Conquer Uniqueness: 5 Novel Ways to Educate Yourself and Expand Your Advanced Practice Nursing Career

You're an experienced nurse practitioner (NP) who meets all the standards: inquisitive, analytical, compassionate, communicative, and a strong leader. You're the NP whom others look to for clinical advice, and have autonomy and respect in your field. However, you know that there is more to your advanced practice role than this and you just can't shake that nagging feeling that you haven't mastered it all. Does this sound familiar? Explore the following opportunities to find additional value in your NP role.

1. Explore New Areas of Expertise

Have you ever dabbled in areas outside of the traditional NP practice? Here are some new areas of expertise that can broaden your scope and give you the opportunity to leverage valuable skills:

Do you love travel and adventure? Consider a career as a foreign affairs NP. These federal government positions care for United States citizens and their families serving abroad – typically in remote countries. Foreign affairs NPs relocate every two to four years. After all, there's no better education than real-world experience!

Explore medical writing as a potential career. Medical writers prepare continuing education, contribute to professional articles, and provide health literacy content throughout the industry. You can learn more about medical writing (and editing) here.

Are you the nurse practitioner who answers clinical questions for staff and orients all of the new practitioners? Harness that valuable skill set and pursue a nurse practitioner educator role. These highly communicative nurse practitioners are often sought after to educate future nurses and nurse practitioners within universities, hospitals, and medical device/pharmaceutical companies.

Like flexibility and no commute? Try telemedicine. Serving as a significant growth area during the past 10 years, telemedicine is now more popular than ever! Telemedicine connects remote patients and providers through the use of medical electronics and video or telephone communication. If you don't have access to telemedicine in your practice, consider becoming the telemedicine point person and start offering increased flexibility for patients and bringing more creative revenue to the practice.

Advanced nurse practitioner education and experience is a solid foundation for legal nurse consulting. Legal nurse consultants (LNC) require strong knowledge about the legal system, as the role involves reviewing medical records, health care timelines, and organizational policies and procedures. The LNC is a valuable team member in hospitals, law firms, and court systems.

2. Become a Political Advocate for Nurse Practitioners and Nursing

Nurse practitioners are crucial to transforming health policies and creating an environment for independent practice and professional advocacy. Despite having the trust of the public, advanced education, and professional standing, nurse practitioners often underestimate their political power. Ryan & Rosenberg (2015) explain how nurse practitioners can maximize their political influence and be a voice for change. Visit the advocacy pages of state nursing and nurse practitioner associations such as the American Association of Nurse Practitioner (AANP) advocacy page to learn about the latest political goals and how you can help advance both the NP practice and your leadership career.

RELATED: A 7 Step Health Policy Toolkit to Flex Your Political Muscle as a Nurse Practitioner

3. Obtain Additional Certifications in Your Field

Nurse practitioners can obtain specialty certifications outside of their population focus to advance their practice in specialized areas. There are specialty certifications in emergency medicine, orthopedics, palliative care, oncology, dermatology, nephrology, and cardiology. Many certifications require a certain number of clinical hours, in addition to continuing education and testing.

4. Pursue an Additional Post-Master's Certificate

To maximize your career variability, consider an additional post masters certificate outside of your population focus. You can choose to cross over to a different specialty or add to your population focus. For instance, family NPs may consider the psychiatric nurse practitioner realm, or acute care NPs might want to add a pediatric NP role to their resume. If you are interested in health care business management, a Master's in Business Administration (MBA) or Master's in Health Administration (MHA) are good options. A newly popular choice, the health informatics master's program, focuses on nursing electronic systems support, management, and data monitoring.

5. Participate in Continuing Education in a New Way

While on-site conferences are a traditional way to learn new skills and collaborate with colleagues, they are also expensive and the associated travel is typically not conducive to the busy lives of NPs. Luckily, there are many online webinars and conferences available to NPs for continuing education credit.

Other alternative ways to participate in continuing education include:

  • Podcasts offer continuing education credits
  • Portable education
  • Searchable subjects of interest
  • Doximity– read peer-reviewed articles and your continuing education credits are tracked and easily uploaded
  • Publish articles
  • Present at web conferences

Innovative NP education provides unique clinical experiences, fosters leadership, and expands our world view. Combining traditional education with unique clinical experiences expands an individual's NP career, and provides an upstream view of health care and the world. Contribute, be creative, and continuously meet your personal and professional goals!

New Graduate Nurse Practitioners: Keep Learning to Build Confidence

As a new graduate nurse practitioner, you're equipped with all of the latest information and guidelines to inform your practice. You demonstrate enthusiasm and compassion, and offer a fresh set of eyes in the medical field. However, you can't help but feel nervous, uneasy, and overwhelmed by the sheer volume of knowledge required to provide safe and effective care for a wide variety of patients. Understanding the important ways to support and advocate for yourself as a new grad is essential to your long-term success in this demanding field.

Build Confidence With a Fellowship Program

With varying credentials among nurse practitioners including MSN and DNP, formal education and hands-on clinic experience can vary at the time of graduation. Some universities and healthcare facilities are expanding post-graduate training to include NP residency and fellowship programs. These programs may focus on a particular specialty, or offer further training in the broad field of primary care. These programs offer support for new NPs in developing assertiveness, long-term patient planning, and critical thinking skills. According to JoAnne Saxe from the UCSF School of Nursing, "The community setting is demanding – even for those who are excellently prepared. The extra in-the-trenches learning of a residency not only solidifies skills, but also acts as a testing ground for future work experience."

Focus Your Skills With Specialty Training

Nurse practitioners are employed in nearly every medical specialty. Specialty training is critical for success in these focused fields. Specialty training may include:

  • On-the job training
  • Course work for specialty certifications
  • Conference training sessions

Many healthcare facilities and clinics offer specialty training after employment begins. This is a simple way to obtain extra training and gain invaluable experience while working as an independent provider. Attending specialty professional conferences that offer clinical training sessions is another skill-building technique. These hands-on training sessions are particularly effective for NPs moving into fields such as dermatology, cardiology, neurology, or orthopedics. Attending conferences is also beneficial for building a network of colleagues. Maintaining collaborative relationships with other providers both locally and remotely is a great confidence builder. Specialty professional organizations, such as the Orthopedic Nurses Certification Board or Dermatology Nurse Practitioner Certification Board, also offer coursework for certifications in these fields. Reviewing test-prep materials and educational resources for specialty certifications offer a deep understanding of current evaluations, diagnoses, and treatments for NPs who are motivated to pursue specialty practices.

Collaborate With a Mentor

As noted in a 2018 review in The Clinical Teacher, "the practice of mentorship may help to foster an understanding of the enduring elements of practice within these organizations. Mentoring involves both a coaching and an educational role, requiring a generosity of time, empathy, a willingness to share knowledge and skills, and an enthusiasm for teaching and the success of others. Being mentored is believed to have an important influence on personal development, career guidance and career choice."

Finding a mentor may be your most important task as a new grad NP. A good mentor is invaluable in any career setting, but it's particularly essential in the healthcare field. In addition to helping build confidence and skills among new grad NPs, mentors also offer the moral and emotional support that's critical to practitioners' success in today's demanding environment. A mentor-mentee relationship does not end when you become a seasoned practitioner. Mentorship is an important part of a career-long support chain that will eventually lead to you serving as a mentor. Healthcare providers must hold each other up, challenge each other to provide the best patient care possible, and protect each other during challenges to effectively maintain a passionate and progressive standard of care. A mentor may be:

  • An experienced physician in your clinic
  • An experienced NP in your clinic
  • Another new grad NP
  • A clinical professor
  • A previous clinic preceptor

As long as a colleague supports your ongoing learning, offers helpful and timely advice, and lends an open ear for any challenges you may have, you can consider them a mentor.

Get Comfortable With a Learning Mindset

Scientific studies, evidence-based practice guidelines, and treatment updates are constantly evolving. Therefore, it is critical to find resources that support your ongoing learning. Having a go-to toolbox is helpful for day-to-day learning during clinical practice. Programs such as UpToDate, 5-Minute Consult, and National Clinician and Consultation Center offer quick, concise, evidence-based guidelines for treating a wide variety of conditions. Finding a program that works for you is key. A pharmaceutical reference such as Epocrates, Physicians' Desk Reference, or Lexicomp is also useful for safely prescribing medications. Specialty organizations and the USPSTF offer convenient access to the guidelines for a variety of common health treatments and screening procedures. Additionally, learning continues outside of clinical practice. The variety of online and in-person CME products and online and print professional journals allows NPs to choose the format and topics they wish to study.

RELATED: What I Wish I Had Known as a New NP

Ultimately, succeeding as a new grad NP requires a growth mindset of constantly gaining knowledge and adapting. Whether we are calling on a colleague, reading a journal article, or completing a hands-on clinical session, we are never done learning.

Is Full Practice Authority Here to Stay? How COVID-19 is Advancing the Future of Nurse Practitioner Practice

In 2011, the Robert Wood Johnson Foundation Initiative on the Future of Nursing released The Future of Nursing: Leading Change, Advancing Health. This compelling report called for the "transformation" of health care delivery by allowing nurses – especially APRNs – to "practice to the full extent of their education and training" as an opportunity to address the challenges involved in primary care and our healthcare system. Nearly 10 years later and amid a global pandemic, we are seeing some of the fruition of this report come to life. With concerns regarding obtaining access to care in rural populations, creating equitable systems for racial and ethnic minorities, and maintaining care for an aging population, our profession and society is facing a sudden shift to address the drastic impact that COVID-19 has created.

Varying Guidelines on Nurse Practitioner Full Practice Authority

Although there is growing evidence linking nurse practitioners to higher quality of care and safety for patients, shortages of care remains a long-standing discussion in healthcare – particularly for APRNs. Additionally, varying guidelines on nurse practitioner full practice authority continues to be an ongoing conversation. In fact, it's often a "regulatory barrier" for the profession and our ability to deliver care at our highest abilities for the communities we serve. This is primarily due to the fact that our licensure has been heavily regulated on the state level, as opposed to a federal level. This legislative regulation often makes it difficult to consistently ensure that nurse practitioners are able to deliver care without the challenge of legal and geographical boundaries that can leave some states far more restrictive in practice than others. While small advances have occurred over the years, they have been slow-coming up until now.

NP Practice Authority During a State of Emergency

Since the onset of COVID-19, we have seen an immediate shift in the various legislative barriers and regulatory practices that have served as a major obstacle for nurse practitioners. Governing bodies, both within the healthcare industry and on a national level, have also embraced the urgent need to reevaluate the traditional restrictions that have been in place since the profession began in the 1960s. One visible shift in this understanding has been made public in an evolving statement from the American Association of Nurse Practitioners, which details the various ongoing changes occurring on a policy level to temporarily suspend and waive practice agreement requirements. These waivers have been the solution to the growing need for competent health care providers to address the exponential necessity of access to care. This refers to cases that relate to the global pandemic of COVID-19, as well as primary care and population health needs that have been present all along. In the midst of social distancing guidelines and state lockdowns, one major tool that has helped drive this accessibility is telehealth. 

The Rise and Impact of Telehealth on NP Practice

The presence of telehealth, or telemedicine, is not a new topic or concept. However, with the rise of technological innovations and societal changes that have occurred due to the global pandemic, the conversation surrounding telehealth has become the topic of our times. According to a 2018 article, Telehealth and Legal Implications for Nurse Practitioners, the most basic definition of telehealth is the "use of…telecommunication technologies to support and promote long distance…health care." The article further explains that telehealth's original goal was to meet the needs of underserved and rural patients. However, much like what has been seen in traditional primary care practices, there are regulatory barriers to telehealth as well. Requirements have often varied from state to state, which has ultimately led to confusion for NPs involved in the practice. Regardless of these obstacles, we have recently seen a drastic transformation in the extended permission of this valuable and urgently necessary tool for the practice of all healthcare providers. This change has truly represented a shift toward practice transformation, as hoped for in the 2011 Future of Nursing Report.

Approaching NP Practice in a Post-Pandemic Society

The major question on everyone's minds is, what's next? How do we approach NP practice in a post-pandemic society, assuming how quickly our trajectory changes? Even more importantly, how do we adequately equip future and new-to-practice nurse practitioners to be well-prepared to handle shifting policies, requirements, and ongoing credentialing needs? The need to implement unique ways to fulfill clinical requirements is now more important than ever. On a positive note, with the ongoing need for social distancing guidelines, future nurse practitioners are being strategically prepared to thrive in telehealth and technology-heavy health care systems. Nurse practitioner students, faculty, and (most importantly) policy-makers must continue to consider all of the possibilities in this "new normal." So, is full practice authority here to stay? If we truly hope to see a transformation in practice, we must aim to follow the pivotal 2011 report: be the future of nursing by leading change and advancing healthcare.