Preparing to become a Nurse Practitioner? Here are 3 Tips
I’m fortunate to have people in my life who helped prepare me for a career as a nurse practitioner. I’ve had several nurses and NP students approach me asking for advice on how to prepare for school and for the transition from being an RN to an NP. I hope to provide some guidance for those of you out there thinking of pursing this rewarding career path, with 3 tips:
#1: Experience
As discussed in a previous post on how to become an NP (Canada and the U.S.), NP programs have mandatory clinical hours to complete as an RN prior to applying. For example, in Ontario, 2 years full time clinical experience is a common requirement for many primary health care NP programs.
My advice – there’s no need to rush. Some NP candidates enter into NP programs with the minimum hourly requirements, some have decades of experience, and others somewhere in between. Gain as much clinical experience as you feel you need prior to becoming an NP. I worked for 6 years as an RN in various specialties (mental health, addictions medicine, geriatrics, family medicine, pediatrics). Diverse clinical experience provided a strong clinical foundation for entering the primary health care NP realm and helped me realize my passion for family medicine. After working in family medicine, I knew I wanted to work in this field as an NP. Not everyone is able to find work in a family medicine practice, but don’t worry – experience in the emergency department, community nursing, public health nursing, acute care settings (and more!) are all very valuable to help you prepare for a career as an NP.
Alternatively, if you are interested in working in an acute care setting as an NP, focus your clinical time as an RN in acute care. If you are keen to enter a pediatric NP program, focus your clinical hours in pediatric settings. Regardless of what type of NP you want to be, I think many would agree that diversifying your experience is helpful. Every nurse practitioner brings their own unique experience and clinical expertise to the table, enriching the much-needed care provided to our patients.
If you have the means, working in remote/rural settings is also an excellent idea. As an RN you work to full scope and see a variety of conditions and work with different communities, which makes for a good stepping stone to the NP role. Travel nursing is also a great way to gain varied experience, with many Canadian and International agencies available.
#2: Learn about Diagnostic Reasoning
Learning to think like a diagnostician (the process of diagnostic reasoning and forming a medical diagnosis) is arguably the steepest learning curve to transitioning to the NP role. Learning the theoretical underpinnings for diagnostic reasoning will help prime your brain before you enter clinical course work and placements. Diagnosing patients is not a random process, nor is it about memorizing every single disease entity that exists (knowing everything is impossible!) If you learn how to approach clinical problems in an organized way, you can solve even the most puzzling diagnostic dilemmas. Learning about diagnostic reasoning before becoming an NP helped me integrate these concepts early as an NP student. I started to establish diagnostic reasoning skills from the get-go. I often turned to the IM Reasoning podcast which was integral to my learning experience. That being said, I am far from an expert. Diagnostic reasoning is a tough, iterative process, even for the most experienced clinicians. With this blog, I hope to provide diagnostic reasoning education for aspiring NP students, current NP students, practicing NPs, and other medical providers.
#3: Study Ahead of Time
This sounds ridiculous I know – who has the time to study in our busy, forever multi-tasking lives? I use the term “study” loosely. Just as we are mandated to stay up to date with best practices, there is no harm in learning NP-level concepts and knowledge ahead of time if you are considering this career path. When I decided to apply to a primary health care NP program, I set aside time to read around various primary health care topics. I did this over the course of about a year, without pressure, at a slow pace. I read what I wanted, when I wanted, with no time commitment. I was also inspired by the fact that I had made up my mind about going back to school to become an NP. I reflected on my learning gaps and tried to act on them ahead of time. Do what works best for you – textbooks, podcasts, review courses, lectures, conferences. Do it in short blocks of time or longer blocks of time.
I want to share the following resources that I found helpful before I started school (and which I still find helpful!)
Case Files Family Medicine (case-based approaches to common primary health care topics): https://accessmedicine.mhmedical.com/cases.aspx?groupid=373
Case Files Emergency Medicine (case-based approaches to common emergency medicine topics): https://casefiles.mhmedical.com/CaseTOC.aspx?gbosContainerID=154&categoryID=40971
Case Files Internal Medicine (case-based approaches to common internal medicine topics):
https://casefiles.mhmedical.com/CaseTOC.aspx?gbosContainerID=248&categoryID=40973
The Fluid, Electrolyte, and Acid-Base Companion book (it describes bodily hemostasis in regard to fluid and electrolyte balance and various pathologies that arise from imbalances):
https://pbfluids.com/2017/09/the-fluid-electrolyte-and-acid-base-companion/
Clinical Microbiology Made Ridiculously Simple (provides a brief, clear, concise approach to microbiology and infection, with fun illustration and mnemonics):
https://www.goodreads.com/book/show/517655.Clinical_Microbiology_Made_Ridiculously_Simple
Pathophysiology of Heart Disease (a concise review of cardiac pathophysiology, diagnosis, and treatment):
https://shop.lww.com/Pathophysiology-of-Heart-Disease/p/9781975120597
Podcasts (free)
EM Basic (emergency medicine)
Pediatric Emergency Playbook (emergency medicine pediatrics)
Curbsiders Internal Medicine podcast (internal medicine topics)
IM Reasoning (diagnostic reasoning topics)
Continued Education as an NP student / practicing NP
Anti-infective Guidelines or Bugs and Drugs (free)
Key Take Home Point: Gain experience, learn key diagnostic reasoning concepts, and try to identify and fill in your learning gaps ahead of time. If you don’t have time to prepare – you’ll be fine, the learning curve is steep regardless!
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