Florida nurse practitioner students face an unethical practice that threatens our profession’s integrity: paying thousands of dollars for their own clinical preceptors. As NP programs proliferate across our state and the preceptor shortage intensifies, this commercialization of clinical education has become increasingly normalized. It’s time for Florida’s nursing community to recognize this practice for what it is; an ethical failure that compromises educational quality, perpetuates inequity, and potentially endangers patient safety.
The Problem
Students sometimes pay $1,500 to $5,000 per clinical rotation, sometimes over $10,000 for an entire program, to secure required preceptors. Programs justify this by citing the preceptor shortage, but calling a practice “necessary” doesn’t make it ethical. When students pay their own evaluators, we’ve fundamentally corrupted professional education.
Why This Matters
Educational Integrity: Clinical education is not optional. It is the foundation of safe practice. When institutions allow students to purchase preceptors, they abdicate their core responsibility for educational quality. Programs can no longer ensure consistent standards, appropriate learning experiences, or meaningful oversight.
Conflicts of Interest: Preceptors who receive direct payment from students face inherent conflicts when evaluating those students. Will a preceptor who depends on student fees honestly assess unsafe practice? Will they identify a student who lacks clinical competence? Financial relationships compromise the objective evaluation our profession demands.
Equity and Access: Requiring students to pay thousands in undisclosed fees creates barriers for economically disadvantaged students and those from underserved communities, the populations that nursing seeks to recruit. We cannot simultaneously advocate for workforce diversity and maintain practices that exclude students based on their ability to pay.
Professional Standards: Nursing has traditionally viewed clinical teaching as professional obligation and service to the profession. Commercializing preceptorships contradicts this value and degrades our professional culture.
A Call to Action
Every Florida nurse practitioner who benefited from quality clinical education, provided by preceptors who mentored us without charging fees, has a stake in this issue. We must advocate for the following:
- Clear position statements from professional organizations opposing student-paid preceptorships
- Transparency requirements so prospective students understand true program costs
- Investment in sustainable preceptor development and support systems
- Commitment from organizations and our own practices to serve as preceptors without charging students
The preceptor shortage demands urgent action and ethical action. Allowing students to pay for required clinical education sets a dangerous precedent that normalizes commercialization of professional preparation.
Florida’s nursing community must reject this practice and commit to solutions that preserve educational integrity, ensure equity, and uphold the professional values that define nursing. Our students, our profession, and our patients deserve nothing less.
References:
Gardenier, Donald, et al. “Should Preceptors Be Paid?” The Journal for Nurse Practitioners, vol. 15, no. 8, 2019, pp. 542 – 543, https://www.npjournal.org/article/S1555-4155(19)30564-1/pdf
Henry-Okafor, Queen, et al. “Addressing the Preceptor Gap in Nurse Practitioner Education.” The Journal for Nurse Practitioners, vol. 19, no. 10, pp. 1-7, https://www.npjournal.org/article/S1555-4155(23)00320-3/abstract
10 Comments. Leave new
The growing practice of charging students for clinical learning opportunities is unethical and undermines the integrity of healthcare education. It creates inequity, limits access, and exploits students who are already investing heavily in their training. There should be clear policies prohibiting this practice, along with a confidential hotline to report violations and meaningful penalties for those who engage in it.
Paying preceptors!!!
I am a Florida nurse that has had preceptors in both RN-BSN and BSN to MSN. I have never heard of anyone I know paying a preceptor.
Absolutely! I am in school for PMHNP and am having to pay for clinicals.
Students are responsible for their college education and tuition, including the clinical components. Didactic instructors post prewritten discussions and grade papers and are paid well for doing what exactly? While preceptors “who are also instructors” are expected to spend hundreds of hours of their time, actually teaching and preparing students to be providers in the real world, utilizing their own private practices, exposing and risking patient and financial loss, for free? Absolutely not.
To preserve the integrity you speak of, how about recommending to decrease the didactics instructors pay by HALF, and offering the other HALF to the precepting instructors. Advocating to stop using paid preceptors will create a greater shortage as they will simply move on to endeavors that offers a “FAIR HOURLY PAY” for the fruits of their labor.
Thank you for writing this article. I am a current PMHNP student and it has taken me longer to complete my program because I haven’t been able to find FREE preceptors in the near and surrounding areas. I also believe that the practice of preceptors charging thousands of dollars for their services is unethical.
This is a very important issue that needs to eb addressed. All good points!
I am so happy to see this article. I am a recent graduate of an accredited MSN FNP program in Florida and I can personally attest to the fact that this horrendous practice of charging students to secure preceptors, is unfortunately alive and well. So many people that I know had to delay graduation, take out additional loans, or even drop out of their programs because they couldn’t pay to secure preceptors. This has got to stop. What can we do? I am ready for the call to action.
Yes! I have had to pay for all my preceptors and it is so expensive! It’s hard and sets you back when living on a budget!
Excellent position
The preceptor situation where I worked – likely similar to many other work environments- required fees for preceptors to train student nurses but the preceptors did not receive that money. The hospital did. It gave the impression of the hospital making money off the backs of the nurses.