Nurse practitioners are among the most essential, and most underrecognized, providers in modern healthcare. They diagnose, treat, prescribe, and advocate. They carry the weight of clinical decisions and still find ways to show up with compassion, shift after shift, for patients in some of the most vulnerable moments of their lives.
In honor of National Nurses Month, we asked three NPs from the Sketchy community to share their stories: what drew them to nursing, what keeps them going, and what they'd tell every NP student heading into clinicals. Their answers remind us why this work matters.
What does it mean to be a nurse practitioner?
Being a nurse practitioner means more than holding an advanced practice credential. It means combining clinical knowledge with the nursing foundation of listening, advocating, and caring for the whole person.
As Olivia, FNP, puts it: "Being an NP means standing at the intersection of science and compassion, carrying the weight of clinical decisions while remaining deeply present, listening, guiding, and showing up for patients in both the big moments and the small ones."
For Bryanna, an NP and nursing educator: "Being an NP means answering a calling. It means walking with patients and families through uncertainty, helping them understand their options, and advocating for care that honors their needs, goals, and dignity."
And for Christine, whose path to nursing started in public policy: "Being an NP means the privilege of directly impacting patients' lives and the opportunity for lifelong learning."
How do nurses know they're in the right career?
Sometimes it's a single moment. More often, it's a constellation of them.
Olivia's story starts in 8th grade, when she lost her best friend Peter to rhabdomyosarcoma. Before he passed, he told her he thought she'd make a good nurse. She applied to nursing school on a whim and never looked back.
"My career is not, and will never be, defined by one instrumental moment," she says. "It is shaped by the meaningful moments in each patient interaction that remind me I am exactly where I am meant to be."
One of those moments happened at 3:30 a.m. in a COVID ICU, the Wednesday before Thanksgiving. Her patient was anxious, alone, afraid of being intubated, and wide awake when Olivia walked in. She sat on the bed, fully gowned and masked, and held her hands. Together, they said: "Today is going to be a good day."
The patient was intubated the next day. She later lost her fight with COVID. But Olivia has never forgotten her.
"She reminded me why I became a nurse: to carry the weight of others' pain and suffering when they no longer have the strength to carry it on their own."
Bryanna found her clarity in oncology and palliative care. Months after supporting a patient and family through end-of-life decisions, a family member tracked her down just to say how much that care had meant to them.
"That moment has stayed with me because it shows that nursing is not always about fixing or curing. Sometimes, nursing is about being present, relieving suffering, honoring dignity, and helping patients and families experience peace in an incredibly vulnerable season."
Christine describes her motivation differently: not a single moment, but a steady accumulation. "A constellation of moments focused around supporting patients and those who love them in navigating complex and serious illnesses." Understanding who patients are outside their diagnosis. Learning what matters to them. Making sure their care reflects it.
What's the hardest part of becoming a nurse practitioner?
For many NPs, the transition has little to do with clinical knowledge. It's about learning to trust your own judgment.
"The most difficult part was stepping into the responsibility of decision-making," Olivia explains. "Instead of carrying out orders and advocating for my patients within an established plan, I became the one creating that plan: placing orders, making diagnoses, and guiding care."
Bryanna felt it too. "Stepping into the NP role meant carrying a different level of responsibility for assessment, diagnosis, treatment planning, and follow-up. That shift can feel heavy at first, especially when you care deeply about making the right decision for your patients."
Her advice: "Confidence does not come all at once. It develops through preparation, practice, humility, and continued learning. I leaned on mentors, asked questions, looked things up often, and gave myself permission to keep growing."
Christine recommends seeking out positions with role clarity and structured onboarding. "Ideally this includes more in-depth and role-specific clinical teaching, guidance in navigating practical aspects of the role, and dedicated mentorship in the multifaceted aspects of evolving to be an independent provider."
What do NP students wish they'd learned in school?
We asked each NP what they wish they'd had more of during training. Their answers point to gaps a lot of NP students feel but rarely say out loud.
Olivia: Sleep. (And an in-home McDonald's fountain Diet Coke dispenser. Her words.)
Christine: Serious illness communication skills training. "Formal instruction in communication skills remains an area in which there is comparatively less dedicated time and curricular content. Trainees can benefit from dedicated didactic content and simulated experiences with incorporated feedback."
Bryanna: More direct instruction on approaching differential diagnoses, and more on the business side of practice. "Coding, billing, documentation, and RVUs affect daily practice, productivity expectations, and reimbursement, but they are often not emphasized enough in school."
What advice would NPs give students starting clinicals?
If you're heading into clinicals, these three have been exactly where you are.
Olivia: "Lean into discomfort. You're going to feel unsure, slow, and sometimes overwhelmed. That's not a sign you're failing; it's a sign you're growing. Remember why you're here. You're not just learning to diagnose and treat. You're learning how to show up for people in some of the most vulnerable moments of their lives."
Bryanna: "Walk in prepared, humble, and ready to learn. You are not expected to know everything on day one. Pay attention to how your preceptor thinks through the visit. Keep a running list of 'I need to understand this better' moments. Confidence grows over time; I promise you, you will get there."
Christine: "Be curious. Clinical competence and efficiency come in time and with clinical exposure and practice. Observe other providers' approaches to assessment, management, and communication, and consider incorporating elements into your own practice that resonate with you."
FAQ: Nurse practitioner career & NP school
What is a nurse practitioner? A nurse practitioner (NP) is an advanced practice registered nurse (APRN) with graduate-level clinical training who can diagnose conditions, prescribe medications, and manage patient care independently or collaboratively with physicians. NPs bring the clinical scope of medicine together with the patient-centered approach of nursing.
What is the hardest part of transitioning from RN to NP? Most NPs point to the shift in decision-making responsibility. As a nurse, you advocate within an existing care plan. As an NP, you create the plan, including orders, diagnoses, and treatment. Building clinical confidence takes time, mentorship, and repeated patient encounters.
What should NP students focus on during clinicals? Active observation, curiosity, and building a habit of looking things up after each encounter. Reviewing common conditions before each clinical day, paying attention to how preceptors reason through differentials, and asking thoughtful questions are the strategies most consistently cited by practicing NPs.
What do nurse practitioners wish they'd learned in NP school? Common gaps include serious illness communication skills, differential diagnosis reasoning, and the business side of practice: coding, billing, documentation, and RVU expectations.
How long does it take to feel confident as a new NP? Confidence builds gradually through clinical exposure, mentorship, and continued learning. Most NPs say the first one to two years in practice are the steepest part of the learning curve, and that structured onboarding with dedicated mentorship makes a significant difference.
