What I Look For When Hiring a Nurse Practitioner

I get asked this a lot, so let's talk about what I actually look for when hiring a nurse practitioner for my plastic surgery team.

I wish I could give you an exact scientific formula. I can't, a lot of it is getting a feel for someone. But there are specific things I'm looking for every time, and here they are.

The first thing I look for is a history of working in an area with more autonomy.

This matters especially for a new grad who hasn't yet worked as a nurse practitioner. In that case, I look at their experience as a nurse, and specifically whether they worked somewhere they had to function independently. The settings that stand out:

• Emergency department
• Labor and delivery
• ICU
• Surgery

I find that nurses with that kind of experience tend to make the best nurse practitioners for my field. They've already had to make calls under pressure without someone standing over them, and that translates directly.

For this job specifically, what I want most is someone who has had really good experience taking care of surgical patients, in the ICU, the ER, or on a surgical floor, and I want multiple years of it. There isn't really a "surgical nurse practitioner" track, so that experience is where you learn surgical and post-surgical care. Surgical patients are complicated, and this is acute care. You need to really know your stuff. I want someone who's got chops, so to speak.

That's why this usually isn't the best job for a new grad. There are exceptions, and sometimes you know it when you meet someone. But in general, having a couple of years under your belt is really important.

This one is more of a je ne sais quoi, but I can usually tell within an interview whether someone is curious.

I love people who are open, curious, and eager to learn. I want someone who seems genuinely excited about the subject matter, even when it's completely new to them. Plastic surgery has a steep learning curve, and enthusiasm for the material beats existing knowledge every time.

The next thing is overall personality and how well someone meshes with me specifically.

I'll be blunt about this: timid personalities don't do well in this field. I like people who are:

• Strong
• Assertive
• Comfortable having discussions with me right off the bat

If you can't push back on me in an interview, it's going to be hard to push back on me when it matters, and in medicine, that matters. I want someone who will say "I think we should look at this again."

This is the big one, and it's the thing I evaluate during the trial period. When I hire someone, we usually have a several-month trial period, which is pretty standard for this kind of role.

What I'm watching for is the difference between problem solving and information gathering.

Here's the distinction in practice. When a patient has an issue, the person I want has already thought through what they believe it is and what they think the solution is before they walk into my office, even when it's a brand-new problem. They may be wrong, that's fine. But they've engaged with it.

The alternative is someone who simply gathers information and hands it to me to solve. And I can always tell which one I'm getting by the way information arrives.

I want an active mind, someone always thinking three steps ahead. That way they're a genuine part of the team, and together we take better care of the patient. That collaborative capability is a big part of how a practice actually manages complications well.

The last thing is simple: I like good vibes. I like positive people.

We are together all the time. And more importantly, we are our patients' biggest cheerleaders when they're going through something hard. A lot of what we do involves people at vulnerable moments, cancer diagnoses, difficult recoveries, complications.

I want a sunny personality to complement mine, so that our patients have a genuinely great experience and we can hype them up during the hard stuff. That isn't a soft consideration. For the patient, it's a real part of the care.

People also ask what a nurse practitioner on a plastic surgery team actually does. On my team, the job is primarily post-op care.

• Patients are connected with our nurse practitioner on our encrypted messaging system on the day of surgery. They have a direct line to our NP for the first month after surgery, so they can ask all of the questions that come up during recovery.
• Our NP comes into post-op appointments with me on clinic days. Because they're in direct communication with my patients, they keep me up to date on every concern and everything that's going on.
• It's a flexible job. A lot of it is answering calls and messages, which can be done from home, and that isn't possible in many nursing jobs.

Before I had a nurse practitioner, I took all my own calls. I rarely got called at night or on weekends, and I thought it was because I'm awesome, I'm good at educating, and my patients didn't have questions.

Turns out they did have questions.

When my nurse practitioner started taking calls and answering messages during the day while I'm in the OR, the volume of messages went up. People are commonly a little intimidated to call their physician. They don't want to bother us at night or on weekends, and if it's not a big concern, they don't want to bug us. But they have a concern.

Now my patients are much more comfortable, and I think they get better care with a nurse practitioner on the team. It makes me better, too. Talking with our NP about what patients are worried about teaches me how to educate better up front, on dressings, wound care, and everything else. (It's part of why post-op follow-up matters as much as it does.)

We all get better as a team. I love having a nurse practitioner on my team.

What I look for in a nurse practitioner:

1. Autonomous background, ED, L&D, ICU, or surgery experience
2. Curiosity, open and excited to learn, even about unfamiliar material
3. A strong, assertive personality that can hold a discussion with me
4. Problem solving over information gathering, thinking three steps ahead
5. Good vibes, because we're together constantly and our patients need cheerleaders

For this role, add multiple years of surgical, acute-care experience. The job itself is mostly post-op care: being the person patients feel comfortable reaching out to, because anxiety is the enemy of healing.

None of that is a formula, and I still go on feel more than I'd like to admit. But if you're a nurse hoping to move into plastic surgery, those are the things that make me lean forward in an interview.