What was your training like as a new grad NP?

ToFNPandBeyond · Dec 8, 2018

I'm within my 90 days and like you, was freaking out thinking I wouldn't know anything or would need hand-holding before I dove in the deep end. I work in primary care at a community clinic with 3 family MDs, 2 peds, 1 PA and me. My first week I shadowed. Week 1- 2 I saw patients once an hour. And since week 2 I've seen patients once every 30 minutes. Starting next week it'll be a full ramp up. So 15 min sick and 30 min physicals, ER f/u and pap. It's sooner than what we negotiated but we both acknowledge that I'm ready to take on more.

I found that the program I went to adequately prepared me for practice. If you went to an accredited school and actually put in the work, you'll be prepared for practice. Like riding a bike, it comes back to you. Trust me, because I was skeptical. I heavily rely on my med apps, EPOCRATES, followed by Uptodate during clinic visits which gives me instant access to info I need. I admit what I don't know and actively seek to educate myself. My supervising physician is only on-site a couple of times a week, but she's easily accessible by phone. It's key to have your supervising physician or some mentor who is open to having you as an inexperienced provider available for questions when needed.

Anywho that's my experience. No sure if I answered your question. I'm in the West coast.

FullGlass, BSN, MSN, NP · Dec 11, 2018

It will be ok! When looking for your first NP job, be careful to choose a position that provides good support to a new grad NP with realistic expectations. This is something you must discuss during job interviews. You can also apply for NP residencies.

1. I have 9 months experience now working as NP in an FQHC in rural California up in the mountains.

2. There was no training per se. My contract states I was to work up to seeing a full load of patients (18 per day in this clinic) over 6 months. I started out with 2 days of orientation, then 4 patients a day for the rest of the first week, in order to learn the EHR. I had a one on one EHR trainer with me for about 10 days and ramped up to 6 patients a day. By the end of 6 months, I was capable of seeing 18 patients per day.

3. I chose this clinic because it has a very supportive environment. There are 2 MDs and 2 other NPs, who all encouraged me to ask questions and reassured me they expected a new grad to know nothing. If I didn't ask enough questions, they would check in with me and reassure me it was okay to ask a lot of questions. They also helped me understand when a patient should be referred to an MD and that an NP, especially a new grad, is not expected to be able to treat very complicated cases - that's what MDs are for. The other providers were also willing to come in and see my patient if I was unsure of what I was seeing or needed a 2nd opinion (and still do). Of course, over time, I asked fewer questions and now I can get through entire days with out panicking and having to ask questions. :) I have become friends with the other NPs and when we socialize, we also discuss interesting cases together, which has been a great learning experience.

Every NP I have talked to has said they totally freaked out their first year, often went home and cried, and felt like they knew nothing and would never be able to learn everything. Yet, they survived and you will, too. I would say the first 6 months were the worst. I would come home every night completely brain dead and exhausted, terrified I had missed something important or done something wrong. In retrospect, I sent too many patients to the ER. Fortunately, everyone has been very supportive. After 6 months, things gradually got better. Now, I am reasonably confident.

In conclusion, be very careful in choosing your first job. Pick a position which provides good support at a reasonable pace. Good luck.