I distinctly recall learning about the stages of grief during a psychiatric rotation in my nursing program. Having experienced the recent death of a family member, I identified with the content, and was impressed that the textbook outline of the grieving process was so spot on. The emotional stages of a new grad nurse practitioner are much different than those of the grief process (thank goodness!), however, for most NPs, new grad emotions come in a somewhat predictable pattern. 

Foresight into the ups and downs you can expect to face early in your nurse practitioner career helps you ride out the tough times looking forward to small victories ahead. What are the emotional stages of life as a new grad nurse practitioner?

1. Excitement

Congratulations on your graduation! You may have never thought this day would actually arrive. You bask in the time freed up by completing your nurse practitioner program and are elated that your graduate education is complete. 

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2. Relief 

Graduation from NP school isn’t the end as new grads are aware. Once you have taken and passed your nurse practitioner certification exam, the ultimate sense of relief sets in. Finally, you can get back to a new normal that does not include finals and clinicals. The hard part is over now, right?

3. Enthusiasm 

Starting a new job and a new role can be challenging, but you’re up for it. Fueled by enthusiasm for your new career, you jump in to your new nurse practitioner job wholeheartedly ready to impress your employer and help patients make meaningful life changes. 

4. Overwhelmed

Unfortunately, you don’t seem to be crushing your new role quite like you anticipated. In fact, you’re in way over your head. The jump from a clinical preceptorship to managing patients on your own is overwhelming and you feel inadequate in your new role. The stress is more than you imagined and quite taxing on a day to day basis. 

4. Failure and Self Doubt 

Feeling overwhelmed slowly turns into a sensation of failure and self-doubt. Sure, it’s natural to feel overwhelmed as a new nurse practitioner, but for this long? You begin to feel frustrated as your clinical skills are not improving as quickly as you had hoped. You feel like an annoyance to coworkers by asking for constant help. The support system you had hoped for is lacking. You doubt your ability to become a competent NP and wonder if making the career leap was the right decision. 

5. Beat Down 

As you continue to feel inadequate when it comes to your level of competence as a nurse practitioner, the burden of your day to day of your job becomes heavier to bear. You arrive home from work each day, exhausted. You dread waking up for work each morning. Your enthusiasm towards launching your new career no longer seems to motivate you to accept challenges and put forward effort to overcome them.

6. Even Keeled

Slowly, you begin to feel more comfortable in your role. Incremental improvements in your skills as a provider have amounted to the point where you practice more autonomously. Initially, you may not even notice the change. The burden of your new nurse practitioner job becomes more manageable. A flicker of enthusiasm may even begin to reappear. 

7. Hopeful 

You realize that things are looking up. And, that the positive career trajectory seems likely to continue. Your competence and autonomy improve daily. You are able to focus on more than just making it through the day. You begin to enjoy working as a nurse practitioner and are cautiously hopeful the trend continues. 

8. Acceptance

Having developed the baseline competencies necessary to do your job well, challenges become more manageable. You even begin to embrace them once again as learning opportunities. You accept that you will have frustrations along the way during the course of your career, but these bumps in the road no longer seem insurmountable.

9. Confident 

Not to worry! You will eventually build your nurse practitioner skill set to the point where you feel comfortable, and even confident in your job performance. Your ability to live up to the expectations of your employer and use your knowledge to help others leads to career satisfaction. Sure, sometimes your job will feel like work, but overall, you can rest satisfied that you chose the right career path. 

What emotions have you experienced as a new grad nurse practitioner?


3 thoughts on “The Emotional Stages of Life as a New Grad Nurse Practitioner”

  1. Kathryne Volpe-Bates

    I can relate to all the emotions listed above. I go from self-doubt to enthusiasm to excitement to inadequacy to overwhelmed to hopeful and back through the emotions again. I’ve been at my new job for about 2 months and usually I feel I’m right where I need to be in terms of competency but then some days I think I should be further along. I had a conversation today with my physician mentor about this topic and he seems to feel I’m progressing well and right on target. So who am I to question his judgement???


  2. OMG
    I am at stage 4…overwelmed
    New FNP
    I have been on my own for 2 months, employed for 3.
    I literally get nauseous as I drive up to my clinic.
    I constantly second guess mostly everything
    Glad to know that this is a thing and I won’t feel this way forever…hopefully.
    20+ years of inpatient nursing (nursing home to ICU to NICU to LDR) and I feel like I just graduated and I’m back at my new RN job at a nursing home.

  3. Thank you for publishing this. I am 2 months off orientation in my first NP job in a cardiac surgery ICU. I am certainly in stage 4: self doubt and failure. This post gives me some hope that I will progress and not feel like a complete idiot forever.

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