New NP insecurities

Riburn3, BSN, MSN, APRN, NP · Dec 18, 2014

Sounds like the first thing you need to do is use Uptodate or cross reference it before presenting your plan. You clearly have access to it, and checking it after the fact has thus far been futile. As you go you'll start memorizing this stuff and need to look at it less and less.

Feeling like a deer in the headlights or an imposter is a common thing reported here amongst new nurses in all specialties, NPs included. Stay positive and it'll get better.

BirkieGirl · Dec 18, 2014

i have found that one huge help for me (still in school) is to utilize my real-life experiences. i have two kids who have had just about every single thing you can think of between them. just having dealt with that for the past 12 years has been extremely helpful!

i agree that we all have to start somewhere. why don't you ask your colleague for some basic flowcharts or treatment plan charts of HER preferences and you can reference those? that would help a lot.

allnurses Guide · Dec 19, 2014

UpToDate is a worthwhile and (IMHO) critical tool for both novices and experienced providers (NP/MD/etc).

Remember your experienced mentor is there for that exact reason. In a year you will have seen most common things several times and know exactly what the Uptodate recommendations are.

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burnedoutRNinSC · Jan 20, 2015

If you live in a state where you have to have a collaborative agreement with a supervising physician there should be a list of references that should tell you what guidelines to use when you practice.

I'm right there with you as I just survived my first day as a hospitalist NP. Besides pulling teeth getting my credentials switched over in the electronic record, and having someone else write my controlled substances because my federal DEA has not yet been processed it was not a bad day.

There is definitely that anxiety element that can be overwhelming. Having to think like a NP is a big leap from being a staff nurse.

Give your self a break though. You have all the formal education you need to be able to do your job. However, you might want to consider getting some CEU's it might help with how you feel. Besides, you have to get CEU's anyway to maintain your certification. Your masters or DNP is only going to give you preparation to perform minimally. Grow yourself professionally by attending some conferences. What do you have to loose?

travelcrazyRN · Jan 20, 2015

Boston and Riburn- I see you post a lot, and have enjoyed reading your responses to other's questions. Thanks for being such active members to these boards. Besides Uptodate do you have other references that you recommend for novice NPs?

allnurses Guide · Jan 20, 2015

Boston and Riburn- I see you post a lot, and have enjoyed reading your responses to other's questions. Thanks for being such active members to these boards. Besides Uptodate do you have other references that you recommend for novice NPs?

UpToDate is something I use multiple times every day; well worth the investment at the student rate if your clinical sites/program don't offer access. Hopefully your work will pay your sub once you are working.

For adult primary care, the Buttaro text is an excellent clinical reference, especially with differentials and work ups.

The 5-minute Clinical Consult app is also quite good and I have several students that use it. Once you are worming you may get a pharma rep that will give you free access, if your facility allows them.

The USPSTF website is a great resource.

Your state's prescriber gateway or prescription monitoring program is very important.

When I was first in practice the Prescriber's Letter was very helpful

as well.

Sent from my iPhone.

Riburn3, BSN, MSN, APRN, NP · Jan 23, 2015

I tend to use Uptodate and epocrates, the latter more for quick pediatric info.

Boston added anything else I would have said and then some.

The reality is uptodate is going to be the go to reference for most occasions. Since I am new I use it often, and the other providers I work with use it regularly as well.

orangepink, NP · Mar 14, 2015

No u don't need to go back to school. Your mentor however wise she may be now was once a new grad too so don't let all her knowledge intimidate you. Use her as a reference and also do your part by studying more at home. I thought when I graduated that I don't have to study anymore but here I am still studying on a weekend.

AtomicWoman · Mar 15, 2015

I like the Johns Hopkins antibiotics app a lot, because it is constantly updated and a very quick reference. Johns Hopkins Guides: Antibiotic (ABX), HIV, Diabetes & Psychiatry

Whoever told you you are functioning at the level of a first semester NP student (a) is not being helpful, just cruel and critical and (b) does not remember just how little a first semester NP student knows! You are doing fine. Once you see some things over and over, you will have a lot more confidence.

NSUNP · Mar 15, 2015

Truly it could be worse. I simply went to work in my first job as a NP in Internal Medicine. Needless to say that is not ideal. I LIVED on up to date and family practice notebook and epocrates and micromedex and curbsided my MDs whenever I needed to in a shameless fashion. I would much rather feel uncomfortable getting the right answer than send a patient out with the wrong treatment plan. Being a novice is just painful. There is no way to get past it except the lived experience of getting more experienced. One day at a time my friend. Rome was not built in a day. Hang in there and before long things will feel much more settled. This is the practice of medicine we are talking about. It will not be easy but it will absolutely be worth it. Sounds like you are also learning how not to treat the person you will train in the future.

SassyRN_972 · Apr 3, 2015

It's crazy to think that the feeling you have in school will translate on a couple of years out of school as well.