What I Wish I Knew In NP School

Hindsight is 20/20 as the saying goes. Well that couldn’t be further from the truth when I look back on NP school and what kept me up at night. NP school is a time filled with worry, stress and anxiety. As NPs, we have the best job in the world but also a job with a ton of responsibility. While in school, it’s challenging to know if you’re on track and learning everything you need to. Today I’m going to share the top 5 things I wish I knew in NP school. 

If there’s ever a time in life to doubt yourself and not feel confident, NP school is it. It has a way of making us second guess ourselves and wonder if there’s ever going to come a time where we feel competent and confident in our new role. 

It’s normal to ask yourself:

I’m excited to share with you today what I found to be true in hindsight. I hope by sharing the top 5 things I wish I knew in NP school, that you will be able to trust in the process a little bit more as you become the best Nurse Practitioner you can be. 

Top 5 things i wish i knew in np school

#1 – By the end of clinical rotations you WILL feel more comfortable and confident in your abilities

• If someone would have told me the transformation that was about to take place from day #1 of clinical rotation to the final clinical day of the program a year later, there is no way I would have believed them. It truly was a dramatic transformation. 
• There was a lot of fear and feelings of inadequacy and discomfort those first clinical days. Nothing can quite prepare you for those feelings. As RNs, we feel confident and comfortable in our role, and then to step into a new role, as a provider, where we are a novice can be a shock to the system. 
• By the end of your program, you will have made significant progress towards becoming the best provider you can be. 
• This is not a change that you notice day to day. My whole first clinical rotation I felt like a fish out of water. Trust in the process and you will see that as you complete more and more hours, you will settle into the role of student and novice.
• Walking out of my final clinical day a few weeks prior to graduation, I felt so proud of how far I had come and you will too. While we still have so much to learn once we graduate, trust that you will be where you should be as a new graduate provider at the end of your program. 

#2 – You know more than you think you do

• Throughout school and clinical rotations, professors and preceptors kept reminding me that I know more than I think I do. I truly didn’t believe them as I did not feel confident as a student provider. 
• It’s part of the process as students to be told we’re wrong or that we could be doing something better. That’s why we’re in school – to learn from our professors and preceptors. This feedback should not deter you. This feedback helps us learn and grow. 
• Between our RN education and our graduate school courses, we have learned so much and have studied for hundreds of hours. It can be helpful to remember that our courses and curriculum were designed to help us learn everything we need to know to be safe and competent new Nurse Practitioners. 
• Once I began studying for my board exam, I finally realized I had learned so much and way more than I thought I had. There will come a point where you realize this same thing! 

#3 – Spend a lot of time studying pharmacology 

• There is no such thing as knowing enough about pharmacology. 
• Pharmacology is a very anxiety inducing topic for me and many others. To prescribe carries a huge amount of responsibility and requires a very deep understanding of pharmacological principles. 
• My pharmacology course was 10 weeks long, and it was jam packed full of information and moved at lightning speed. The amount of material that was presented was overwhelming. If this course was taken in isolation, maybe it would be okay. For me pharmacology took place during the most challenging quarter of the program, so like many other NP students, I was balancing this course with several others. 
• In addition to learning as much as you can in your pharmacology course, I recommend using every opportunity possible in clinical rotations to look up the drug you are prescribing in a drug reference. 
• Once you finish school and if you are in an independent practice state, you alone are responsible for safe prescribing. This means it’s imperative we take every opportunity to learn more.

#4 – Never turn down an opportunity to practice physical exam techniques

• Take advantage of your health assessment courses. These courses are part of our foundation as Nurse Practitioners. Learning and practicing physical exam techniques in the lab and with our classmates is a great opportunity to get more comfortable before you start practicing on actual patients. 
• Correctly doing an exam technique and being able to recognize what findings are normal vs. abnormal is a critical skill that is imperative to accurate assessment and diagnosis. I recommend really taking the time to understand how to do the exam technique correctly, understanding the why behind that particular exam, and then knowing what findings are normal vs. abnormal. 
• I cannot tell you how many pharynx and ear exams I completed in clinical rotations, but without fail I took every opportunity presented to examine these areas. There are so many variations of normal. Only by seeing normal time and time again, can we better identify abnormal when it comes along. 
• The neuro exam for me was one of the more challenging. As it turns out, I had few opportunities to practice the full neuro exam in my clinical rotations. As students, we often have little choice in the types of patients we see and what complaints they present with. So moral of the story – take advantage of every opportunity that presents itself as you don’t know when you’ll have another chance. 
• On a separate note, there is nothing wrong with asking your instructor or preceptor to verify any exam findings. Depending on how far along you are in your program and depending on your preceptor, your preceptor may not verify all or any of your exam findings. So if you are unsure, always ask. This is especially helpful if you aren’t sure if a finding is a normal variation or abnormal. 

#5 – You WILL pass your certification exam 

• We often worry about these sorts of big milestones very early on. I kid you not – from day 1 of school I began worrying about my certification exam. When should I start studying? Which certification exam should I take? How should I study? Should I be studying right this moment? Will I pass? What happens if I don’t pass?
• While these questions are all valid, as NP students, we have more immediate concerns such as learning the material presented in our courses and maximizing our learning in clinical rotations. By studying hard in our classes and learning everything possible in clinical, we will be better prepared for our board exams. In fact, it’s very likely we learned everything we need to in school in order to pass the board exam. 
• For me, I decided that I would worry about studying for boards once I had finished school. Until then, I had so much to learn and do that adding studying on top would not permit me to give anything my best effort.
• Know that your curriculum was designed to teach you everything you need to know to have a solid foundation as a new Nurse Practitioner. This also means that by studying and doing well in your classes, you will be well set up to pass your board exams. 
• If you’re ready to start studying for board exams, check out this post on all my study tips. 

Summary

NP school is a time filled with stress and anxiety. We’re taken out of our comfort zone as RNs and thrown into being a student again. The transition from RN to provider is a scary one. You are not alone! As you go through school, keep in mind the following:

• By the end of clinical rotations you WILL feel more comfortable and confident in your abilities
• You know more than you think you do
• Spend a lot of time studying pharmacology 
• Never turn down an opportunity to practice physical exam techniques
• You WILL pass your certification exam

Make sure to check out other recent posts and visit the resource page:

• Interview Tips for New Nurse Practitioners
• FNP Certification Exam Study Tips
• Your NHSC Loan Repayment Program Guide
• Lessons Learned as a New Nurse Practitioner
• New Graduate Nurse Practitioner Checklist