new RN vs. new APN orientation

[PMHNP10]

How do they compare? When you graduate from nursing school to become a RN, you know virtually nothing and so you require an extensive orientation, preceptorship, etc.; and of course we all know how stressful that first year was; and if you don't, just look at the 100s of posts on this MB for a reminder

NP orientations, in general, I suspect are quite a bit different.

First of all, since you work with an MD, do they teach you the ins and outs of doing your job or do you learn from other NPs, or is a majority of your learning done during school?

If a MD is your "preceptor" how does that work?

Aside from the private practice settings, do the docs value you as a professional, or are you still relegated to being "just a nurse"? For that fact, do private practice docs who use NPs resent them at the same time?

Is the experience of starting your career as an APN more or less stressful as it was when you first became a nurse?

[traumaRUs, MSN, APRN]

I graduated in May 06 with a post-MSN CNS. I took a job with a large nephrology practice with 15 MDs and 7 mid-levels. My preceptor was an NP. I also had some didactic with the MDs who were and still are very cordial. We are made to feel as though we are part of the team. However, this practice is known to be very mid-level friendly (we have 3 PAs, 3 NPs and me; a CNS). I think it helps that it is such a big practice too. We are really on the forefront of many aspects of nephrology.

Good luck....

[PMHNP10]

I'm so glad someone answered some of my questions and hope more share their experiences. Thank you.

So if you can take yourself back to the day you started as a nurse vs as a NP, how was the stress? Were you more anxious as a NP because of the increased accountability/autonomy of your role or less because you were better prepared for your AP role through your prior experience as a RN where you obviously learned more about what MDs prescribe and when which you incorporate into your NP practice, etc. as well as you NP education

[westcoastgirl]

the stress was about the same, but I appreciated that as a NP no one batted an eye if I needed to consult with another provider or look something up. It was pretty scary the first days as both RN and NP.

as a RN I was always running around, and there did not seem to be as much acceptance or time for looking things up.

I chose a practice with several supportive MDs as well as supervisors who were familiar with training mid level providers, that makes a big difference I think. There is one recent grad MD that seems to resent mid levels both PA and NP but it's easy enough for me to deal politely with her and focus on my own patients and my own work.

[butch228]

So far I've been in my current position as a new NP for about 4 months now..so I can feel the similarities and differences btwn this NP orientation and my RN orientation.

MY NP orientation has different kind of stresses..like am i prescribing the right meds?...insurance rules and regulations related to what meds and how often they will pay for..another stress is when patients call up the last minute looking for narcotics/ benzos..all related to being a primary care NP.

As for RN orientation..stresses were diff b/c it was on a acute medical floor. A big stress were distractions coming left / right...doctors..NPs calling you asking about their patients....or sick patients whose families who were making big demands from the nurse