First Internal Medicine Job-Feel like I don't know anything

[googs]

Hey everyone,

I graduated NP school with my FNP last August, passed boards in November and I started working a month ago and I thought I'd be comfortable. Is it normal to feel like I don't know anything? To have to look up things constantly and not remember things often and have to ask questions? To miss differential diagnoses? I feel like I don't know anything. I'd like to one day be as much of an expert as one of the docs I'm working with...he's been in practice for 20 years and seems to know everything in depth. Will I get there one day? How long does this take? Will I never get to that level since I never did a residency? Is it possible to get on the knowledge level of a medical school graduate through experience in practice and personal research?

Thanks for your replies in advance.

[lhflanurseNP, APRN]

Perservere. Your confidence is most likely diminished from the absence of working for all this time. You may want to do some refresher study with a board review to help you out.

[TammyG]

I think you can take all the refreshers in the world and you aren't going to know what a practitioner knows after 20 years (or 1 year). The only way to get experience is get experience. To answer your question . . . it will take you 20 years to know what that practitioner knows. Every time you are out of your comfort zone, you are learning. So welcome those opportunities when you are clueless, and climb your way out best you can with knowledge.

[AtomicWoman]

I think everyone feels that way in the beginning. Ask lots of questions. Have good apps (like Epocrates), good places to look up clinical questions (like UpToDate) and starting keeping notes in a free app like Ever Note. You can't possibly know as much as your doc with 20 years experience, but you can look at him as a great source of information! Don't be embarrassed to look things up in front of your patient, if you need to. "Oh, let me look up that drug's maximum dose". Or "Let me make sure that drug doesn't interact with your other medications". I still say stuff like that 3 years in. I think patients appreciate the fact that I don't pretend to remember everything.