6 Tips for New Nurse Practitioners
I'm no expert NP — but I know what it's like to be a new one. No matter what setting you start in, use the resources available to you, work hard, and stay open to learning — and you will succeed.
To help you on the journey, here are 6 of my best practical tips for clinical practice as a new Nurse Practitioner.
1. Use UpToDate Religiously
If you haven't heard of UpToDate, I don't know how you made it through NP school. This medical reference database is the gold standard of medical information for providers. While working, I use it to quickly reference drug dosing and renal dosing considerations.
On the spot, the algorithms are super useful — scroll to the algorithm section and you suddenly know just what to do for, say, hyponatremia of unknown etiology. With more time, you can read in-depth on whatever topic is relevant to your practice. Keep a running list of symptoms and diagnoses you're not 100% comfortable with, and make a habit of reading up on them at the end of each day.
Get It for Free
UpToDate is expensive, but most hospitals provide free access for their providers. Create an account, log in once every 3 months on the hospital network to maintain access, and download the smartphone app. There are other reference apps, but UpToDate is my favorite and the gold standard — see my top 5 medical reference apps.
2. Templates, Templates, Templates
As a new NP, you're going to be overwhelmed — especially in a new hospital or office. You'll forget to ask basic questions and feel dumb plenty of times, and your history and physical won't feel confident yet. That's why templates are your back-up.
Find or build History & Physical and SOAP note templates and use them with every patient. This ensures you don't forget surgical history, family history, smoking status, or even allergies. If you can't find one that works, make your own. Get a system down — write the same information in the same place during chart reviews — so you always know where to find it, especially in high-stress situations.
3. Master Verbal Report
As an NP, you'll communicate with physicians and colleagues far more often, and mastering verbal report is essential. You may have given great nursing report for years, but NP-to-physician report is different. Physicians are trained to give and receive report a certain way, and they can get testy if you take too long or leave out crucial information. Be concise, but include the relevant clinical detail.
In general, start with: age, sex, relevant past medical history, admission diagnosis, relevant findings, physical assessment, and any recommendations.
After the basics, specify exactly why you're calling and tailor it to that specialty — calling nephrology, you'd focus on renal function, blood pressure, and electrolytes, and so on.
4. When in Doubt, Cheat
When I started as a new NP in the hospital, I brainstormed the top 20 common diagnoses in my specialty and made cheat sheets for each — etiology, pathophysiology, clinical manifestations, diagnostic findings, and clinical management. Use textbooks and trusted online resources (I recommend UpToDate) to keep them current.
Making these cheat sheets yourself helps you retain the information and narrow down need-to-know facts for your exact role. If you can't find the time, these books have solid cheat sheets:
These help you look up relevant need-to-know information on the spot at work. Personally, my sheets on acute kidney injury and hyponatremia have been especially handy inpatient.
5. Follow the Paper Trail
Whether inpatient or outpatient, there will be specialist consultation notes for you to read — and you can learn a ton from them. These are literally specialists; as a generalist you're the jack of all trades, master of none. Simply reading up on your patients after you've seen them expands your knowledge tremendously.
And don't only read specialist notes. Inpatient, medical student and resident notes are often very detailed and provide the rationale attending notes leave out. Don't write them off just because they aren't attendings — they learn so much in school that we as NPs do not, and these notes can be invaluable.
6. Have the Right Attitude
As a new NP, you're the new kid on the block. Be humble, ready to learn, and confident in yourself — but willing to admit when you don't know. Trust your instincts, but check your ego at the door. We're dealing with patients' lives, and nothing is more important than hard work, communication, and collaboration with our patients and knowledgeable colleagues.
There are many more tips, but I kept this list short and practical — things that will genuinely help you succeed in the clinical setting.
It’s good to know that you can make templates for any history or physical with every patient. My sister is wanting to become a nurse practitioner this year and she wants to enroll in some sort of program. I’ll have to send her this so she knows what to expect in the field as she searches for a good program she can be in.
I would like access to your templates please? Very nervous new NP – I have a second interview with an employer and I think they are going to give me an offer next week.
I have sent you an Email! I hope you got the job!
Could you send to me as well? I am a student in my first month of clinicals and feel very lost and discouraged x(
Hey, love website. Very helpful. Can I have those templates as well? Thanks
Brilliant! So happy to have found you. – FNP Student
So happy to help!
I just subscribed! I am a new Hospitalist NP starting this month. I’ve started making some cheat sheets of my own and I was glad to see that on your tips list! I’d love to see some of the ones you made too! Do we have access to those once subscribed?
Those cheat sheets are not in there currently. I am working on reformatting the cheatsheets in order to be able to sell for a small charge, so that will be coming soon!
It was great to review the different apps that are available to us as new Nurse Practitioners. I would love to be able to access you templates, to help me starting out Please? Just getting started in a family practice and feel like a fish out of water at times. TY
Teresa, DId you sign up to the list? If not I can add your email manually
I would like your templates please. I am a AGNP student soon to graduate.
I will add your email to the list!
if you could add me too that would be great 🙂
done!
I would also love your templates
I would like access to the Tip sheets please. I am a new NP and struggling to find good tip sheets
Tandika, It looks like you originally got the email sent February 27th, so when you sign up again sometimes it won’t work. I resent you an email with access!
Thank you for the tips, Will. I have recently graduated and I will be starting my very first job as an NP in October. The caveat is I will be the ONLY provider for an isolated rural community of about 3000. Do you have any tips beyond these basics? I feel like a paratrooper dropping in alone behind enemy lines, and need all the info I can get!
Honestly just get ALL the resources – Uptodate, textbooks, etc. Make yourself cheat sheets can help too if you find the time. Honestly, once you get started it will be a whirlwind but you can only prepare so much – you’ll learn a ton on the job!
Hello, could you share your cheat sheet on the top 20 diagnoses?
Hi, just subscribed and watched your videos, I would love to be able to access your templates, to help start me start new NP hospitalist job. Please help. Thank you
Good morning Will, I am a fairly new NP working in urgent care. I love reading your blog and all the info you provide. I have learned so much from following you. Will you be including any modules that we can purchase for your cheat sheets of top 20 diagnoses? Also can I get access to your templates?
I would love this too.. I have been looking online for cheat sheets.. thanks