Things to Know Before Starting Your New Job as a Nurse Practitioner

Cassandra Guenthardt

If you are looking to get into a Nurse Practitioner (NP) program or recently graduated from one, congratulations. You are getting into one of the most rewarding careers out there! Coming out of my Nurse Practitioner program, I felt excited and nervous but ready to take on my new role. Our goals as healthcare providers are to help keep our community healthy and to educate about healthy habits. There were some things when starting my new role that I felt ill-prepared for, and I wished I had prepared a bit more before starting.

Coding and Billing

I have been told by many different providers that this is a "learn on the job" topic. In my MSN program, we had a single view on our own PowerPoint about this. I wish there were a lot more in school about this. I felt learning as I went was at the expense of my patients. I feared coding something wrong would have my patients pay more than they should or have patients think I was not knowledgeable in my expertise.

I took some extra time out to learn the most used CPT and ICD 10 codes. I even bought a coding and billing book that I read in the evenings. My recommendation is to learn the commonly used codes where you will be working. Put in some extra work here so you do not have upset patients.

Charting System

I highly encourage learning about the system you will be charting on before starting. Going from a floor nurse to a provider, things are different, even if you will be working for the same company. Take a day or two with your IT specialist to ask questions and learn where to find your lab results, documents, and what your responsibility is.

If you have the time, ask some of the other providers if they have any helpful hints for you. They will be the ones who are most familiar with it and will know what you need to do. Do not wait until your first day to try to learn as you go.

Common Conditions

Common conditions happen commonly. In class, you learn all the possible conditions out there to become prepared for anything and everything. What you will most often see are common conditions. For primary care, things like hypertension, hyperlipidemia, GERD, allergic rhinitis, cellulitis, bronchitis, urinary tract infections, the common cold, and headaches.

Do not go down the road of immediately thinking it must be a 1% of the population autoimmune condition when the patient comes in with a headache, fatigue and a rash. It is most likely something like seasonal allergies, as this is a very common condition. Now, you should always have a number of differential diagnoses in mind so you are prepared if your initial diagnosis is incorrect so you can formulate a plan B.

You should also keep up to date with the most recent guidelines and medications for your specialty. As we all know, medicine and health care are changing rapidly. In order to be the best provider for your patients, you will need to keep up with these changes. Get a subscription to a medical journal or take frequent CME classes.

Know Your Medical Assistant

Get to know your medical assistant or nurse. This is a big key to your success. Let them know your limitations and get to know theirs. It will create a good working environment and help your day flow a lot better. This helps your patients in the long run, and they will feel more comfortable with you if they see you two working as a team. As nurses, we are used to working as a team, but some need a reminder.

Keep Going!

Starting out as a new Nurse Practitioner is an exciting journey. You will have tough days, but keep going; things will get easier. You can do it; remember your reasoning for starting your NP journey! I hope these tips will take some of the stress away and will help you thrive in your new role.

Things to Know Before Starting Your New Job as a Nurse Practitioner

Coding and Billing

Charting System

Common Conditions

Know Your Medical Assistant

Keep Going!

About Cassandra Guenthardt

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