in response to a recent comment from Neophyte NP as to what I would tell recent grads... especially for a more mature graduate that is completing her clinical soon.
here goes a stream of consciousness reply to that post (as I cannot apparently reply with anything longer than 4000 characters, i will post it here!)
basic things that come to mind;
- choose your own clinicals... focus on places/jobs that mirror those you would like to consider (and if you're not sure, then choose a variety), finding your own preceptors ensures that you have a placement where you learn from your preceptor, and experience the work environment/patient set that you will need experience with for the future. Much of what you learn in school is learned in clinical, make the most of it. A tip: talk with students that are one year ahead of you (or one semester) and ask about their clinicals... find preceptors that other students love and ask in advance to be recommended to work with that preceptor next semester (I found most of my precptors this way)... another idea; talk with professors you highly respect (well in advance) and ask to do a clinical rotation with them (be persistent!). It's a good idea to either work a BUNCH of days at one site in a row, or to spread your clinical over regular days at the same site... thus you can either get a feel for a LOT of work flow at one time, or get to follow up with your own patient "panel" during clinical. Consider daily topics with your preceptor... choose common disease topics, pediatric physical age sets, or the like, and discuss for 15 minutes over lunch... often, you can choose the topics in advance, and then you can present the topic to your preceptor over lunch, this gives them a chance to add their two cents at the end, and to review their own knowledge base as well! I'm a proponent of the idea of NP residency, but until this occurs, chica, your clinicals are your residency before the trial by fire begins on your first day, so make them your own, it's your last chance to control where you work/what you do!
good sites for preceptorships;
- community clinics
- planned parenthood
- other sites where your friends have really enjoyed their clinicals
- specialty sites you might consider working in the future.. give it a try before you commit!
other things to remember... you are 48, I consider experience to be a good thing (and it freaks the patients out less.... after all, I'm 31, but patients often ask if I'm 19, not exactly ensuing confidence from the first visit, lol). When you are new, you will have to ask a lot of questions/look up a lot of stuff/ take a lot of NSAIDS for the headaches this will cause (lol, no seriously....)... each day, you will answer another question that you will then know the answer to the next day... after a while at the job, you will be a pro (really, you will) and you won't have to ask those same questiona again, you will remember the basics, and look up the rest, I promise!
Funding; consider the NHSC (National Health Service Corps) their loan repayment program is way easier to get approved than the scholarship program, and it's a great way to get your feet wet in the community, while getting loans paid! Also, community clinics are often more eager to hire NPs right out of school (even before that pesky furnishing license has been earned!).
things to learn now; schools don't often teach about medical coding/billing and proper paperwork/NP practice protocols for clinical work. Clinics REALLY don't know about them... so take the opportunity to rack the professorial brains and preceptor opportunities available to you now (learn how to fill out an encounter form/super bill, play with electronic health records), ask your professors how to write your own standardized procedures, and what your state regulations are... trust me, most clinics and clinicians don't know how to write paperwork for legal NP practice, and most med students don't know HOW to fill out a billing form (even though doing it wrong actually constitutes fraud... and frankly, it's our bread and butter to keep the doors open).
well... phew, those were my initial thoughts that came to mind under the "what I wish I had known" category.
Good luck neophyte, soon you'll be an oak tree :)