Difficulty transitioning from nurse to NP student

[spacegal52]

I am looking for tips on how to make the transition from seasoned nurse to new NP student. I can do assessments and take histories like nobody's business, but have difficulty coming up with diagnosis, and then how to treat. I am a great student in class with a 3.8 GPA, but am having problems doing well in the clinical setting. I feel so dumb and I hate it! I have always thought I was a critical thinker but now I'm not so sure....

At this point I am so discouraged and am half-tempted to not continue, but I know that would be crazy after I have invested this much time and money in it. (I graduate in two semesters.) I have had some great preceptors, but there are others who just allow me to observe them and not participate. I know I need to get this down before I can even attempt to practice safety. Any tips are welcomed!

[traumaRUs, MSN, APRN]

For me, I had to change my mindset. I was an RN with 13 yrs exp when I became an APN.

1. History and assessment are the keys for me. My RN exp was ER and ICU but I had to change focus a little by digging deeper, family history, social history, OTC meds and herbals. Im in a specialty practice so I need to know about other providers too.

2. Delegate. I try not to do something that an RN or tech can do. Sure I can start IVs, give meds, do EKGs, order tests, but that is not good use of my time. Use your resources. Im fortunate to have excellent staff. The social worker or RN gets prior auths done, the dietician reviews labs, the RN or secretary sets up appts. This gives me the time to organize care, take care of physician communication, review all labs, tests, determine what else needs to be done, etc.

3. Stay organized. I use UpToDate and fortunately my practice pays for that. I also use my iPhone to keep track of stuff I need to follow up on. I use an app from thre american diabetes association for my diabetics. I only have to care for minor med changes for DM. I do treat HTN though and use UpToDate for that. I use lists also for things that need to be followed up on.

4. I do not work closely with my docs so I make lists for calls. We have an EMR also and I use that for most messages as it attaches to the pts chart.

5. Be patient. I've been with this practice almost 7 yrs and it really took 3-4 yrs before I felt comfortable and believe me, I still look up stuff.

[dazzleddee]

I am curious for some pointers as well. I will be starting UIC BSN-DNP program in the fall and I am so nervous. I want to make sure I transition into this role properly. I've been a nurse for almost 7 years and I can only imagine it being difficult to switch gears and think on a practitioner level. Prioritizing whats important, etc.