10 Tips to Surviving Your First Year as a Nurse Practitioner

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My first year as a new grad nurse practitioner was a difficult yet rewarding experience. I don’t feel like I had much guidance as a new grad nurse practitioner. Nurse practitioner school left me with lofty expectations of having a great mentor my first job who will guide me into my new provider role. It doesn’t usually work out this way as my classmates and I can testify. Usually you’re thrown into a practice that is already stretched thin and desperate for help. As a new grad nurse practitioner this is jarring and difficult.

Don’t panic though, you probably were a great RN because of your ability to adapt to stressful situations. You’re going to need to use these skill to pivot and adapt to this new stressful situation as a new grad nurse practitioner in your first provider job. Here are 10 proven and practical tips that helped me survive my first year as a nurse practitioner.

1) Get UpToDate.

UpToDate is your mentor. Read UpToDate everyday and rely heavily on it. UpToDate has articles on diagnosing and treating most disease processes. They have tons of algorithms and calculators. Look up every medication until you know everything about that medication and then continue to confirm it with UpToDate. UpToDate should be your closest mentor.

2) Read chart notes.

If allowed by your company or group, read other providers’ chart notes. This help you figure out wording and how other providers are dealing with common patient problems.

3) Watch Youtube videos on disease diagnosis and management.

Osmosis is also great, and they even have tons of free Osmosis Youtube content. I got a paid subscription, and it’s great. Ideally you’d use this tool while you’re in school. I found UpToDate more useful but this is a great alternative way to learn more and sharpen knowledge. Another great channel is Strong Medicine. There are tons of videos and channels available on Youtube for every learning style and attention span.

4) Communicate often with your physician and experienced NP colleagues.

Text, email, and call if they’ll let you. Consult UpToDate first to avoid unnecessarily calls but most colleagues are more than willing to provide their advice if they know you.

5) Sleep and exercise regularly if possible.

It’s hard with kids I know, but regular, scheduled sleep is so important for your mental health as a new grad nurse practitioner at a new job.  Sleep and exercise are a cornerstone outside of work in helping you survive your first year.

6) Create a work routine.

Plan for success the day before. I developed the routine of seeing all my patients, writing notes on a legal pad, and then charting at the end of the day.

7) Break your day and focus into smaller chunks.

A whole day as a nurse practitioner provider feels overwhelming at first. A 15 minute chunk talking to one patient feels manageable. 1-2 patient problems feels manageable.

8) Leave work at work.

When you’re not at work, make an effort to not think about or obsess about a patient or other problem at work. Many sleepless nights were lost due to not heeding this tip. Do fun stuff with your family and friend. Enjoy the time off work at the end of the day and on weekends.

9) Listen to patients.

They’re the whole reason we do this. It’s rewarding seeing someone improve, but you have to listen to them and filter through what they’re saying. Try to focus on what’s most concerning to them and recognize you may not be able to help them medically, but at least they will feel heard. On the flip-side, don’t feel obligated to spend tons of time with every patient. I”m not primarily there to socialize and swap stories. I rather do this outside work with my friends and family.  I usually have a specific focus in mind with every patient and try to guide conversation toward this goal. It is an acquired art more than a science.

10) Concentrate on the big things.

You determine what these big things are, but it’s okay to let some or a lot of the little stuff go for now. For example, I prioritized seeing my patients and getting their charts and orders done. The extra admin stuff I ignored for awhile until I got feedback on what admin stuff was important and what stuff didn’t matter. Patient care and documentation is the priority.

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