questions about first job as NP and on-the-job learning

[bailey728]

Hello all,

Before I ask my questions, I just wanted to say that I am so happy to have found this website. You all are a wealth of information, and I am glad to have a place to ask your opinions.

My eventual career plan, after obtaining my BSN and working for a few years, is to attend an NP program. One of my concerns is whether the clinical preparation in the NP programs would enable me to be comfortable with practice after graduation.

I have been reading through the NP forum and saw quite a few posts from NPs who did not feel they had adequate clinical training during their programs, and who said that they honed many of their skills after they graduated and started working. This makes sense to me when thinking of how MDs learn many of their skills in residency. Since NPs do not have a formal training period akin to residency however, I was curious as to how this period of learning on the job works. Are new NPs paired with seasoned NPs or MDs who show them procedures, double-check every case, etc? Or do the new NPs just ask for help where they need it (which might be for every case in the beginning)? What do employers expect of new NPs in terms of knowledge and clinical skill, and does this differ depending on what specialty one chooses?

Thanks in advance for any information / opinions you can share. :)

~Heather

[traumaRUs, MSN, APRN]

Hi Heather and welcome. I can only speak from my own experience. I graduated last year with an adult-health CNS. I was hired by a large nephrology practice (15 MD's, 3 PAs, 4 NPs, and me). I rec'd 4 months of official orientation where I was never left alone - I always had an experienced NP with me and then another two months of mentored preceptorship. I still ask questions, lots of them! No issue with that either. When I call a doc now though, I have a definite plan formulated and just run it by the doc. I usually talk to the docs two or three times per week (not every doctor of course, this is my total doctor encounters). The orientation I received was excellent: both didactic (lectures by the MDs) and hands-on. I will also add that it takes a while to get your license, DEA number, hospital priviledges, etc., so its not practical to just get hired and be on your own instantly.

[bailey728]

Hi Trauma,

Thank you for sharing your experience with me. That is exactly what I was hoping to hear. I hope that your experience is the norm. I hadn't considered the time involved in getting a license, etc -- that makes sense that legally a new grad wouldn't be allowed to be completely on their own.

One other question for you... how long did it take you to feel comfortable doing things on your own? I've heard that 6 months to a year is typical for people to feel more settled into their new role. Does this sound right?

Thanks again!