Nurse Practitioner-Ish

My transition from registered nurse to nurse practitioner has been somewhat long and drawn out, but I am realizing via conversations with my peers that this is nothing new. What I hadn’t realized when I started this experience is that there are multiple steps to actually¬†practicing:

  1. Pass the national certification exam.
  2. Become licensed in the state where you plan to practice.
  3. Obtain authorization to prescribe controlled substances at the state and federal levels.
  4. Become credentialed as a provider at the institution where you will be practicing, so that the services you provide can be correctly billed to insurance.

This last credentialing piece is the biggest hurdle. It involves so.much.paperwork. They dig deep into your professional history and your history as a provider (which I didn’t really have since this was my first NP job). They want CVs, copies of liability insurance, proof of license/certification/ability to prescribe, educational transcripts, and the like. I must have scanned and submitted 100+ pages.

And you can’t really fully practice until credentialing is approved. So far I have been approved by two separate committees, with one more vote to come from the general board of directors. Assuming there are no unexpected hiccups, I’ll be credentialed next week.

In the meantime, I’ve basically been working an infusion nurse. The medical oncology practice has its own infusion center and mixes its own chemo, and there are three registered nurses working full time to administer chemo, fluids, and other infusions to our patients. One of the nurses happens to be out on medical leave (originally until mid-May), so I was asked to take her spot. It actually turned out to be a great way to get to know the staff and patients, show the medical staff and physicians that I know what I am doing, and start familiarizing myself with our protocols. And boy do I have a whole new level of respect for infusion nurses. I thought floor nursing was exhausting, but managing care for 10+ patients at once, handling crises, taking triage calls from patients AND mixing/administering serious amounts of chemo is no joke. I end

But this is the challenge in being the first NP to join the practice… They don’t really have a concrete orientation plan for me. And now the nurse out on leave won’t be back until July, at the earliest. So they’ve asked me to continue helping out the nurses in the morning, when they are busiest, and shadow the physicians in the afternoon. While I’m happy to be a team player, this plan makes me a bit nervous because I don’t want to become the default pitch hitter for the RNs when I am supposed to be learning how to be an NP. Not to mention I have that whole DNP project that I’m supposed to be working on for school, which I can’t do if I’m spending half of my days running around like a chicken with my head cut off. It’s also a bit schizophrenic-feeling. It’s hard to transition between roles when I’m trying to do them both at the same time.

So I’m working on my professional self-advocacy skills, while trying to take advantage of the benefits to this plan. Like setting my DNP project up for success by convincing the nurses that it will help them too. And reminding myself that nurse practitioners are nurses first – we think differently than medical providers, and getting to know the patients in this setting will hopefully help make me a trusted member of the team when I am wearing a different hat.

The good news is, I’m in a place that is supportive and nurturing and all about teamwork. The practice staff consider themselves a family. And that is a huge relief. The learning curve for this new role is already steep enough. I am joining a team that wants me to be successful and wants me to love what I do. I really couldn’t ask for anything more.

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