Hey, hey nurse practitioner new grads – congratulations are in order. Becoming a nurse practitioner is no easy feat and, well, you did it! While you may be donning your cap and gown this month, stress and anxiety don’t go away as you walk down the steps of your university one last time (good riddance nursing school!). In fact, your worries may be just beginning. 

Nurse practitioner new grads don’t have it easy. I understand. I was in your shoes several years ago. Not only are you navigating the challenges of certification, a job search and licensing, you may be making life transitions as well. Moving to a new city or state, starting a new job and a new career path are widely acknowledged to be some of life’s more stressful events and can’t be discounted as you walk off the graduation stage. 

So, as you take the next steps in your nurse practitioner career, I’m here to share some of the anxieties I experienced in my initial months f practice in hopes that you can avoid (or at least expect) some of the stress that accompanies this transition. 

There are two kinds of nerves you need to distinguish between in your initial months of practice.

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The Anxiety of Life Changes

Moving, a new job, a different career…oh my!

First, there’s the anxiety and emotion associated with life changes. The isolation of moving to a new place and not knowing another soul is stress-provoking. The financial implications of relocating take a toll on your already strapped bank account (here’s how much you’ll need to budget). Not to mention, starting any job new job, clinical or otherwise, can be stressful. You aren’t sure who to approach when you have a question. It takes you an inordinate amount of time to carry out simple tasks because you aren’t sure how things work with your new employer’s systems and processes. 

In my conversations with new grads I find that most don’t give themselves enough credit for these major life events they’re going through. They expect to have clinical questions and challenges but neglect to anticipate the stress that inevitably accompanies the transition of graduation, employment and relocation. So, adjust your expectations as you don your cap and gown this spring. Keep your head held high when anxiety comes knocking and remember that uncertainty, stress and fear are normal in this phase of life. In a matter of months you’ll be back in a routine. 

The Anxiety of Clinical Practice

Clinical gaps

Alright, so you’re probably expecting to have some anxiety in the clinical setting. But, as a nurse practitioner who has been there I’m here to tell you it will be worse than you think (sorry). In my NP school clinicals, I felt reasonably confident about my clinical decision making by graduation day. But, when I entered the employment setting and no longer had  preceptor holding my hand from patient-to-patient, that all changed. My patients were complex and while my colleagues were helpful I felt like a total bother with my constant line of questioning. Be patient with yourself as you realize that you’ve got a ways to go with your clinical know-how (also check out our program, ThriveAP, that helps educate and support new grads). You’ll get there eventually but must set aside the associated stress and work towards improving your knowledge base. 

Management responsibilities…wait, what?!

My nurse practitioner program also forgot to mention that not only would my job responsibilities as a NP include treating patients, they would also include leadership. Others in the employment setting like nurses and medical assistants would be looking to me for clinical guidance and direction. When their performance was sub-par, I would be responsible for correcting it. Unfortunately, management 101 wasn’t the title of any of my NP school courses. It takes a while to develop such management and leadership skills, especially when you’re operating from a limited knowledge base and feel insecure in your new role. The simple realization that this will be a part of your job as a nurse practitioner will help mitigate some of your initial on-the-job stress. 

The employment pressure cooker

While anxieties related to patient care are top-of-mind for new grads, employer-related concerns seem to be far more common once freshly minted nurse practitioners start their jobs. They were for me. School is an ideal sort of patient care environment. NP students aren’t subject to the billing and productivity pressures of employers and are trained to provide textbook patient care. In reality, however, the workplace is a pressure cooker. Your employer doesn’t make money unless you as a nurse practitioner are seeing patients. You must meet certain levels of productivity in practice to carry your own weight and this minimal effective patient volume can be difficult for new grads to maintain. As a new grad, I often became frustrated with my employer’s constant demand to work faster and more efficiently. I interpreted it as cutting corners. Expect stress angst about meeting productivity requirements and understand the reason for these expectations. This way you can protect yourself from burnout and disillusionment.

What do you have anxiety about as a new grad nurse practitioner?


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