For decades, family nurse practitioners (FNPs) have been providing medical services to underserved communities and rural populations. With the current shortage of primary healthcare providers, the increased needs of the aging population, and the growing number of people accessing medical insurance, the scope of the FNP practice has expanded across the United States. FNPs are taking on roles once held exclusively by primary care physicians, including prescribing medications and ordering diagnostic tests.
The shift from working as a registered nurse (RN) to an FNP has been described as complex, stressful, and exciting. As autonomous caregivers, FNPs face new roles that present unfamiliar challenges that might cause stumbling blocks along the way. Even RNs who attended the top nursing schools face “imposter anxiety,” or fear that others will discover them as “frauds” despite years of experience and training.
Experienced FNPs have words of wisdom for the novices in the field: adjusting to the new position can be challenging, but the right education and realistic expectations smooth the transition.
“Remember that when you become an NP, you assume a new professional role. You’re now a primary care provider. Even though you may be a seasoned RN with years of experience, the NP’s provider role is new to you,” Kimberly Poje, an FNP at the Brain Center of Hudson Valley in Newburgh, N.Y., wrote in American Nurse Today. “Questioning your assumptions and actions is normal because you’re making different types of patient-care decisions than you’ve made in the past. This can be intimidating.”
Experts agree the FNP workforce is essential to meeting the increasing challenges of healthcare access nationwide. With their experience as RNs and advanced education, FNPs are positioned to improve healthcare outcomes.
Multiple studies have looked at the struggles of first-year FNPs and produced guidelines for a smooth transition. The following are some suggestions:
In 2010, the Institute of Medicine, now called the National Academy of Medicine, recommended post-graduate residency programs as a means to ease transitions throughout the nursing profession. In its 2015 follow-up report, the academy reaffirmed and expanded its recommendation to say post-graduate residence programs provide some “positive outcomes, including improved ability to organize, manage, and communicate, as well as higher retention.”
While there are some employee-sponsored post-graduation residency programs, the number is still limited. Some of the leading FNP education programs, including Duquesne University’s online Post-Master’s Certificate in Family (Individual Across the Lifespan) Nurse Practitioner degree, offer on-campus residency curricula.
As licensed independent practitioners who provide primary care in acute and long-term settings, FNPs are expected to utilize the scientific process and national standards of care for the following: managing patients, setting patient care priorities, interacting and leading collaborative health and medical efforts, and acting as patient advocates, among others.
While the leading graduate nursing programs prepare students for the challenges that come with a transition from RN to FNP, new graduates also can be overwhelmed by the challenges of the position in real-world applications.
In seeking a new job, ask about the patient load, work hours, available administrative and clinical support and job expectations. Ensuring job requirements are commensurate with skills is important for success and satisfaction.
A study of advanced practice registered nurses (APRNs) in North Carolina found “the prevailing majority of novices reported feeling ‘not competent’ or ‘neither competent nor confident’ upon beginning their employment as a NP.” Indeed, the 2014 survey results are translated to today’s novice NPs across the nation.
Anxiety about beginning professional work as an FNP can be overwhelming, prompting what is commonly called “imposter phenomenon” or “imposter syndrome.” While not listed as an official psychological diagnosis, the American Psychological Association acknowledges the anxiety as “a very real and specific form of intellectual self-doubt.”
The APA said the fear and insecurity derives from an internal pressure to succeed and is common among graduate students who are taking on new endeavors. Experts recommend seeking supportive and encouraging mentors and making realistic assessments of personal abilities.
The goals of FNPs is to, in part, treat patients holistically, utilizing the compassion of nursing and the skill that comes with autonomous practice. FNPs are not doctors but are filling primary care needs nationwide. Researchers have found the best FNPs are empathetic, enthusiastic, tenacious, creative, and trustworthy.
The American Association of Nurse Practitioners said FNPs “deliver a unique blend of nursing and medical care, assisting patients in making better lifestyle and healthcare decisions.”
FNPs have more opportunities now than ever because in most states they are legally permitted to operate without supervision from physicians. They practice preventive care, help patients manage chronic medical conditions and provide high-quality, cost-effective services.
To become an FNP, students must have completed a Bachelor of Science in Nursing (BSN) degree program, passed the NCLEX-RN exam, and completed the three-year Master of Science in Nursing (MSN) degree program. Most states require FNPs to successfully complete the American Association of Nurse Practitioners Certification Program (AANPCP) exam or the American Nurses Credentialing Center (ANCC) Family Nurse Practitioner exam.
RNs who already have an MSN degree have the opportunity to learn specialized skills as well. Duquesne University offers Post-Master’s Certificates in Family (Individual Across the Lifespan) Nurse Practitioner, Forensic Nursing or Nursing Education and Faculty Role.
Duquesne University has been a leader in online nursing education for years and has been recognized by U.S. News and World Report as a 2017 Best Online Graduate Nursing Program and among the Top 10 Best Online Graduate Nursing Programs for Veterans.
The university’s three areas of Post-Master’s Certificate specializations allow RNs to advance their careers in accordance with state and federal core competencies and assist in the growing need for qualified providers nationwide.