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New Grad NP

Advice for New NPs

Published December 13, 2012 3:16 PM by Samantha Damren
Time, because of its duplicitous intangibility and quantifiable nature is, to me, a perennially elusive phenomenon. You can measure it but you can't hold it and yet it dictates the rhythms of life. While I reflect on these ephemeral characteristics, the advent of 2013 ushers forth the commencement of my second year as a Nurse Practitioner.

I still feel every ounce the neophyte but am pleased to share with any new clinician that as the days pass a feeling of authority and competence will slowly replace the choke hold of anxiety associated with the responsibility of diagnosing and treating patients.

From one new practitioner to another, I have included some tidbits to help surmount the inevitable challenges associated with this work and ultimately dominate the passage of time.

  1. Do your research and shadow another NP during their routine work day before deciding to accept the job
  2. Ask for CME funds as part of your hiring negotiations
  3. Utilize resources like Uptodate often
  4. Approach your job in the same studious manner that you approached your exams: this means a lot of reading outside of work
  5. Always ask for help
  6. Follow up with your patients, their labs and their imagery studies
  7. Become familiar with the medications you most often prescribe, e.g. dose, drug interactions, side effects, safety in pregnancy, duration of treatment, frequency of administration
  8. Seek peer review
  9. Always work to refine and improve your documentation skills
  10. Leave the position if you don't feel well supported
  11. Practice prescience, always think about where you are now and where you want to be in your practice - set both short and long term goals
  12. Never forget, nor overlook your nursing background
Happy New Year! May 2013 bring you and yours health, wealth, happiness and much love.


Well I am truly amazed by your level of confidence with diagnosis and treatment fresh into your practice. For me I study and read LOTS to learn ways of practice in the family setting. My love for OB and GYN even as RN has never been a path that the Lord has yet given me to walk down. I am in a rural clinic/hospital/ER as a New first job NP and I am totally not at peace. Is it confidence, second guessing, new environment? I can't put my finger on it no matter how hard I analyze my life. Any suggestions?

Traci Ellis, Family - NP November 14, 2014 1:05 PM

To Cheryl,

When I was looking to find NPs to shadow, I first "googled" for any nurse practitioners employed in the state where I resided.  Then I looked for ones with employment nearest to my home.  And then I "cold called" them or stopped by their office and asked them. It took guts.  There are always some NPs who enjoy teaching and remember their own life as a student and will "pay back" to others what they received when they were a student.  The larger clinics require all student inquiries to be made through the clinic manager rather than the NP personally.  I would recommend asking several because you probably will be turned out 2 out of 3 times.  Start asking at least 5 - 6 months prior to when you need it.  In the end someone special will say yes.  

Brenda Lenz December 23, 2012 8:29 PM

Thank you for the excellent advice! As a new grad practicing in a specialty, I can say that being supported is so important. Having an employer who enjoys teaching is an added bonus.

Kris, Allergy & Asthma - FNP-C December 20, 2012 9:29 PM

I'm pursuing a Master's degree in Family Health. My question is " How do you find nurse practitioners to shadow in order to get your clinical hours done? " Do you have any tips or advice for this?

Cheryl Mathis December 20, 2012 10:22 AM

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