New PNP Job Orientation

New Graduates’ First Job and Practicing PNPs Changing Jobs


The transition from experienced bedside nurse to pediatric nurse practitioner (PNP) or from experienced PNP to a new PNP role involves going from an expert level to starting over as a novice.  With this transition you can experience feelings of decreased confidence, anxiety and frustration.  During the first year, most practitioners make a critical transition and develop a sense of belonging in their NP role.

This transition occurs in phases (Chang, Mu & Tsay, 2006).  During the initial phase PNPs often experience role ambiguity.  All NPs may struggle to give up bedside nursing tasks, gain respect from bedside nurses as they assume the new role, and often face a steep learning curve.  With time comes familiarity with the new role.  As PNPs begin to understand the daily demands of practice and start to develop a professional support system, they gain confidence in decision-making. The final phase of transition to the role involves grasping the role to the extent that rapport and ability to collaborate with physicians and nurses evolve.  They rely on you, the PNP, to be a critical part of the team.  Patients and families will also respect and value the care you provide.

Experience – Self-Assessment

Conducting a self-assessment when starting a new PNP job is advantageous.  Being able to identify personal strengths and areas for development will help you focus on what you bring to your new position. Self-assessment should focus on your clinical skills and knowledge.  Areas for consideration when performing a self-assessment may include comfort with general management and knowledge of common disease processes, relevant surgical procedures and any other procedures you may have to perform.

As valuable as hospital procedures are, do not neglect the areas of community services and business management experience when assessing your skills.  Consider if you are IT literate and ask yourself questions such as:

  • Were you a school nurse and were you present for children with special needs assessment meetings?
  • Did you do agency nursing or public health nursing and are you aware of the services in the community (i.e. PT, OT, psych services, primary care providers, pediatric home care agencies, agencies that provide pediatric respite, housing, free clinics, “soup” kitchens, community pantries, etc.)?
  • Do you have experience in business operations (i.e. spreadsheets, budget management, project management, public relations/media, public speaking, finance, fund raising)?

Sharing these results with your new employer will help you direct your learning and aid in tailoring your orientation.