Well hi there! It’s been a while. I could not have fully anticipated how difficult and all-consuming it would be to transition to being a full-time Nurse Practitioner which explains my absence. Life as a new Nurse Practitioner has been both exciting and overwhelming at the same time. I also started my career during a pandemic so that has been interesting, to say the least. I’m excited to be back and writing again here.
In my 16 months as a new graduate nurse practitioner, I’ve learned so much personally and professionally. I dialed it all down to four big lessons and takeaways. I hope that by sharing my experience you will know that you are not alone.
Today, I plan to give an update on what it looks like to be a Nurse Practitioner 16 months in and some lessons learned as a new Nurse Practitioner.
Update 16 Months In
Overall, my job is going very well. I still feel like a novice provider but every day I make progress. I completed my ramp up to a full schedule over the course of 4 months. My schedule is four 10 hours shifts per week. On a weekly basis, I have 34 hours of patient care during which I am scheduled to see 3 patients per hour plus 6 hours of administrative time.
At this point, I am comfortable managing the most common chronic and acute conditions. There are times when I encounter a patient with a very complicated medical history where I struggle and need to ask a colleague for help or spend more time reading up on the latest diagnostic criteria or treatment plans. I have a good workflow now for patient visits and feel more comfortable managing my time on busy days. I will ask for help a few times per week usually regarding a patient with a complex medical history, an acute complaint I’m not 100% confident in managing, or with lab interpretation.
Lessons Learned as a New NP
Lesson 1: This job is hard
- We all know that being a new NP is going to be hard. We understand this fact in school but it doesn’t really hit until you’re in the thick of it.
- I did not anticipate how overwhelming the responsibility would be. As a new NP, I no longer have the backing of my instructors and preceptor. Instead, I have felt a huge weight on my shoulders.
- No one double checks my work. While I can ask for help, at the end of the day I am solely responsible for diagnosing and coming up with a treatment plan.
- The good news is this: I feel more comfortable now with the responsibility than I did at the beginning. And, with more experience, I take home less work stress with me at the end of the day than I used to.
- Check out this post about how to prepare for your first NP job
Lesson 2: Becoming comfortable asking questions and asking for help is critical
- There is no room for ego in being a new provider. I have been humbled again and again by how much there is to learn, especially in primary care. We are expected to have a certain degree of knowledge about a huge range of health conditions.
- With time, I started to be comfortable with the common diagnoses and treatment. With the breadth of primary care, it’s likely that at least a couple times per week I will still encounter a patient’s case or a new diagnosis that I’m not sure of my next steps.
- For a lot of us it can be hard to ask for help. This is a must though. When I feel like I’ve already asked too many questions that day, I put aside my worries and ask anyway. The most important thing is to provide safe and quality care. Sometimes that means putting aside your pride and asking for help.
Lesson 3: There is so much to learn that you’re not taught in school
- In school and clinical rotations, our education is focused on taking a history, doing a physical exam, diagnosing and coming up with a treatment plan. This information is the backbone of our work of course. Once I started as a new NP, I was surprised just how much I would need to learn on the job that did not directly relate to taking care of patients.
- I did not expect how much I would need to learn about health insurance, insurance medication formularies, discerning different types of disability paperwork, navigating with specialists, etc.
- We expect, just like when we were RNs, how much more you learn on the job than you do in school. That holds true as an NP too. Every single day, especially in the first year, you will learn so much.
Lesson 4: Find a supportive place to work
- I cannot emphasize how important this is. Working in a supportive environment has been the primary reason I have been successful as a new graduate.
- Between my Chief Medical Officer, medical director and other providers I work with, I know I have their full support. I feel comfortable to ask for help – whether that be a question about a patient case or to confirm an exam finding I’m unsure about. Every provider I work with will stop what they’re doing and help me when needed.
- As a new provider, this has made all the difference in the world. I am never alone in this sometimes daunting job. This value of this support cannot be overstated.
Summary: Lessons Learned as a New Nurse Practitioner
Being a new graduate Nurse Practitioner is simultaneously terrifying and exciting. You will be successful by becoming comfortable in the novice role again and asking for help. Finding a supportive place to work, where you can ask for help when needed, is critical.
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