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Discussion

Questioning My Future While in NP School

I started NP school in the fall of 2020, but shortly after I began my program I started to doubt my career pursuits. I am so worried about 1) not finding a job in a saturated market, 2) being overwhelmed with the amount of responsibility, and 3) fear of imposter syndrome for years before I'm comfortable with the job. All of these things have me questioning my path, but at the same time I have NO idea what I would want to do otherwise. I have no interest in continuing as a bedside nurse until retirement, and I have always wanted to have the ability to diagnose, prescribe, and work with patients on a long-term basis. 

NPs reading this -  how much stress do you truly feel on a daily basis? Is it manageable? Do you ever regret your career choice? I understand stress is inevitable to some degree with any career, and especially when you are responsible for people's lives, but I am just trying to gauge (to some degree) stress level among NPs. Also, how many years did you work as a NP before you had a good grip on your knowledge in the field and felt confident in your diagnoses?

Thank you in advance for any advice or answers to these questions! 

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    I think the biggest struggle for NP's is that though we have specialized tracks, our job opportunities in the real world tend to be broad and diverse enough that it's hard to come out of your program fully prepared.  It's not like CRNA or CNM which really has a narrow field of clinical practice.  Because of that, many tend to draw from previous nursing experience on top of what was taught in NP school.  It's important to start out in a clinical practice with lots of mentoring.  Having said that, there should be enough competence for a new grad to see a patient, make an assessment of their problems, and have an idea of how to evaluate it.  Knowing where to find or seek the sources of information to guide that decision making should also be a skill taught in NP school.

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    I did not work as an RN.  My first specialization was Primary Care.  My first 6 months were extremely stressful, due to a steep learning curve.  After that, it was actually LESS stressful than my previous career, as a high tech mgt consulting executive.  Currently, I work in Mental Health and am also earning my PMHNP.  My first 3 months in mental health were stressful, but then it calmed back down as I became comfortable in my role.

    As for "saturated" job markets, that depends on where you plan to live and work.  There are large parts of the US with a desperate shortage of primary care and mental health care providers.  Do your research.

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    https://www.AANP.org/about/all-about-nps/NP-fact-sheet

    I think this is what you should worry about most. Specialization guarantees you will be in much greater demand.  I would just advise not going into primary care.

    Compared with the RN hospital role (which I grew to hate), being a NP is 100 times better. Nearly every place I worked, lunch was catered like 2-3 times a week... Everyone talks $$$, but medically speaking, we should all be more concerned about chronic stress and systemic serum cortisol. The biggest thing for me is not being split between 7 people with bs slamming you all at the same time + the new admit since the charge RN was buddy buddy with nursing team A. Pharmacy calling you cuz the doc didn't do the order right, MDs ignoring you cuz nurses page for dumb shite, admin and family to tip toe around all week... yeah, uh no thanks. Granted, these affect the NP somewhat to a lesser degree.

    For me, it was very worth it. 0 regrets about doing my program. At a better place in my life every day. Eventually I'll probably teach or pick up a second speciality. 

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    While I don't work in primary care, I can touch on a couple of your questions. I think it would be abnormal to walk into a new role and feel like you know what you're doing, right? So imposter syndrome was real for me and lasted a good 2 years. You will see common things commonly and for those more unusual things, you ask your peers/preceptors.

    I would absolutely do it all over again. While I have my FNP I practice in surgery, soon to transition to a Urology outpatient office (God willing) so you're not limited to a 'saturated market'. You may have to consider working in a less desirable field such a urgent care or a pain clinic just to get started. 

    Negotiate, negotiate and then negotiate some more. I can't say that enough. You are worthy. This is the time to lay out your path. 

    Good luck!

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