How Can a New NP Graduate Prepare for a First Job?

Margaret (Peg) A. Fitzgerald, MS, APRN, BC, NP-C, FAANP


January 05, 2006


I recently graduated with a master's degree in nursing and will soon be certified as a nurse practitioner (NP). With plans to work in a primary care setting, what areas would you suggest I focus my attention on in order to prepare for a position in the next couple of months?

Nacole Nelson, RN,MSN

Response From the Expert

Margaret A. Fitzgerald, MS, APRN, BC, NP-C, FAANP 
President/Principle Lecturer, Fitzgerald Health Education Associates, Inc., Andover, Massachusetts

This is an exciting and challenging time to enter NP practice. With a growing variety of practice opportunities and increased responsibility, the newly graduated NP looks forward to the challenge of this new role, but is also anxious about the transition from the RN or other roles. How can you set the stage for success in your new NP role? Ask yourself the following questions:

Why did I become a nurse practitioner?

If you are a new NP graduate, you might now find yourself asking the question, "Why did I become a nurse practitioner?" You left the comfortable and respected role in your former nursing practice or other line of work. Now, as a newly graduated NP, you are in the rather unfamiliar, often uncomfortable role of the novice. As you seek your first NP position, remember what motivated you to make this change.

What have I achieved professionally to date in my professional career?

Most NPs are professionally successful, whether they are relatively new to nursing or a seasoned nursing clinician. Draw up an inventory of your professional history, highlighting the high and low points, successes, and failures.

What do I do well and enjoy in my current role? What do I not enjoy or need to work on in my current role?

Answering these questions will enhance personal and professional growth and perhaps help avoid difficulties in NP practice.

What are my clinical strengths? What are the diagnoses I handle the best? What areas do I need to continue to develop?

The NP should be able to list the diagnoses that he/she handles most proficiently. This can be a powerful marketing tool as well as a reminder of the skills you have gained during your studies and professional experience. You probably have developed expertise in the areas that interest you most. When you look at this list, do you see a common thread? Will this information help direct you to a certain type of practice?

Everyone has clinical weaknesses as well as strengths. However, you should have a plan to expand your knowledge and skill base. Successful NPs are truly life-long students of their work.

Another tip: When interviewing for a job, ask about the top 10 diagnoses seen at the practice. This will give you an idea about the match of your current skill set with the practice's needs. But what should you do if the position is appealing but your top diagnoses list does not match theirs? I recommend learning all you can about those diagnoses prior to starting so that your practice unfolds as a mix of the well known along with the clinical challenges.

How do skills acquired in my current role translate to other practice areas?

Often, the NP approaches the job search with significant experience in healthcare and in other fields. While all work experience contributes in some way, the reality is that the healthcare marketplace will likely not be impressed simply by a number of years of past nursing experience. However, do not overlook the skills from your current position that do translate well to NP practice. Make a list of the skills you now have that are common to all areas of healthcare. Be able to verbalize these skills well, such as the ability to deal with families in crisis, work effectively with limited resources, supervise and direct professional and paraprofessional healthcare staff, assess rapidly changing situations, set priorities, and alter plans of care in a timely manner.

How do I view the contribution of the NP to healthcare practice?

How does the NP role enhance the delivery of healthcare? How is it similar to or different from the medical physician or physician assistant? Having a well-developed frame of reference will help you in your role negotiation.

What do I believe is my personal contribution to NP practice?

Be able to verbalize what you can add to NP practice. What will be your special contribution? What skill, passion, and experience do you carry from your educational, professional, and personal experience? What opportunities do you plan to seek out that will further enhance your role as an NP?

What do I know about the state's requirements for NP practice?

The educational preparation needed for entry into advanced practice nursing as well as the NP's scope of practice and prescriptive authority are determined at the state level. Prior to applying for any position, be prepared to answer questions about your state's requirements for advanced practice.[1] Also, be well versed in your ability to obtain a federal DEA number, which is needed to prescribe controlled substances.[2,3]

Find out about Medicare, Medicaid, and other insurances and their policies on reimbursement to NPs. In addition, make sure you have a plan in place to become nationally certified as an NP, since many employers require certification as a condition of hire. Obtain the needed paperwork and organize your documents so that you can proceed with this in an expeditious manner.

Now that you have completed your time of reflection, it is time to get to the work of finding an NP position. And once again, for those of you new to NP practice, welcome to the best work on Earth!