New NP advice

I'm almost 5 years into my practice and have only recently felt like I'm no longer a novice. This does not mean I am now an expert, not by a long shot, but it means I'm not running to a resource every time a patient comes in with a complaint!

Looking back to the beginning, what would I tell myself? What would I have spent more time on in school? Let me share with you!

1. Spend a lot of time on pathophysiology. The patho, the way the body works specifically in a diseased state, is so important. You can spend an entire lifetime learning about cells, the way they respond during times of disease and stress, the end-organ results, etc. When you then add medications to the disease process, it changes a lot of things-kidneys, liver, other disease processes. The more you continue to work on your pathophysiology, the better off you'll be.

2. Mind your own business. In the age of social media and being 'friends' with everyone it is easy to blur the lines of friends and colleagues. The party from last weekend may have unintended consequences during the work week. If you're friends with one person and not another it can cause unnecessary drama at work.

3. Practice what you preach. People are watching you. Patients, coworkers, administration. There are eyes (and ears) everywhere. Being impeccable with your word, minding your own business, and doing what is required (and expected) of you will go a long way.

4. Keep in touch with your NP classmates. There are 2-3 girls I'm in regular contact with. Whether to ask a question ("If the patient had the BCG vaccine in their original country, do they need treatment when their PPD comes back positive?" (No, order a CXR. Most likely positive from antibodies from BCG vaccine; pt shouldn't have another PPD, thanks Aileen!)), or if you just need to vent, it helps to have someone in the same boat as you.

5. Have a mentor. While I don't have a formal mentor, there are several nurses in my life and one NP friend. I love seeing her at conferences and sharing my experiences with her. She is always available if I have questions regarding nursing, my practice, or my personal life. She has more years experience than my classmates and knows me better than my colleagues.

Are you a new NP? A seasoned veteran? What have you learned about your job over the past several years?