended early. #### Questions **When exactly does the money arrive?** Each half is released when the matching evaluation is signed, and direct deposits usually settle within a few business days. A midpoint signed in week seven pays in week seven or eight. If a school is slow returning its form, your coordinator chases it, because the signature is the trigger. **What happens to my pay if the student drops out?** You are paid at your figure for every hour the log shows on the day the rotation closes, whether that is 20 hours or 110. If the withdrawal follows a signed midpoint, the first half is already yours and the balance is trued up to the logged total. Nothing is clawed back. **Can I raise my rate for the next student?** Yes. Edit the field and the next card you accept carries the new number. Anything already accepted stays where it was. Most preceptors settle on one figure and leave it, revisiting after a term or two once they know how many teaching days a student really costs them. **Do I pay anything to NPhours out of my rate?** No. Preceptors are never charged, and nothing is subtracted from the figures above. The number you set is the number you are paid. If anyone ever asks you for a fee in the name of NPhours, stop and tell your coordinator that day. **How is this income reported to the IRS?** On a 1099-NEC when your deposits for the calendar year reach $600, issued each January for the year before. Below that threshold no form is issued and the income is still reportable. Keep your own note of deposit dates and amounts; it is the quickest way to reconcile the form at filing time. ### The orientation: 90 minutes before your first student URL: https://www.nphours.com/preceptor-orientation/ Before your first student, you watch a 90-minute orientation. It is video, split into short modules, and you take it whenever you have the time, in pieces if you like. It covers the log, the two evaluation forms, the first morning, two teaching methods you can use tomorrow, and what to do when a student is behind. #### What the ninety minutes covers The modules follow a rotation in order. First the log: which system the school uses, what a student records about each patient, the rule that entries go in within 48 hours of the visit, and where you sign off. Then the two evaluation forms, midpoint and final, shown as the real forms with the fields you will fill. Then the first morning, the weekly progression, the two methods, and your coordinator. Nothing in it is philosophy. Every module ends with something to do: a sentence to say, a field to fill, a question to ask. Stop after any module and come back; the video returns you to the same point. Most preceptors get through it across two or three evenings in the week before a student starts. - The log system, the 48-hour rule, your sign-off. - The midpoint and final forms, field by field. - The day-one huddle, then shadow, see, present. - The one-minute preceptor and SNAPPS, with scripts. - What to do when hours run short. - When to call your coordinator. #### The first morning, and the progression after it The day-one huddle is fifteen minutes before the first patient. You cover four things: how you want to be interrupted, where the student sits and stands in a room, what they may do without asking, and what time you break. Then you say the week's goal out loud. Students arrive braced for a test and are relieved to get logistics instead. After that the rotation moves in three stages. For the first days the student shadows and writes questions down instead of asking mid-visit. Then they take the history and one focused exam first, and you come in after. By the second half they run the room, present, and you confirm. The orientation shows when to move on, which is usually earlier than a cautious preceptor thinks. #### Two teaching methods you can use the next day The first is the one-minute preceptor, for the doorway conversation. Ask the student to commit to a diagnosis before you discuss anything. Ask what in the history or exam took them there. Give one rule they can carry to the next patient. Name the specific thing they did well. Correct one thing, not five. It fits between two rooms. The second is SNAPPS, for the student who talks for four minutes and lands nowhere. They summarise briefly, narrow to two or three possibilities, compare those out loud, then ask you about the part that confuses them. You settle the plan together, and they pick one question to read on that evening. The orientation runs both methods on the same case. #### Forms, hours running short, and what this is not Two modules deal with writing. On the evaluation forms, a comment that helps starts with a behaviour and a case, not an adjective: what the student did, in which visit, and what you want next time. Three weak comments get rewritten on screen. On hours, you hold logged hours against weeks elapsed at week four, and choose among three fixes. One thing to be plain about: this is not accredited continuing education. No CE certificate is issued, no contact hours are awarded, and nothing in it counts toward a state renewal or a certification cycle. Precepting hours themselves may count with your certifying body, which is a separate matter with its own paperwork. The orientation exists to make your first rotation easier. #### In order 1. Clearance first: The orientation opens once your documents are checked, before you accept a card. 2. Watch in pieces: Ninety minutes across as many sittings as you want, on your own hours. 3. Answer the short checks: A few questions per module, so the log and forms are familiar later. 4. Take a student: Your coordinator confirms it is done before a first day is set. 5. Rewatch as needed: The modules stay open for as long as you precept. #### Questions **Do I get CE credit or a certificate for this?** No. The orientation is not accredited continuing education, no contact hours are awarded, and no certificate is issued. It is practical training for the rotation you are about to run. Precepting hours may count toward your own recertification under your certifying body's rules, but that is a separate process with separate documentation. **Is the orientation required before my first student?** Yes, once. Your coordinator checks it off before a first day is scheduled. It is not repeated for later students, though the modules stay open. Preceptors who have taught for years still watch the log and forms modules, because those are school systems rather than clinical ones. **How long does it really take?** About ninety minutes of video, plus a few minutes of questions between modules. In one sitting it is a long evening. Split across three evenings it is half an hour each, and that is how most preceptors do it. You can pause anywhere and pick the thread back up. **Does it cost me anything?** No. The orientation is free to preceptors and nothing is deducted from a rotation to pay for it. You are not paid for the time you spend on it either, because it happens before a student is assigned and before any hours exist to log. Rotation pay follows student hours only. **What if I run into something the modules did not cover?** Call your coordinator. The orientation covers the common ground: logs, forms, the first morning, the two methods, hours running short. Anything specific to your school, your clinic or your student is exactly what a named coordinator is for, and you get an answer inside one business day. ### Scheduling: where 120 hours go on your calendar URL: https://www.nphours.com/scheduling/ A block is 120 student hours and a half-block is 60. The shape of those hours is yours. Most preceptors spread a block across 14 to 16 weeks at eight or nine hours a week, which is one clinic day or two half days. This page covers the weekly shapes, the crowded months, and moving dates. #### The weekly shapes that add up to a block Do the arithmetic once and the rest is easy. One nine-hour clinic day a week for fourteen weeks is 126 hours, so a block fits with a day to spare. Two four-and-a-half-hour half days over the same fourteen weeks reach the same total. Programs care about the total and the end date, not which weekday you picked. Choose the shape that matches how your week already runs. Preceptors in full-time posts usually give one fixed day, because a student on the same weekday learns your rhythm and your staff stop asking who they are. Two half days suit clinics with heavy mornings. Four scattered afternoons is the pattern to avoid: hours arrive slowly and every session restarts. - One nine-hour day a week for fourteen weeks: 126 hours. - Two half days a week for fourteen weeks: about the same. - Three days a week for five weeks: an intensive block. - One day a week for seven weeks: a 60-hour half-block. #### Term starts, and the months that fill first Rotations start when school terms start, so January, May and August carry most of them. Requests for those months reach coordinators eight to twelve weeks ahead, which means a preceptor who opens hours in June is looking at August or January rather than July. October and February are genuinely quiet, and a few programs run off-cycle terms. Your own dates go in first. Tell your coordinator the earliest week you could start, the weekday you can give, and the weeks you are away in the next six months. Cards then arrive with dates already inside that window, which beats negotiating backwards from a school's proposed calendar. Nothing is booked without you naming a start week. #### Blackout weeks, your cap, and pauses Two settings protect your calendar. Blackout weeks mark the time you are away, and no rotation is proposed that would run through them. Mark a conference, a holiday, a family week, a surgery, and mark it early. Your cap on students at one time is the second setting, and it counts rotations that overlap by even a day. A rotation already running can pause. Your own illness, a family emergency, jury duty, an unexpected locum stretch: tell your coordinator and the calendar stops instead of the rotation ending. A week or two is absorbed by extending the end date. Longer needs the school's agreement, which your coordinator asks for directly. #### Moving dates, and how shift work is handled Hours slip. A student misses two weeks with a sick child, an ice storm closes your clinic, your own schedule turns over. The usual fix is the end date: keep the weekly pattern and add weeks until the logged total reaches the requirement. Adding a second day for the final month is the other route. Both need the school's sign-off. Acute care and inpatient rotations are built differently, because you work shifts rather than clinic days. The schedule there is a list of named shifts, twelve hours at a time, taken from your own rota once it is published. Often the first month is fixed and the rest follows in batches. #### In order 1. Name your day and your window: The weekday you can give, your earliest start week, the weeks you are away. 2. Accept dates already inside it: Cards arrive with a start and an end date you have not had to argue for. 3. Set the pattern with the student: First day, weekly hours and a standing arrival time, agreed in week one. 4. Check the total at week four: Logged hours against weeks elapsed, early enough that one added week fixes it. 5. Extend, pause or close: Your coordinator takes any date change to the school and confirms it in writing. #### Questions **Can I precept without giving up a whole day a week?** Yes. Two half days a week reach a block in the same fourteen weeks, and a half-block asks one day a week for seven weeks. What matters is that the day is predictable and that your volume on it is real. Four scattered afternoons add up on paper and teach much less. **How far ahead are rotations scheduled?** Schools usually place students eight to twelve weeks before a term starts, and the three term months fill first. Open your hours a season ahead of when you want a student and you see the widest choice of dates. Late requests do appear, two or three weeks out, when another preceptor withdraws. **What happens if I book a holiday mid-rotation?** Put it in your blackout weeks and it is planned around rather than worked around. If it falls inside a rotation already running, the usual answer is to add the weeks you are gone to the end date. The student keeps the same weekly pattern and their total hours do not change. Tell your coordinator once the dates are set. **Can I take two students at once?** You can raise your cap, but coordinators will ask what your volume looks like on the days involved. Two students in one session usually halves what each of them sees, and hours only count with a patient in front of them. Sequential rotations, a week apart, is the pattern that holds. **How are inpatient and shift-based rotations scheduled?** By shift rather than by weekday. You give the shifts you are working once your rota is published, the student is matched to a set of them, and the batch is confirmed month by month. Acute care rotations are therefore less predictable in advance and often shorter in calendar weeks, since twelve-hour shifts add up quickly. ### Support: one named coordinator, start to finish URL: https://www.nphours.com/support/ Every rotation has one coordinator, by name, with a direct line. They check in three times, they answer inside one business day, and they take the school on so you do not have to. This page says what they check, what they will handle for you, and the three things they will not do. #### Who they are, and how to reach them You are introduced by name before the first day, and that person stays with the rotation until the final evaluation is filed. They know your clinic, your weekday, your school and your student, so nothing has to be explained twice. Coordinators are not clinicians; they are the people who run placements for a living and who talk to placement offices every day of the week. Reach them however suits the day. Text for anything short, including from the parking lot between patients. Email when there is a form or a date to quote. Phone on +1 (888) 640-4687 when it needs a conversation. Every route gets an answer inside one business day, and usually the same day. If your coordinator is away, the person covering has your file open before they call back. #### The three points they check Week four is the log check. Your coordinator opens the school's log, counts the hours the student has recorded, and sets that number beside the weeks gone by. Nine hours short in week four is a small fix. Forty hours short in week eleven is not. They call either way, and ask whether a thin number is attendance, logging or clinic volume. The midpoint is the second check, and it is a pay date too, so they confirm the form reached you and chase the school if it did not. The final check closes things: last hours verified, evaluation signed, log closed, second deposit released. Then they ask you one question, which is whether you want another student and when. #### What they take off your desk The work a coordinator absorbs is the work that has nothing to do with teaching. A student behind on hours becomes a revised end date agreed with the school. A student who is a poor fit becomes a conversation, then a plan, then sometimes a reassignment. A placement office that stopped answering email becomes a phone call to its director. You are also allowed to just ask. Preceptors call about a student who arrives late twice, about a form field they have not seen before, about how blunt to be in a midpoint comment. That is the job. A coordinator who hears about a problem in week five has options that one who hears in week fifteen does not. - A student behind on hours, and the date change that fixes it. - A fit that is not working, before it becomes a failed rotation. - A placement office that has gone quiet. - An evaluation form that has not arrived. - A pause for illness, leave or a family week. - A withdrawal, and what is paid. #### The three lines they do not cross A coordinator does not practise medicine. They will not advise on a patient, review a chart, or weigh in on a clinical decision, and if you ask they will say so plainly. Clinical questions belong to you and, for teaching questions with a clinical edge, to the orientation modules and the articles written by the clinical leads on the team. They also do not grade. The midpoint and final evaluations are yours to write and sign, and no coordinator edits your wording or softens a score. And they do not hand out your details: schools see the profile you built and nothing beyond it, and your phone number, home address and pay rate are not part of what a program receives when it approves you. #### In order 1. You are introduced: Name, direct line and email, before the student's first day. 2. Week four, the log check: Hours recorded against weeks elapsed, with a call either way. 3. The midpoint: The form confirmed in your hands, the school chased if it is late. 4. Anything, any time: Text, email or phone, with an answer inside one business day. 5. The final: Hours verified, evaluation signed, log closed, second deposit released. #### Questions **Is it the same person for the whole rotation?** Yes. One coordinator is assigned before the first day and stays through the final evaluation. Take a second student later and you may get the same person again, particularly at the same school. When your coordinator is on leave, a named colleague covers with your file already read, and you are told who. **How quickly do they actually reply?** Inside one business day, on any of the three routes, and usually faster. Texts are often answered within an hour or two during clinic hours. If something is urgent, say so in the first line and call rather than email. A student safety concern goes to your own practice first, not to a coordinator. **What if the student is not working out?** Call in the week you first think it, not the week you are certain. Your coordinator will ask what specifically is happening, help you put it into the midpoint evaluation in writing, and take it to the school. Outcomes range from a clear plan for the second half to a reassignment. Early beats tactful here. **Will a coordinator answer a clinical question?** No. Coordinators do not give clinical advice or review charts, and they will tell you so. What they can do is point you at the teaching material for the situation, whether that is how to structure a doorway conversation or what to write about a student who is not ready to see patients alone. **What do programs learn about me?** The profile you built: your credential, your practice, your setting, your population, your availability. Nothing else. Your rate, your phone number and your home address are not sent to schools, and NPhours does not add you to any list that programs or students can browse without your having accepted a rotation. ### Teleprecepting setup: platform, consent, chart, headset URL: https://www.nphours.com/teleprecepting-setup/ A video rotation runs on your practice's own visit platform, not on anything NPhours installs. What has to be arranged is a seat for the student, a spoken consent at the top of each visit, somewhere to hear a presentation, and a chart login. All of it is set before the first visit. #### The platform, and the student's seat in the visit Video rotations use whatever HIPAA-compliant visit system your practice already runs. Nothing is swapped out and no new vendor appears. The student joins one of two ways. You add them to the visit link as a second participant, named in full so the patient can read who is present. Or they sit in your virtual waiting room and you admit them once the patient has agreed. Pick one before day one and tell your coordinator, because it changes what the student is sent. A second-participant setup puts them on your visit invitations. A waiting-room setup gives them the room link and the habit of waiting quietly. Either way, the student never opens a visit alone. #### The consent line, and the private call to present Every visit opens with the patient hearing that a student is there. Give the student's first and last name, say they are a nurse practitioner student from a named school, say what they will do in the visit, and say the patient may ask for them to leave with nothing lost. Wait for a spoken yes before the camera goes on, then note the consent in the chart. You still need somewhere to hear a presentation. Two arrangements work. A breakout room inside your platform, where the student goes while the patient stays on the call. Or a second channel: the student drops off, rings your cell or a separate meeting line, takes ninety seconds, and rejoins. Say how many minutes you will be gone, because quiet on a video call feels long. #### Chart access, and the equipment that makes it bearable The student needs the chart open while the visit happens, and that login comes from your practice's IT or EMR administrator, never from NPhours. Ask for a scoped account: read-only, or note drafting that cannot be filed without your signature, limited to the schedules the student is on, expiring on the last date. Request it the week the agreement is signed, since provisioning can take days. Two pieces of hardware do most of the work. A wired headset with a boom microphone, so the student hears the patient and nobody shares a room speaker. And a second screen, so the chart sits on one display and faces on the other. If you work from a home office, test everything the day before. - Scoped student login, expiring on the rotation's last day. - Wired headset with a boom microphone, for both of you. - A second screen, so the chart never covers a face. - A rehearsal call the day before the first visit. #### Logging a video encounter, and what your program permits A video encounter is logged like any other, with one extra field. The student records the date, the visit length, the age band, diagnoses and procedures, their own level of participation, and the mode as telehealth rather than in person. You verify those entries in the log system the school uses, while you can still remember the patient. How many of those entries count is the school's call, not yours and not ours. Some accept a whole rotation by video. Some cap the video share and want the rest in person. Some allow video only for follow-ups and medication management. The permitted mode is named on the card you accepted. #### In order 1. Name your platform: Tell your coordinator which visit system you use and who administers it. 2. Choose how the student joins: Second participant on the invitation, or admitted from the waiting room. 3. Request the chart login: Scoped, read-only, expiring on the last day of the rotation. 4. Test the kit: Headset, second screen, wired network, one rehearsal call. 5. Run the first visit: Consent spoken aloud, student admitted, a short presentation off the call. #### Questions **Does NPhours provide the video platform?** No. You use the HIPAA-compliant system your practice already pays for and already trains staff on. NPhours arranges the student's seat in it, the consent wording, the chart request and the schedule. If your practice runs no video visits at all, your coordinator will say a video rotation is the wrong first one. **Who says the consent line, me or the student?** Either, as long as the patient hears it before the student appears on camera. Many preceptors let the student say it, because naming their own school out loud is useful practice. You confirm it and answer whatever the patient asks. Then document that consent was obtained, in the visit note itself. **What if a patient says no to a student?** The student leaves the call and the visit continues. No explanation is owed, and nothing is recorded beyond the fact that consent was declined. Warn the student in advance that this happens and that it is not about them. Those minutes are not logged as an encounter. **Can the student write in my chart?** Only if your practice wants that and your EMR supports a draft note that cannot be filed without your signature. Read-only is the simpler start and is enough for a first rotation. Either way the account belongs to your practice, is created by your own administrator, and closes on the final day. **Will a school accept a rotation done entirely by video?** Some will and some will not. The permitted mode appears on the card before you accept anything, so you are never guessing. If a school caps the video share, your coordinator books the in-person days from the start rather than letting them pile up in the last two weeks. ## Home page questions **Who can precept through NPhours?** Nurse practitioners, certified nurse-midwives, CRNAs and clinical nurse specialists with an active, unencumbered license, national certification in the population they would teach, and two years of practice since certification. Registered nurses with an MSN or higher and a current teaching or management role can precept MSN education and leadership practica. Physicians and PAs are accepted where a program's handbook allows them. **What does a block pay, and when?** You choose a rate from $12 up to $20 for every hour of student time. A standard block of 120 hours therefore pays $1,440 to $2,400. Half is deposited when you sign the midpoint evaluation and half when you sign the final. Pay follows the hours the program's log shows, so a rotation that ends early pays for the hours completed. **Can the whole rotation be by telehealth?** Sometimes. The program decides what share of a student's hours may be completed by video, and it writes that share into the affiliation agreement. Psychiatric and primary care follow-up visits are the ones most often permitted. Acute care and procedural rotations rarely qualify. Your card shows the permitted mode before you accept, so a video-only preceptor never sees an in-person rotation. **How much of my clinic day does a student take?** Expect one fewer patient an hour during the first fortnight, while the student learns your flow and your EMR. After that most preceptors recover the time as the student takes the history and drafts the note. The orientation covers two teaching methods, the one-minute preceptor and SNAPPS, built for exactly this problem. **Who handles the paperwork with the school?** Program relations at NPhours. The affiliation agreement is drafted in the school's own template or an existing one is confirmed, your license and certification are verified once and re-used across programs, and the student's onboarding packet is collected before day one. You sign the agreement if you own the practice; otherwise your administrator does, and a coordinator walks them through it. **Is there any cost to me?** No. NPhours is paid by the programs and students it places, not by preceptors. There is no fee to apply, to be on the roster, to decline a card, or to leave. The only money that moves toward you is the two halves of each block, reported on a 1099-NEC each January if the year's total reaches $600. ## Questions page **Do I need my employer's permission to precept?** In practice yes, because the affiliation agreement is between the program and the practice where the student will be, and someone with authority signs it. If you own the practice that is you. Employed clinicians usually need a clinic manager or a medical director to agree, and many health systems have a standing process. A coordinator sends the agreement to whoever you name. **Is a student ever alone with a patient on my rotation?** No. A student on your rotation sees patients under your direct supervision and every encounter is reviewed with you before the patient leaves or the video visit ends. Programs write this into the agreement and NPhours enforces it. A student may take a history alone and present to you; they may not manage a visit alone. **What if my clinic uses an EMR the student cannot access?** Most rotations solve this with a read-only student login or a shadow login under your account, arranged with your practice's IT before day one. Onboarding at NPhours has connected students on eleven EMRs and can tell your administrator which route each vendor supports. If none is possible, the student documents in the program's log and you attest. **How is my rate chosen, and can I change it?** You choose it, anywhere from $12 to $20 per student hour, when you join, and you can change it on your preferences page. A change applies to cards you accept afterward, not to a rotation in progress. Preceptors in high-demand populations and states tend to set the top of the band and still receive cards. **What if a student is not a fit for my clinic?** Tell your coordinator early, ideally in the first two weeks. Most problems are scheduling or expectations and are fixed by a call between the coordinator, the student and the program. Where the fit is genuinely wrong, the program reassigns the student and you are paid for hours already logged. Nothing is recorded against you. **Does precepting affect my malpractice coverage?** Usually not, but confirm it. Students carry their own policy through the program, and the affiliation agreement states the program's coverage for the student. Your own policy covers your supervision as part of your practice in most cases; some carriers ask to be told. Onboarding provides the agreement language your carrier will want to see. **Can I precept students from more than one program?** Yes. Your four documents are verified once and each program approves you against its own handbook. Cards then arrive from every program that has approved you, and your concurrent-student cap decides how many you hold at a time. Most preceptors keep the cap at one and take students from whichever program's calendar fits. **How are my hours documented for recertification?** The program provides a letter stating the student, the dates and the hours precepted, which is what ANCC asks for under its professional development categories and what AANPCB asks for when converting precepting hours to CE. Your coordinator requests the letter at the close of each rotation so it exists before you need it. **What happens if I need to pause mid-term?** Tell your coordinator as soon as you know. For a short absence the student's dates are extended with the program's agreement. For a longer one the program reassigns the student to another roster preceptor of the same population in the same state, and you are paid for the hours logged with you. Illness and family emergencies are not held against anyone. **Is NPhours a school or a staffing agency?** Neither. NPhours is an independent preceptor network. It does not enroll students, award credit, employ preceptors or place them in jobs. Programs and their students pay NPhours to find and coordinate preceptors; preceptors are paid as independent contractors per block. It is not affiliated with any university or certifying body. **What do students actually do on a video rotation?** They join your visit with the patient's consent, take the history or run the follow-up on camera while you observe, present to you in a private breakout between calls, and draft the note where the program and your EMR allow it. The program decides what share of the student's hours may be video, and that share is on the card. **How long is the commitment?** One block, which most students complete in a term of 14 to 16 weeks at eight to nine hours a week. After that you decide whether to take the next card. There is no minimum number of rotations, no notice period to leave the roster, and no penalty for a season off.