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What to Expect as a Nurse Practitioner

A good Master of Science in Nursing — Family Nurse Practitioner (MSN — FNP) program, such as the one offered by the University of Texas at Arlington, develops your research, diagnostic and clinical skills. You will be prepared to pass the American Nurses Credentialing Center National Certification Examination or the American Academy of Nurse Practitioners National Certification Board exam and take on the role of a healthcare treatment provider and health management resource for diverse groups of patients in a variety of clinical settings.

Being an FNP will be a whole new experience that is likely to be exciting, stressful, and rewarding. It will also come with some surprises.

Advice From an FNP

Family Nurse Practitioner Erin Tolbert offers advice for new NPs on her MidlevelU blog:

  • Finding a job may take months. Most employers look for experienced NPs. For this reason, your first job may not be one you love. To expedite your job search, start thinking about it one year before graduation. The one thing employers most look for is hands-on patient care experience. Focus your energy on your nurse practitioner program clinical hours.
  • Know that your first job will be very stressful. You do not yet know what you are doing, and “even when you do, your clinical decision making is clouded by a heavy fog of doubt.” Tolbert notes that bridging the gap between what you learned in school and the knowledge and skills you need in your new job will probably not be easy.
  • You are expected to take on leadership duties. In a clinic, that might include hiring and firing people.

Real-World Shock

In her blog, Is There An NP In the House?, nurse practitioner and nurse educator Angel Shannon details some more of what new NPs can expect:

  • In school, you had someone guiding your learning experience. In the real world, learning is your responsibility. “What you don’t know will show up one patient at a time. Part of your role as a clinician is to stay abreast of new developments — to stay current — so you can provide your patients with the best, evidence-based care possible.”
  • In school, you had a preceptor to check up on your work and diagnoses. In the real world, your first job may or may not have someone willing to double-check your work.
  • In school, you had classmates who knew what you were going through. Even though your new colleagues may have some similar experiences, you do not want to unload on them. Instead, Shannon recommends maintaining friendships from your NP program as support for dealing with challenges, for networking and increasing your knowledge base.
  • In school, you learned much that was “true but not absolute. Health care is both a science and an art. No two people practice health care the same way, and you will have to develop a style that works for you.”

Other experiences reported by new NPs include the following:

  • The need to learn medical coding and billing.
  • Surprise at the time required for duties such as prescription refills, reviewing labs and diagnostic results, and answering questions and phone calls from patients, pharmacies, hospitals, nursing homes and insurance companies.
  • A feeling of isolation at being the only NP in a medical office.
  • A feeling of starting over, of being a novice again.
  • Lack of acceptance of the NP’s leadership role from nurses who were formerly colleagues, now that the NP is making rounds and writing orders for them to follow. Some NPs look for a new job to avoid having to manage former colleagues.

As you begin your career as an NP, without the protective academic environment, you may have high expectations of yourself and think you should be able to handle everything. But, as Tolbert advises, “Remember, it’s always better to ask than make a mistake. If you aren’t sure or are not confident about something, ask! Trust me, your employer will be glad you did.”

You will eventually learn to trust your NP assessment skills and stand by your professional judgment. Value every moment and learn as much as you can from the people around you.

Learn more about the UTA online MSN – FNP program.


Sources:

Advance Healthcare Network for NPs and PAs: What To Expect From Your First NP Position

Nurse.com: Survival Tips for New Advance Practice Nurses

NP in the House: New NP Grad? Some Career Realities and a Little Advice

MidlevelU: How I Bridged the Knowledge Gap Between My NP Program and Practice

MidlevelU: When Should New NP Grads Start a Job Search?

MidlevelU: 6 Things No One Tells You About Being a New Grad NP


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