What was your first job after becoming an NP?

  1. Not there yet, but I may be there soon.......

    What was your first job after becoming an NP?

    Was the transition from RN to NP a culture shock? Did you have a "sink or swim" feeling? :smiletea2:
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  2. 8 Comments

  3. by   traumaRUs
    No sink or swim feeling at all. My RN experience is ER/ICU and my first position was nephrology. I got the job in July and wasn't on my own until October and not taking any call until this coming weekend - very generous.
  4. by   mom and nurse
    That's good to know that you have an orientation after becoming an NP just like when you first become an RN..... Wow you had 3 months before you were on your own. I hope I'm as fortunate....
  5. by   traumaRUs
    Much of that time is required for credentialling at different hospitals.
  6. by   scribblerpnp
    Mine was in an office setting. Definately sink or swim, The doc who hired me had never worked with an NP before, and I had never been an NP before. Very stressful for both of us! But it doesn't have to be that way for a first-timer!
  7. by   mom and nurse
    Quote from scribblerrn
    Mine was in an office setting. Definately sink or swim, The doc who hired me had never worked with an NP before, and I had never been an NP before. Very stressful for both of us! But it doesn't have to be that way for a first-timer!
    Hi. Thanks for your response. Just curious.....What was most challenging for you? How supportive was the doctor? Does this mean that you had no orientation to your new role as an NP. :smiley_ab
  8. by   scribblerpnp
    In my case the main problem was simply a difficult employer who promised me orientation in my interview, but I never received it. I could write pages about the things I was promised, but never received. The best advice I can recommend is to make sure you have these things in an employment contract. I was brand new and out of school and all of my previous jobs had been positive. I had never had an employer who treated me badly, so I had no reason to think that when someone said I would receive oreintation that I wouldn't receive it. Oh, well. It consider it just as much my fault as his. I didn't protect myself as I should have. But I sure learned a lot!

    The hardest part of my job was managing pts in the hospital. The NP program I was in focused on office-setting care and there was NO hospital management. I knew when they needed to go, just not what to do once they were there. My employer really didn't want to take the time to train me well, which didn't help. Part of that was my fault because as a nurse I worked in a very specialized pediatric unit, so I didn't care for peds pts with the common types of problems you would deal with as an NP in primary care.

    However, my expierice is not the norm. I have plenty of PNP friends who had wonderful first jobs. Mostly in chidren's hospitals and pediatric offices who have experience with PNP's, know the scope of practice, and correctly utilize them. My problem was an MD who really didn't know how an NP was to be effectively used, didn't know the scope of practice, didn't really care, and was just plainly a difficult employer and a jerk.
  9. by   traumaRUs
    Scribblerrn brings up a good point - you need a written contract that delineates orientation, salary, any bonuses, call, hospital work, and any other duties. It is vitally important that you be aware of what needs to be charted in order to bill successfully too.
  10. by   mom and nurse
    scribblern - i hope things became better for you as the months went by with that particular MD. (or perhaps that you quit and found another place to work).

    Scribblern and TraumaRus - Thanks for your replies....Yep....looks like its best to have a written contract... Guess its also good to keep in touch with the instructors in the NP program to learn the ins and outs of what is an appropriate written contract (orientation, salary, etc). I would imagine it would be hard as a new NP knowing exactly what salary is appropriate for an NP (though I am familiar with the internet salary scales), how long orientation should be, etc. etc.

    I'm heading into my senior last year in the program, just preparing to start real clinicals and I have a lot to learn.... I've started subscribing to the free Advance for Nurse Practitioners hoping it will give me some pointers as I head into my last year......


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