Ep #106: How to Succeed on Your First Day as a New NP

Welcome to Becoming a Stress-Free Nurse Practitioner, a show for new NPs and students that want to pass their board exam the first time and make that transition from RN to NP as seamless as possible. I’m your host Sarah Michelle. Now, let’s dive into today’s episode.

Sarah: All right, y’all, this might be one of my favorite topics we’ve done on this podcast in a while. And we are going to be talking about those of you that are getting ready to head out into their first jobs as real-deal nurse practitioners. The day has finally come, you have passed your exam, we are going to walk you through your first day as a real-deal nurse practitioner. 

I know, you’re a little overwhelmed. You’re anxious. It can be intimidating. Just even really thinking about starting a new job, and really you’re starting a new career when you’re transitioning from being a nurse to nurse practitioner, it’s a big deal, you’re in a new role. But Anna and I we’re going to talk about how to mentally prepare and what to do once you get into the office so that your first day is successful and ideally as stress-free as possible. I can’t say it’ll be totally stress-free, but as stress-free as possible. 

Anna: Yeah, I totally remember my first day walking into a clinic and, yes, I was so excited, but so nervous and stressed at the same time, right? I really wanted to make a good first impression with the staff and my new colleagues, but I also wanted to come across as an experienced nurse practitioner to my new patients as well. 

So we need to talk about how we can set ourselves up for success on day one. 

Sarah: Yes. I think one thing you can do is prepare yourself before you even get to the office on your first day. So a few weeks, a few days in advance, you are going to want to start gathering resources or do some refreshing for your specialty. 

Are you working in a general family practice setting? Then let’s start thinking about mobile apps on your phone that you’re going to be using like Epocrates, UpToDate, Medscape, and check with your office manager too. The office or organization might have a subscription on one of those and so that way you don’t have to pay extra for it either. 

Anna: Yeah, I always recommend finding out what resources your new employer has for you. And if you’re going into a specialty like maybe endocrine or women’s health or a cardiology office, it might be a good idea, like Sarah said, to do some refreshing on important topics. So for example, if you are going into cardiology, you can find free CEUs on hypertension management or ECG interpretation. 

Sarah: And another important thing, this might seem a little obvious, is to practice your travel route. So do at least one trip during the time your commute would be. And maybe you interviewed at the office in the afternoon but now you’re going to be traveling in the morning to get to work. You know, will there be school bus traffic, which is like my ultimate enemy. Or is there new construction going on? 

You want to make sure that you know that route well and you can plan to be at work on time. And really, when you’re brand new you want to be early. 

Anna: Definitely. I am always way more flustered starting work if I’m running late and that is not how you want to start your first day. You should also be thinking about how you’ll be introducing yourself to patients. I know that sounds silly, but it is so important to know ahead of time how you are going to present yourself. 

So I always say, hi my name is Anna, the nurse practitioner, nice to meet you. But maybe you want to use your last name. Or if you have a DNP or other doctorate, will you use the title of doctor? But if using doctor, just make sure to follow it up with the nurse practitioner so as to not be misleading to patients who might not understand the difference between nurse practitioner and physician. 

Sarah: Yeah, I just definitely recommend limiting that stress in any way that you can. On the morning of my first day as a nurse practitioner, I woke up a little early, I took my time getting ready. Make sure you have a good breakfast. And you don’t want hunger getting in the way of your success. I know that seems like a silly point, but it’s a very important one. 

Now you’ve arrived on time or about 20 minutes early, if you’re like me. Anna, what are we going to be doing next? 

Anna: Well, after putting your stuff away, go check out the exam rooms if you haven’t yet, because you want to familiarize yourself with where things are located, right? Where are the otoscopes or ophthalmoscopes? Where are the swabs to do routine cultures or check for flu or strep? Will you be doing pap smears, right? Then you need to know where the speculums, gowns and drapes are. 

Anna: Those are all great points. And beyond that, take a little time to tour the office and see where additional resources are too. Where’s the emergency cart with oxygen and an ECG machine or an AED? Where’s the supply closet? Where are medications that can be administered to patients like acetaminophen and ibuprofen cap? And also super important to know where the staff bathrooms and break rooms are located too. 

Anna: Yes, yes, absolutely important. 

And before you start seeing patients, you’ll want to get oriented with the electronic medical record system or other charting system. So the office manager or whoever is orienting you will help you with the preliminary setup. But hopefully you’ll also have some time to document on a test patient and play around with navigating a patient chart before seeing patients. 

Sarah: And don’t forget to remember your login to that as well. I’ve done that too many times and started my day unable to even log in, which is super frustrating and super flustering. 

Anna: Yes. And you will likely have new usernames and passwords to remember for a few different things, your email, the charting system. So just keep that login information stored in a safe, secure place until you commit it to memory. 

And if it’s anything like our work, we have to change different passwords at different frequencies, it feels like all the time. So I personally use a password manager to help. 

Sarah: Yes, I feel like I change my password every single day. 

But another super important part of your first day on the job as a nurse practitioner is just introducing yourself to the staff and other clinicians. And it’s 1,000% okay to be nervous about meeting new people and being in a new place, but these people are going to become your work family. And ideally, they’re going to be a really great resource to you as a new nurse practitioner. 

So when you introduce yourself, try to be warm, try to be friendly and approachable. Just show your excitement and your eagerness to be there because that’s contagious. And you want to treat the entire staff with the same respect as you do with the nursing staff and the other conditions that you work with. 

Anna: Yeah, and when you’re learning the names of staff members, make sure you’re asking about their roles, right? There might be some secretaries, who is helping check in patients? Who helps more with checkout. Who will help you with managing referrals. And with medical staff, are you working with medical assistants, LPNs, RNs, knowing their roles or their credentials can help guide you in knowing what they can assist you with in patient care. 

Sarah: And make sure too, that you identify your mentor and who is going to be guiding your orientations, very important. The office manager might have their own orientation plan for you. But you should be paired up with an experienced clinician in the office to guide you as well. Remember, you’re new, you are going to need support, you are going to need nurturing. 

Anna: Yes, and we have mentioned this before, we mention it in our job hunt course. But this is just another great time to mention the importance of advocating for a thorough orientation for yourself. You need that training time. 

Sarah: Absolutely, 1,100%. Commonly we hear things like someone starts their first NP job, they didn’t have a formal orientation. Maybe they shadowed a collaborating physician for a couple of days and then the office staff started scheduling patients for you to see on your own. That can be really difficult to just be kind of thrown in. 

So if you are experiencing anything like that, ask about orientations, ask how you can best be supported. And if you’re not in an environment to be supported, that’s also a different conversation. 

Anna: Yeah. And we also have a blog post on landing your first NP job with some really great guidance on things you should be asking about during the interview that you can find on our site if you’re unsure where to start. 

Sarah: And another bit of advice we want to give about having a successful first day is, I know this is like the core advice everyone gives, but really just be yourself. Be your authentic, genuine self. 

Anna: Yes, you got the job because of your skills and your knowledge and let that confidence shine. They hired you for a reason. Even if you’re feeling imposter syndrome, like you are meant to be there, of course. 

Sarah: And you want to be kind. You want to be courteous. Show the staff and your colleagues that you’re excited to be there. You’re eager to learn. You’re eager to care for patients. If you have some downtime, ask if there’s anything you can do to help because it’s really going to show them you’re a team player. You’re showing up and you might also be able to learn the routines of the office faster that way, too. 

Anna: Yeah. And don’t be afraid to ask lots and lots and lots of questions and ask for help when you need it. Nobody, I repeat, nobody expects you to know everything on the first day. But the staff and your colleagues, they cannot anticipate everything you need to know to get settled into the office routine. So you can try to figure out things on your own as you’re able to, but please, please don’t hesitate to ask questions to keep the day running smoothly. 

Sarah: Yeah, and I think really to tie this up, I want to talk about combating imposter syndrome because we’re all going to be up against it. Even after years of being a nurse practitioner now, I still find myself doubting myself sometimes. And I run an entire review company. Anna is our lead of content. We all doubt ourselves sometimes. 

So I think it’s natural that whenever we’re nervous these signs of self-doubt and not being sure pop up. But you also need to know how to cope with it and be able to manage it and really bring that confidence in with you because you’ve passed your exam. You are a real-deal nurse practitioner. You have graduate school. You’ve passed your exam. You are here doing it and you should be confident in that. 

Anna: Yeah. To help reduce that imposter syndrome, I think one of the best things you can do at first is just acknowledge your feelings. Yes, you might be scared or nervous or anxious or worried. And that’s okay. 

Sarah: Or all of those. 

Anna: All of those at the same time. And it’s okay to feel that way. But those feelings, they do not define you or your worth. They do not diminish your capabilities as a nurse practitioner. And hopefully you’ll have a mentor that you can share your feelings with and they can help you unlock that confidence. 

Sarah: And things really do get easier with time. After the first few weeks, you’ll know how the office is organized, what the workflow looks like, the types of patients you’re going to be seeing and managing, and there will be less fear of the unknown. And that alone will help to boost up your confidence. 

Anna: Yeah. And hopefully you’ll just feel better prepared to walk into that new job and plan for success. 

Like Sarah said, you have passed your boards. You secured a job because you have the skills and the knowledge needed to be a safe and competent nurse practitioner. We know you can do this. 

Sarah: Yes. Go out there, be the real deal, be confident in yourself. And if you need a little bit of support, we also have that Real Deal NP group on Facebook too. So it is full of people just like you that are figuring out their foundation, their footing in this new role. And so it’s a place of endless support, and I would definitely suggest checking it out. And we’ll be talking to y’all soon.

As an extra bonus, friends, if you’re looking for support no matter what phase of your nurse practitioner journey you’re currently in, I have communities available for both students and new nurse practitioners. In these communities, we work to uplift one another and grow this profession together every single day. Links to join will be included for you in the show notes. 

Thanks for listening to Becoming a Stress-Free Nurse Practitioner. If you want more information about the different types of support we offer to students and new NPs, visit npreviews.com/resources. See you next week.