As a new NP, did you do a residency program?

[jensfbay, BSN, DNP]

We have very limited number of clinics that provide residency programs, so I plan on signing up to do Thrive AP (formerly known as MidlevelU) for a year as a novice NP. Has anybody done this program? What are your thoughts? 

For those of you who did not do a residency program, what was it that made you succeed and continue to thrive as an NP? I plan on doing primary care as an FNP. Thanks!

[Zyprexa_Ho]

My understanding is that most NPs go from school --> Boards --> practicing. It sounds like to me that most don't have a residency before practicing. 

[etoile88, BSN, MSN, RN, NP]

I tried to! There weren't many PNP fellowships when I graduated, but I would have loved to have done one ? I think they're a great idea, but, I'm doing just fine without having done one. 

[jensfbay, BSN, DNP]

Thank you, Etoile. I'm glad you're doing just fine without having done one. I'm starting to get my cohort together and see if we could all sign up for ThriveAP as a group. How are you liking Pediatric Primary care? I'm an FNP and currently doing a clinical rotation in pediatrics. I was set on doing adults or geriatrics, but I did not know I would love this demographic!

[JBMmom, MSN, NP]

There is one large hospital within long driving distance from my house that I heard might have a residency program next Summer. That's the only one in my area. I haven't heard of ThriveAP, good luck!

[etoile88, BSN, MSN, RN, NP]

That sounds really cool - I just read about ThriveAP. I can see that really taking off.

I really love it! It definitely has its challenges.. kids can only tell you so much, or they present differently than what you'd expect, and sometimes parents can be even more challenging! But it's so rewarding, and I love seeing kids grow up, be a part of their lives, empower families.. that makes me so happy you're liking it! 

[Neuro Guy NP, DNP, PhD, APRN]

Yes, I did one and it put me light years ahead of where I'd have been otherwise and taught me competencies, skills, etc that I now have that I probably still wouldn't have if I hadn't done it. I learned things that NPs 5 years out are still working on. If you can swing it, and it's a high quality program I.e not just a glorified extended orientation, then it will be worth its weight in gold. If it's just a glorified orientation, then don't bother. 

[MentalKlarity, BSN, NP]

I just looked up Thrive, that's a really great idea!

I completed a residency. It was amazing. I worked with NPs and physicians for 12 months, full-time and essentially worked as a full provider diagnosing and treating on my own while still having those experienced providers meeting with me daily to go over cases, answer questions, etc. Since I wasn't expected to "make money" for them as a resident, spending extra time with patients or asking questions so I could really learn was encouraged.

I left feeling confident for my first job. I highly, highly recommend a residency. They should be standardized.

[verene, MSN]

I did not. I started working as an attending PMHNP less than 4 months after graduating (time for boards, DEA, credentialing).  Orientation was 1.5 weeks of general hospital employe orientation and then I was handed a full panel of patients. I did meet with my supervisor weekly to review cases for the first few months, and we do have a seminar series for new to hospital providers (NP and MD) which was useful,  but really - I was expected to hit the ground running.  It was terrifying, but also validating in terms of how much *did* feel familiar and comfortable and how much applicable knowledge I did actually have floating around my brain, even if I didn't realize it.  I've had cases were I've felt out of my depth - but that is why having colleagues to consult with is AWESOME because every one of us has cases that are out of our comfort zone or subspecialty at times and wanting to run thoughts past a colleague is completely normal and encouraged! (e.g. Recently had a complicated gero case and was feeling out of my comfort zone - I tracked down a couple of gero-specialized colleagues and had regular consults with them on this patient; they really appreciate that I am using them as a resource and am seeking their expertise - and it means I'm now learning more about how to handle this kind of case should I have one again! Also - despite the push back I got from some folks earlier on - my hunch for diagnosis turned out to be spot on - even if I needed one of our experts to confirm my findings and help guide the next steps). 

While I don't always feel confident  (imposter syndrome is real) the feedback I've had from colleagues across departments is that I clearly know how to work with this population of patients/this setting, have strong instincts for this work, am highly conscientious and seek out resources - be they colleagues or literature/guidelines as necessary - and am highly patient centered and safe in my approach to practice - and they love my willingness to collaborate across disciplines to get my patients what they need when they need it. 

[Guest1144461]

I did a year long residency/fellowship, it was worth more than my entire program x10....

[Guest1144461]

You don't know what you don't know. 0 NP programs prepare someone for independent practice on graduation.

500 clinical hours vs a MDs 10-15,0000? C'mon now...

[umbdude, MSN, APRN]

I declined an offer to a residency. In my case, I didn't think that residency would benefit me that much and I simply had a better job choice.

I would add that not all residency programs are created equal, and not having a residency program doesn't mean you cannot have great training. The training I get as a new grad is pretty great; and in reality it's not all that different from a residency.

There's definitely a lot of "you don't know what you don't know." Having great supervision in the first year is crucial.