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Gradvanced Practice: It’s a thing!

Gradvanced Practice: It’s a thing!

What am I talking about? Need some cold hard proof? Ask any nurse who has completed grad school and is an NP to take you down Memory Lane and you’ll hear some degree of “It was rough.”


What is it? Gradvanced practice is that pivotal time period when a nurse transitions from RN to NP. It’s a culmination of emotions and experiences to include — excitement, fear, doubt, accomplishment, confidence, exhaustion, adventure, and overwhelm to name a few. Imposter syndrome and the internal saboteur surfaces at critical times. But running parallel is a growth mindset and opportunities waiting to be nourished.


I believe that new grad NPs go through stages of gradvanced practice. The key components are as follows:

  1. Recognition of transition. Gradvanced practice is less of a barrier and more of a shift as nurses move from one point to another. An evolution if you will. Be mindful that good things take time to develop. Setting reasonable goals and expectations from the start sets you up for success.

  2. Role acquisition. Landing that ideal job that works for you also takes time. It takes patience and a well-designed plan to receive an offer that is mutually beneficial for both you and the organization. Oftentimes we succumb to accepting any position, usually against better judgment and mostly out of fear, only to suffer burnout soon after starting the job.

  3. Responsibility adaptation. The role and responsibility as a provider is vastly different from that of a registered nurse. As a new graduate nurse practitioner, you may be starting in a new speciality or service. Creating routines, setting priorities, and maintaining boundaries are critically important factors in this stage. They build a strong framework that leads to successful transition.

  4. Reformation celebration. The sweet spot of competence and confidence! By no means have you arrived, I mean, do we ever? But here, you’re comfortable in your advanced practice role. You’ll continue to evaluate and refine your processes, but this is a good place to be. You’re flexing your NP muscles and are able to accurately diagnose, evaluate, treat, and manage patients’ medical care. And, hopefully you’re enjoying this new stage that deserves to be celebrated.


Moving from one stage to another is better achieved with the right systems and processes in place. Mentorship should top the list. Whether formal or informal, being coached through the transition is such an invaluable resource for NPs and should be a non-negotiable aspect of transitioning into advanced practice. Mentees, especially within nursing, should find no shame in relying on experienced providers who have walked that road, carried those burdens and want to make your new NP life easier for you.

So yes, go out there and start your NP career. Make a difference. Make an impact. Live your life’s work. Fulfill your purpose. But also know, you don’t have to do it alone.

About the Author

Josie Tate is a successful nurse practitioner, visionary nurse leader, and inspirational career mentor. She is the creator of Clincepts, a professional development resource that helps bridge the gap for nurses transitioning into advanced practice.

Nurse practitioners across the industry get and stay happily hired using strategies from Josie’s proven framework. At its core, Clincepts empowers and equips nurse practitioners to stand out, shine bright, and speak up as the best candidates for the job.

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