This is a rather broad question.  Although I have only been a nurse practitioner for less than a year, I think that it’s not as hard as I thought it would be.  The one thing that I do find is that I second guess myself constantly.  Even after I calculate a pediatric dosage twice and get the same number, I am finding myself calculating it again after the patient has left.  I hope that this will get better once I have done it for a while and become more familiar with it all.

Another thing that is surprising to me is that I am feeling guilty taking payment.  I think because I have been on the other side of the fence and know how much it costs, especially for cash patients or patients with deductible plans.  They pay an outrageous amount of money and take a day off of work only for me to tell them that they have a virus and need rest, fluids and symptom management which simply consists of over the counter medications.  Patients frequently feel that they have not “gotten their money’s worth” if they do not walk out with a prescription.  This has been a rather difficult issue to deal with.  I mean,  they can either do what I said above and get better in 7-10 days or take an antibiotic and get better in 7-10 days.  Same result either way, and risk of resistance if using an unnecessary antibiotic! This is actually much easier do deal with in adult patients versus pediatric patients with parents who insist on getting a prescription. 

So, back to the question:  Is it hard to be an NP?  I think some areas of it are and they’re probably different among different people.  I think that the hardest piece I’ve run into by far is selling “It’s a virus and you don’t need an antibiotic” .  So, for those of you getting out of school, work on your sales pitch ahead of time.  It will save you a lot of time later.