JeanettePNP

Im in a similar situation, we are moving to pa but the closest job I could find was 40 miles away. The road is not high traffic and its a pretty easy drive. I already spend over an hour commuting by public transportation in my current job. Only disadvantage is that my commute is by turnpike and the toll is nearly $3 each way on top of gas. If I took a non-toll road it would add 20 minutes each way and my time is worth way more than the $3. I am working 4 days and also weighing going 1099 because then my transportation expenses are deductible. Not sure if it's worth it though all else considered.

if the attending wants to bill under his/her name (incident to) then the initial visit must be completed by the attending. If you are billing under your own name there is no reason you can't see the patient initially. I work in a specialty and when we see new patients I usually take the h&p and then the attending will speak to the patient and make the plan of care. At this point unless it's a complex case I can usually make the plan of care for new patients myself but patients feel better that they were seen by a specialist, not an NP.

Goldenrod, you plan to write articles on the topic of your choice and then submit them for publication? I guess my first step would be getting my paper from school published... It was rejected from the first journal i submitted to and then i started my first job and never got around to polishing it and submitting it again.

I have extensive freelance writing/editing experience but not in the medical field. How do I break in? I'd like to work on a freelance basis. I actually interviewed once for a clinical editing job with a major publisher but they required full time and I would have had to give up clinical practice, which I was not willing to do.

I do not work in an ER but I did do clinical rotations in an ER so I will try to answer some of your questions. - What level ESIs do you see? Do you see only 4/5s? Or all acuities? As a student I only saw 4-5's but I shadowed on more acute patients as well. There is a collaborative approach in the ED so basically the next available provider takes the next patient, and if a patient is more acute then it's "all hands on deck." The physicians and NPs work together, consult with each other on cases or call in specialists as needed. Defniitely the NPs I shadowed took care of higher acuity patients as well. - Does every patient who walks through your door have to be seen by an attending physician or are there some patients who are handled 100% independently by the PA/NP? The NPs/PAs handle their cases independently. If they decide they want a consultation/referral they will initiate that on their own. - What procedures do you do? I have heard that there are very few NPs/PAs who intubate, run codes, place central lines etc but I know there are "residency" programs that teach this so it must be done in some places? I don't care so much about being able to do procedures but I would like to be involved in the decision-making process for complex patients. All depends on your training/comfort level but generally they are happy to train you in these skills. I was just talking to a critical care MD who told me that a child needed a central line placed. The parents said they were not sure if they wanted an NP to place the central line. The MD said, trust me, you want this NP to place your child's central line. - What are your hours like? Do you work rotating shifts like MDs or strictly days/nights? The NPs in the particular site I was in with were either straight days or straight nights but that can differ depending on the hospital. I interviewed for a different job where they had rotating shifts. And any other general insight would be great. Sorry about the length of this post ... am very curious!

My thoughts exactly. There hasn't been any real break in this case for over a year. I'm also surprised she's held out as long as she has, but the family will do whatever they're gonna do. For people who ask why they can't move on, maybe the question should be--why can't YOU?

We had a suturing workshop in NP school but I didn't have an opportunity to practice the skill in clinicals. During my ER rotation they mostly used glue. In my workplace suturing doesn't come up.

I got my first bachelor's through an online school, which I was then able to use to get into an accelerated nursing program (I did science pre-reqs at a brick-and-mortar). My experience with them was very good. I had an advisor who was very supportive and helpful in thinking through what I wanted to do with my degree and what I needed to do to get there. I happen to be a very independent, self-motivated learner and classroom learning is just not for me. I do most of my learning on my own, through reading books and articles, not through listening to a lecturer. I also have kids and was trying to minimize time away from home. Going the online route probably cut a few years off my schooling because I took the maximum course load each semester. Being able to take classes from home enabled me to complete many more credits than I would have been able to otherwise. For the actual nursing and masters' programs though I went with highly regarded traditional nursing schools. I gained a lot from collaboration with fellow students which just isn't possible in an online setting, not to mention that you can't learn clinical skills online. I also don't think students should have to arrange their own preceptors and when they do schools have little control over the quality of students' clinical experience. I think though that they could have offered more online courses for things like nursing research, nursing theory, healthcare economics etc.

Drove to Ohio for a job interview. drove back. Didn't get the job. went to a job fair. No leads. sent out more resumes made more calls went on more interviews lather, rinse repeat for three months until BINGO

Why not? I am proud to use the term nurse and I always consider myself a nurse first and foremost in the way I approach and relate to a patient.

My first job is in pediatric pulmonology. Pros: 1. an area where there's a lot of need (where I live has one of the highest rates of asthma in the country) and you can really see your work making a difference in kids' lives 2. Lots of autonomy, I work in my own office 2 days a week and it's basically up to me how I want to grow my practice. 3. Great doctor to work for, congenial work environment. Cons: 1. Limited skill set, I know a lot about asthma and sleep medicine but would like to expand. 2. First NP hired by the practice so a lot was trial and error, figuring out my role, salary, benefits etc. 3. Long hours, we work evenings to accommodate kids after school and it's hard as a working mother not to be home for supper/bedtime 3 nights a week. What I would have done differently: Nope. It was my first job offer and I grabbed it. I have no regrets.

I don't regret becoming an NP but I sometimes regret my choice of specialty. I still feel that pediatrics is the best fit for me in terms of personality and aptitude, but I wish I had gone with a higher-paying choice. Also, the FNP program was only one semester longer than PNP and I could have done peds but had so many more opportunities open to me.

As a new grad RN I interviewed for a job in Albany Medical Center and the starting salary for an RN was about 50k, so 80k for an NP does not surprise me.

I have been working as an NP for about a year and a half. What you feel is completely normal. For a good six months I felt like I was play-acting. I checked everything with the MD. Now I check maybe 1 in 10 patients with the MD. I work in a specialty so most of my patients have a pretty well-defined set of problems. Sometimes, though, they'll come in with something that is completely out of my depth and I have no idea how to begin assessing them. But the MD I work with is very accessible so I can always ask him when I'm in doubt. In time things will become more routine. There are certain problems you will see over and over and you'll be able to diagnose and treat with your eyes closed. Then there are some that come up less frequently but once you've seen 2-3 cases you'll know the routine. Then there are things that only come up once in a while that you may still need help with. Then there are the cases that will stump the MD's too!

There is no single best NP job. The best job is the one that's the best fit for you. Sometimes you have to see the opportunities and use your job as a platform to get to where you want to be. You may not have a lot of choices straight out of school for where you work. You have to take what's available and appreciate any opportunity that comes your way. Even the "worst" job can become the best one if you focus on excellence and patient care rather than the job perks.