9 months into FIRST FNP job

[anh06005]

I updated a few months ago because I always searched these forums for anything to show me the light at the end. Here's another update:

I am about 9 months into my first FNP position. I could have cooked a baby at this point in time but, instead, all I got was a poodle. Anyway...

I am able to run through some rooms without my phone to triple checks dosages and tests. I haven't killed anybody (that I know of). I have some regular patients who comment on my new haircut and thank me for helping them. I feel like I'm getting an entire city caught up on PAP smears (since there aren't any full time local OBGYNs and my partner in the office is a young male physician).

I feel like I have learned sooooo much in these last few months it's unreal. I THOUGHT school stuffed my head full of knowledge but it's finally really clicking.

I still look up plenty. Refresh myself before a patient by glancing at an algorithm.

At this point I'm really seeing medicine (oh, uh, ahem...advanced practice nursing) as doable. I think I will eventually be like some of my favorite preceptors who I aspire to be. To be as knowledgable as my physician counterparts but still have my nurse-y ways.

I passed that dang test 10 months ago but I'm still studying almost daily to better understand what I'm doing.

For NP students: you will finish.

For new NP's: you will feel more confident.

Just give it some time!

[ksenakim]

Wow.

I'm currently in my second to last term of my FNP program and the stress/anxiety/weight of everything I don't know makes me regret having applied sometimes. This post gives me hope. Thank you.

[BostonFNP, APRN]

I still look up plenty. Refresh myself before a patient by glancing at an algorithm.

That's ok! In fact you should be looking things up all the time, we all should, that is part of maintaining your practice. I work with a colleague who has been a physician for more than 40 years and he uses UpToDate and reads journals as much as I do.

It sounds like you are nearly fully transitioned into the role, congrats.

Usually about this time is when novice NPs have their first run in with an error or a missed diagnosis, and if/when that happens, remember that no provider catches everything or is fully free of mistakes. This is a job that tends to humble you as soon as you get too confident.

[Nursetk4]

I constantly am looking things up. I use my epocrates and drug calculations in the room with the patient. The patients appreciate that I am taking the extra time. I rather take a few extra minutes than have to have an error.

[anh06005, MSN, APRN, NP]

That's ok! In fact you should be looking things up all the time, we all should, that is part of maintaining your practice. I work with a colleague who has been a physician for more than 40 years and he uses UpToDate and reads journals as much as I do.

It sounds like you are nearly fully transitioned into the role, congrats.

Usually about this time is when novice NPs have their first run in with an error or a missed diagnosis, and if/when that happens, remember that no provider catches everything or is fully free of mistakes. This is a job that tends to humble you as soon as you get too confident.

I hate that we are human but it's reality I suppose. I'm hopeful in the next year or so I can get off of my Lexapro I started my last semester. I'm too tightly wound with all of these changes the last year or so.

[BostonFNP, APRN]

I hate that we are human but it's reality I suppose. I'm hopeful in the next year or so I can get off of my Lexapro I started my last semester. I'm too tightly wound with all of these changes the last year or so.

It will always be a humbling job; just when you think you've got it, it turns you on your head.

[Nursetk4]

I appreciate that everyone is so opened about this transition. So many act like this is the easiest job. I finally am realizing it's ok to admit this a stressful time. We will get through this.

[cayenne06, MSN, CNM]

I paid for a personal subscription to uptodate (and have the app on my phone). I paid for the ASCCP pap/colpo guidelines app. Every morning, when I log in to my computer, I log on to uptodate and pull up my protocols (omg, I LOVE that my organization has detailed and comprehensive protocols that are constantly kept up to date) and leave them open on my desktop.

I am lucky enough to work in a 2 provider clinic, so I am almost never without an experienced NP/CNM to bounce questions off of, and my medical director is amazing about responding quickly to questions/consultations. There are a dozen clinics in my affiliate, and all the clinicians (newbies like me and seasoned providers) informally consult each other constantly. There is a real culture of teamwork here, and I am so incredibly grateful for the encouragement and ample education/training I get on the job. Never, ever have I been made to feel silly for asking a question or requesting a second opinion.

I've been a practicing CNM for just over 4 months, and my head sometimes hurts from all the new skills/information I am constantly learning.

[wanderlea]

Thanks for that post! I just finished school but I'm terrified of looking for a job! That post makes me feel better

[anh06005, MSN, APRN, NP]

Thanks for that post! I just finished school but I'm terrified of looking for a job! That post makes me feel better

Only way to feel better is jump into a job! Thankfully my collaborating physicians are supportive and understand I'm new. I'm not consulting with them as much as I'm getting better at x-rays, finding resources that work for me, etc.

Good luck on the job hunt! I never thought I'd enjoy primary care but I've come to enjoy the variety so don't be afraid to take something you're unsure of.