Flying Solo

I've been a practicing nurse practitioner for a year now, and am finally feeling more confident in my abilities to practice independently. My first job out of school was working in an emergency room, where I was surrounded by seasoned EM doctors, physician assistants, and nurse practitioners I had to reference when I encountered an unfamiliar situation. Although my time in this practice setting was short-lived, the mentorship I received was invaluable. The mentors I had were overwhelmingly helpful in giving me guidance with procedures, x-ray interpretation, and in general when I was second-guessing my plan or diagnoses. When I decided to leave the acute care setting for urgent care and primary care, one of my fears was that I would not have all the resources available to me as I did working in the emergency room. In the emergency room I would be able to consult with any number of providers, and had the quick turn-around time for labs and other imaging tests to rule out many life-threatening conditions. I feared my assessment skills would not be strong enough without all of these tools at my disposal in an outpatient setting. I was also afraid of being the only provider in a clinic, and being faced with a situation I didn't know how to handle. Of course I am faced with situations every day I haven't encountered. That is what I love about my job is that I am always learning. Medicine is not a static field by any means. Knowing where to find the information is the key, which I have written about here. I don't need to have someone holding my hand anymore; I trust my instincts and assessment skills. This week was a testament to this feeling of self-assurance in my practice. I currently work with a physician in a private practice, and although this physician is available most days in the clinic, I am the sole provider several days a week. This week he went on a long-overdue week-long vacation, leaving myself as the only provider the whole week. Being the go-to person for all the patient calls and follow-ups was overwhelming. There were a few urgent situations I had to refer to ER, simply because I didn't have the resources available to me at the clinic to safely manage these patients. The others I was able to handle and follow up on my own. I'm lucky to work with a physician who treats me as a collaborating colleague, rather than an inferior. He trusts me to make judgement calls and to refer or consult when I am out of my scope of practice or knowledge. I would never make the mistake of thinking "I know it all" or be afraid to ask questions, but I feel I no longer have the feelings of self-doubt holding me back either.
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