New Graduate PNP

New Graduate Transition, What Now?

When you transition from a registered nurse to a pediatric nurse practitioner (PNP), your job transitions from a “job” to a “career.” That transition can be both exciting and uncertain. The transition has been described as carrying the bloody diaper to the provider to ask, “What do I do?” to being the provider.  Many refer to it as learning to become the decision maker.  That new level of PNP knowledge and responsibility carries with it documented levels of stress and fear that is reasonable but requires support.

When you enter the last six months of your educational training to become a PNP, you might also consider starting your job search.  Consider your PNP network, make a list of references, map out your geographic, practice setting, and unit or clinic preferences, and then start an electronic or paper file to track your plan and efforts.  Create a calendar; include dates when you can work on your plan and times when you can interview either by phone or on-site.  In addition, include two-four weeks of focused time after you graduate, to study for your boards.  Think about your ideal PNP start date as well.

Some things for a new graduate PNP to consider when evaluating a job offer:

  • Orientation/transition to practice process
  • Preceptor(s)
  • Mentor
  • Other PNPs for support
  • Physician involvement in orientation/transition
  • Time allotted before being expected to carry a full patient load
  • Physicians’ understanding of the role and expectations
  • Staff’s understanding of the PNP role
  • Support for the stress and challenges of transitioning into the new role
  • Time set aside to review research and self-study
  • Didactic training
  • Opportunity to learn from shadowing and assisting
  • Electronic Heath Record (EHR) training
  • Process for establishing competencies
  • Metrics used for evaluation and productivity
  • Malpractice Insurance coverage

Hospital Setting:

  • Advanced Practice Structure
  • Designated process prior to working the night shift-with full responsibility for patients and less available support

Clinic setting:

  • Patient load expectations in the first four months
  • Physician training of the PNP
  • Night coverage, weekends, evenings, on-call responsibilities
  • Admitting privileges