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Advice for New Grad NPs from Not-So-New Grad NPs | ThriveAP

Written by Erin Tolbert, MSN, FNP-C | Jun 29, 2017 4:12:55 PM

Kicking off your nurse practitioner career is stressful to say the least. Not only are you starting a new profession, chances are that life is throwing other major transitions your way as you wrap up your NP program. You may be moving to a new city, for example, to begin working for a new employer. Each of these changes in itself can be a lot to manage. When major transitions occur simultaneously, it’s natural for new grad NPs to feel overwhelmed. 

If you are a new nurse practitioner and find yourself in this boat, one way to ease the anxiety and stress that comes with major personal and professional changes is to seek advice from those who have been in your shoes. So, I asked our first ThriveAP+ class to weigh in when it comes to advice for new grad NPs. The nurse practitioners in this group have been practicing for nearly a year now. They are still quite close to the challenges recent grads face in their first months of practice but have progressed immensely over their first year working as nurse practitioners. 

Here are a few pieces of advice from the not-so-new NPs in our residency class.

Develop Relationships with Support Staff

When you’re a new nurse practitioner, the clinical component of your job is overwhelming. You find yourself with no less than a million questions and constantly referring to resources – a major time suck. The temptation is to become hyper-focused on getting through the patient care portion of your day. The NPs I talked to advise against this. 

“Take a few minutes here and there to connect with your support staff, the MAs and nurses you work with. These individuals are crucial to making the clinical day go smoothly. Investing time in these relationships in your first days on the job pays of big time” nurse practitioners with experience say. Even though you feel busy and stressed out, taking time to develop collegial relationships is well worth the effort. Your coworkers will thank you by helping out even more!

Ask Questions

As a new graduate nurse practitioner, it’s normal to grow tired of asking questions. You feel like you are bothering your coworkers. You feel incompetent as there is still so much you don’t know. One of the nurse practitioners I talked with pointed out, however, that asking questions is the only way to succeed. “Don’t be afraid to ask questions and sound stupid” she says. “If you don’t ask questions, you will be doing things incorrectly in which case your coworkers will be talking about your performance, anyway!”. Good point. Asking questions seems to be a no-lose situation!

Don’t Be Too Hard On Yourself

Like I mentioned above, life as a new grad nurse practitioner is no cakewalk. Moving to a different city alone, for example, is a lot to handle. Piling a new career and job on top of this can be enough to stress you to the max. “Don’t be too hard on yourself, you can’t learn everything at once. Be patient with yourself as you adjust”, advises one NP. “Focus on improving one thing, one day and one step at a time; doing otherwise isn’t going to happen”. So, put your type-A tendencies aside and give yourself some grace as you navigate the transitions that new grad nurse practitioners face. 

Start Learning with Common Conditions

When it comes to clinical knowledge, mastering the vast array of medical conditions you’ll encounter is overwhelming. “Start with the things you see recurrently” advises one nurse practitioner. For her, this was anemias. “I kept seeing patients whose labs would come back abnormal signaling some form of anemia, so I started there by doing more research and learning in that area”, she says. The nurse practitioners in our group also advise mastery of red flags so that you know when a patient has a more serious condition and may need a higher level of care. 

In addition to having a plan for advancing your clinical knowledge, identify a few key resources you can easily access to help throughout the day. Our group of NPs suggests UpToDate and labtestsonline.org. 

Don’t Be Afraid to Schedule a Follow-Up Visit

Along the same lines, our nurse practitioners also advise “Don’t be afraid to have patients follow up”. Many patients present with complex histories or multiple problems they hope all get addressed at a single visit. In reality, there isn’t time to address more than one or two concerns in one visit, especially as a new grad still mastering clinical time management. Address the most urgent problems the first visit, then schedule a second appointment where you can continue the interaction. “This also gives you time to do some background research and learning in areas where you aren’t as confident before the patient returns” says the group. 

Familiarize Yourself With the Community

While nurse practitioners most often consider online databanks and textbooks when they think of clinical backup, there is another category of resources our NPs suggest familiarizing yourself with. “Get to know your area, especially when it comes to resources for your patients”, suggests one NP. Understanding which diagnostic imaging centers, specialists and other facilities to refer to will be important to getting through your day to day. Other patients may need items like transportation or medication assistance. “Learn what is available for patients in your community and keep this information handy” they say. 

Experienced NPs, what advice do you have for nurse practitioners who are just getting started?

 

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