I always knew I wanted to care for others. Although I haven’t been a nurse for long, I’ve had many nursing roles, including working as a bedside nurse, teaching, serving as Sigma’s UN representative, and sitting on the boards of various nonprofits. While I enjoyed all these experiences, I found my calling as a nurse practitioner.
Currently, I work as an adult primary care practitioner at a community clinic in Los Angeles, CA. I serve a diverse population of uninsured, low-income, immigrant, and unhoused patients. It's busy, chaotic, and hands-on. No two days are the same, and that’s part of what keeps it exciting. My first year as a nurse practitioner has been a journey of growth, resilience, and learning—both professionally and personally. Here’s what it taught me.
Embracing the learning curve
No textbook or rotation prepares you for the reality of calling the shots. My first year as a nurse practitioner taught me one thing loud and clear: It’s okay not to have all the answers. Every patient is a lesson. The trick is staying curious, asking questions, and welcoming feedback. Admitting, “I don’t know, but I’ll look that up,” not only built trust with my patients but also ensured they received the best care possible.
As a nurse practitioner, you have to make decisions fast, embrace the unknown, and stay open to learning. It was humbling to realize how much I didn’t know and comforting to understand that asking for help is a sign of strength, not weakness.
Discovering clinical autonomy
One of the biggest changes when I became a nurse practitioner was stepping into clinical autonomy. It’s exciting to be making decisions that impact a patient’s health, but it can also be intimidating. I’ve learned to trust my training, lean on evidence-based guidelines, and ask for help when I need it. Having a supervising physician as a resource has been so helpful. Autonomy doesn’t mean doing everything on your own. Working with colleagues, specialists, and patients to figure out the best plan is what makes this role so rewarding.
Time management is survival
School prepared me to handle 10 patients per day, each with straightforward complaints. But in my first year as a nurse practitioner, I often saw 20+ patients a day, many with multiple uncontrolled chronic conditions. Managing this volume isn’t about rushing; it’s about strategizing. I had to find my rhythm—prioritizing complex cases, building in time to close charts, and setting boundaries to ensure I didn’t carry my work home. The concept of “pajama time” (finishing charts after hours) quickly faded once I established systems to manage my workload efficiently. Time management became more than a skill; it was key to staying afloat in a demanding environment.
Overcoming imposter syndrome & prioritizing self-care
Imposter syndrome has been my constant companion throughout my career. I experienced imposter syndrome during nursing school, as an RN, and now as a nurse practitioner. There were many moments in my first year when I doubted myself and wondered if I was truly cut out for the role. Here’s the thing: Imposter syndrome doesn’t magically disappear with an “advanced” degree. I’ve learned to acknowledge it and push through by focusing on the wins.
The first year also revealed the emotional weight of working in a system that often feels broken. I saw patients struggle to navigate barriers like high costs, insurance challenges, and long wait times. Advocating for them became part of the job. And I realized that even small victories—like connecting someone to affordable care or explaining complex medical jargon—can make a huge difference. At the same time, I learned that neglecting my well-being isn’t sustainable. Setting boundaries, taking breaks, and leaving work at work became non-negotiable. If I’m not taking care of myself, I can’t show up as the provider my patients deserve.
Building patient relationships
The best part of being a nurse practitioner? The relationships I’ve built with my patients. Whether I’m helping them navigate a tough diagnosis or celebrating health milestones, it’s moments like these that remind me why I do this.
Working with a diverse population has also taught me the art of cultural humility. It’s not just about understanding medical conditions but also respecting a patient’s background, values, and story. Many of my patients have felt dehumanized by a system that treats them like numbers. Listening has been my way of showing them that they are seen, heard, and valued. You’re treating the person, not the condition.
This role has also given me a front-row seat to the gaps in the US healthcare system. Patients need more than medications; they need advocates who can help them navigate a system that often fails them. Being able to bridge those gaps, even in small ways, has been one of the most rewarding parts of the job.
Wrapping it up
Being a nurse practitioner at a community clinic is challenging but incredibly rewarding. If you’re a recent graduate, I’d highly recommend exploring federally qualified health centers (FQHCs). Not only do they offer invaluable learning opportunities, but they’re also consistently hiring, provide loan repayment options, and offer room for growth—just what a new grad needs.
This past year has taught me that learning never ends, and that’s the beauty of this work. To anyone stepping into this field: You’ve got this, and you’re not alone. Let your patients and your experiences guide you—it’s the best way to grow into the role.
Dania Itani Mousa, DNP, FNP-C, RN, is a family nurse practitioner in Los Angeles, California, and a fellow at the University of California, Irvine. She served as Sigma’s UN Youth Representative from 2020-2024. Dr. Mousa is a member of Sigma’s Iota Eta Chapter, and she continues to pursue excellence in nursing practice through patient care, advocacy, and leadership.