Surviving as a New Grad Nurse Practitioner

I survived my first year as a new grad nurse practitioner in 2019. It was a challenging rewarding experience! I had to dig deep many days especially at the beginning because it was so overwhelming. I remember my last class in NP school required us to write a paper about how we planned on getting through our first year as a new grad nurse practitioner.

The main survival strategies I wrote about while in school was to get a good mentor and to keep a professional journal. I only journaled my first day or two as a new grad nurse practitioner. UpToDate was my main new grad nurse practitioner mentor. Not really the experience I had in mind for my first year as a new grad nurse practitioner.

Imposter Syndrome

The imposter syndrome is a real experience for a new grad nurse practitioner. This is when you feel like you’re just faking it. As a new grad, you often don’t feel you belong or are qualified for the role you’re playing.

I definitely felt it for the first several months as a new grad nurse practitioner and less often probably after 8 months or so into it all. I don’t think I really felt like I fit into my role as a provider until after a year or so. Even now, I will occasionally experience the imposter syndrome. It’s okay to feel this as long as constructive growth continues to happen.

New Grad Nurse Practitioner Myth Busting

I think nurse practitioner schools expect their new grad nurse practitioners to find a great mentor. This is supposed to be an experienced provider who will take them under their wings and guide their new grad into a skilled medical provider.

New Grad Nurse Practitioner Job Market

First, the job market doesn’t support this mythical idea. I applied to dozens and dozens of jobs with little response. Most nurse practitioner jobs in my area are available to NPs with 1-2+ years experience and not for new grad nurse practitioners.

Why? The amount of on the job learning and development of clinical skills is astronomical that first year as a new grad nurse practitioner. The healthcare industry is not currently looking to increase their risk and decrease their productivity training a new grad nurse practitioner at this time.

New Grad Nurse Practitioner Education

Second, new grad nurse practitioners are inadequately trained at NP school for today’s healthcare needs. New grads should either have more clinical training in NP school or graduate into a residency program like their physician colleagues. I felt competent and trained in primary preventative care or for treating most basic ailments like a provider would see at a minute clinic or outpatient urgent care, but family medicine has evolved into a more complex, chronic care management business.

My typical patient is a 65+ year old with recent CVA with underlying COPD, HFpEF, DM2, chronic pain, and AFib. I’m seeing chronically sick patients all day. I’m not sure where all the healthy, younger patients are, but I don’t get to see them.

I would love to be involved with primary preventative care, but that’s not where our healthcare system is at. Nurse practitioner students desperately need not an extra year to do research for a DNP but an extra year or two to hone clinical skills and knowledge.

New Grad Nurse Practitioner Survival Skills

I went into my first year as a new grad with these huge barriers. No lying about it. It was tough! I didn’t have a great mentor or on the job training program. I did have a physician who I could call and text my questions which helped me survive, but this is far from a mentor helping guide my experience.

UpToDate, My Virtual Mentor

My primary tool of survival as a new grad nurse practitioner was and still is UpToDate. I bought a 3 year subscription right away and read hundreds of hours of content my first year as a new grad nurse practitioner. I would look up every medication and relied heavily on it for my clinical practice as a new grad nurse practitioner. I still do rely heavily on UpToDate especially for medications.

Developing Good Routines

I also put in a lot of long clinical hours the first couple of months as a new grad nurse practitioner. This meant I needed a good routine outside of work. Exercise especially weightlifting was key for me outside of work especially for boosting confidence and mood. Regular sleep also was a cornerstone outside of work. My motto was work hard while at work and play and rest hard outside work.

Breaking Tasks into Smaller Chunks

Even with a pretty good routine outside of work, I still often felt overwhelmed and an imposter as a new grad nurse practitioner. Mentally I had to break down the work week day by day and visit by visit. If I literally tried to think about getting through an entire week or even day, I would feel so overwhelmed and start shutting down mentally.

I got a legal pad and wrote down notes while visiting with patients so I could remember stuff. Breaking my day and week into smaller chunks made life more manageable. With time, I became a more confident provider and my new job as a new grad nurse practitioner provider became more natural and easy.

I still have to manage the underlying uneasiness and fear I automatically sense sometimes on a Monday morning, but I can say I’ve survived my first year as a new grad nurse practitioner and looking back it was a challenging yet rewarding experience.

Check out my 10 Tips for Surviving Your First Year as a Nurse Practitioner.