25 Qualities that Make a Good Nurse Practitioner (2024)

Written By: Andrea Mosher, CPNP, PMHS

25 Qualities that Make a Good Nurse Practitioner (1)

Taking the next step from nurse to nurse practitioner is a big step, and it isn’t for everyone. Many factors play into whether or not you will make a successful nurse practitioner. There are many characteristics that a quality nurse practitioner embodies. Some of the qualities are personality traits that we are born with, but nurse practitioners can strengthen and build some features necessary to be a successful NP. So, what qualities make a good nurse practitioner? In this article are the 25 qualities that make a good nurse practitioner.


WHAT QUALITIES MAKE A GOOD NURSE PRACTITIONER?

(Following are the 25 Qualities that all Nurse Practitioners must have to succeed in their profession.)

1.Attentiveness

When dealing with a patient’s health, it is essential to be attentive to what they tell you and what you see on the exam. If you are only half-listening to what they are saying, you may miss an essential clue to what the cause of their complaint is. If you are just going through the motions during your exam or only looking for what you think you should see, you may miss a significant physical finding.

There are many nurse practitioner qualities that new NPs tend to excel at, but the most notable is attentiveness. They haven’t done hundreds or thousands of exams and typically are nervous about missing something. Thus, their attentiveness is on point. More seasoned NPs can sometimes rest on their laurels because they have seen a specific presentation a million times.

To strengthen your attention during patient encounters. Try to focus on what the patient or the family is telling you. Additionally, do not make assumptions. Assumptions are one of the critical factors that limit a provider’s attention. Keep several differential diagnoses in mind to avoid tunnel vision during your physical examination.

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2.Compassion

Having compassion is not just a quality that you should have as a nurse. It is also one of the most critical nurse practitioner qualities. Nurses and nurse practitioners are the most trusted professionals because of their compassion. More often than not, we meet our patients when they are sick, in pain, and even dying. It is essential to be concerned about their potential suffering and let them know we care and want to support them.

However, if you suffer from compassion burnout and have difficulty showing your patients compassion, imagine your patient is you or a close family member. It is doubtful you became a nurse and didn’t have a compassionate personality. Changing your perspective in that way can help you be a little more sympathetic towards your patient.

3.Integrity

As previously mentioned, the nursing profession is the most trusted profession, and integrity is among the nurse practitioner characteristics that help build patient-provider trust. If patients feel that we are not upfront and honest with them, they may withhold critical information necessary for their care or, worse yet, not seek care due to the mistrust.

Not only is integrity vital in the patient-provider relationship, but it is also a factor in patient safety. We deal with people’s health, well-being, and life daily, so dishonesty can negatively affect that.

Integrity is a characteristic you should have for any job, but it is even more critical in the medical field. Integrity is typically part of your personality, but if it isn’t, be sure that you are honest with your patients, regardless of what it will make you look like to them. If you don’t know the answer to a question, say, “I don’t know that information off the top of my head, but let me go find it.” I assure you, your patient will feel more comfortable knowing that you were honest and are getting the correct information versus just guessing and getting it wrong.

Additionally, if you make a mistake, take responsibility for it. In my experience, I unintentionally sent the wrong dose of antibiotic to the pharmacy for a pediatric patient. The medical assistant unintentionally put the wrong weight into the chart. Did I throw the medical assistant under the bus? No! It was my responsibility to check that the weight made sense for the patient, and I didn’t, which I told the parents. They were understanding, and thankfully the patient did not take any of the medication, so there were no adverse outcomes.

4.Competence

Being competent may be one of the most obvious nurse practitioner qualities, but nurse practitioners must be competent in their practice before practicing independently. When you manage a patient’s healthcare, you must be skilled in your practice. If you aren’t proficient, you can put your patient and your health and safety at risk.

When working as a nurse practitioner, it is essential to know what you don’t know. That may seem confusing, but having a solid grasp on what is outside of your comfort zone or knowledge base is just as important as your knowledge base itself. You could potentially put your patient in danger if you try to practice outside of your training.

Increasing your competence comes with time. Having first-hand workplace experience is the best way to build competence, but there are other approaches you can also take, including:

◦Have an experienced colleague mentor you
◦Ask questions if you are unsure
◦Read articles and books about unfamiliar topics
◦Attend seminars and conferences


5.Communication

Being able to communicate is one of the qualities of a nurse practitioner that is vital in all aspects of their role. You should be able to communicate with your patients, your colleagues, and your upper management. Communication skills are also not a one-way street. You should not only be able to express yourself clearly and concisely, but you should also be able to actively listen to those who are communicating with you.

Poor communication skills can create challenging and even dangerous patient encounters. If you aren’t clear in your instructions, the patient may be non-compliant or confused. Additionally, if you are not a successful active listener, you may miss critical subjective information from the patient.

If you struggle with your communication skills, there are ways that you can improve both your expressive and receptive language.

To improve expressive communication:

◦Keep your message simple and clear
◦Discuss key points at the beginning of the conversation and repeat them at the end
◦Maintain eye contact
◦Make sure you are understood

To become a better active listener:

◦Stop preemptively thinking about your response
◦Acknowledge the thoughts and feelings of the party you are speaking with
◦Nonverbally engage in the conversation
◦Clarify if you didn’t hear or understand what was said


6.Optimism

The world of healthcare can be a very negative place, but being optimistic for your patients is integral to a good provider-patient relationship. A patient will likely avoid getting care from their nurse practitioner if a provider constantly points out the negative in their health or lifestyle.

There is a fine line between optimism and dishonesty, though. If your patient’s illness or injury has a dismal prognosis, it isn’t fair to give them false hope. If a patient has a terminal illness or injury, telling them they will make a full recovery is not optimistic. It is optimism to tell your patient you will do all you can to keep them comfortable during their illness progression.

Optimism is one of the nurse practitioner qualities that typically is a part of your personality, but there are different ways to help build your optimism. Transition your focus to the solution versus having the problem at the forefront of your mind’s eye. Switching your thoughts to positive outcomes instead of the difficult task at hand creates a more positive outlook.

Additionally, attempt to find a silver lining in the current situation. I recently had a patient with a traumatic brain injury, and their parent was concerned about discussions they had with the specialists. The specialists mentioned that the patient could potentially be on the autism spectrum. The parent was worried about this statement, but I pointed out that she is already in several therapies for her injury, and if she was on the spectrum, we were already helping her.

7.Empathy

Being empathetic is one of the most important qualities of a great nurse practitioner. Having empathy is similar to compassion, but it is not the same. These nurse practitioner characteristics are often used interchangeably, but having empathy allows you to put yourself into your patient’s shoes and identify with their feelings.

Having empathy is an integral factor in building a trusting patient-provider relationship. Imagine getting terrible news about your health, and your healthcare provider is cold and distant during the encounter. Would you trust that provider to have your best interest at heart?

Empathy is a trait that is a little more difficult to learn unless you have had specific experiences in life. However, there are a few ways to learn empathy. You can discuss how someone feels in their current situation and picture how you would think in that situation. Additionally, stepping out of your comfort zone can give you empathy-building experiences.

Working in pediatrics, I often have exhausted and exasperated parents. I do not have my own children, but I have plenty of friends and family members that do. I use what I see them experiencing to build my empathy for my patient parents.

8.Creativity

Healthcare is full of creative people. This concept may seem bizarre because the field is based on science, but if we didn’t have creative people, we wouldn’t have the medical advances that we do. Now I am not saying that you have to invent a new medical device to be a creative provider. But on occasion, it does take some creativity to develop an appropriate plan or diagnosis for a patient.

During school, you are taught the diagnostics and treatments for hundreds if not thousands of illnesses and injuries. This information can be a helpful guide in your practice, but not all patients are created equal, so you can’t use a cookie-cutter approach to your diagnostic and treatment plans. Factors like allergies, medical history, compliance, and cost all play a role in how you care for your patient.

Creativity is one of the most undervalued of the necessary nurse practitioner traits; nonetheless, it is one of the many qualities of a good nurse practitioner. Creativity is a quality that some people are born with, but it is also something you can work on. Having a creative mind in the workplace starts outside of the workplace. Try new creative hobbies like music, art, crafting, or writing. Stimulating the creative areas in the brain is beneficial for your performance in the workplace and is also excellent stress management.

9.Tenacity

As previously mentioned, medical care is not a cookie-cutter approach; not all patients are the same, nor will they respond the same way to the same treatment plan. If a diagnostic test or a treatment option doesn’t go to plan, you are not allowed just to give up. This is someone’s health or potentially their life we are talking about!

Tenacity is one of the undervalued nurse practitioner qualities. A nurse practitioner has to persevere and come up with alternate plans to help their patient. Creating these plans may take some out-of-the-box thinking, but they are necessary.

To help strengthen your tenacity, it may be helpful to create small goals with your patient. For example, if you have a patient with an out-of-control hemoglobin A1C, have them try to have blood sugars under 200 for one week instead of giving them a specific hemoglobin A1C goal number. After achieving that goal, create another small goal. Smaller, more attainable goals are easier not to quit on.

10.Time Management

Patient and workload demands are continuing to increase on nurse practitioners; so, in addition to the aforementioned qualities of successful nurse practitioners, time management skills are pertinent. It is something they teach in school and clinical rotations. If you struggle with time management, you will learn its importance very quickly.

Whether you work inpatient or outpatient, managing your time is essential to your workflow and your patients. When working inpatient, you must consider that the patient may need additional diagnostics, waiting for procedures, or even needing discharge. If you do not manage your time wisely, your patient could spend unnecessary time admitted or even decompensate if they are critical. When working outpatient, it is crucial to remember your patients have lives outside of the office. They may be missing work, late to pick up their children, or late to other appointments if you fall behind.

Time management isn’t trying to minimize the amount of time you spend with your patients, though. It is making the most of the time you are with them and throughout the day. If possible, have nurses or other support staff collect base information from the patient before your encounter. During the appointment, learn how to succinctly communicate with your patients by asking closed-ended questions versus open-ended ones. Additionally, learn how to politely control the direction of the conversation to help prevent getting off-topic.

11.Flexibility

As mentioned before, working in healthcare cannot be a cookie-cutter approach. Everyone is different in their own way and needs to have healthcare designed for them and their needs. This is why provider flexibility is one of the qualities of a good nurse practitioner.

Being flexible is one of the necessary nurse practitioner qualities whether you work inpatient or outpatient. It is important when considering treatment approaches for your patients and when looking at your patient load or schedule. When working inpatient, you rarely know what your patient load will look like before you walk in the door. You must be able to adjust to what is thrown your way. Otherwise, you will not be a successful nurse practitioner.

When working in an outpatient clinic, it is a bit different. You typically know what your schedule looks like before walking in the door. However, that doesn’t mean that’s how your day is going to play out. You may need to squeeze patients in that need to be seen urgently; you may have patients that show up out of order or even have to address pressing administrative work.

If you struggle with flexibility, being a nurse practitioner may not be suitable for you. Still, if you are willing to work on your flexibility, you will be more employable and have better job satisfaction. To help increase your flexibility, accept that your daily duties and expectations will change. These changes may be challenging for you, but set goals to overcome the challenge instead of focusing on the potential inconvenience that you will experience.

12.Confidence

One of the most complex nurse practitioner qualities to embrace is confidence. One of the most challenging transitions, at least for me, was taking that leap to “I’m the provider” versus “let me go ask the provider.” You are the troubleshooter now, and you need to develop treatment plans and solutions to problems.

Making decisions like that takes confidence in yourself, your knowledge base, and your skills. Patients don’t need a wishy-washy nurse practitioner that can’t decide what they want to do. They will surely lose confidence in your competence if you can’t choose or make a decision and keep changing your mind.

There is a fine line, though, not being overconfident and overstepping your scope or making a decision outside of your knowledge base. Being overconfident in your practice can be dangerous for your patients. As previously mentioned, it is essential to know what you don’t know and embrace it. If you need help with a patient, that doesn’t mean you aren’t an exemplary nurse practitioner or aren’t competent. It means you are willing to learn and build your knowledge base for the betterment of your patients.

How do you build confidence in your practice, you ask? Building confidence is a process and will come with experience, but there are things that you can do to make the process easier, including:

◦Acknowledge your lack of confidence
◦Repeat positive self-talk and avoid self-depreciation
◦Understand discomfort and insecurity is normal
◦Create realistic expectations for yourself
◦Embrace any improvement
◦Find a supportive mentor.


13.Preparation

Being prepared in your career is not unique to being a nurse practitioner, but it is one of the qualities of a successful nurse practitioner. Preparing yourself for your patient encounter is an essential part of successful time management and will benefit your workflow. When meeting with a patient, you should know the reason for the meeting and have some baseline information. Patients will lose confidence in their nurse practitioner quickly if they walk in and you have no idea why the encounter or any of the patient’s medical history.

It does not take much to build this skill as it does for other nurse practitioner traits and be ready for a patient encounter. You do not need to know everything about the patient on command. Still, you should understand why you are seeing them and if they have any pertinent medical history or medications. Take a few minutes to discuss the patient with the nursing staff or take a few minutes to review the chart before entering the room. These simple things will boost your confidence, help build a solid patient-provider relationship, and support your time management skills.

14.Leadership

As a healthcare provider, you are seen as one of the healthcare team leaders, and you must act the part. Being a leader doesn’t mean that you get to boss everyone around and watch from the sidelines. The other staff on your team will look to you in times of doubt, and with your advanced degree, you need to be ready to support your team.

Being a good leader combines several of the aforementioned nurse practitioner characteristics together. Leaders need to have integrity, good communication skills, and confidence. Without those qualities, it will be difficult for you to be a successful leader. Good leaders set an example for their team by showing them what is expected instead of using the “do as I say and not as I do” approach.

As nurses, we aren’t used to being in the spotlight and being the leader of the team, we lead in our own ways, but they are typically more behind the scenes. When you become a nurse practitioner, you are automatically looked at as a leader due to your advanced degree. So, how do you build your leadership skills?

◦Find a supportive mentor
◦Focus on career growth by staying up to date on clinical recommendations and joining professional groups
◦Engage in self-care outside of work to promote a positive attitude in the workplace


15.Analytical Skills

As previously mentioned working in healthcare is not a one size fits all approach. Each patient has a different body, different history, and different needs; that is why having sharp analytical skills is one of the most crucial qualities of a great nurse practitioner. Having strong analytical thinking skills is pertinent to gathering appropriate data, solving complex problems, and making rational decisions.

As a healthcare provider, you constantly have to collect information about your patients to solve complex problems; thus, sharpening your analytical skills would be beneficial. Additionally, you need to employ these analytical skills quickly. It is essential that you can efficiently use these skills. Whether you work in acute or primary care, you need to assess and treat patients promptly.

Building your analytical skills isn’t just for your career. It is a lifelong task. Improving your analytical skills is a task that occurs inside and outside of the workplace. To improve your analytical thinking skills, you should:

◦Not be afraid to ask questions
◦Be observant of yourself and others
◦Learn new skills related to your career and recreation
◦Analyze the potential outcomes of your decisions
◦Read more, both professionally and for fun
◦Play brain games that require you to think critically


16.Patience

From the outside looking in, it seems like nurse practitioners are always in a hurry or bustling about when they are working. But contrary to popular belief, nurse practitioners have a lot of patience. Nurse practitioners combine the care and cure worlds of medicine. That means not only do we have to treat our patients, but we still have that instinct to hold their hand when they are nervous or anxious. Without patience, this level of care wouldn’t be possible. Patience is one of the nurse practitioner qualities that enhance our bedside manner.

Not only do nurse practitioners need to have patience with their patients, but they also need to have patience when working with colleagues and other departments. Other staff may not complete tasks and procedures the way we want them to be. We need to consider those other staff members who have busy days and are most likely prioritizing based on their workload. In addition to being a more pleasant coworker, being patient will help prevent mistakes that can occur if you are rushing.

The saying patience is a virtue is so true, and many people think that you are born a patient person, and if you aren’t, there is nothing you can do about it, but that isn’t the case! If you want to be a more patient person, there are several things that you can do:

◦ Be empathetic and consider the situation from someone else’s point of view
◦Take a moment to walk away and breathe if you are feeling impatient
◦Complete another task if the situation allows you to
◦Practice being patient in more minor situations outside of the workplace
◦Identify what triggers your impatience and address that


17.Enthusiasm

Another important trait is enthusiasm. This may not seem to be one of the most vital nurse practitioner qualities, but it is. You have to be excited about your career and proud of the work that you do. Not only does it provide more job satisfaction for you, but it also helps strengthen patient-provider relationships.

Being enthusiastic sometimes gets a bad reputation. People often see the enthusiasm as being over the top, in your face, and at times annoying. This is not what being an enthusiastic nurse practitioner is at all! You need to be inquisitive, eager to teach, and passionate about your specialty and patients.

If you are not enthusiastic about your current specialty, reflect and decipher if it is the specialty as a whole or is it your current employer. If possible, change whichever factor you are no longer passionate about. Additionally, reflect on what is going well in your workplace and what isn’t. Be thankful for the positives, and plan how you will handle the things that aren’t going well.

It is easy to get enthusiasm burnout, especially if no one else around you shares your same energy. Don’t forget to participate in self-care outside of the workplace to help ease that burnout.

18.Self-Awareness

Self-awareness is your ability to understand your emotions and the reactions that you have to those emotions. You are also able to understand better your strengths, weaknesses, motivators, and triggers. Thus, self-awareness is a characteristic that is important to focus on while at work and outside of work.

Having self-awareness is a trait that is the foundation for many other nurse practitioner qualities. Not only does strong self-awareness help you manage stress, but it also helps with your time management skills and helps increase your self-confidence. Having this foundation will make it easier for you to receive constructive criticism and other feedback.

It is essential to be self-aware outside of work and in the workplace. To help build and strengthen your self-awareness in both areas, you can:

◦Focus on being open-minded
◦Reflect on your strengths and weaknesses
◦Stay focused on your task at hand
◦Set appropriate boundaries
◦Know your emotional triggers
◦Trust your instincts
◦Encourage feedback from coworkers and friends


19.Endurance

Endurance is often associated with physical activity and running long distances, so you may wonder why it is one of the most vital nurse practitioner characteristics. Nurse practitioners need to have both physical and mental endurance to help prevent burnout.

Physically, nurse practitioners work long hours and are typically on their feet for most of them. Additionally, depending on the specialty they work in have to physically move or lift patients.

Mentally, nurse practitioners take on so much. They have to handle an enormous amount of stress daily. Nurse practitioners must work with patients and family members who are scared, angry, or in pain. Additionally, they constantly solve problems and accept criticism from patients, family, staff, upper management, and themselves. These factors can be emotionally draining.

To help build physical endurance, it is essential to participate in physical activity regularly. Do I mean you need to be a marathon runner? Not, unless that is what you want to do. But make time to do cardio, weight training, or yoga a few times per week. Trying to fit it in such a busy schedule can be challenging, so take advantage of any downtime you have to help strengthen your body.

To help build mental endurance, you must start with a positive attitude. If not, your efforts won’t be successful. Additionally, you must focus on gratitude. Any silver lining you can find in your day or situation will help. Further, prepare yourself for change and setbacks; they are inevitable. Finally, when a challenge arises, don’t look at as insurmountable. Building mental endurance does take work on your part, but it will positively affect your overall mental health.

20.Encouraging

As mentioned in the previous nurse practitioner qualities, we typically see our patients when they are sick, in pain, and even dying. In those times, they need someone who has a positive attitude and is encouraging towards them. Encouragement is the strongest motivator and comfort for patients. Whether or not they act like your encouragement is helping, know that it is most likely exactly what they needed under the surface.

To help be a more encouraging nurse practitioner, start with a gentle smile and a positive attitude when encountering patients. Listen and acknowledge your patient’s thoughts and feelings. Being heard can be one of the more encouraging feelings for a patient. Additionally, let them know when something positive happens, even if it is a minuscule thing. Did their labs improve slightly? Tell them! Are they able to have a procedure or diagnostic test sooner than expected? Let them know!

Finally, praising any progress is the most encouraging action from a nurse practitioner. Letting your patient know that you recognize their progress and don’t expect them to be textbook perfect helps build their confidence and can sometimes speed up the recovery process.

21.Respectful

There are many nurse practitioner qualities that affect our bedside manner, and being respectful is the most important. If you want to be respected as a provider, you must first offer respect. This not only applies to your patients but also to your colleagues.

Honestly, it can be difficult to respect someone who doesn’t respect you, but you must flip the script. If you feel disrespected by a patient or a coworker, our initial reaction is to return the disrespect, but that will not solve anything. If you continuously show appreciation and consideration for them, they typically will return the favor.

I had an instance in which I felt disrespected by a coworker, and no matter how much I wanted to return that disrespect, I knew that wouldn’t resolve anything. Instead, I continued to offer as much consideration to them as I possibly could. Did it completely solve the issue? No, but it did improve it significantly to the point that I could easily tolerate it.

There are so many ways you can show respect to others, here are a few basic ways:

◦Make eye contact and actively listen
◦Be mindful of other people’s feelings
◦Say please and thank you
◦Address mistakes with kindness
◦Understand other people’s boundaries and acknowledge them


22.Emotional Stability

Nurse practitioners experience a plethora of emotions daily. It is one of the most crucial nurse practitioner traits that we are emotionally stable not only for our mental health but also for the safety of our patients. If we don’t keep our emotions in check during high-stress situations, it can be detrimental to our patients. Does that mean we must be stoic all the time and never show emotion? No, that isn’t healthy either. You must find a balance.

To help strengthen your emotional stability, you must first start with your self-awareness. If you are not self-aware, it will be challenging for you to manage your emotions. As previously mentioned, self-awareness is a foundational building block for many characteristics.

How do you further strengthen your emotional stability, though? Emotional stability seems like a personality trait and not something you can change, right? That is only partially true. To help strengthen your emotional resilience, you should:

◦Find a supportive colleague that you can turn to during stressful times
◦Have a safe space at work that you can retreat to when you are feeling overwhelmed
◦Continuously strengthen your self-awareness
◦Talk to a professional counselor or therapist


23.Critical Thinker

Being a solid critical thinker is vital in your role as a nurse, and it remains as such in your role as a nurse practitioner. Just as your role expands when transitioning from a nurse to a nurse practitioner, so does your level of critical thinking. It is necessary to solve your patient’s problems efficiently. When you are in charge of the treatment plan, these skills are vital to creating a safe and effective intervention.

Critical thinking culminates several necessary nurse practitioner qualities like competence, creativity, and analytical skills into one characteristic. You should already have the baseline capability to critically think if you are a nurse, but there are approaches to help further develop the skill you should:

◦Practice procedural skills until they are second nature to you
◦Ask questions if you don’t understand or can’t find a solution
◦Look for new learning experiences and read professional resources
◦Work on your creativity
◦Be open-minded to different solutions to a problem


24.Team Player

Healthcare is an incredible team trying to improve the health and care of our patients. There are jobs that I know I cannot do without the help of others, and there are so many essential roles to healthcare workflow. Being a team player is one of the necessary nurse practitioner qualities if you want to work efficiently and keep your patients safe.

Collaborating as a team also is essential to achieving clinical goals for better outcomes. Quality improvement is an integral part of healthcare, and working as a team allows for new, creative ideas to form.

More often than not, you will have a leadership role on the team due to your advanced degree. You mustn’t confuse being a leader with not being a team player. You have the most significant responsibility of setting the example of what a team player is.

How to be a successful team player:

◦Have good communications skills
◦Take responsibility for successes and setbacks
◦Be flexible
◦Be willing to help
◦Be open to collaboration
◦Celebrate teammate success
◦Understand your role on the team
◦Respect your team members


25.Professional

Being a professional means conducting yourself in a manner that represents you and represents your employer. Being professional is crucial in creating a courteous and considerate work environment. Most people spend most of their time at their workplace. It mustn’t be a toxic place to be.

Hostile workplaces not only have a difficult time retaining staff, but they also typically have a hard time staying in business. Patients do not want to go somewhere where they can feel the tension amongst the staff.

Professionalism is one of the nurse practitioner qualities that can’t be overlooked. There are several ways to strengthen your professional capabilities, including:

◦Embodying the companies values
◦Dress appropriately
◦Have strong communication skills
◦Find a positive mentor
◦Practice professionalism when attending events, conferences, and meetings
◦Avoid office politics and gossip
◦Focus on treating others with respect

My Final Thoughts

So, these are what qualities it takes to be a good nurse practitioner. As you can see, it takes a lot to be a successful nurse practitioner, but don’t be discouraged if you don’t possess all of the nurse practitioner qualities. You can build and strengthen any of the characteristics mentioned above. All it takes is a little conscious effort. After considering the 25 qualities that make a good nurse practitioner, do you have what it takes?

25 Qualities that Make a Good Nurse Practitioner (2)Andrea Mosher, CPNP, PMHS
Andrea Mosher, CPNP, is a primary care pediatric nurse practitioner with a variety of nursing experience. She has worked in medical-surgical, emergency departments, urgent care and primary care pediatrics.

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