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What to Ask When Shadowing a Nurse Practitioner

During nurse practitioner school, NP students have to complete several hundred clinical hours. Depending on their specialty, they will shadow and learn from experienced NPs in the clinical setting. Sometimes, NP students can feel lost and overwhelmed during their initial clinical rotations. To make the most of a preceptorship, NP students should be prepared with questions to ask their preceptor.

Students can learn the most from a professional NP by being prepared with a list of questions to ask during their shadowing experience. Asking questions will show the NP that the student is inquisitive and willing to learn. It also demonstrates that the student is dedicated to their future profession and excited to discover more. By asking questions, students can further understand the role of an NP, along with the opportunities and obstacles that NPs face.

Students need to be curious when shadowing NPs during their clinical rotations. They can learn to make clinical decisions and provide patient-centered, safe care. They can learn how to transition information taught in class into a practice environment. They can understand how to navigate complex patients and challenging decision-making. Shadowing can also facilitate building relationships and a professional network with mentors and peers.

Below are the top 15 questions to ask when shadowing an NP.

1. What motivated you to become a nurse practitioner?

This is a great way to break the ice and learn more about the NP both personally and professionally. The student can learn about various backgrounds that may have led to pursuing a career as an advanced practice nurse.

The NP’s answers can help the student contemplate their own options and decide on a specialty or ideal workplace setting as an NP. It can also offer insight into what creates a successful NP. For instance, perhaps the NP wanted more autonomy and the ability to open their open practice.

2. What does a typical day look like for you?

This question will give students insight into what an NP’s responsibilities and workload can be. It will allow student NPs to understand the scope of practice of NPs and navigate practice-related challenges. NPs can discuss the number of patients they see per day and when they can finish charting on each patient.

They may have administrative time, which allows them to catch up on patient messages, lab and imaging results, and medication refill requests. Some NPs work between the clinic and hospital setting and have to travel and split their time in multiple locations. Students can learn the importance of time management by asking this question.

3. Can you explain your scope of practice and the types of patients you typically see?

Each state defines a nurse practitioner’s scope of practice differently. By having an NP explain how they practice and what duties are under their scope, students will better understand what NPs do. NPs see a variety of clinical cases unless they choose to specialize. By clarifying the most common disorders seen in practice, students can refer to their textbooks and notes to focus on learning about these illnesses. They can identify what they study in their didactic courses that would be relevant in the clinical field. This includes the most common prescribed medications and labs or imaging ordered.

NPs may see urgent visits for acute illnesses like colds or urinary tract infections. NPs may see patients for their annual wellness exam or well-child visit. They will also see routine follow-ups for patients with chronic disorders that need routine care, such as hypertension, chronic obstructive pulmonary disease, and diabetes. NPs will see patients for ER or hospital discharge follow-ups to ensure they are feeling better and tie up loose ends after leaving the hospital.

4. How do you collaborate with other healthcare professionals?

One of the main responsibilities of NPs is collaborating with other healthcare professionals. NPs may consult with physicians at their practice or specialists caring for their patients. They will collaborate with social workers and behavioral health specialists to ensure patients have the necessary resources. They discuss cases with case managers and nurses to monitor patients’ progress.

They also work with physical and occupational therapists to help their patients. By asking this question, students can learn how to communicate with other healthcare professionals and manage patients in an interdisciplinary team.

5. How do you approach decision-making and patient care?

Students may be overwhelmed by the medical knowledge and the complexity of a patient’s health. Asking this question helps students narrow down a plan that is ultimately right for the patient. NPs focus on the patient and provide holistic care when managing diseases. Many NPs offer the patient treatment options, allowing them to choose what they want. Some patients with a history of non-compliance may need more direct and stern coaching. Students can learn that it is vital to collaborate with patients to manage their disease and improve overall patient outcomes.

6. How do you stay current with clinical research and best practices?

NPs should stay up to date on evidence-based practice. This means that the care they provide and their clinical decisions are informed by research. Medical guidelines are constantly changing, so it is important for an NP to remain knowledgeable. NPs can explain that they attend conferences and constantly complete continuing education courses.

Many NPs use a medical reference program called UpToDate, which allows them to search for illness and treatment guidelines. This includes guidance in diagnosing and common symptomology. Students can use these resources when they become an NP.

7. What is your process for diagnosing a patient?

This question allows students to learn how NPs formulate a diagnosis. The NP can explain that gathering a thorough history is the most important first step. Then the NP performs a physical exam. Based on the data they collected, they can narrow the patient’s illness down to several differential diagnoses. One diagnosis can be selected depending on the data, but if there are still many possibilities, the NP can order further testing to reach a conclusion.

8. How do you manage complex patients?

Listening to how an NP navigates complex cases can show students how to prioritize patient problems and use an interdisciplinary approach to care. NPs can provide a patient case study, in which students can learn how the NP applied clinical and critical thinking skills, along with problem-solving techniques.

NPs should discuss things they would have done differently. This shows students how to reflect on their experiences and learn from them. Students will learn that complex patients are monitored closely and it is best to avoid making too many changes in their treatment plan at once.

9. What are some challenges you face as an NP, and how do you overcome them?

A novice NP is unaware of the challenges of working as an NP. By asking this question, students can learn about struggles they should be prepared for. Some challenges can include needing more time to spend with each patient; having to spend a lot of time documenting or doing administrative tasks; not being respected by physicians or patients; non-compliant patients; and complex patients.

NPs may explain that the first year working as an NP can be tough, but the more they practice, the more efficient they become. They also become more confident in their skills and decision-making, allowing them to care better for their patients. By being a good practitioner, they will eventually gain the trust of patients and physician peers.

10. What advice would you give someone starting a new career as an NP?

Student NPs should ask this question to be prepared when starting their new role. They can ascertain that their first year practicing as an NP can be difficult and challenging. NPs would recommend that new NPs study during their off-hours and be prepared to ask experienced providers tons of questions. Novice NPs should try to find a mentor who can help guide them. Experienced NPs can help novice NPs navigate through imposter syndrome as they transition from being an RN to NP.

11. How did your clinical rotations prepare you for your role as an NP?

Going through clinical rotations can be intimidating for students. However, many NPs wish they had taken better advantage of that time. Instead of being too shy to see patients, they should have jumped in, knowing that their preceptor’s expectations were low and that they could have learned from the experience.

Students should try to be more proactive during their rotations. They should be comfortable gathering patients’ histories, performing physical exams, and developing differential diagnoses. They should transition into being more autonomous while progressing through each clinical rotation.

12. How do you maintain a work-life balance and avoid burnout?

Working in healthcare can be stressful. It is important for NPs to learn how to manage their careers and personal lives. Students can ask NPs this question to provide guidance. They can gather that they should try not to take work home. They should learn to be efficient so they are able to catch up in their schedule. They should be physically active and practice mindfulness to help manage stress. NPs should use their paid time off to take vacations instead of feeling guilty about being unable to work.

13. What do you find most rewarding about being an NP?

When starting a new career, student NPs want to feel inspired and content with choosing the right profession. NPs can identify that helping others and watching their patients’ progress can be very rewarding. They may enjoy the fact that they are constantly learning and teaching others. Being an NP allows for continued growth and opportunities. NPs can transition from one specialty to another and from the clinical setting to academics or research.

14. How has the NP profession changed since you started practicing?

Experienced NPs can explain how the NP profession has evolved over the last several years. Perhaps their state changed from being a restricted state practice to an autonomous state practice for NPs. This meant they originally needed a supervising physician to practice, but now they can practice independently. Laws have evolved so NPs are now able to order home health for their patients or controlled substances as needed. Also, more patients are becoming more familiar with what a nurse practitioner does so there is less stigma.

15. What are some opportunities for advancement for NPs?

Students can discover various opportunities as NPs that can lead to growth. Some practices allow the NP to work towards becoming a partner or increase their salary based on revenue and productivity. NPs have the option to open their own practice once they have gained enough experience. Some institutions enlist NPs to work in executive roles, such as nursing directors or advanced practice educators.

Sophia Khawly, MSN

Writer

Sophia Khawly is a traveling nurse practitioner from Miami, Florida. She has been a nurse for 14 years and has worked in nine different states. She likes to travel in her spare time and has visited over 40 countries.

Being a traveling nurse practitioner allows her to combine her love of learning, travel, and serving others. Learn more about Sophia at www.travelingNP.com.