As a new graduate:


The euphoria of graduation is often tempered by the tenuousness of the job search and the inevitable assumption of the responsibilities inherent in a new position. As tiresome as the student role may have become, the days of supervised clinical rotations and faculty coordination of the educational process are soon replaced by the demands of clinical practice. These demands must now be negotiated independently by the APN, albeit, new graduate. It is an ambivalent time, consisting of equal parts excitement and anxiety.

The new graduate must demonstrate an appropriate level of competence while establishing a structure that allows for collaboration, consultation and continued professional growth. All actions are conducted within a framework that assures safe, quality care for patients.

Success in your first year of employment will be positively influenced by establishing clear, concise expectations regarding your time and effort. Delineation of expectations should occur during the negotiating process and should be clearly articulated and agreed upon by all those affected. This may include but is not restricted to:

  • Support staff
  • Other APN peers
  • Physician colleagues
  • Administrators
Investment in a formal orientation program by both you and your employer will enhance satisfaction for all involved parties. As you become comfortable with your role and familiar with the organization, appropriate adjustments can be made to schedules. T he orientation period facilitates a process which is conducive to job satisfaction and professional growth.

Suggestions for establishing an orientation program include:

  • Negotiating a defined time period for orientation - recommended period of 6-12 months

  • Establishing scheduled reviews and evaluations with appropriate administrators during this time - recommended every 3 months

  • Creating a template for your clinic schedule, to minimally include the following:

Visit type

Time allotment
Complicated (examples): Routine (examples): By age (examples): By visit type (examples):
abdominal pain in a female of childbearing age preventive health exams 40 years and older: 45 min. appointments routine acute: 20 min.
complicated acute: 45 min.
new onset headache in a 60 year-old follow up of stable chronic illness less than 40 years: 20 min. appointments preventive health exams: by age


  • Designating a collaborating physician and establishing regularly scheduled meetings - recommended every 1-2 weeks in the first 4-8 weeks of employment, then decrease frequency as indicated

  • Designating an APN mentor and establishing regularly scheduled meetings - recommended every 1-2 weeks in the first 4-8 weeks of employment, then decrease frequency as indicated

  • Determining need for additional skills and establish mechanism for skill acquirement - often dictated by type of practice (e.g., suturing in an urgent care clinic)
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