Finding Support in Your First Nurse Practitioner Job

After graduating from your nurse practitioner program, finding a job is priority #1.  Once you've landed an NP position, you can breathe a sigh of relief, right?  Not so fast.  Making it through your first few months as an NP can be pretty tough and it's important you are intentional about how you make it through.

As a new nurse practitioner, I arrived at work every day totally stressed.  While I felt comfortable diagnosing and treating the most basic primary care problems, some patients were quite complex and others just didn't quite fit into the perfect clinical picture leaving me doubting my decision making.  Fortunately, the physician working in my practice was more than helpful and enjoyed teaching.  But then she quit her job.

With my primary support system gone and still a very new nurse practitioner, I turned to other NP's and PA's in my clinic.  They were happy to help me out but didn't have as much time to teach me new skills and reassure me in my first months of practice.  I was left alone in the clinic too often, a dangerous situation given my inexperience.  Thankfully, I was able to continue learning, albeit slowly, despite the lack of support as a new NP in my clinic.  

My experience is all to common among new nurse practitioners, especially those who like me had little or no prior nursing experience.  As you look for your first job as an NP, there are a few qualities you should look for in your new position.

Hourly or Salaried Pay, Not Productivity

There are a few different ways you may be paid as a nurse practitioner.  Some employers pay by the hour, others a salary and some based on productivity.  Productivity payments are determined by how much you bill and are highly dependent upon the number of patients you see in a given day.  As a new nurse practitioner, your focus should be learning not speed.  If your co-workers are paid on productivity as well, they will be less willing to take time to help you out as it directly affects their paycheck.  Being paid based on productivity as a new NP can be frustrating and isn't conducive to a supportive learning environment.

Multiple Providers On Site

Working alone isn't the best environment for a new nurse practitioner.  Clinics and hospital settings with multiple NP's, PA's and MD's working in your area will offer you the most support as you continue learning on the job.  The more coworkers you have to ask questions of, the better in your first NP position.  The one caveat to this advice would be retail health clinics.  Retail health clinics treat patients with simple medical issues, are very protocol driven and offer access to physician support for NP's working alone.  The drawback of this environment is that if you never encounter more complex clinical situations in your first job, you won't learn to navigate them early in your career.

An Understanding Employer

It's important that your employer recognize your limitations as a new nurse practitioner.  Of course, you must work hard and learn as much as possible, but an understanding of how much you currently know helps your employer set a reasonable trajectory for your progress.  Employers who have hired nurse practitioners in the past make the best first employers because they have a good understanding of the NP role. 

The good news is that after a few months of working, you will become comfortable as a nurse practitioner.  You will begin to see similar clinical situations over and over again becoming confident in treating them.  Starting off your career in a supportive environment will help lay a strong foundation for future jobs where you may find yourself working independently.

 

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Comments

Your article is totally correct. I have been very fortunate to have generous physicians always on-site as I grow my recent-grad practice abilities. It makes a world of difference.

Anonymous

Great article! Thanks for being honest about your challenges as a new practitioner--it's reassuring to know other NPs had a steep learning curve as well. I am a new graduate currently looking for my first job and finding one with support is one of my top priorities.

Heather

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