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What is the most challenging aspect of being a nurse practitioner?

I want to work in the health care field, but I am still trying to figure out what part I want to do. I am between two professions right now and I want to know everything before I make a decision. #health

Thank you comment icon As a PATIENT in a hospital, I’ve seen them doing a lot of paperwork and activities along those lines but then again that could be your strength! Mike
Thank you comment icon Hello Jayden, This is a good question for those who have an interest or have never worked as a nurse practitioner like myself; I found an article that discusses the challenges and rewards of becoming a nurse practitioner and including how to overcome those challenges: https://www.nursingprocess.org/nurse-practitioner-challenges.html ; also, here is a video on NP responsibilities and education requirements: https://www.youtube.com/watch?v=XpgRBz8mJvs ; I sat and watched both videos that were very informative; good luck on your decision Sandra Hurst

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Thomas’s Answer

"The biggest challenges for new NPs (and how to overcome them)
From: September 1, 2020

One of the hardest things about becoming an NP must be getting a preceptor when you’re a student. But what about after graduation? What happens when you don’t have that problem anymore? There are a lot of different answers to these questions.

In a world where some NP are suffering from skin conditions, or “insufficient resource trauma,” some of the following challenges might seem like they’re nothing. However, it’s important to talk about them because these issues affect every NP in their professional journeys.

Being compared to a physician

The fight for recognition is something that many nurse practitioners deal with on the regular. They get compared with physicians all the time. Their coworkers and family members might not know exactly what their careers entail.

Also, as nurse practitioners get more independence and traction, some organizations push back to limit their scope of practice. Instead of seeing NPs as another type of provider, they sometimes view NPs as “wannabe doctors” who present a threat to their income.

New NPs may encounter this bias, even in states where they don’t need physician oversight. It’s important for you (as a new graduate) to know that you may find yourself in one or two awkward situations because of this.

What you can do about it: Understand that it isn’t your duty to change anyone’s mind but to educate them on how you are and what you can do. You should be open to people that come to you with questions.

Also, don’t think about all doctors as bad guys. NPs have lots of allies. Your job is to be the best NP you can be with what you get. Patients come first, and if you treat them right, you’ll be doing your part to change and nurture the public’s perception of nurse practitioners.

Not being able to practice independently

If you live in a state where you can’t practice on your own, you’ll sometimes find it difficult to get the things you need from your supervising physician. You might feel ignored many times, which can lead to anxiety.

Many nurses find the job a lot less rewarding because of this issue. It can be bad enough to have an impact on your practice. Keep this in mind on your first day as an NP. This part of the job will definitely bother you, but you’re not alone in that regard.

Many NPs and non-profit organizations are fighting to give NPs full practice authority in every state. California just passed some important legislation on the matter. Things are moving constantly, and your state might be next.


As a novice, you might find it difficult to accept that some patients don’t want to see an NP or don’t understand what a nurse practitioner is. This is not very common, but it can happen. It might affect you if you’re not careful.

It’s important to remember that the nurses play a very important role, in general, as patient educators. As you gain experience, you will develop the skills to explain to patients who you are and what your job is.

In any case, you should know that lots of patients in the US have reported higher satisfaction when treated by NPs. You can find lots of research on it on this AANP page.

What you can do about it: These patients won’t cease to exist, but they also need the best care possible. Just do your best to ensure they get it. Don’t let your ego get involved and you’ll do fine.

The business side of the business

Hospitals are businesses. Clinics are businesses. Sometimes, the decisions management makes won’t necessarily be in the best interests of the patient. You might see a lot of these cases in your career.

If you have a natural inclination to help your patients be healthy, as every NP does, you will sometimes disagree with the status quo. You then will find out that there’s a lot of pressure to make a profit, and this can be frustrating.

There are a lot of patients with external, non-medical issues, that will come your way. Things that you won’t be able to solve for them. Maybe they’ll have money issues, maybe they’ll get some treatment or procedure that you don’t think they need. Sometimes you’ll have to be the one that explains that to them.

What you can do about it: You don’t want to lose your job, but you can help patients to understand what’s behind their treatment, know what their best options are, and ask the right questions.

Putting it all together

No matter which specialty you choose, these are the challenges you will encounter in this awesome profession. Keep your head high, and know that you’ll end up getting the experience you need to overcome them. It’s all in the attitude.

Each of these challenges presents a unique learning opportunity. Whatever lessons you get from them will help shape you as a nurse. It would be bad to try and avoid them.

If you’re graduating this year, congratulations! We’re glad that you were able to get the hours you needed. If you haven’t graduated yet, then keep pushing! We believe in you, future NP."

Source: https://nphub.com/blog/the-biggest-challenges-for-new-nps-and-how-to-overcome-them/
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Karl’s Answer

Hi Jadyn,

Speaking from the standpoint of a physician that has hired many NPs an PAs….I would say that the most challenging aspect of this professional is practicing within your scope. Also, making sure to ask questions and continually stay as up to date with new information. This is also true for physicians as well, however because the training is a bit more extensive for MDs the breadth of practice usually starts a bit more broader than NPs/PAs. However, moving toward these two professionals is a quicker way to get into patient care and earn a great living while doing what you love. The market for NPs/PAs is great, so that if you choose these professions you will always be needed. Opportunities also exist far past just working in a hospital or office based practice. Exploding areas include but are not limited to working in Industry (medical affairs for a insurance company or pharmaceutical company), working in research’/clinical trials, Education, hospital administration, entrepreneurship and public health (local, state or federal). Hope this helps - Karl
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