New NP: Nervous, need resources and advice!

[Flaring]

Hello everyone! I am a new nurse practitioner and have been offered my first job in a general medicine outpatient clinic. I will be seeing 15-20 patients daily (at my max) and there are a few others nps and physicians who work there. Salary and benefits seem great (everything paid, 5 weeks vacation, salary 100k + productivity)

Thing is, I am terrified. I feel like I wont know what to do when I see patients. Even if I have a vague idea of what to order I feel like I might miss something. like if someone comes in with high BP, maybe I prescribe an ace inhibitor but what if I should have also done a more thorough workup for hidden causes? If I tell someone to put hydrocortisone on a rash when I should have checked for another disease? I feel like I just need access to big book of guidelines to help me get started. Can anyone help?

1. What's a good resource book or website that can help me follow best care guidelines for patients so I don't miss anything?

2. Does anyone else feel this way at first? Aren't you scared of really screwing up and losing your license? Does it get better? What's the best way to gain confidence?

I'm freaking out, sick to my stomach about starting next week. Need advice please!

[BostonFNP, APRN]

Hahahaha! You are joking, right?

There is nothing worse than those two.

[mrl3fnp]

There is nothing worse than those two.

I will let their own words speak for themselves.........

[mrl3fnp]

Enlighten us on why you find my post to be amusing.

It goes way back when they tried to inspire everyone to believe that the great socialist health care experiment that evolved into Obamacare was somehow better than a free market version of health care. Well, I guess no more words need to be spoken. Socialist health care in America is DOA.

[HealthANDLove1122]

Hello,

I'm sorry that you are experiencing this initial form of anxiety and worry. I'm sure by now you've grasped the concept for an advanced practice nurse. I will be starting a new role as a new graduate FNP in an outpatient setting and I also worry about making mistakes. I have thought about it a lot and told myself that I will use my resources such as UpToDate and Practice Guidelines for Family Nurse Practice. I will also ask the other doctors ONLY if I am absolutely stuck. The key thing is remain confident, believe in yourself, and utilize any free time to read up on things you may not have had exposure to. I even told my new employer that there are certain patient groups which I didn't get much experience with in clinical such as babies and would like to work with the pediatrician in the practice to obtain more exposure. You must have the desire to learn and the motivation to better yourself as a professional and you will succeed!

[Oldmahubbard]

All those years ago when I did my NP, there were ample standard references, ie treatment protocols, for all the major conditions usually seen in primary care.

I picked the top 10, and essentially memorized them.

To be fair, in those days, people with some type of unusual problem were generally booked with the MD.

Now in mental health, there are 2 major questions to be asked:

Is it dangerous?

Is it acute?

It takes a lot of pressure off. The situation is rarely dangerous, and even more rarely acute.

I would be a little more worried if you felt totally prepared, but it still surprises me you are asking this type of question.

The information is amply available, but you have to make it your own, which no one can do for you.