How not to suck!

Jules A, MSN · Dec 27, 2016

Excellent query, I wish more were this thoughtful instead of thinking since Online U provided them with a piece of paper saying they are able to prescribe medications to the unsuspecting public it must mean they are a rock star. My best advice would be get solid experience in whatever specialty you are pursuing as a NP-NOW, yeah that means working while you are in school. In addition to the knowledge you will make professional contacts and trust me that is the name of the game for support, opportunities and your reputation. If you are going for FNP consider ED as a RN or even a physician's office. Make solid contacts with NPs and MDs yesterday rather than attempting to scramble around after you graduate. Ask the NPs how much you can expect to make as a new grad. Find a couple of really good MDs and stick to them like gum under their shoe, emulate their style both in practice and office politics. Join your state's NP organization and make your self known among the key players. Select your clinical sites based on places you would like to work after graduation, learn the routine, climate and get yourself on the radar of anyone who is in power to bring you on board after graduation. Lastly if you think your school is preparing you to practice I'd ask you to question that assumption because at least in my experience in two well respected programs and having seen the performance of scores of new grad NPs yeahhhhhNO thats rarely the case. Best of luck to you!

casias12 · Dec 27, 2016

You are way too nice Jules.

Dude, if you are this far in and feel like, this....do us all a favor.

JellyDonut · Dec 27, 2016

Hate to tell you this, but as a new NP your are gonna suck or at least have many days where you suck. No matter how well you do in school it is a different world when the training wheels come off. Now, I have several friends I graduated (people who never cracked a book and studied the power points) with who claim they were brilliant from the moment they accepted their offers and I love and support them - i just would not want any of my family members treated by them. I think it is good to be humbled by the vast responsibility we walk into and the huge amount of knowledge we do not yet grasp. Someone tried to equate it as the transition to an RN and it is in no way like that. As an RN you are basically a task master, doing what you are told and as an NP you have to have the answers. However, it gets better the longer you do it and the more you look stuff up and ask questions. I have been told that even after 10+ years experience you can still have some bad moments and horrible days just like with every other job. but over time you develop skills and learn (whether you want to or not) and put fewer patients at risk LOL

Trauma Columnist · Dec 27, 2016

I still suck some days and I'm almost 11 years into this APRN gig!

Don't be too high and mighty cause you can fall off that mountain quicker than you can climb it.

allnurses Guide · Dec 27, 2016

I'd rather you feel that you're going to "suck", then feeling you're going to graduate as the best NP on the planet. Overconfidence is so dangerous. Remember that you graduate as a novice NP, and novices have a lot to learn. Do as many clinical hours as you can. Ask as many questions as you have to. Know that being an NP requires lifelong learning. Try and find a job where you will have the support of other seasoned providers, and use them as mentors.

I'm almost 8 years into the NP gig. I still learn something new everyday, I still study, and I ask questions. Some days suck, and there are definitely days when I know I could have done better. I try to learn from those sucky days.

Best of luck to you!

NurseLauraM · Dec 27, 2016

You are way too nice Jules.
Dude, if you are this far in and feel like, this....do us all a favor.

How do you know how far along she is? The OP only states she is in an NP program. She does not mention what semester she is in, if she has started clinical rotations, how close to graduation she is, etc. I should hope that an NP student, grasping that she will be solely liable for the health of human beings, feels apprehensive about practicing in the "real world". This is especially true if she is early in her program. I would much rather have a provider who is self-aware and unafraid to ask for support than one who is over-confident and too proud to admit any shortcomings (who by the way, tend to be the ones who refuse to stay up-to-date because "this is how we've always done it!")

"True wisdom is knowing what you don't know" - Confucius

And OP: as for worrying about being one of "those NPs" that the doctors complain about... there is nothing you can do but be humble, work hard, and ask for help when you need it. There are professionals across all disciplines who become easily annoyed by new colleagues, whether they are NPs, doctors, RNs, teachers, mailmen, you name it. All you can do is grow thick skin, learn from every experience, and hope to eventually earn their respect.

Aromatic · Dec 27, 2016

I would add to this but i think its mostly all been covered. Good job preparing early and knowing you dont know it all.

Goldenfox · Dec 27, 2016

I am an NP student who is doing fairly well in my program. I feel this program is challenging and is doing a sufficient job training me for a provider role. The only thing is I can't imagine being able to start a job as a provider when my schooling is over. I know a lot of people feel this way so can anyone give me some tips on how not to be one of "those" nurse practitioners. The ones the doctors complain about. What can I do now to help me become a better provider? All help is appreciated!

I seriously doubt that any NP school out there prepares students sufficiently enough that the students absolutely will not suck. I've been at this a while and I have 'suckey' days where I occasionally brain f**t and and then catch myself just in time to avoid stupid mistakes. You cannot escape this as a new grad...no matter how much you think you know. You will find that that there are many things that you still do not know and will have to look up. You will also find that a lot of things you encounter in the real clinical world do not match up tidily with the textbook examples of what you're supposed to see, nor is every situation best managed with traditional treatment modalities. Much of it you will learn from experience.

I don't think too much about doctors who look askance at members of our profession. True, there are some sloppy NPs out there who don't have a clue, but I don't believe that most of us fall into that category. It is an exception if you find one (maybe a few) doctors who won't think of you as 'one of "those" NPs'. In their minds, its their way of keeping us all in our place. Many of them, even the ones who don't have much sense (and you will encounter quite a few of these throughout your career) will have that attitude towards you no matter how smart or how good you are as an NP.

Aromatic · Dec 27, 2016

I seriously doubt that any NP school out there prepares students sufficiently enough that the students absolutely will not suck. I've been at this a while and I have 'suckey' days where I occasionally brain f**t and and then catch myself just in time to avoid stupid mistakes. You cannot escape this as a new grad...no matter how much you think you know. You will find that that there are many things that you still do not know and will have to look up. You will also find that a lot of things you encounter in the real clinical world do not match up tidily with the textbook examples of what you're supposed to see, nor is every situation best managed with traditional treatment modalities. Much of it you will learn from experience.
I don't think too much about doctors who look askance at members of our profession. True, there are some sloppy NPs out there who don't have a clue, but I don't believe that most of us fall into that category. It is an exception if you find one (maybe a few) doctors who won't think of you as 'one of "those" NPs'. In their minds, its their way of keeping us all in our place. Many of them, even the ones who don't have much sense (and you will encounter quite a few of these throughout your career) will have that attitude towards you no matter how smart or how good you are as an NP.

Yeah I like what GF says. Being a know-it-all is only useful if you like it when people hate you and try to undermine you. Just dont be one of those, again, unless you want your life to suck too ha.

foggnm · Dec 28, 2016

Other than the clinical parts, NP school is unfortunately too much like nursing school and not enough like PA school. I'm an RN, but my friends and colleagues that have made that transition attest to the first few years being a learning curve. But the same goes for MD residents. And just remember the MD residents got 4 years of school with clinicals, then get several more years of training after they do boards. Most things in medicine are also protocol driven, so you can have some reassurance that if you learn protocols for your specialty that you'll have a fail-safe for making decent decisions. To me, learning the decision/protocol/inquiry process is what makes a good provider. You can always learn the technical stuff with experience.

lhflanurseNP, APRN · Dec 28, 2016

One thing that can help is doing as much clinical time as you can. Just doing the "minimum" hours doesn't cut it. The problem most NP students have is they still have to work so they wind up shortchanging themselves in regards to the clinical practicum hours. This is where you will learn the most...well...hopefully if you have good preceptors/mentors. I try to get my students to get more involved in the clinical rotations...I even do "projects" in which they need to research an actual patient scenario and come up with how they would evaluate, diagnose, and follow the patient. I cannot tell you how many times the answers are typical "nursing"...vital signs, oxygen, diet, some even tell me "what ever the physician orders". One of my pet peeves why NP students need more experience under their belts and be in positions where they have actually had to do critical thinking. Something to consider is while working as a nurse...look at your patient and consider what would you order? why? what about follow-up outside the critical setting?