NP Preceptor Burnout: What To Do When You're Just Done

Every person in this world is at risk of burning out. Especially you, if you decide to become an NP preceptor in this economy. Preceptor burnout is very, very common.

All joking aside, becoming a preceptor for NP students is a very cool thing. If you do it through NPHub, you get paid, you get to choose your ideal students, and you get some cool bonuses every once in a while.

However, you will also find yourself at risk of having too much to do. Too much for any person to handle. Not just you.

We are not trying to discourage you. On the contrary, we want you to come in and do this job, but we thought about discussing this problem, and a few possible strategies to prevent it.

So, what is “burnout”? How does it affect NP preceptors?

As a clinical term, the word “burnout” first appeared in 1974, coined by American psychologist Herbert Freudenberger.

It has taken decades of research to describe its symptoms, causes, and management, but it’s practically everywhere now.

In simple terms, “burning out” refers to losing your drive, going through the motions, becoming a robot, and suffering from elevated anxiety and fatigue while performing your duties.

If you are a preceptor, you might know where this is going. Preceptor burnout can be very different from, say, “nursing student burnout” because of the added responsibilities that come with the job. Things such as:

• Teaching adults (not the same as teaching children, and neither comes easy).
• Keeping up with your day-to-day responsibilities while doing this.
• Dealing with constant bureaucracy, delays, and barriers to precepting.
• Dealing with barriers to practice as a nurse practitioner.
• Performing the role of the mentor, the aid, the shoulder NP students can cry on when they’re struggling.

Preceptor burnout includes all of the symptoms that have been previously described in older research, from mild cases of anxiety to full-fledged depersonalization. It’s a big thing. And we haven’t even mentioned what it’s like to burn out as a preceptor during the pandemic.

But, anyway, let’s keep digging.

What we know about NP preceptor burnout

In 2018, Jennifer L. Bodine (DNP, RN-BC, CEN) published a short paper called “Preventing Preceptor Burnout Through Engagement,” talking about this issue in detail.

We have previous research on preceptor burnout, but nothing this specific. Bodine says that “the added role of preceptor and the heavy responsibility of ensuring the success of a new nurse graduate or transitioning nurse place additional stress upon an already tense work environment.”

And this is true, right? It rings true for many preceptors, even if they feel motivated and happy to get started.

Bodine’s paper tells us the main reasons why preceptors end up burning out (according to her research):

• A preceptor’s lack of confidence in their own knowledge and their perceived lack of proficiency in the latest clinical procedures (when compared to students).

• A preceptor’s natural aversion to being critical of their students (especially if there’s a wide age gap).

• Lack of appreciation and support for the additional responsibilities they’re taking on (by their clinical institutions and colleagues)

• Lack of a structured approach to teaching students in general (no guidelines, no system, only experience).

These findings are similar to what our own preceptors are saying. We’ve discussed this issue before on our Healthcare Heroes podcast, and we’re always on the lookout for preceptors who might have issues balancing the weight of both jobs.

Why do NP preceptors in America have these issues?

As you can see, NP preceptors in the US face a distinct set of challenges that create a burnout-friendly environment, as bad as that sounds. But why is this?

Well, for example, we could mention how they’re expected to teach students, the fact that US healthcare is not universal nor completely public. We’re standing at the tip of the iceberg here.

Also, we haven’t talked about the elephant in the room, which is the ongoing shortage of qualified NP preceptors. The fact that we don’t have enough preceptors guarantees that those that are already working might have to work twice as hard.

How to know if you’re suffering from burnout as an NP preceptor

Bodine writes that “lack of compassion, decreased attention to detail, apathy, and a decreased interest in professional aspirations are signs that may be observed in a preceptor who is experiencing burnout.”

Those are the main signs of burnout in an NP preceptor. As you can see, they’re pretty noticeable, right?

Well, the truth is you won’t always be able to tell if you, or somebody else, is suffering from burnout.

As human beings, we tend to rationalize things, to look for excuses. “I feel fine,” “it’s okay,” “I’m having a hard week but I’ll keep going,” etcetera.

We don’t want to admit that we’re burning out, because that just adds another layer of stress to our lives. Imagine having to admit that you’re just done. Mentally, emotionally. What do you do next? Most of us don’t have the opportunity to just stop going to work.

Other, more common symptoms of burnout include:

• Insomnia
• Physical pain or aching, seemingly without cause
• Headaches
• Low immunity
• Changes in appetite

Once you’re in that state, you have to climb your way back to your ol’ healthy self. It’s a rocky path, so our best strategy is to try and prevent this.

So, how can we keep our beloved preceptors from burning out on the job?

Possible solutions for NP preceptor burnout

If you are a preceptor, you might be thinking “I already know why this happens, and I’m already doing something about it.”

If you’re a student, you might be thinking “heck, I’m never precepting anybody.” (We’re just kidding, but it wouldn’t be unusual).

You can see why it’s important to identify the root causes of this decades-old problem. We need to find actionable solutions that can work for everyone.

Bodine talks about engagement, which (for her) would reduce the pressure that we put on preceptors to succeed at teaching.

She suggests involving preceptors in the onboarding process, recognizing their opinions and feedback, implementing educational opportunities for them, and creating a Preceptor Coordinator or Lead Preceptor role for management and support.

Honestly? That sounds great. It’s a step in the right direction. We’re sure many NP programs have thought about these things, so our job (as a community) would be to make sure these things become widespread.

We really invite you to read the article. It’s quite short, and there are a couple of interesting examples from NP programs in California and Maryland.

Best practices to avoid NP preceptor burnout

Bodine suggests looking at the Model for Improvement, a guide put together by the Institute for Healthcare Improvement. This model focuses on tackling the most common issues that healthcare facilities face, regardless of their size or focus.

Personally, as a preceptor, or as a student, there’s lots of things that you can do on your own to avoid burning out as an NP preceptor. Here’s some of them:

Seek support: We can’t stress this enough, no pun intended. External support, hopefully in the form of actual therapy, should be your first concern. This is to prevent burnout. Get therapy before you throw in the towel. Not after.

Communicate: Holding things in is terrible for your wellbeing. You can’t tell the truth all the time, but you have to (at least) get things out of your system. This helps you to prevent overthinking, rumination, and anxiety.

Exercise: Walking around the clinic and seeing patients doesn’t count. Get those running shoes and hit the road, or the gym. Lift weights. Do some yoga. Light or strong, get some actual exercise to help your body release endorphins and reset after a hard day. Or before.

Clarify your goals: Uncertainty for the future is a big human issue. We all get it sometimes. Defining our goals once again will help you avoid this. Do it as many times as you need. Don’t be afraid to change them, to change your priorities. Trust your gut.

Building a better future for NP preceptors

The rest is just what you already know, as a clinician. If you start seeing the symptoms, on yourself or somebody else, try to take action as early as possible.

Educate your peers on the realities of burning out. Once again, many people are quick to discard their own feelings and work even harder. Especially when they should be taking a break.

If you are a preceptor, or know a preceptor, talk to them about burnout. Is it something that they’re keeping in mind? Have they felt the symptoms? Remember that preceptors have a very specific experience with this problem.

We should take care of them as much as we can. But more importantly, we should always encourage them to take care of themselves. It’s hard out here for an NP, and more so for an NP preceptor.

The only way we’re getting through, is together.