New Grad NP Working Alone

Updated | Posted
by LuckystarNP LuckystarNP (New) New Nurse

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I am a new grad NP. I am currently working in a pediatric private practice . The doctor  wants me to work alone in the office after 60 hours of "training". My training was  a 8 hour shadowing, and starting to see patients myself. The doctor would come over and double check after I am done seeing the patients. He would tell me to go to the other room to see another patient while he double checking. During this week, the doctor gave me feedback, saying that I am too slow and I should be able to see patients on my own by now.

Because the doctor has two offices,  he wants to put me in one office by myself with a MA, so that he can be in the other office. I told him that I don't feel comfortable yet. He was upset and telling me I am wasting his time. He said he has already gave me a lot of training. He wants me to give him a timeframe to let him know when will I be comfortable to work solo. I feel that I am rushed to finish training and I don't feel safe at all. I told him my feeling and he said I will not be able to be a provider since he thinks that I don't have confidence. 

Also, the MA in the office only does measurement, such as weight and head circumference. She also prepares vaccines. I need to do all the blood drawn which I think it made me slow down on seeing patients. Since I need to hold down the fussy kid in order to take blood. 

I am thinking about quitting, but not sure if this is a good decision. Any advice please?  Thank you. (English is my second language, sorry for any grammatical mistakes)

 

I think you are not ready to meet the doctor's expectations and if I were you, I would resign.  He knew darn well what he most likely would be getting by hiring a new grad without experience, so do not think this is all your fault.

MentalKlarity, BSN, NP

Specializes in Psychiatry. Has 8 years experience.

This is why residency should be mandatory. We market ourselves as population experts equal to other providers but we DO require a long orientation to transition from school to practice. Unfortunately we are billed as "ready to go" and employers expect that. 

This position isn't safe and the doctor wants you to be RN and NP and is angry you're not making him enough money quickly enough. Look elsewhere. 

19 minutes ago, MentalKlarity said:

This is why residency should be mandatory.

This.  Many times over.

Thank you for the advices. I totally agree that residency should be mandatory. It helps boosting self confidence and knowledge in order to ease the transition from being a nurse to a provider.

I was self doubting myself everyday when I left the office, because I received negative feedback from him almost everyday. He always compares me to his previous NP, who was also a new grad. He said she was able to see patients on her own after 3 days training. Even though he said that the NP was lack of knowledge, he saw her very confident in front of parents and able to made parents believe in what she said. He said my experience and knowledge are much better than her but he could not see me confident enough to be a provider. I guess this job is a mismatch. Quitting is better for him and I, so that we won't waste each other time. 

Miss.Jersey, MSN, APN

Specializes in PMHNP.

Whether you're a nurse practitioner, a PA, or a physician, we get more proficient and confident as we go. Should this doctor be expecting more of you after a few hours in your new role? I don't know, I find it a bit unrealistic. But if his expectations are unrealistic for YOU, it's probably not the right fit.

It takes a lot of confidence to begin in your new role, and this doctor is undermining that confidence. He is not supportive it sounds like it all. Really seems like a bad start. I wouldn't want to work there. Good luck to you!good luck to you!

As a new grad, I look forward to beginning work with my former preceptor. She knows me, she's confident enough in me after observing me to feel I would do a good job. I already asked her, can I collaborate with you and the answer was of course! That's the type of support I want. Could you find a job with a nurse practitioner?

Edited by Miss.Jersey

Miss.Jersey, MSN, APN

Specializes in PMHNP.

12 hours ago, LuckystarNP said:

He always compares me to his previous NP, who was also a new grad. He said she was able to see patients on her own after 3 days training. Even though he said that the NP was lack of knowledge, he saw her very confident in front of parents and able to made parents believe in what she said.

He said my experience and knowledge are much better than her but he could not see me confident enough to be a provider. I guess this job is a mismatch. Quitting is better for him and I, so that we won't waste each other time. 

1. This statement is disturbing. He said that she wasn't knowledgeable. She presented herself to patients and parents' knowledgeable. And parents would believe her because how she presented herself. There's a saying that says people have confidence in those who have confidence in themselves, and that is true. False confidence and pride is dangerous.

2. During clinical I sometimes felt the pressure to behave as if I was an expert and knowledgeable like an experienced practitioner like my preceptor. Eventually I learned to be truthful with my patients. I started telling them "you know, I'm still learning. We're going to get the answers for you. Give me a minute to research our best option." The patience respected that, and it also gave my patients permission not to pretend to be perfect themselves. It made me approachable, and showed humility. But it also showed confidence tha in another way. Not in pretending I knew everything but that I was confident that I could get any answer we need. And that I'm committed to truth and informed decision making. When I would come back to my patients in a minute I would tell them exactly what I came up with, explain it to them so that they understood and were comfortable as well. Sometimes people like to *** patients, so the patient thinks that they know everything. A lot of times patients can see through that and it erodes confidence.

3. This doctor's not supportive. He can't see you as a provider because somebody who lacked knowledge but faked it till she make it is more his speed. Even after acknowledging that you were knowledgeable. What an unsupportive jerk. He is totally not on the same page as you. I would totally move on  

I'm glad to read at the end that you did move on. What is your plan? How are you going to find a better fit?

Thank you very much  I was honest to the patients that I am in training, but he didn't like me saying that. He told me I should tell patients that I am a doctor. I told him I am not supposed to. I think patients should have the right to know if they are seeing a doctor or a NP. He told me no one will want to see me if I tell them I am a NP. (due to the language barrier since the patients are mostly immigrants).

I talked to my preceptor today who is also a pediatric doctor. He said I am more than welcome to work with him. I hope this will work out well. I wish I can find a job with a NP just like you, because I think a lot of doctors don't understand the role of NP. Thank you for your support. I wish you good luck as well.

Tell patients you are a doctor? Where do we begin? This guy has no scruples. You are better off hiking down the road.

CommunityRNBSN, BSN, RN

Specializes in Community health. Has 3 years experience.

I also work in a practice with a ton of immigrants. They often call our NPs “doctor.”  We always gently correct them and refer to the NP by their first name, or Miss-LastName. It is insulting that your MD thinks “Well these people can’t understand, so just call yourself Doctor.” That is unethical. 

He doesn't respect you or your NP practice. Move on. Never work where you feel uncomfortable and don't fake it to make it. We're dealing with people's lives. Look for an NP residency program in your area or find an MD who is willing to train you the right way. Good luck!

Yes, literally he told me that these people cannot understand, so just call yourself a doctor. He said he cannot understand why he needs to spend time with me to discuss about this. 

I also don't like the idea of "fake it to make it". He told me this is unprofessional to tell patients that, "I am not sure the answer, but I will find out for you." He does not have respect to me, to the NP profession, and to his patients. I will definitely move on and hopefully can find someone who is supportive.  Thank you for your encouragement.