Most people enter a new job and step into several unknowns. These blind spots are particularly prevalent for new NP graduates. You don’t know what you don’t know until you get into the job and gain experience over the next several months. There are landmines to avoid, and your MSN program likely didn’t do the best job to prepare you for all the unknowns ahead. Your school is not totally to blame—there’s so much important information to teach within a specific timeframe.
It’s not as if you won’t learn as you go–you will certainly gain experience, knowledge, and ultimately confidence in your role. But the journey to this destination does not need to be entered blindly.
With almost four years of experience as an NP and some difficulty navigating my way in the beginning, there are a few things new grads should keep in mind when finding their first job.
Complexity of patients
It might seem odd to consider patient complexity because most patients are complex, but patients can be complex in different ways. Working with patient populations with many different psychosocial stressors, such as unemployment, domestic violence, or homelessness, for example, adds nuance to your role. You will be coordinating with other agencies to link your patients to various necessary services. Additionally, the efficacy of the medications you prescribe may be lowered simply because the patient cannot take them consistently if they don’t have the income or environmental stability to do so.
You, as a provider, may feel frustrated not seeing your patients get better. You probably entered the healthcare field to help patients get better and lack of patient improvement may take a toll on you over time.
On the other hand, helping challenging patients with many psychosocial needs may feel very rewarding and meaningful for you. The key is to be aware of patient complexity as a factor to consider in your job search.
How your time is structured
Will you be seeing patients back-to-back from the moment you get to the office to the end of your day? Or will you have some downtime to catch up on phone calls and documentation? For some providers, having all your time accounted for can be difficult. Working in an environment with more autonomy and flexibility may lead you to feel happier in your role.
Level of support
Support in your role as a new nurse practitioner is important, especially in the beginning. The ability to talk to your more experienced colleagues on difficult cases or meet with a collaborating provider weekly is a level of support that cannot be understated.
If you are the only prescriber in an organization, you may feel isolated and as though your other non-provider colleagues do not understand your experiences or struggles. Working alongside other providers fosters a sense of camaraderie, which is nice to have when you’re starting. Being able to drop into your fellow NP’s office to talk for a few minutes about a challenging patient or vent about something they can relate to makes you feel understood. Validation in the beginning especially helps you persist and feel less overwhelmed.
Number of patients you are expected to see
Your role as a provider is to see and help patients. It is assumed that the more patients you see, the more patients you help. That being said, there are only so many patients you can safely see in a day where you provide quality care to each patient and preserve your mental well-being.
It can be exhausting seeing patients back-to-back all day, every day. This is one of the quickest ways to feeling burned out in your role. To preserve our energy and maintain high quality and high productivity, we need to be on the same page as our employers regarding the number of patients seen daily.
It’s in your employer’s best interest that you see many, many patients each day, while it’s in your best interest (and your patient’s) to not see the maximum number of patients daily. There is a higher chance for mistakes to be made when we stretch ourselves too far. Understanding that you are working in a business (the business of healthcare) and balancing quality of care by limiting the number of patients you see each day is an art. If you balance these competing priorities well, all parties are satisfied.
Keeping in mind these four factors will help ensure the job you choose nurtures you in your transition to practice. A healthy, happy, satisfied you allows you to do your job well, leading to better patient outcomes.
