Finding Mid-Career Inspiration as a Nurse Practitioner

I must be in a mushy mood of some sort, because all I can think to write about today is the ‘softer’ side of the nurse practitioner career. I haven’t had a bad day in the emergency department recently, nor am I feeling burnt out in general. Everything is just fine. And, maybe that’s my non-problem.

Yesterday I worked a shift in the emergency department that was really quite ideal on paper. It was a day shift, so, no sleep deprivation required. The patient flow was steady so I was neither busy nor bored. For the first time in a while, staffing was adequate so I had the support I needed from nurses to get my job done efficiently.

A physician assistant student was paired with me for the afternoon. My medial assistant for the day was also training a newbie. The juxtaposition of myself, eight years into my practice, with a brand new physician assistant student, as well as the novice medical assistant, made for an interesting contrast. The students were just so full of energy. They eagerly looked on as I sutured a few wounds, that to me weren’t so interesting. They offered to help with everything, even tasks below their future pay grades. They asked questions, lots of questions.

Working alongside a student was certainly more work for me, but I appreciated the experience as it was a sort of reality check. It made me realize how far I’ve come, but also how far I have to go. I didn’t have a sound answer for every question that was asked. The biggest reality check for me, however, came from the enthusiasm these students had for patient care, for learning, and for their future careers. I do like my job and could not see myself doing anything else with my life, but I don’t know that anyone would describe me as ‘enthusiastic’ at work.

Waning enthusiasm is normal. As a new NP, I would pick up extra shifts and take on PRN positions with abandon. This was a recipe for burnout. Thankfully, my eagerness to please my employer and earn an extra paycheck faded a notch. In the early days of my practice, I truly believed I could inspire lifestyle change in my patients. Slowly, however, I became disillusioned by the lack of action on patient’s parts and my health coaching efforts suffered. Pressure to bill and meet practice metrics, which were often not in the best interest of patient care, resulted in compromise, balancing employers expectations and the quality of care I provided for patients.

Despite the inevitable tendency for enthusiasm to abate with time, I would like to reclaim some of mine that was lost. Rather than going through the motions, repeating my ‘back pain speech’ and my ‘head injury precautions’ instructions from memory, I would like to infuse some inspiration into my clinical nurse practitioner career.

I’m not sure what this looks like at the moment. So, to start, I’ve decided to go back to the basics, the thing that I loved most about my job when I first started. The people. My patients are farmers from neighboring rural Kentucky, Nashville music producers, kids from all cultural backgrounds that amazingly are in many ways so alike, convicts and felons, housewives, and on and on. To rekindle my passion, I need to hear people’s stories rather than list of symptoms.

As I think about it, connecting with patients was in some ways all that I had as a new nurse practitioner. I didn’t have all the answers clinically, so I compensated and inspired trust with relationships rather than with information. Perhaps knowing less allowed me to focus on driving home the most basic concepts of healthcare and act as a support system, which is often really what patients are looking for. 

There are days when I feel like I’ve heard it all before. But, let’s be honest, I haven’t. As I try to connect again beyond the superficial, I’m interested to see what I find.

How do you stay inspired in your nurse practitioner career?

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