Is Working as a Nurse Practitioner Stressful?
A reader emailed me the other day and asked me a simple question. "Is working as a nurse practitioner stressful?", she inquired. While the question was straightforward, I had a difficult time formulating a response. "Yes, no, well sometimes, it depends" was essentially the jumble that I typed out in response. So, I've arranged my thoughts on the question in a more put-together fashion. I'm curious to see what you think as well.
My first year practicing as a nurse practitioner was somewhat stressful. I was fortunate to work with a physician who enjoyed helping me navigate through my inexperience and surrounded by other nurse practitioners who patiently responded to my questions. When I worked alone in the clinic on weekends, I was able to call my supervising physician for help should an issue arise. I was motivated to work hard and incentivized to do so as well. As a result, I found the high patient volume of the practice where I was working to be motivating rather than stressful.
To quantify my experience, my stress level was around a six or seven on a ten point scale for the duration of my first year practicing as a nurse practitioner. I would classify my stress level as healthy. I was learning new skills, working very hard but surrounded by encouraging coworkers, and found the position appropriately challenging.
My goal as a nurse practitioner was always to work in the emergency department. So, after a year of practicing in primary care, I transitioned to a position in an urgent care clinic. Again, I was surrounded by supportive physicians. Given my foundation in primary care, I had few questions and required little assistance as I transitioned to urgent care. My stress level was next to nothing. The stress I did experience on occasion related more to multitasking and attempting to work quickly to keep patients from waiting as well as pulling 12-hour shifts on my feet rather than stress related to clinical knowledge. As a more experienced NP working in a relatively low acuity environment, my stress level ranked around a two or three on a ten point scale.
Finally, I made it to the emergency department! I was hired by a group of providers willing to take a chance on me given my minimal experience. While my urgent care and primary care skills did apply to the patients I treated in the emergency department, the high volume, high acuity environment made me a nervous wreck. As I drove to work each day, I would literally talk myself down from an panic attack. And, I'm not normally one to be anxious. Inexperienced, I would ask question after question of my physician coworkers. I felt they must be annoyed by the number of times I interrupted their day although most never let on to this. Managing multiple patients at once who needed medications ordered, lacerations repaired, X-rays read and EKGs interpreted at times seemed too much to handle. I was stressed to the max-I'm talking a twelve out of ten situation.
My anxiety over my new position didn't disappear quickly. For months, I dreaded my upcoming shifts. While the emergency department was a good personality match for me and I enjoyed the work clinically, multi-tasking and the added responsibility of caring for sicker patients weighed on me heavily for months. Fortunately, little by little, this burden lifted and my stress decreased.
Finally, after working as a nurse practitioner in the emergency department for nearly five years, I can say my job rarely frazzles me. Yes, there are days when I'm so busy that I don't get to eat and my feet ache at the end of the day. There are times when I'm not sure about the best course of treatment for a patient and I ask a physician to help out. But, since I am confident in my clinical abilities, multi-tasking and seeking assistance come much easier. If I had to rank the stress level of my current position, I would give it a five out of ten, the perfect balance.
Stress on the job helps you grow as a nurse practitioner. It forces you to learn and to become more efficient. A challenge helps keep you sharp and prevents your from career boredom. Too much stress on the other hand can lead to burnout.
How stressed do you feel in your nurse practitioner position?
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I've been a Nurse Practitioner for six years in Psychiatry. I've been a nurse for over 30 years. I still find the job very stressful due to the fact that I do not have a lot of contact with my supervising physician and I have no mid-level practitioners at the practice to bounce questions or ideas off of. The more support available will definitely decrease your stress. If you are not lucky enough to have that support, I've found that continually using my resources (books, apps, CME) helps me gain confidence.
I would say this depends on your RN experience. If you have a solid foundation of RN experience you may be able to find a job as an ER NP right out of school. If not, a year or two in primary or urgent care can help you build a your skill set and get a broad foundation for a career in the emergency department. I would apply to both types of jobs initially to maximize your job search and see where that takes you.
I am a nurse practitioner student doing my primary care rotation now. I am looking forward to practicing in the emergency department also. Do you suggest a stint in primary care first?