Taking charge of the challenge: Factors to consider in taking your first nurse practitioner job


Sarah L. Szanton, PhD, CRNP, Johns Hopkins University School of Nursing, 525 N. Wolfe Avenue, Room 424, Baltimore, MD 21205. Tel: 410-502-2605;
Fax: 410-955-7463;
E-mail: sszanton@son.jhmi.edu


Purpose: To describe factors that ensure a smooth transition from nurse practitioner (NP) student to independent NP during the first year of practice.

Data sources: Two contrasting case examples, the authors' experiences, and selected professional literature.

Conclusions: Key points to consider upon searching or taking a first NP job include patient, colleague, and clinic factors. Patient factors include mix of patient presentations, complexity of patient presentations, insurance status, and population. Colleague factors include mentorship, charting, mix of providers, and availability of providers. Perhaps most importantly, clinic factors include productivity expectations, practice mission, charting systems, on-call requirements, supervision of other staff, and teaching status. Together, these factors can largely determine whether an NP's days are satisfying or frustrating in a new job.

Implications for practice: The transition from NP student to independent NP can be daunting. Although nursing schools and practice sites have responsibilities to ensure the transition is smooth, the new NP is ultimately responsible for the transition.