Written By: Lauren Jacobson MS, RN, WHNP-BC
In nurse practitioner school you will hear a lot of talk about “skills.” You will be provided certain training, perhaps even advised to make a list of the skills you have acquired during your clinical rotations. What is all this emphasis on “skills” really getting at though? Nurse practitioner skills encompass a lot more than just the clinical skills you learn in school. Some skills needed to become a nurse practitioner cannot necessarily be learned or taught. They are more inherent personality traits that enable you to connect with and read patients. On the other hand, there are many nurse practitioner skills that you will learn theoretically in school and then practice and develop later when you are working as an NP.
So, what are the top nurse practitioner skills? The skills required for a nurse practitioner are diverse and encompass everything from time management to be able to order and interpret diagnostic tests. Regardless of what level your skills are at, this list of 29 top nurse practitioner skills you’ll need to succeed in 2022 is designed to help you prepare for the career of your dreams.
What Are The Different Types Of Nurse Practitioner Skills?
Skills you will need to be a successful nurse practitioner in 2022 include both hard and soft skills.
Hard Nurse Practitioner Skills:
Hard skills are things like clinical skills such as procedures, giving injections, or conducting a physical exam. These are often learned in school and on the job and require some amount of specific training.
Soft Nurse Practitioner Skills:
Soft skills such as interpersonal skills, creating a calming environment, and conflict resolution are soft skills. There may be some amount of training or learning with these skills such as having a lecture on building patient-provider relationships, but soft skills are a bit more inherent and not specific to being a nurse practitioner. You may have learned them in a past job or in your day-to-day life and they may come in handy in your career as a nurse practitioner.
The intersection of Hard and Soft Skills:
Hard skills and soft skills can also intersect. For example, you may need to do a procedure like a biopsy on a patient. This is a skill that you had specific training on in school; however, your patient is extremely nervous. Your interpersonal skills and ability to create a calming environment for the patient can help make the biopsy process much easier for both of you. Afterall, you need the patient to be on board with your medical plan and if they are resistant, it may not matter how good your biopsy skills are. Hard skills and soft skills are acquired in different ways but will both be equally important in your career as a nurse practitioner.
10 Reasons Why Nurse Practitioners Need To Develop A Great Skillset?
The following are 10 reasons why you should develop a great skillset. You will see all of these reflected in the nurse practitioner skills checklist below.
1.To work efficiently
2.To provide high-quality patient care
3.To work effectively as a part of a team
4.To maintain a work-life balance
5.To keep patient’s safe
6.To build trusting relationships
7.To stay up to date with changing clinical practice
8.To advocate for patients
9.To advance your career
10.To empower your patients
WHAT ARE THE TOP NURSE PRACTITIONER SKILLS YOU'LL NEED TO SUCCEED IN 2022?
(The following is a checklist of 29 top skills that every nurse practitioner must have to be successful in 2022.)
1.Time management
What is it:
24 hours a day. That’s all you get to eat, sleep, work, relax, enjoy life, use the bathroom, commute, and more. Time management is the skill of organizing and prioritizing your daily activities so that you can get the most out of your day. As an NP this means making use of every minute during the workday. When your patient is changing, now is the time to use the bathroom so that you can work on your clinical notes in between patients.
Why is this Skill Required for an NP:
Time management is one of the top nurse practitioner skills. Depending on the clinical setting you work in, you may have only 15 minutes to see a patient and when you come out of the exam room you may have to move on to the next patient immediately. If you don’t want to be staying late every day you will need to make the most of your time. Time management is also essential so that your patients are not waiting too long for you to see them as this can affect their impression of you. Once mastered, this skill is an easy way to minimize stress, get enough sleep, and have an overall healthy lifestyle. This will only improve the quality of care you provide and the enjoyment you get out of your work.
How to Develop this skill:
Time management looks different for everyone. We all have our own style. You will develop yours as you work but it’s essential that you manage your time effectively so that you can get the most out of your career and your free time. It’s a good idea to start your first NP job with inputs from more experienced NPs on how they successfully manage their time. Additionally, many of the other skills on this nurse practitioner skills checklist will help you improve your time management skills!
2.Flexibility
What is it:
Flexibility is the ability to adapt quickly to a changing and/or unpredictable situation.
Why is this Skill Required for an NP:
Clinical work is not always predictable and requires flexible nurse practitioners. Flexibility is one of the essential nurse practitioner skills because it enables you to think quickly on your feet, provide high-quality care, and make the most of your time. Sure, there are certain clinical scenarios or patients that as you gain experience you may be able to predict what will happen based on their signs and symptoms; however, this is not always the case. Additionally, sometimes life gets in the way. Maybe your coworker has an emergency, and you have to pick up half their patients for the day. Maybe the power in the neighborhood goes out and you have a patient who needs to be seen. This happened where I used to work, and I went in with the physician and held the flashlight while she did the gynecologic exam.
How to Develop this skill:
This starts with having solid core skills such as history taking, physical assessment skills, and communication. Having a solid foundation gives you more room to adapt to the moment. Being open to change from the start means that you will be better able to be flexible when the moment arises. For me, the best thing to help with flexibility has been having an open mind.
3.History Taking
What is it:
Being able to take a good medical history is the backbone of providing effective patient-centered medical care. This is the information-gathering part of a clinical visit or phone call where you interview a patient about their medical history and current issues.
Why is this Skill Required for an NP:
The more detailed, the better as sometimes a good medical history
can provide much more than a physical assessment. This is also where you get to know your patient. It is an essential part of the patient-provider relationship-building process. Taking a patient’s medical history is a nurse practitioner skill that you cannot do without. It doesn’t matter how good your physical assessment skills are, if you cannot collect detailed information on a patient’s past, their family history, and their current complaints and medications you may not diagnose them appropriately and you may miss clinical signs that are important to their overall health. Rushing through the history taking also limits the time you have to connect with a patient before doing their physical exam, making this one of the skills of a nurse practitioner that cannot be skimped out on.
How to Develop this skill:
If you’re a new nurse practitioner, this is a very easy skill to practice. You can do mock medical interviews with your friends, family, and colleagues. I found this very helpful. Remember, your friends and family have all been patients before, so if they are up for it they are a great practice tool! I would even ask my friends and family how I presented to them. Did I make them uncomfortable? Did I seem unsure of myself? What should I do differently? Your school will of course train you in this, but don’t hesitate to ask for more practice with your professors. They’ll be skilled at mimicking certain conditions that may require a detailed medical history for you to discover them.
4.Electronic Medical Records
What is it:
Gone are the days of paper charting. Well, mostly. There are various electronic medical record (EMR) systems for patient charts that you will use as an NP and being able to navigate these systems is one of the in-demand nurse practitioner skills. This will contain patient demographics, medical history, current medications, clinical notes, diagnostic test results, vital signs, and more. You may also order tests and prescribe medications through this system. Some examples of EMR systems include Epic, Athena Health, and Cerner PowerChart Ambulatory.
Why is this Skill Required for an NP:
Not only will EMR system familiarity save you time, it will ensure that you can get the full picture of your patient and document efficiently. Knowing where to look for information will also alert you if something has been missed, for example like vital signs or a prescription. Different clinics may use different systems. If you are familiar with one or more systems, it may be a good idea to put it on your CV or motivation letter so that you can show potential employers that you have this nurse practitioner skill.
How to Develop this skill:
As a student, pay attention to the EMR systems used at your clinical sites. Ask your preceptors if you can practice charting using the system so you can start building this NP skill. During your interview, ask what EMR system they use. Then go home and research it. When you start a new job, it may behoove you to stay a bit late the first few days so that you have time to poke around in the system and familiarize yourself.
5.Telemedicine
What is it:
Telemedicine is when clinicians deliver health care from a distance using technology to interface with, assess, and diagnose a patient. This can include a phone call, video call, the use of photos, and documentation with secure online platforms designed for this purpose.
Why is this Skill Required for an NP:
Health care is evolving and so are nurse practitioner skills. Telemedicine has exploded with the COVID-19 pandemic making it one of the latest in-demand nurse practitioner skills. More providers than ever before are using telemedicine to provide care for their patients who do not need to be seen in person. Being able to provide this service to your patients is likely going to be a part of your job as a nurse practitioner, particularly if you work in an outpatient clinic.
How to Develop this skill:
The only way to master this NP skill is through practice at your job, but you can research it beforehand so that you are familiar. However, being skilled in medical history taking is a huge part of telemedicine. Being able to gather detailed information on your patient can help you deliver care more effectively through telemedicine.
6.Clinical Documentation
What is it:
This is the process of documenting your patient’s medical history, vital signs, current complaints, medical treatment, and more.
Why is this Skill Required for an NP:
One of the most important NP skills you will learn is clinical documentation. This includes clinical note-writing which documents the details of your visits with patients. This is not only a guide and organizational tool for you during your process of assessing, diagnosing, and treating your patient, but it is also documentation of your clinical decision making so that other clinicians and (including yourself in the future) and insurance companies can see how you got to a diagnosis and treatment plan. These clinical notes are often written in the form of a SOAP (subjective, objective, assessment, plan) form.
How to Develop this skill:
Like history taking this can be practiced in mock scenarios with classmates and professors prior to getting your first NP job. If you are already employed and want to improve this nurse practitioner skill you can ask your experienced colleagues to look at some of your notes and provide feedback and suggestions. You can also look at some of their notes and see where you can improve.
7.Conflict Resolution and Mediation
What is it:
This is the process of reaching an agreement when two people disagree or helping to relive a conflict or pending conflict that other people might be in.
Why is this Skill Required for an NP:
Sometimes patients and/or their families can be emotionally charged and nervous. This can create an environment where personalities may clash between them or between them and staff. Being able to diffuse these situations allows NPs to keep a safe work environment and continue providing care to their patients. Conflict resolution and mediation are not just nurse practitioner skills. These skills can be useful in most work environments and your personal life.
How to Develop this skill:
Like many nurse practitioner skills, the best way to develop this NP skill is to practice. You undoubtedly encounter scenarios during your clinical practice, either with patients or colleagues where you need to mediate conflict. So, by nature of exposure, you will learn. You can also talk to your more experienced colleagues and give them scenarios and ask them how they might handle it. This can help you think outside of the box. Odds are you have already developed some conflict resolution and mediation skills in your life. Think back to scenarios you have already encountered and analyze what worked and what didn’t.
8.Interpersonal Skills
What is it:
Interpersonal skills are behaviors and skills that we use when communicating and building relationships with other people.
Why is this Skill Required for an NP:
Working as an NP is a team effort. You will work with a diverse team of clinicians and administrative staff. Having interpersonal skills that enable you to communicate across cultural barriers and in tense situations will enable you and your team to provide your patients with high-quality care. It will also help you avoid clinical errors and ensure patients are getting the right follow-up. Additionally, this nurse practitioner skill is essential for building trusting relationships with your patients and eliciting accurate medical histories. Building relationships with your patients is essential because research shows that patients are more likely to adhere to a treatment plan and return for follow-up if they feel listened to and trust their clinician.
How to Develop this skill:
There are simple things you can do to help your patients feel comfortable and begin to trust you. This includes making eye contact (if culturally appropriate) when conversing, not blocking the exam room door, sitting on the same level as your patient, asking personal but not invasive questions to get to know them (like you might any other person), asking permission before touching them. Being an active listener, showing empathy, and trusting that your patient knows their body can also help develop a trusting relationship. While not necessarily something you can learn if you have no baseline, these are common skills of a nurse practitioner that sets them apart from other health professionals.
9.Comprehensive Exam Skills
What is it:
Being able to conduct both a thorough and a targeted physical examination depending on the situation is one of the essential nurse practitioner skills. This is the ability to not only go through the motions of examining a patient based on their clinical complaints, but also the ability to interpret your findings.
Why is this Skill Required for an NP:
Your physical exam skills are a fundamental part of care provision. This is one of the most important tools you will use in assessing a patient and making a diagnosis.
How to Develop this skill:
Developing this NP skill takes practice; however, you will learn how to do it in NP school. It is also an easy exam to practice on your classmates and friends, again, they have all been patients before and can be very helpful! It can be particularly helpful if you find a friend who has a medical anomaly like a heart murmur. This can help you start to recognize abnormalities. Remember, knowing what is normal in a physical exam is one of the most important steps. Once you have a strong sense of what is normal, you’ll be better able to spot abnormalities and follow up appropriately.
10. Personal Protective Equipment
What is it:
This skill involves knowing what personal protective equipment (PPE) is necessary for which situations. It also encompasses the act of putting on and taking off (donning and doffing) PPE.
Why is this Skill Required for an NP:
PPE has been an essential part of health care professional training for decades. However, the COVID-19 pandemic has made this one of the top nurse practitioner skills. PPE protects you from infectious diseases. Having a solid understanding of PPE can help protect you and your patients and enable you to safely care for patients with transmission-based precautions. It will also help you to use resources effectively and not waste materials. The use of gowns, masks, and N95 respirators has become much more common during the pandemic. No matter what field you work in as an NP this is one of the nurse practitioner skills that you are likely to be using in your clinical setting.
How to Develop this skill:
After you are trained on this, you should practice. If you find you are not using PPE often at your clinical setting but suddenly you are required to and feel unprepared, ask someone to watch you or assist you in putting on your PPE. There are also loads of YouTube videos on this and other skills required for a nurse practitioner.
11. Computer Literacy
What is it:
Computer literacy is the basic ability to navigate computers, the internet, and typing. In the 21st century, most adults in the US have some level of computer literacy.
Why is this Skill Required for an NP:
Electronic medical records (EMR), online resources, and telehealth make computers an essential part of caring for patients. If you are not computer literate, you are going to struggle in your clinical setting.
How to Develop this skill:
If you have no computer literacy (which I doubt is the case) you will have a lot of learning to do. However, odds are you have been using computers throughout your studies. If you feel that this is one of the nurse practitioner skills that you need to develop further, ask a tech-savvy classmate to help you practice. You can also ask for more detailed pieces of training on EMR systems and telehealth through your employer.
12. Language Skills
What is it:
This is the ability to speak more than one language.
Why is this Skill Required for an NP:
The United States is becoming increasingly diverse and with this languages other than English are becoming important. Even if you find an NP job that doesn’t require you to speak an additional language, you will find it helpful to know one. Even if you are not able to work in a different language but can say hello and introduce yourself, your patients will appreciate it and it will help you form a relationship with them. Spanish is becoming required or at least desirable for many NP positions. While online or in-person translators are used in many clinical settings, this is time-consuming and sometimes you may have difficulty accessing one. This is also one of the NP skills that is likely to make you a more competitive candidate during the application process.
How to Develop this skill:
How to develop this skill depends on where you are starting from. If you already have skills in a language other than English you can sign up for more classes, watch series on Netflix in that language, and/or go to group meetings where people speak in that language to practice. Meet Up is a great website to find language exchanges near you. If you have no language skills outside of English it may be worth looking into what languages are common in the city or town you want to work in, and then pick one to start studying. While languages are not always required skills of a nurse practitioner, they will certainly help your career and set you apart in the interview process.
13. Mental Health Evaluation
What is it:
A mental health evaluation can come in different forms however basic mental health evaluation skills give NPs ideas about how their patients are doing mentally. This can be a series of quick questions to assess their consciousness or a bit more in-depth evaluation talking about their depression symptoms.
Why is this Skill Required for an NP:
Having basic mental health evaluation skills can assist NPs in recognizing mental health conditions including but not limited to depression, anxiety, PTSD, cognitive disorders, and more. While you may not be a psychiatric mental health nurse practitioner who will manage these conditions long-term, mental health evaluation is one of the NP skills that are essential for you to provide patient-centered holistic care.
How to Develop this skill:
There are numerous online resources for various types of mental health evaluations. Some of them are forms that you give to patients to fill out such as the PHQ9 depression screening form. You will learn some of the basic skills for evaluating a patient’s mental health while you are in school. You can refine this skill through clinical practice, watching online videos, and practicing with your friends.
14. Boundary Setting
What is it:
Boundary setting is when you set limits with other people so that you are protecting your mental and emotional health and staying stable.
Why is this Skill Required for an NP:
Having the skill of being able to set healthy boundaries with other people is essential when you are a care provider. As a nurse practitioner, you have a job to take care of other people. However, this does not mean at the expense of your wellbeing. Being able to set boundaries will prevent patients and colleagues from taking advantage of you or using up all your emotional energy. Boundary setting is one of the nurse practitioner skills that are helpful to both you and others. Demonstrating that you can set healthy boundaries, also shows others how to do this. You can be caring and empathetic without running yourself dry.
How to Develop this skill:
Boundary setting is something that we may learn throughout our life, and it is not easy to do, especially if someone else is not good at respecting boundaries. Setting healthy boundaries with patients can include simple things like not being friends with your patients on social media or talking about your personal lives with patients. What type of boundaries you choose to set can be a personal choice. You can look to colleagues to see what kind of boundaries they find helpful. A good way to set boundaries is to listen to how you feel in certain interactions with other people. If something makes you uncomfortable, unpack that and see what you could do differently.
15. Pharmaceutical Knowledge
What is it:
This is one of the nurse practitioner skills that is essential. As you will learn in NP school having a solid understanding of pharmaceuticals; meaning how medications work on the body, how the body affects the medication, dosages, and drug interactions and side effects is a foundation of nursing.
Why is this Skill Required for an NP:
As a nurse practitioner you will be prescribing medication. Knowing drugs inside and out is required for providing safe and effective care. There will always be times when you have to look something up, but having a good foundation of drug knowledge will save you a lot of time.
How to Develop this skill:
Study. Much of pharmaceutical knowledge comes from studying. It’s a good idea to keep your pharmacology book from NP school handy. It will also help you when you start working to make a list of common drugs that you use and write down common prescriptions, side effects, patient counseling tips, and how it works.
16. Procedural Skills
What is it:
These are skills that enable you to perform certain medical procedures. These can be biopsies, intrauterine device (IUD) insertions, suturing, catheter insertions, and more.
Why is this Skill Required for an NP:
These nurse practitioner skills will enable you to provide more comprehensive care to a wider range of patients. If patients require a certain procedure as a part of their medical care and you can perform the procedure, you will not need to refer them to a colleague. Having procedural skills will also make you more competitive when you are looking for jobs.
How to Develop this skill:
Some procedures will be taught as a part of your nursing education (such as catheterization). Others you will have to get on-the-job training or go to specific pieces of training for them. If you are interested in gaining certain procedural skills, you can ask your employer and/or colleagues to train you or reimburse you for getting the training. Once you are trained it can be helpful to have an experienced clinician supervise you until you feel comfortable doing it independently. Though I always found this last step intimidating, it is necessary. They can provide on-the-spot guidance and are there to help you.
17. Stress Management
What is it:
This is the ability for you to prevent stress and cope with it when it arises.
Why is this Skill Required for an NP:
Providing care for other people can be exhausting mentally, emotionally, and physically. It can be easy when you are putting energy into taking care of others to neglect your wellbeing or at least put it to the side. Stress can be acute and on the job only, or you may find it building up over time and affecting your day-to-day life at work and home. In order to have a high quality of life and get the most out of your job, stress management must be one of your nurse practitioner skills. Being able to decompress and unwind healthily after a stressful day will help you go into the next one refreshed and not feeling worn down. Managing stress is essential to your physical wellbeing as well. If you are going to be caring for others, you need to be caring for yourself first.
How to Develop this skill:
Stress management skills come in many forms, and what works for one person may not work for you. Often effective stress management requires the development of healthy habits that you implement daily to relieve or prevent stress. This can include things like eating healthily and regularly, sleeping well, exercising, deep breathing, meditation, journaling, talking to a mental health counselor, or reading. It takes practice to develop habits, but it will make your life more enjoyable.
18. Facilitating a Calming Environment
What is it:
This is the ability for a person to create an environment with calm energy so that other people and themselves are comfortable and not triggered.
Why is this Skill Required for an NP:
Patients are nervous when they come to receive health care services. Knowing that your body will be examined by who could be a stranger, and having to talk about very personal details is unnerving. Being able to create a calming environment is one of the most important nurse practitioner skills. If your patient is on edge because they feel uncomfortable, it is unlikely that you will be able to get detailed accurate information from them during the medical history. Not having a calm environment can make it difficult to build a trusting relationship with patients and can make them feel unsafe, particularly during a physical exam.
How to Develop this skill:
There are basic tips and tricks you can implement like those described in the section on interpersonal skills. In addition to these, you can make sure that your exam rooms are structured in a way that is warm and inviting. You can put calming pictures on the wall. This also means being able to recognize when a family member is being disruptive or making the patient uncomfortable and asking them to wait in the waiting room. Making sure that other staff members know the importance of keeping a calm environment and not being too loud can also be helpful.
19. Ordering Diagnostic Tests
What is it:
Diagnostic tests are imaging or laboratory tests that help nurse practitioners make a diagnosis.
Why is this Skill Required for an NP:
An essential part of being a nurse practitioner is being able to accurately diagnose and treat your patients. Diagnosing is important for determining the treatment plan. These types of tests can also be used for certain conditions to follow up after treatment as commenced to see if it’s working. Being able to order appropriate diagnostic tests is also important so that you are not wasting valuable health resources. Ordering tests inappropriately can not only give patients the wrong impression of how their condition can be managed, but can also waste money.
How to Develop this skill:
Of the nurse practitioner skills this is probably one of the ones you will most refine once you start working as an NP. You will gain theoretical and foundational knowledge on diagnostic tests during school but often practice will be essential. It is normal when you start as an NP to be nervous and your instinct to be to order a lot of tests. Make sure what you are ordering is essential for informing your diagnosis and treatment plan, and not just to reassure you or your patient.
20. Patient and Family Education
What is it:
This is the ability to educate your patients and their families on their medical care in a way that they can understand. Being able to empower patients through education is one of the top skills for a nurse practitioner.
Why is this Skill Required for an NP:
Nurse practitioners are known for decreasing hospital admission rates and being good at preventative care. A large component of this is empowering patients through education. The paternalistic method of care where “the clinician knows best, and the patient should just listen to what they say” should be a thing of the past. There is a shift now towards collaborative care between the provider and patient. Patients deserve and benefit from knowing how their bodies and health care function. Being able to provide patients and their families with education on their health and care enhances the provider-patient relationship, empowers them to take care of themselves, and can improve treatment outcomes. Patient and family education should be tailored to each individual so that they understand their health and health care plan clearly.
How to Develop this skill:
Writing out how you will explain certain health conditions to patients can help you come up with standardized ways to approach patient education that can then be adjusted based on the needs of the individual. You should aim to write at the 8th-grade reading level (there is a function in Microsoft Word to check the grade level of your writing). Writing it out this way will help you learn to cut out difficult medical jargon and explain things in clear and direct sentences. Then you just have to practice in real life!
21. Leadership
What is it:
Leadership is the ability to inspire and motivate others to achieve a certain goal.
Why is this Skill Required for an NP:
As a nurse practitioner you play a pivotal role in the lives of your patients. Being able to motivate them to change their health will require a level of leadership. Additionally, you are in a position to make a change within the health care system as a whole. If you want to make a change in your health care setting, assuming a leadership role or developing these essential nurse practitioner skills is the way to go.
How to Develop this skill:
This is one of the nurse practitioner skills that you may have gained from prior experiences and can then expand upon while working as an NP. Or perhaps being a leader is new to you and this is a role you will step into with your first NP job. Either way, you can practice your leadership skills by taking on this role with your colleagues and working to inspire change in your patients.
22. Team Management
What is it:
When you manage a team you are also a part of the team. Team management as a nurse practitioner involves delegating tasks, training others, taking on additional roles when needed, and providing feedback to other workers in the clinic.
Why is this Skill Required for an NP:
Nurse practitioners are often the intermediary between medical assistants, nursing assistants, nurses, administrative staff, and physicians, and upper-level administration. Team management nurse practitioner skills will not only enable you to work effectively with others to keep the clinical setting running smoothly, but will also help everyone on the team have clarity about their roles and responsibilities. It will help you form trusting professional relationships with your colleagues.
How to Develop this skill:
Think back to times when you have worked in a team and/or managed a team. Why was this important? What was helpful? What was unhelpful? What kind of feedback did you receive from your team? Reflecting on past experiences can help prepare you to manage a team as a nurse practitioner. Make sure that you are open to feedback and ask your colleagues what you could do better or differently. This will help you refine your team management nurse practitioner skills.
23. Microscope Skills
What is it:
Being able to use a microscope to evaluate clinical samples.
Why is this Skill Required for an NP:
When you look at your nurse practitioner skills checklist, being able to use a microscope should be on there. This is a diagnostic tool that you can use right in the office while your patient is still in the room. Whether it’s checking a skin scraping for a fungal infection, or looking at vagin*l fluid to see if a pregnant woman’s water has broken, using microscopes where appropriate can save you loads of time and health care dollars.
How to Develop this skill:
If you didn’t have microscope training in NP school see if you can either get official training through your employer or ask a skilled colleague to teach you. Then practice!
24. Policy Knowledge
What is it:
This is having an understanding of how different health policies affect your clinical practice and knowing what policies are in the place where you work.
Why is this Skill Required for an NP:
Health policies (whether governmental or within your health care center) can affect how we deliver care and what type of care we can provide. Though not laws, they can influence laws. Some of the most prominent examples of this have to deal with sexual and reproductive health policies. It is helpful to know what policies are in effect that you disagree with so you can work to make changes in them. Knowing what policies do not exist, but that you think should exist, can also inform how you lobby for change.
How to Develop this skill:
Researching policies in the US, the state you work in, and the clinical setting where you practice, as well as laws (which are different from policies), is the way to increase your policy knowledge.
25. Self-Awareness
What is it:
Self-awareness is the act of knowing how you feel, behave, and think and how this affects people and the environment around you. It involves understanding what you want and knowing where your boundaries and limits are. Self-awareness involves knowing your strengths and weaknesses.
Why is this Skill Required for an NP:
Self-awareness is one of the essential skills required for a nurse practitioner. It is incredibly important that you are in tune with yourself so that you can trust and listen to your clinical judgment and intuition which are there to aid all your other nurse practitioner skills. Being self-aware helps you know and respect your clinical and emotional limits so that you know when to ask for help. This is essential for your patient’s safety and wellbeing. It also allows you to know if you are successfully connecting with a patient or not and can help you recognize the needs of your patients. Self-awareness coupled with your clinical expertise can help you decide when a patient needs to be referred.
How to Develop this skill:
Self-reflection and looking back on situations when you have interacted with other people in professional settings is a great way to start to become more self-aware. Meditation and journaling are great ways for you to reflect and start to become more self-aware.
26. Critical Thinking
What is it:
Critical thinking is one of the skills of a nurse practitioner that is both learned before NP school but then refined during it. Critical thinking is the process of analyzing and evaluating information gathered from multiple sources to inform your decision-making.
Why is this Skill Required for an NP:
As a nurse practitioner you are not a task monkey. You are a highly trained professional who looks at the whole picture surrounding a patient and analyzes and integrates all the information you receive to determine the next steps. Critical thinking is one of the top skills needed to become a nurse practitioner.
How to Develop this skill:
Do not just go through the motions in clinical practice because something looks or seems familiar. Take a moment to analyze the whole picture and all the information and make sure that you are critically thinking through your clinical decision-making process. Practice makes perfect. Running tough scenarios by your colleagues and listening to how they think through them can also help you hone your critical thinking skills.
27. Ethical Decision-making
What is it:
Ethical decision-making is the process of making health decisions with and for patients in a way that evaluates all options and eliminates the unethical ones. It encompasses trust, responsibility, and treating people fairly.
Why is this Skill Required for an NP:
As a nurse practitioner your clinical decisions may not always be clear. Sometimes there will be an ethical dilemma present that requires you to work carefully with your patient to eliminate unethical options and ensure they are receiving the care they want and deserve. Examples can include an adolescent with terminal cancer who wants to stop treatment, but their parents want to continue. Sometimes it also involves making ethical decisions for a patient that perhaps go against your morals, such as providing abortion counseling. Being able to set apart our views and provide patients with the ethical and safe care they are entitled to, and advocate for them when they cannot is a huge part of being a nurse practitioner. This is on this nurse practitioner skills checklist because no matter what specialty you are in, ethical decision-making skills are essential.
How to Develop this skill:
You will likely have taken an ethics course as a part of your NP training. Reading books on medical ethics can help you develop this skill as well as think through difficult ethical scenarios with your classmates. Self-awareness can also help with this as it will enable you to separate your morals from your clinical practice.
28. Basic or Advanced Life Support
What is it:
Basic life support (BLS) encompasses CPR, AED, and obstructed airway training. You will need to be BLS certified no matter where you work but some places require at least 1 clinician to be trained in advanced life support (ALS). ALS expands on BLS training and goes more in-depth.
Why is this Skill Required for an NP:
This keeps you up to date on the latest life support methods. If you go for the ALS, you may feel even more prepared to respond to an emergency than you do with basic life support. For NPs not working in emergency environments this may be appealing and a quick way to learn new skills. Additionally, if a clinician where you work is required to have ALS certification, you stepping up to the plate to do this will show your employer and colleagues how proactive and eager to learn you are.
How to Develop this skill:
You will be required to have a BLS or CPR certification regardless of where you work. You can ask your employer to pay for your ALS instead if you want to be prepared to handle more advanced emergencies. ALS includes BLS and then some, so if you are only required BLS certification ALS is even better. You can always pay for it yourself if your employer doesn’t.
29. Triaging
What is it:
Triaging is the ability to quickly assess a patient to determine the prioritization of and type of care needed based on the severity of the situation.
Why is this Skill Required for an NP:
As an NP it is important to make sure patients in an emergency are receiving quick and appropriate care. It is also important to make sure that health services are not being over or misused. Being able to triage your patients can ensure that poor patient outcomes are minimized and appropriate levels of care are being delivered. This is important for resource conservation in health care as well. Examples of triaging skills are seeing a patient who presents with chest pain, shortness of breath, and sweating and you knowing that they should be evaluated before the patient with pain in their ankle after a traumatic incident but who still has palpable pulses and no bleeding. The first patient is at risk for heart attack and quick evaluation is essential. Triaging can also be over the phone. Such as a pregnant patient who is full term calling with signs of early labor, but based on her symptoms you can tell that her contractions are still far enough apart and there are no signs of distress to her or the baby, so she does not need to come into the hospital right away.
*These are very simple examples and should not be used to guide your clinical evaluation.
How to Develop this skill:
There are basic pathophysiological signs and symptoms that you learn as a student to help you start with your triaging skills. However, much of your triage skills will come with practice and experience. The more you are exposed to certain clinical scenarios the better you will be able to read the situation quickly and decide the next steps in care.
What Are Some Of The Top Specialty-Specific Nurse Practitioner Skills?
The above skills are more or less universal for every nurse practitioner specialty, but some will be more important with certain specialties. Being able to conduct a physical exam and take a patient's history is essential for every specialty. However, triaging is at the top of the list for NPs working in acute and emergency settings but is probably not so important for dermatology NPs. Here we go over some of the top specialty-specific nurse practitioner skills.
1.Adult-Gerontology Acute Care Nurse Practitioner:
To become a successful Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) there are many potentially beneficial nurse practitioner skills. One of the most important ones includes triaging, particularly if you are working in an emergency setting. As you will likely be working with older adults who may experience cognitive delays, knowing how to do a thorough mental status exam is also essential. Certain technical skills such as suturing and doing biopsies may also prove useful depending on your clinical setting.
2.Adult-Gerontology Primary Care Nurse Practitioner:
Primary care nurse practitioners are skilled in preventative care. Given this, being able to effectively educate your patients is one of the top skills for a nurse practitioner working in adult-gerontology primary care. To effectively educate your patients you will also need to be able to connect with them Therefore having solid interpersonal skills is also essential. Since you will likely be caring for your patients over the long term, building a trusting relationship with them will be important. Since they may be older you may encounter a variety of complex medical conditions. Being skilled in ordering diagnostic tests will be essential.
3.Dermatology Nurse Practitioner:
Dermatology nurse practitioners are skin experts and thus come with a unique skill set, a lot of which may be learned on the job. Skin biopsies are going to become routine for you after you gain some training and practice. While you may be focused on the skin, don’t neglect your detailed medical histories. Not only will you need to do thorough skin assessments, but getting a detailed history can illuminate your patients' habits, lifestyle, and family history that may predispose them to certain skin conditions.
4.Emergency Nurse Practitioner:
Like a nurse practitioner in acute care, having excellent triaging abilities is one of the skills required for a nurse practitioner working in an emergency setting. You absolutely must be able to triage your patients so that you can effectively determine who gets priority in receiving care. This is an essential life-saving skill. You must also have good team management skills. Emergency nurse practitioners are often working as a part of a team of clinicians with clearly defined roles and responsibilities to safely manage emergencies. Often one nurse or clinician will be in the role of team leader or manager. Knowing how to and who to delegate certain tasks to is essential so that patients are managed safely and quickly.
5.Family Nurse Practitioner:
Family nurse practitioners do it all. They work with patients across the life span and see a variety of clinical situations. Thus, their ability to take a detailed patient history, do a comprehensive physical exam, and provide patient and family education are paramount. These are some of the top skills required to succeed as an FNP.
6.Neonatal Nurse Practitioner:
Neonatal nurse practitioners work with the smallest newest humans. There are without a doubt procedural skills unique to neonatal NPs that you will have to learn. In addition to this, providing family education and facilitating a calming environment is crucial. New parents can be worried and confused and will likely have many questions about the health of their newborn. Being able to calm their nerves while providing them with the education they need is important.
7.Oncology Nurse Practitioner:
There are numerous skills that an oncology nurse practitioner needs to have. Strong pharmaceutical knowledge and being able to appropriately order diagnostic tests are some of the top nurse practitioner skills that they need to have. You will be treating your patients who are battling cancer and must be able to know what medications are best for them, what their side effects are, and how they interact with their other medications. You will also need sounds diagnostic test skills to track progress and ensure that liver and kidney function is stable during treatment.
8.Orthopedic Nurse Practitioner:
Being able to conduct a thorough physical exam is one of the skills needed to become a nurse practitioner working in orthopedics. You need to be able to assess your patient’s bone and muscle health and perform targeted assessments to diagnose particular injuries or conditions. Much of your training and skills acquisition will be acquired on the job so making sure that you roll up with solid physical exam skills will leave you prepared to continue your learning.
9.Pediatric-Acute Care Nurse Practitioner:
As a pediatric acute care nurse practitioner, you need strong history-taking skills. This includes both from the children and the parents or caretakers. You’ll need to be able to focus your history based on the presenting problem and then know which questions are appropriate for the child and the parents based on the situation and the child’s developmental stage. This coupled with strong interpersonal skills are some of the necessary skills for a nurse practitioner working in acute care settings with children.
10.Pediatric-Primary Care Nurse Practitioner:
There are loads of technical skills that are important for pediatric primary care nurse practitioners; however, ethical decision-making and being able to advocate for your patients are the top skills required for pediatric primary care nurse practitioners. Children may be unable to or have difficulty (depending on their age) advocating for themselves and what they want when it comes to their care. Parents and caregivers often have their children’s best interests at heart, though this is not always the case. Being able to assess your patient and advocate for appropriate care and help them have their voices heard (particularly for adolescents) are skills needed to become a successful nurse practitioner in pediatric primary care.
11.Psychiatric Mental Health Nurse Practitioner:
Just in case the title doesn’t explain it, having strong mental health evaluation skills is critical to psychiatric mental health nurse practitioners. This is not just one of the top nurse practitioner skills for this specialty; it is the bread and butter of your practice. You will be assessing the patients' mental status every day and will need to be able to pick up on subtle changes between visits. With experience, you will become a master in this.
12.Women's Health Nurse Practitioner:
Women’s health nurse practitioners need to have excellent interpersonal skills given the sensitivity of the topics they focus on with their patients. It can also be a procedure heavy specialty. The skills of a nurse practitioner working in women’s health will encompass procedural skills such as IUD implants, endometrial biopsies, catheterization, and more. Being able to use a microscope and do diagnostic tests such as ultrasound and ordering blood work are also key.
10 Useful Resources To Help Improve Your Nurse Practitioner Skills
If you are looking to improve your NP skills it can be tough to know where to look. If you look online, make sure you’re checking out a reputable resource. There are also many books that can be helpful resources. Here are some of the resources I have found particularly helpful in improving my nurse practitioner skills.
1.UpToDate:
UpToDate is an evidence-based clinical support tool for medical professionals that covers everything medical including pathophysiology, pharmacology, dosing medications, and performing procedures. Though expensive, many employers will have it included. Ask about it during your interview.
2.Davis's Comprehensive Manual of Laboratory and Diagnostic Tests With Nursing Implications:
This book provides all the information you need on diagnostic testing and interpreting results.
3.Saunders Nursing Drug Handbook 2022:
This book covers common drugs and drugs classes along with their pharmaco*kinetic and pharmacodynamic properties. It also includes everything you need to know to keep patients safe and educate them on their medications.
4.Current Practice Guidelines in Primary Care 2020:
If you’re working in primary care this book will guide you through common clinical scenarios.
5.Nursing Research: Generating and Assessing Evidence for Nursing Practice::
This is the key book to teach you how to conduct or evaluate research.
6.Advanced Assessment: Interpreting Findings and Formulating Differential Diagnoses Fourth Edition:
This book will be your best friend when it comes to assessing and diagnosing your patients.
7.Pediatric Examination and Health Assessment:
If you work in pediatrics, you will need a resource tailored to that population. This book is it.
8.The CDC:
Though not often the first thought, a simple CDC search can give you a lot of information on medical conditions, epidemiology, treatment guidelines, and what to look for.
9.The ASCCP App:
Whether a women’s health nurse practitioner or not, you may find yourself doing pap smears. Being able to counsel patients and follow up appropriately when the results come in is essential. The ASCCP app can help you do this quickly and accurately.
10.The World Health Organization:
The WHO has information not just on diseases and medical conditions but also on policies and health issues worldwide. Their website is a good resource to have in your back pocket.
My Final Thoughts
What are the top nurse practitioner skills? They are a combination of acquired and learned skills as well as personality traits (also referred to as soft skills) that enable you to work as a team, connect with your patients, evaluate their health, and provide them with high-level care. The nice thing about working as a nurse practitioner is that you will work on a team with other clinicians who are all uniquely skilled in their own ways. This is a ripe environment for team learning and you are likely to have a fulfilling career.
If you’re intimidated by my list of 29 top nurse practitioner skills you’ll need to succeed in 2022, don’t be. No nurse practitioner rolls into their first job with all these mastered. Even well into your career as a nurse practitioner, it’s unlikely you will have all of these down. This is the beauty of being a nurse practitioner, you will be a life-long learner and forever self-improving. This nurse practitioner skills checklist is designed to get you thinking and self-reflecting. Hopefully, it will help you evaluate what skills you should focus on and where you excel. It can also keep you motivated for future learning and skills acquisition!
Lauren Jacobson MS, RN, WHNP-BC
Lauren Jacobson is a registered nurse and women’s health nurse practitioner who is passionate about global health and gender-based violence prevention. She is Editor and an Advisory Board Member for the Global Nursing Caucus and volunteers with Physicians for Human Rights as a medical evaluator for asylum seekers.
