Home Health Attorney Joe Flores JD APRN

11/23/2025

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Should Nurse Practitioner Students Be Required To Obtain Their Own Preceptors?

By Joe Flores JD MSN APRN FNP-BC CCRN-K

Info@floreslawfirm.com

Introduction: As a lawyer who represents nurses I have seen the policy of requiring students to obtain their own preceptors become the rule rather than the exception.

Such policies are quite distinct from the medical model of how medical students obtain their clinical experiences. Often disparity between rural and urban learning opportunities is compounded by the majority of Universities charging premium tuition prices coupled with the student having to pay out of pocket for a preceptor in many instances to private third party for profit businesses that match preceptors.

Too often even if the nurse practitioner student does pay a third party entity the student is limited in choice of a preceptor , not given the preceptor’s name or credentials prior to payment and signing a contract and may mandate the student to travel hours for a clinical preceptor.

The litigation surrounding policies that require nurse practitioner (NP) students to obtain their own preceptors has emerged as a significant issue in the nursing education landscape. Here’s an overview of the key aspects of this topic:

Background on the Issue
- Rising Tensions: As NP programs have expanded, the demand for clinical placements has increased. Some universities have implemented policies requiring students to find their own preceptors as a way to address this demand and promote autonomy. Many NP students I have interviewed reasonably complain that their tuition should include preceptor opportunities for the student in a prearranged fashion.

Recently the Department of Education hase made a public statement that nurses and nurse practitioners do not fall under the category of “professionals” which may cap the ability for the NP student to obtain loans and other federal aid.

Concerns Raised:

Students and advocacy groups have raised concerns that such policies may violate principles of equity, access, and educational quality, potentially leading to disparities in training opportunities.

Legal Challenges
1. Discrimination Claims:
- Some litigation has focused on claims that requiring students to find their own preceptors disproportionately harms students from marginalized backgrounds or those without existing professional networks.
- Lawsuits may argue that these policies create barriers to education for individuals who may already face systemic inequities.

2. Breach of Contract:
- Students may allege that universities have breached their contractual obligations by not providing adequate support for securing clinical placements.
- Cases could arise if students believe that the university promised to facilitate preceptor placements as part of their educational program.

3. Negligence and Duty of Care:
- There are potential claims related to the university's duty to ensure that all students have equal access to quality educational experiences.
- If students are unable to secure placements due to university policies, they may argue that the institution is negligent in fulfilling its educational responsibilities.

Notable Cases
- While specific cases may not always be widely publicized, there have been instances where students have filed grievances and lawsuits against universities over preceptor placement issues. These cases often focus on the broader implications of educational access and equity.

Institutional Responses
1. Policy Revisions:
- In response to litigation or the threat of legal action, some universities have begun revising their policies to provide more support in securing preceptors, aiming to reduce legal liability and promote equitable access.

2. Creating Partnerships:
- Institutions may seek partnerships with healthcare organizations to establish a more robust network of available preceptors, thereby alleviating the burden on students. Many students believe this should be the rule not a bonus for their expenditure for tuition and education.

3. Enhanced Communication:
- Universities are increasingly communicating expectations clearly to students regarding preceptor requirements and the support available to them.

Advocacy and Recommendations
- Professional Organizations: Groups like the American Association of Nurse Practitioners (AANP) advocate for policies that facilitate equitable access to clinical placements and encourage schools to provide support for students in securing preceptors.

- Legislative Action: Advocacy for legislative measures that require educational institutions to ensure clinical placement availability may also be a pathway to address these concerns.

Conclusion
The litigation surrounding NP programs requiring students to find their own preceptors underscores significant issues related to equity, access, and the responsibilities of educational institutions. As this issue continues to evolve, it is likely to prompt further discussion and action within the nursing education community.

Questions or Feedback?
Email
Info@floreslawfirm.com
361-887-8670

Reference List

1. American Association of Nurse Practitioners (AANP). (2021). Position Statement on Nurse Practitioner Education and Clinical Experiences. Retrieved from [AANP website](https://www.aanp.org).

2. Billings, J. A., & Halstead, J. A. (2020). Teaching in Nursing: A Guide for Faculty. Jones & Bartlett Learning.
- This book discusses the role of preceptors in nursing education and the implications of policies requiring students to find their own preceptors.

3. Buchanan, R. J., & McNair, S. (2019). "Exploring the Impact of Preceptor Quality on Student Learning Outcomes in Nurse Practitioner Programs." Journal of Nursing Education, 58(6), 340-347.
- This study examines how the quality of preceptors affects NP students' educational outcomes.

4. Kutz, K., & Adams, A. ( 2022). "Equity in Clinical Placements: The Need for Support in Nurse Practitioner Education." Nursing Outlook. 70(5), 852-860.
- This article addresses the challenges faced by NP students in securing preceptors, particularly those from underserved backgrounds.

5. Laven, G. H., & Wilkinson, D. (2018). "The Challenges of Securing Clinical Placements for Nurse Practitioner Students: A Systematic Review." Journal of Clinical Nursing, 27(23-24), 4500-4510.
- A systematic review that discusses the barriers NP students face in finding preceptors and implications for nursing education.

6. Mendez, C., & Kearney, M. H. (2021). "Student Perspectives on Finding Preceptors: A Qualitative Study." Nurse Educator, 46(2), 66-70.
- This qualitative study explores NP students' experiences and challenges when required to find their own preceptors.

7. National Organization of Nurse Practitioner Faculties (NONPF). (2020). Nurse Practitioner Core Competencies Content. Retrieved from [NONPF website](https://www.nonpf.org).
- This document outlines core competencies for NP education, including the importance of clinical placements.

8. Patel, R., & Smith, L. (2023). "Legal Considerations in Nurse Practitioner Education: The Case for Institutional Support in Preceptor Placement." Nursing Law Review, 28(1), 25-40.
- This article discusses potential legal implications of policies requiring NP students to secure their own preceptors.

9. Sullivan, M. J., & McCullough, A. (2022). "The Autonomy Dilemma: Balancing Independence and Support in Nurse Practitioner Education." Journal of Professional Nursing, 38(3), 180-187.
- This paper reviews the debate on student autonomy in finding preceptors versus the need for institutional support.

10. U.S. Department of Health and Human Services (HHS). (2021). The Future of Nursing: Leading Change, Advancing Health. Retrieved from [HHS website](https://www.hhs.gov).
- A report that discusses the future of nursing education, including the role of clinical placements.

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11/10/2025

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11/04/2025

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Joe Flores JD APRN FNP-BC
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10/07/2025

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09/20/2025

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Top Interventions You Can Do If Accused of Health Fraud

Joe Flores JD APRN MSN CCRN-K LNC

Federal and TX Attorney and FNP-BC
National and Global Speaker

If a nurse practitioner (NP) is facing an investigation for health fraud, it's crucial to approach the situation with care and diligence. Here are ten steps that can be taken:

1. Consult Legal Counsel: Engage an attorney with experience in healthcare law and fraud investigations to understand rights and options. Providing Statements without council can cost you not only fines but can lead to criminal charges for lying to a federal agent.

2. Gather Documentation: Collect all relevant documentation, including patient records, billing statements, and communications that may pertain to the investigation. Your laptop, devices and hard files may be seized and held for a prolonged period of time. Back up all data and be ready to continue delivering care if allowed.

3. Understand the Allegations: Clarify the specific allegations being made to prepare an appropriate response. Denial or anger at being “targeted” solves nothing. Make sure you have competent council and an accountant plus a biller with a reputable character before starting a business and do not partner with anyone you have not performed strict due diligence on and certainly never partner with someone who has less to lose than you do. Too many NP’s think theyvneed a partner o or mentor controlling your business. Far too many nurse practitioners have been prosecuted because of third parties that were unnecessary or dangerous.

4. Review Policies and Procedures: Ensure compliance with healthcare regulations and internal policies to identify any potential areas of concern.

5. Cooperate with Investigators: While maintaining legal counsel, cooperate with the investigation to demonstrate transparency. Never debrief or give context to documentation without your lawyer by your side. Far too many NP’s
are under the belief they do not need a lawyer to their detriment. Simple audits and brief 1-2 hour consults protect you from contractual , employment law and state and federal law mistakes. Seek a Non Prosecutorial Agreement ( NPA) or a lawyer who can provide a reasonable and truthful explanation for certain documentation or actions by you or employees under your control.


6. Avoid Public Statements: Refrain from making public comments or discussing the case on social media to prevent further complications. Do not talk to anyone without your attorney’s monitoring of such activity. Anyone including a spouse or significant other can be a fact witness against you.

7. Prepare for Possible Outcomes: Consider potential consequences, including administrative actions, civil penalties, or criminal charges, and prepare accordingly. Too many NP’s live under the impression prosecution cannot happen to them. Lawyer up.

8. Seek Support: Connect with professional organizations for guidance and support during the investigation process without sharing your particular situation. Many NP articles and posts share their experience but read and listen not contribute to avoid any inadvertent admissions.

9. Maintain Professionalism: Continue to uphold professional standards and ethics in practice, regardless of the ongoing investigation. Whether the Board of Nursing, Medicare and Medicaid or other agencies or any agency has you under investigation you must ensure that the “show goes on”. Many investigations are resolved relatively quickly or a compromise may be reached. Cooler heads prevail.

10. Plan for Future Prevention: After resolving the investigation, implement changes to prevent future issues, such as additional training or policy revisions. Learn from the experience and be prepared. Too many NP’s enter into business without an accountant and legal counsel to protect them financially and legally.

Taking these steps can help navigate the complexities of a health fraud investigation while protecting the NP's rights and career.

Joe is a national speaker on issues where law and healthcare overlap. He has experience in civil, criminal defense, administrative and federal law matters for nearly 25 years.

Contact Info

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09/15/2025

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09/15/2025

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09/15/2025

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09/13/2025

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Joe Flores is licensed in all state courts in Texas and the Southern District of Texas in the Federal Court from Houston to the Rio Grande Valley. He is a member of the bar for the 5th Circuit Federal Appellate Court.