The biggest challenges for new NPs (and how to overcome them)

One of the hardest things about becoming an NP must be getting a preceptor when you’re a student. But what about after graduation? What happens when you don’t have that problem anymore? There are a lot of different answers to these questions.


In a world where some NP are suffering from skin conditions, or “insufficient resource trauma,” some of the following challenges might seem like they’re nothing. However, it’s important to talk about them because these issues affect every NP in their professional journeys.


Here’s what we think are the biggest challenges for new NPs in 2020 (and what to do about them):



Being compared to a physician


The fight for recognition is something that many nurse practitioners deal with on the regular. They get compared with physicians all the time. Their coworkers and family members might not know exactly what their careers entail.


Also, as nurse practitioners get more independence and traction, some organizations push back to limit their scope of practice. Instead of seeing NPs as another type of provider, they sometimes view NPs as “wannabe doctors” who present a threat to their income.


New NPs may encounter this bias, even in states where they don’t need physician oversight. It’s important for you (as a new graduate) to know that you may find yourself in one or two awkward situations because of this.


What you can do about it: Understand that it isn’t your duty to change anyone’s mind but to educate them on how you are and what you can do. You should be open to people that come to you with questions. 


Also, don’t think about all doctors as bad guys. NPs have lots of allies. Your job is to be the best NP you can be with what you get. Patients come first, and if you treat them right, you’ll be doing your part to change and nurture the public’s perception of nurse practitioners.


Read more: NPs vs MDs: This is how you end the discussion


Not being able to practice independently


If you live in a state where you can’t practice on your own, you’ll sometimes find it difficult to get the things you need from your supervising physician. You might feel ignored many times, which can lead to anxiety.


Many nurses find the job a lot less rewarding because of this issue. It can be bad enough to have an impact on your practice. Keep this in mind on your first day as an NP. This part of the job will definitely bother you, but you’re not alone in that regard.


Many NPs and non-profit organizations are fighting to give NPs full practice authority in every state. California just passed some important legislation on the matter. Things are moving constantly, and your state might be next.


What you can do about it: Get involved! See if there is any news about the scope of practice for nurses in your state.


Facing some rejection from patients


As a novice, you might find it difficult to accept that some patients don’t want to see an NP or don’t understand what a nurse practitioner is. This is not very common, but it can happen. It might affect you if you’re not careful.


It’s important to remember that the nurses play a very important role, in general, as patient educators. As you gain experience, you will develop the skills to explain to patients who you are and what your job is. 


In any case, you should know that lots of patients in the US have reported higher satisfaction when treated by NPs. You can find lots of research on it on this AANP page.


What you can do about it: These patients won’t cease to exist, but they also need the best care possible. Just do your best to ensure they get it. Don’t let your ego get involved and you’ll do fine.



The business side of the business


Hospitals are businesses. Clinics are businesses. Sometimes, the decisions management makes won’t necessarily be in the best interests of the patient. You might see a lot of these cases in your career.


If you have a natural inclination to help your patients be healthy, as every NP does, you will sometimes disagree with the status quo. You then will find out that there’s a lot of pressure to make a profit, and this can be frustrating. 


There are a lot of patients with external, non-medical issues, that will come your way. Things that you won’t be able to solve for them. Maybe they’ll have money issues, maybe they’ll get some treatment or procedure that you don’t think they need. Sometimes you’ll have to be the one that explains that to them.


What you can do about it: You don’t want to lose your job, but you can help patients to understand what’s behind their treatment,  know what their best options are, and ask the right questions.


Putting it all together


No matter which specialty you choose, these are the challenges you will encounter in this awesome profession. Keep your head high, and know that you’ll end up getting the experience you need to overcome them. It’s all in the attitude.


Each of these challenges presents a unique learning opportunity. Whatever lessons you get from them will help shape you as a nurse. It would be bad to try and avoid them.


If you’re graduating this year, congratulations! We’re glad that you were able to get the hours you needed. If you haven’t graduated yet, then keep pushing! We believe in you, future NP.


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