Fired From First NP Job: Struggling Emotionally

allnurses Guide · Aug 13, 2022

17 minutes ago, manxx said:

If after 10 days you were fired it makes me wonder if (1) the another candidate decided they wanted the job and you were a "placeholder" until they decided (2) there were some discriminatory issues going on there, or (3) they did not really want to be bothered with a new graduate??

To be honest, as someone who has owned a practice and has hired both physician and NP/PAs, there is more than just those three possibilities.

1.) I have hired experienced providers to plug directly into a gap in the schedule/roster (from a provider leaving or out on long-term leave). These providers have been hired under the assumption they can immediately step in and cover a (nearly) full patient load with minimal OTJ training. Obviously we pay a premium here but we have discussions ahead of time about expectations and make sure the incoming hire feels comfortable with the job requirements.

2. I have hired novice providers (both NPs and MD/DOs) that are being brought on to expand the practice. These providers start slow and build up to a full load over time (though to be frank, MD/DOs are expected to do this much faster, but again a price premium here).

If the OP was on day 10 and still shadowing, it seems like there was some kind of (hopefully mutual) trial going on for both parties. It is obvious it wasn't a good fit. I wouldn't blame either party from professionally and respectably walking away before too much was invested. Insert other media

manxx, ASN, BSN, MSN, LPN, RN, APRN · Aug 13, 2022

Thanks for the added imput, however it makes me wonder if she was clearly a new NP (checking the license would have verified this) as I am sure she reported in her interview, then the above stated leaves me scratching my head. New providers to expand the practice should have more than 10 days I would think. However, I have not owned a practice in which more than just myself was involved so outside of my personal experience I can/will not speak to. 10 days for me (unless there was something she left out) was a little rush to judgement in firing a new grad in training. Again, I have not had the experience as a lead NP but I have been in situations that left me wondering about the experience at that particular time.

Regards'

MLH NP

Tegridy · Aug 14, 2022

On 8/11/2022 at 1:33 PM, CH_NP said:

Yes, I agree. Primary care is extremely difficult. Normally, I would check the chart first before I see the patient but there's a specific provider who just wants me to go straight to the room without reviewing the chart or bringing my computer into the pt's room.

To calm myself, I try to look on the bright side and as you have said, it may be a blessing in disguise. However, the stings stay there and now I am torn if I should continue working as NP or should I just go back to working as an RN as I am more comfortable in that role.

Sounds like a crap hole with not great people working there. Be glad you are done with that place

CH_NP · Aug 14, 2022

21 hours ago, manxx said:

Thanks for the added imput, however it makes me wonder if she was clearly a new NP (checking the license would have verified this) as I am sure she reported in her interview, then the above stated leaves me scratching my head. New providers to expand the practice should have more than 10 days I would think. However, I have not owned a practice in which more than just myself was involved so outside of my personal experience I can/will not speak to. 10 days for me (unless there was something she left out) was a little rush to judgement in firing a new grad in training. Again, I have not had the experience as a lead NP but I have been in situations that left me wondering about the experience at that particular time.

Regards'

MLH NP

Hi, I was told that my coworkers like my work ethic it's just that I need extensive hands-on training and the clinic cannot provide that. They advised me to start working in urgent care first and to get can get in touch with them once I get more clinical experience. I honestly want to apply for NP residency but it requires to be a recent graduate of <18 months. I graduated in 2020 but only took the exam end of last year. I tried looking for jobs that welcome new NPs and willing to train but it's just super hard to find.

subee, MSN, CRNA · Aug 14, 2022

On 8/11/2022 at 5:03 PM, BostonFNP said:

I am sure it stings. I still vividly remember the first job I was fired from at age 13 and a half. It has shaped my work ethic my whole life but it also still stings a bit.

My advice would be that any job you take as an NP is going to be less comfortable for you than the RN role you know well; only time and experience working in the NP role will change that, but, that doesn't mean you shouldn't do it. This was a single, short, experience. There are lots of other jobs that will invest more in training you or allow you to work in a more confined practice area until you feel more comfortable. I have a great friend/colleague I went to NP school with that had a similar experience, she went to work in retail clinic (CVS) and she loved it.

If someone is asking you to go see a patient without looking at the chart....that's a symptom of serious dysfunction in that place. Begone!

Guest1144461 · Aug 15, 2022

On 8/10/2022 at 6:27 PM, CH_NP said:

seems like a good idea and thank you for the suggestion.. However, I have a baby and a 4 y/o and I don't think this will work for my family ?

Many of the resident MDs I worked with had families and lives as well, yet moved for internship, residency, fellowship etc.

Not everyone is in the life position to be a provider. Too many RNs just think it’s a simple natural role/change upgrade that they can do on a whim and be competent/prepared afterward.

Your employer should have done a better job vetting you before hiring, but on the flip side if you are looking for a job that is going to gleefully take a new NP and mold them for free when there are thousands of candidates (thanks NP education) that isn’t going to happen. As an aside your employer sounded baseline terrible for other reasons, but expecting competency from a fully licensed provider that should be ready to practice isn’t absurd. I am going to take your word at face value and give you the benefit of a doubt, but a clinic expecting someone to go see a patient without doing any chart review is pretty ridiculous and almost unheard of to be honest.

There is always the bedside role that’s open and flexible. No shame in that for your life situation.

CH_NP · Aug 15, 2022

14 minutes ago, Numenor said:

Many of the resident MDs I worked with had families and lives as well, yet moved for internship, residency, fellowship etc.

Not everyone is in the life position to be a provider. Too many RNs just think it’s a simple natural role/change upgrade that they can do on a whim and be competent/prepared afterward.

Your employer should have done a better job vetting you before hiring, but on the flip side if you are looking for a job that is going to gleefully take a new NP and mold them for free when there are thousands of candidates (thanks NP education) that isn’t going to happen. As an aside your employer sounded baseline terrible for other reasons but expecting competency was a fully licensed provider that should be ready to practice isn’t absurd. I am going to take your word at face value and give you the benefit of a doubt, but a clinic expecting someone to go see a patient without doing any chart review is pretty ridiculous and almost unheard of to be honest.

There is always the bedside role that’s open and flexible. No shame in that for your life situation.

I agree. Not everyone is in the position to be a provider. I will always prioritize my family over anything else even it means I have to go back to bedside. I always know it will be a hard transition but just didn’t expect this will happen to me as I was clear to them about my limitations as a new grad and I was told they would support and mentor me. Not all providers were like that, there was just one provider who really doesn’t want me to check the chart. He said he wants me to get used to talking to patients first which I somewhat understand. Nevertheless, I’m in a better headspace now compared to a few days ago. I realized that specific job was not really meant for me and that God has a better plan for me.

masafnp · Aug 17, 2022

I am so sorry this happened to you. It must feel devastating. Can you turn the picture around? This is about them and their lack of knowing how to care for a new NP - you were up front with them. It's actually not about you because someone else in your position would probably have been treated the same way. And they said they liked you. Consider this a blip in a very long career as a growing NP. We learn constantly on the job, and now you know what kind of questions to ask at your next interview. Don't give up on your dream. Being an NP is an amazing profession and it may take a couple of tries to get into the job that is the right fit. This one obviously was the wrong fit - doesn't make you bad/wrong/going down the wrong career path. Hang in there. Try again. Don't give up. You will find the right fit for you. Good luck.

DNP4u · Aug 17, 2022

I feel for you! I have been an NP for 10 years all in Urgent Care! Decided I wanted to try primary care because my patients kept asking me “do you see patients outside of urgent care I want to see you again” never did primary care ever! Don’t feel bad! I needed orientation too (this was promised to me but not delivered!) I sank faster than the titanic! My nurse sabotaged me as well. It’s all in the training! Please don’t think bad about yourself. I think residencies are great but keep looking for some where you live! Don’t go back to working as a RN you will never move forward again. YOU can do this. Trust me not working there is a blessing! I lasted 3 months at this place and it was a nightmare for me. I inherited 200+ pts! Next job be very specific look for mentors! Try something else besides primary care it’s tough as a new grad! CVS would be perfect or something where you have support! Good luck and don’t give up!!

athey1999 · Aug 17, 2022

Thank you for sharing your story. I am in my first year of the NP Program and your story was a real eye-opener. Due to the market being saturated with NPs as it is here, jobs are hard to come by and there may be some out there like the one you dealt with, who just want to fill a position and throw you in the deep end without teaching you how to swim first in terms of letting you learn and acclimate. Please don’t give up. You worked very hard to get through the program and get your license. You sound amazing and humble. They may have told you that you weren’t a good fit, but it sounds to me like they weren’t a good fit for any new grad NP if they would just throw you out there like that and not help you to acclimate first. I realize the experience can really make you question your judgement and your career choice, but don’t feel that way. You’ll find your best fit and you’ll be a rock star. In the meantime, thank you for sharing your story. You have given the rest of us NPs in training some food for thought about the reality of the jobs out there and I will definitely ask a lot of questions when the time comes to get job interviews. Best wishes, Hon. Don’t get discouraged. You’ve got this.

nitenurse · Aug 18, 2022

On 8/10/2022 at 1:55 PM, CH_NP said:

I was let go today from my 1st NP job after working there for 10 days. I was told I wasn't a good fit and I needed more training. It is ironic that they have so many students in the clinic yet they won't spend enough time training me. I feel defeated and I am struggling emotionally. I was told they like me and I can get in touch with them when I am more equipped and have gained more experience. I was upfront with them that this is my first NP job. They should have not hired me if they will just let me go this quick. If only I would get fired I should have not resigned from my previous RN job. I don't know what to do. I don't know anymore if NP is for me or if should I just go back to working as an RN. Any advice?

It sounds like this particular practice was not a good fit for your style or personality maybe. Without knowing more, perhaps they wanted you to hit the ground running in a way and the lack of confidence in your abilities as a new graduate may have had a hand in that. However, if this setback has you scrambling for cover in the comfort of being an RN, then you should search your soul to figure out what it is you really want to do at the moment.

Getting let go when you are just trying to do your best is a punch in the chest that knocks the wind out of you and that never feels good. So, you have a couple of different options: 1. go back to nursing while shadowing providers on one of your day offs to get your feet underneath you. 2. try a hospital facility or another clinic that would have a bit more hand holding with a formal program (for an example of what those can look like, see links below) 3. try being a NP in a different specialty -which can bring a new set of challenges but since you are new, they should not be insurmountable.

https://www.VA.gov/southern-arizona-health-care/work-with-us/internships-and-fellowships/primary-care-nurse-practitioner-residency-program/

https://www.carilionclinic.org/fellowships/np_pa#programs

CH_NP · Aug 18, 2022

6 hours ago, nitenurse said:

It sounds like this particular practice was not a good fit for your style or personality maybe. Without knowing more, perhaps they wanted you to hit the ground running in a way and the lack of confidence in your abilities as a new graduate may have had a hand in that. However, if this setback has you scrambling for cover in the comfort of being an RN, then you should search your soul to figure out what it is you really want to do at the moment.

Getting let go when you are just trying to do your best is a punch in the chest that knocks the wind out of you and that never feels good. So, you have a couple of different options: 1. go back to nursing while shadowing providers on one of your day offs to get your feet underneath you. 2. try a hospital facility or another clinic that would have a bit more hand holding with a formal program (for an example of what those can look like, see links below) 3. try being a NP in a different specialty -which can bring a new set of challenges but since you are new, they should not be insurmountable.

https://www.VA.gov/southern-arizona-health-care/work-with-us/internships-and-fellowships/primary-care-nurse-practitioner-residency-program/

https://www.carilionclinic.org/fellowships/np_pa#programs

Hi nitenurse,

I can't deny that I am actually struggling with imposter syndrome. I graduated 2 years ago and it feels like I did not get adequate hands-on training. There were times I resorted to doing virtual clinicals during the peak of the pandemic. I also had a medical condition that prevented me from working and pursuing NP after graduation. I am interested in shadowing other providers while working as an RN. How does that work though? I thought you can only do that when you are employed.