Scared to start a real NP job

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Just graduated in January and waiting to take boards which I am terrified of not passing! I am currently the ADON at a LTC facility which I love. I was supposed to keep my job there with a few added NP duties and I was absolutely happy because I love my job.

I recently found out this all fell through and they can't pay to keep me so now I am forced to look for a job in a clinic. I am totally scared to death. I made it through the NP program and graduated. It was not easy, it was very hard but I did it! Made it through all my clinicals. But I feel like I know absolutely no more now than when I started the program! The thought of having to see pts on a daily basis makes me sick to my stomach.

To be honest, during clinical rotations, I didn't see that many pts totally on my own. Every time my preceptor would say what they were going to do I would think to myself "why didn't I think of that!". I can't see myself evaluating, diagnosing and coming up with a plan for patients. I will have to leave the room, research the symptoms and tx. for at least 20 minutes for each person I see.

I feel as if I know nothing. When I go over in my mind possible pt scenarios, my mind goes completley blank and I dont know what to do. Everyone tells me I will get the hang of it but I just don't see myself being able to work on my own. I'm going to have a nervous breakdown but I have to work! I have spent too much money on my education to just keep working as an RN.

I don't really know any advice anyone could provide, but I had to vent.

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Specializes in Nephrology, Cardiology, ER, ICU.

I think everyone feels that way in the beginning. I know that in my area, the big nursing home chains (Manor Care) comes to mind, that they hire NPs to handle their pts in-house to help avoid ER visits and hospital admissions. During clinicals for my adult APN, I was with an FNP who worked at a 300 bed NH. She loved her job.

You will become more comfortable and you will pass your certifying exam....

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Specializes in Psychiatry (PMHNP), Family (FNP).

Yes I think you are just feeling overwhelmed. There is so much to know and I suspect you know more than you are giving yourself credit for. Also you may be getting panicked by nerves and self-doubt. How about getting a pocket sized book or stack of cards that have the protocols for very common conditions? Then you can just jump start your thinking if you get frozen in your tracks. I bet after 3 months you will be just fine. "Fake it until you make it!!" :)

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I think studying for boards incites a more than normal sense of panic. I mean, you sit down with a review book and with each page you are like "crap..I forgot about that disease" and "crap, I forgot that med was an cytochrome inducer" and "crap, I forgot XXXX" The reality is that we will tend to see a lot of common disease processes and will get very experienced at treating those and will be able to recognize when we see something out of the norms.

There has actually been whole articles written on "imposter syndrome"...google them and see what you find.

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Specializes in allergy and asthma, urgent care.

It would be strange if you felt totally confident and ready to conquer the NP world...lol. We all felt overwhelmed and scared with our first jobs. I just started working as an NP 7 months ago and I am so much more comfortable now. I'm not an expert by any stretch of the imagination, but I'm worlds away from where I was on Day One. Focus on passing your boards for now (and you will pass), and then worry about the job once you get there. Find yourself a position where you'll be well supported and you will be fine.

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Specializes in Emergency Nursing, Critical Care Nursing.
Yes I think you are just feeling overwhelmed. There is so much to know and I suspect you know more than you are giving yourself credit for. Also you may be getting panicked by nerves and self-doubt. How about getting a pocket sized book or stack of cards that have the protocols for very common conditions? Then you can just jump start your thinking if you get frozen in your tracks. I bet after 3 months you will be just fine. "Fake it until you make it!!" :)

I love that suggestion about the pocket sized book for protocols for say, the most commonly seen conditions. A friend of mine did the FNP program at UAB. She ended up landing a job a GI medicine clinic. She is going to become an expert diagnostician of all things GI, because that's what HER clinic in HER specialty sees. You will be fine! I'm not a NP, but I know from my own experience that the more I was exposed to different symptom groups in the ER and Critical Care, the more I could almost ANTICIPATE what the docs would order.

Go get a massage, take a weekend to relax, then begin the first day of the rest of your life!! :yeah:

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I love the massage idea...I get massages and they are great!

So, just take a real deep breath and...relax....ahhhh...isn't that better? First I would just focus on studying and passing your exam. That's enough to deal with at one time. After you have passed your exam, do yourself a hugh favor...either take a vacation or do absolutely nothing for at least two weeks, if possible. Because you will be very stressed the day you take your test and will somehow need to wind down from all of the stress. It's so important.

Try not to do what I did...I took my boards on a monday, worked at my teaching job for days that week and then started my new NP job the very next monday. That was crazy on my part because I never gave my body a chance to wind down and rest and so I continued to feel very tense even into the new job, which made it hard to focus and concentrate.

In starting your new NP job, just take it one day at a time and believe me you are not alone in how you feel. It's very scary when you begin working as an NP. The expectations are high, but depending on where you will work, most MDs and experienced NPs are good about answering questions. My hope for you is that you will find a great team to work with, people who will mentor you and teach you. That's exactly what I had and I am so grateful for it.

I would just focus on the exam for now, though. Good luck and let us know how it goes.

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