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First Day on the Job

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Whether it was last month or years ago, share your memories of your first day on the job as an official NP. Then read others' comments.

I had worked in this facility as a pediatric ICU RN for 17 years prior to returning to school. Most of my coleagues thought I was crazy @ 53 to return to school. I chose to stay in the hospital setting but thought it was not in my best interest to work directly with the staff members that were previously peers. I stepped into a newly created position with the ER staff to see only the pediatric patients. Within the last two years the program has expanded to include seven pediatric ER/ICU physicians, myself and two PA's and continues to expand currently. The first few weeks were difficult as the MD's truly did not know what my role was;and perhaps I did not either. I think the most difficult part of the transition has to be the mindset change that has to happen. I found that I felt guilt when it was obvious that the nursing staff needed help and often tried to do my job and theirs as well. One physician said to me that I 'must stop thinking/acting like a nurse and start thinking/acting like a physician'. I sat down and thought seriously about his words. I still don't agree entirely with those words and believe that I am and always will be a nurse and believe that this is an asset not a deficiency. I am not a physician although I see the patients equally with them. I am now better at establishing boundaries. I have since found a happy medium between the two roles. It took a period of time to settle into what I believed my role to be and establish a good balance in the relationships between myself and the medical and nursing staff. I have developed a greater understand and ability to interact with the political arena that medicine provides. I have also established my role within my own mind and the nursing staff. This didn't happen over night as the nursing staff originally wanted to prove that they were better at the job than I was. I now believe that I have the best of all worlds. I have established in my own mind that I can do this job and know what my limits are. I have established a balance with and acceptance from the physicians and they now believe that my nursing background can be of great benefit with some patients; particularly in the education component. I have established a balance with the nursing staff where they now trust my judgement and we have created a team concept. This has taken some time and effort on all our parts. I think that any new grad must come out with a 'can do' attitude and trust their own skills and judgement. The stress level within the first year is very high; and I believe that it is very important to balance one's life with other positives to counteract the high level of stress. It is now very rewarding to feel as though I am an integral part of the program and that I have established strong relationships with my patients.
Andrea Storrie CPNP
Pediatric Emergency Room
Healthpark Medical Center
Fort Myers, Florida

Andrea Storrie, CPNP, Healthpark Medical Center	September 24, 2008
Fort Myers, FL

I was lucky to have been accepted by the Emory University Nurse Practitioner program that was run through the Emory School of Medicine. I was lucky to have precepted at the St Louis County Public Health Department for 5 months.

I was not so lucky at securing a job immediately after graduation as the positions available for NP's in St Louis were not only full, but few in number.

However, a FEMA-supported position opened up during the flood in the Midwest in '93 and a friend of mine was the medical director of that clinic--and he hired me as the NP.

I went in there the first day with a confidence that only Emory could have given me after working at Grady Hospital while in school and the public health experience of preceptorship.

There was no one else but me there to take care of these displaced people--and I found some inner confidence I never knew I had.

It was the greatest experience anyone could have had--scared to death that first day, confident as heck, and lived to this day to tell the story.

Thank you for giving me the chance to re-live it.

Susan	September 23, 2008

My first day on the job as an NP was bizarre.

First, I was told that I would be leading a team of nurses and case managers but only from a clinical perspective. It turned out that I had to be their administrative manager, too, which I (still) do not want to do. Then I found out that the other advanced practice nurse who started the same day was told that she was hired for my job. Our HR department did not even realize that they hired both of us for the same position. And she didn't have an office. Then my 'collaborating physician' had no idea about Ohio's law requiring a "standard care agreement" between us, so I had to do some educating. That was just the first day. It was unbelievable and quite difficult. I didn't start seeing patients for nearly two weeks until we could iron out all of the details. [sigh]

But now, I wouldn't trade my job for almost anything. I love the patients and most of the people I work for. And the administrative task has been reassigned to another person. So, I'm doing exactly what I want to do now.

John Chovan, CNP, North Central Community Mental Health Services, In	September 23, 2008
Columbus, OH

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