I had waited for this day for years, I was finally an acute care nurse practitioner, beginning my first day of work as a trauma NP in a high acuity/volume level two trauma center. It had been years in the making, filled with what seemed like endless clinical hours, SOAP notes, lectures, hours and hours of studying, research papers, and let’s not forget the tears! I finished my program, passed my boards, made it through what seemed like YEARS of credentialing, and I was finally here – I had done it! I made my transition from a bedside emergency/trauma nurse to a trauma nurse practitioner, right where I wanted to be. I was fully equipped with all of the skills and knowledge that I needed to make this transition; I mean I did spend years in NP school, right? Well, truth be told there was nothing that I could have learned from a book or lecture during my schooling that would have prepared me for this role change. I went into this new career knowing what I was leaving behind. I was leaving behind my expert status as a bedside nurse and trading it for novice status as a brand-new nurse practitioner. I entered this new endeavor with enough self-realization that I knew nothing, and that my first years spent as a nurse practitioner would not be easy; it would require lots of patience and grace and most importantly, a lot of learning.

In the beginning

My first week in my new role was a huge eye-opener. As a bedside ED/trauma nurse, I knew exactly what I was doing; I could anticipate what needed to be done in a resuscitation and felt confident and calm in any given situation. Although my 9+ years of experience in this role did help me tremendously transition form RN to NP, I quickly realized there was so much that I didn’t know, and so much that goes into being a provider that you don’t realize. I think the biggest eye opener for me was the importance of time management and attention to detail. I would hardly order ibuprofen without a bit of hesitation and self-doubt. I spent my first year studying, listening intently during rounds, researching algorithms and treatment guidelines, and learning from everyone I could.  Most importantly I spent my first year (and still do) constantly double and triple checking everything I did, because the most important thing as a new provider is to realize that your ego is never more important than your patients.  I learned it is okay to not know everything, and it’s ok to ask questions and to constantly second guess yourself because at the end of the day every order you place and decision you make is now on you.

I have been a nurse practitioner for three years now, and I still see myself as a novice, but with every patient encounter my confidence grows just a tiny bit. I still find myself in a constant state of questioning and learning and to be honest I don’t see that ever changing in me. While this role has been a difficult transition, I have to say that it has been the most rewarding! I have finally found my niche, and a career that leaves me feeling fulfilled in every aspect of my professional life. I can’t say I am an expert anymore and that’s okay – maybe someday I will get there again like many of my co-workers. For now, I can leave you with some advice, just a few tips that I have picked up along this journey that I hope can help new NPs in their role change.

Advice for new NPs

1. Never forget you’re a nurse. One thing that I will never ever forget is that I am a nurse. Always remember where you started. Now that you’re a provider doesn’t mean that you aren’t able to help your fellow nurses. You can and should help “give a boost,” cut up someone’s food and feed them, assist with a bedpan or a bed bath, and take the time to sit and hold someone’s hand and lend a listening ear when needed. Also, respect the nurses that carry out your orders. If they question what you order, be thankful and gracious, because someday they will save you from a mistake. Answer their questions and pages and be nice, be approachable and remember that you were once in their shoes.
2. Stay current. Healthcare is constantly changing. Just because you now have your master’s degree and have passed your boards, your education isn’t over. Read new articles and treatment algorithms, stay up to date on new drugs/antibiotics, and always be open to learning.
3. Listen. I can’t stress this enough. You have to always be listening and engaged. Listen to your patients, attendings, colleagues, nurses and everyone involved in the patient’s care. It’s important to remember that you aren’t treating a set of symptoms, you are treating a human being! Listen to them and listen to those around them.
4. Double check yourself. It’s always a good idea, especially when you are first starting out, to constantly double check yourself. When ordering medications, consult with your pharmacist (I became best friends with our clinical pharmacist.) It is ok to ask questions to ensure you are providing the best care possible! At the end of the day or with any downtime I have, I always – still till this day – double check all my patient orders.
5. Have confidence. Lastly, be confident! You have made it this far and that is something to be proud of. Trust your instincts and your gut and stand behind your decisions. No one will ever fault you for making a decision you took the time to think through! Have confidence, but don’t ever forget that asking questions and leaning on someone else for a second opinion is important.