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missvictoriat, MSN, RN 3,192 Views

Joined Apr 20, '11 - from 'LEWISVILLE, TX'. missvictoriat is a STAFF RN. She has '5' year(s) of experience and specializes in 'Med-Surg, Telemetry, Oncology'. Posts: 79 (14% Liked) Likes: 13

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  • Feb 18 '15

    Hello all!

    I passed boards last week and accepted my first NP job in primary care beginning next month. I want to solicit advice for how I should get organized to be able to hit the ground running. All advise is much appreciated.

  • Feb 17 '15

    They wouldn't accept the preliminary results for me. But they did accept the wallet card that the AANP posts on their site after receiving all of the other requirements. I downloaded the card in PDF then emailed it to the BON. Just know that the BON's website says that it takes 10 business days to process documents after receiving them, that includes 10 days after receiving the last document. And it doesn't help to call or email due to the sheer inundation they must be getting this time of year.

  • Jan 29 '15

    Hi Ariel25,

    Sorry for the long delay, I don't check this too often. In response to your question I am really loving my position in the retail clinic setting. It has taken some getting used to In terms of pros and cons: I feel that my orientation was a bit short considering my new grad status. I believe it was 9 shifts with a preceptor. Also, I started during their busiest time December (winter in general) very heavy patient volume during this time, it has definitely slowed down. It is a bit difficult working entirely solo, especially at first. This is where it helps to have really nice helpful co-workers to call on for help and advice when you find yourself feeling lost or unsure. There is also a physician assigned to each clinic available anytime for consult, if you run into a difficult case. Most of the time having a difficult case can be ruled out by guideline exclusion. There are strict guidelines set forth to follow that usually keep things from becoming to complicated or time consuming in an environment where you are generally expected to complete a patient visit in about 15 mins. This sounds like typical doctors office time slots but it is not. As a retail clinician you will perform EVERY aspect of the patient visit starting with entering insurance information, performing a full set of vitals, the hx, and assessment of the pt., e-prescribing medications if necessary (of course) closing the visit with taking any required payment. This can sound like a lot but once you get used to it this becomes second nature. Overall the position offers great pay, benefits, and retirement plan. Let me know if you would like more info.

  • Jan 29 '15

    Dont be nervous. You will do fine! I hope its going well. I think its not a bad start. I would have started there too if they would have called me back. I was lucky enough to get a family practice job, believe me I am running my little butt off. I am learning so much! I think if you keep yourself current you will be fine. You will see acute illnesses and their computer automated systems take the thinking process out of the way for you. So you should definitely learn protocols for acute illnesses. And you will see kids and adults so thats cool. Its probably not the best place to start and probably a better place to retire, but you have to start somewhere. I know a few girls that started off there from my school and they like it. How is it going? And congrats by the way! There is no shame in an honest job

  • Jan 29 '15

    Thanks! It's good to hear from someone else in a similar place entering the first job and all. It can be a scary thing. I haven't actually started yet. In 2 weeks I will have orientation online live online for 3 days straight with new NP's to the company from all over the country. I am curious how that works exactly. This is assuming the whole credentialing process goes as planned, I recently got married and my ANCC certificate needs to to be changed into my married name for me to be credentialed. I am not sure how fast the ANCC will do this, even though they assured me it would only take a few days once they received a copy of my marriage certificate. If they don't change it fast enough my hire date will be backed up. Do you have any good advice for entering the new job? Things you wish you had done ahead of time and such, brushed up on etc.? I am trying to prepare the best I can.

  • Jan 29 '15

    I know this topic has been discussed on here before a few years back, but I was hoping to get some current feedback. I graduated a year ago and passed my boards as an FNP last December. I have been having trouble finding a position that does not require experience, or a least a position that would be days versus nights. I have been working nights as an ICU nurse for the last 7 years. I was also hoping for an office or clinic position as opposed to hospital, seeing as how that is what my clinicals consisted of and I have had no hospital training from the NP standpoint. I had one potential office position a few months back that fell through because their NP unexpectedly decided to come back after her baby was born, that was pretty upsetting I really liked the office and physicians. I seem to be on the brink of an offer with a retail clinic at the moment and am planning on taking it because I feel that the longer I wait without a position of some sort, the rustier my NP skills will get and worse I will look to potential employers. I was even asked as the first question of my phone interview with the retail clinic very cleverly in not so many words why I still have not found an NP position, I believe I handled it well but that's not the point, I don't think I want to encounter that again, and it sure won't get better with time. I do realize that accepting this position will limit my scope of practice and many people in this industry have a distaste for these type of clinics, but I feel I need to start somewhere. Thus far the people I have met seem really nice the position itself seems like a good place for a new grad to start, sick visits for adults and kids, URI's, strep, UTI's, that sort of thing. The clinic offers physicals and diabetic and hypertension evaluations but I am not sure how many they perform. This all seems pretty good aside from the fact that the NP is completely alone in the clinic. That part is a bit worrisome, apparently there are many contact NP's and a collaborating physician available though. Just wondering if anyone has been in my predicament or has any good advice. Thanks!

  • Jan 29 '15

    Just a heads-up to future graduates.

    1. Graduated on 12/13
    2. Took the AANP boards on 12/16
    3. Finally everything was approved at the Texas BON on 1/14
    4. License was granted by the BON 1/27/15

    In case you want to plan job starting dates. I pretty much worked as fast as I could, it still took 6 weeks. Hope this helps.

  • Jan 11 '12

    Why did you go for your NP rather than continuing to work as an RN?

    I am currently half way through my NP program. I feel my strengths fit better with the NP role than it does the bedside nurse role. I'm not happy with my current level of knowledge. Even in nursing school, I was always asking practitioner level questions and was frustrated that it wasn't stuff that nurses knew. I wanted to know why a particular ABX was ordered, how to interpret the CBC, etc. I would rather use my brain more and my body less, lol.

    How much more money do you make as a NP rather than as an RN?

    A non-ICU NP at my hospital makes about the same or less than an experienced RN who works nights. Money is not a reason to become an NP. They can make more, but it isn't a huge difference unless you're talking about CRNAs.

    How long after becoming an RN did you go back to become a NP?

    Applied to school after 5 months, started the program after 8 months experience.

    Any thoughts on the requirement changes for NPs (needing a DNP as of
    2015 rather than MSN)??

    Until they mandate it, I wouldn't worry about it too much. Thing is, now it is harder to find programs that aren't DNPs.

    How long did you wait between getting your RN license and starting
    your graduate program?

    8 months.

    I am considering the BSN-DNP program that is offered online through
    University of Southern Alabama, anyone have any opinion about this
    (school, internet program, or anything else)??

    There is a lot of info on this school on these forums, just search for it. My impression of the school from a good friend who went there is it is less rigorous and thorough than some of the other programs and they don't always support their students very well. However, they generally have good pass rates, so if you are motivated and self-directed, you can at least learn what you need to get your certification.

    What is the biggest difference between working as a NP over an RN?

    You aren't being told a diagnosis, you have to figure it out and then give the orders instead of following them. It is a completely different mind-set. It is a lot more responsibility and it requires a lot more dedication to continuing education. You have to be a leader to other nurses and be comfortable in that role. If you just want to go to work, get your paycheck and go home, then you'll likely be happier as a bedside nurse.

    What is your work schedule like (days, nights, weekends)?

    Completely varies by position. The jobs I'm interested in are 24-hour shifts including holidays and weekends. I think they generally do between 6-8 24-hour shifts per month. Clinics tend to be M-F, often without holidays, weekends or call.

    Do you specialize (Neonatal NP, Psych NP, etc.) and if so do you wish
    you would have just become a FNP? (I am asking this because I love the
    idea of neonatal NP but I do not see any openings in this area within
    100 miles of my house, rarely any I can even find in the US)

    FYI, I think almost all NNP programs require 2 years NICU nursing before you can apply. They seem to be the strictest about that. Just like RN jobs NP jobs are harder to find right now. By specializing as an NP, it definitely limits your ability to get a job. If you are unable to relocate for a job, that is something to consider. I am doing Acute Care PNP, and I would never want to be an FNP. Primary care, and adults? No thanks! You need to pick the speciality that fits you, not anyone else.

    How long did it take you to find a job?

    I'll let you know in a year and a half, lol.

    OK this is a silly question - I know, but just answer the question and
    try not to laugh at me too hard lol! If you have a doctorate in
    nursing do people call you "Dr. so and so" also does this cause some
    confusion since you aren't a medical doctor or physician but instead a
    nurse practitioner with a doctorate?

    This is a very touchy political issue. The AMA has been lobbying to make it illegal for nurses with doctoral degrees from using the title Dr. in a clinical setting. Several states have made it illegal. The whole thing is ridiculous. Nurses aren't using the title to confuse patients into believing they are physicians. They are using a title that is conferred to almost everyone who receives a doctoral degree. So if you get a DNP, you will have to check to see what your state has to say on the issue.

    I think once you get out and get some RN experience you will figure out what you want to do. NP school is a major commitment. It is extremely difficult and time consuming, not to mention stressful. As you work with NPs and see what they do, you'll know if you want to make that step or not. I thought I'd wait several years, but once I saw what they did in our ICU I knew that was what I wanted to do and applied to school that month. But if you're happy as an RN, there is really no reason to put yourself through the frustration and stress that is grad school. You give up a lot of good things to become an NP, and the things you gain have to be worth more than what you lose.

  • Jan 11 '12

    i graduate after this semester and have been offered my first job after graduation. i have a few options, all of which are different. money is not my greatest focus but rather finding a placement that will teach me and support me as a new grad np. having said that:

    1. what do i need to ask about the job conditions? they are offering an hourly rate and "usual" benefits. it is the same organization i already work for. expected days, hours, how many patients/day, do you have to take call? do you have expenses associated with the practice? (a colleague found out after the fact that she had to pay for her own laptop-$1800 out of her own pocket just to start the job) profit sharing potential? since you already work there, does your previous experience count as "time in service?" another colleague worked icu as a staff nurse for 19 years, went to np school and then went to work in the same unit as a np. when they calculated her pay, she got credit for having been there for 19 years and started out at over 100k a year, much more than the experienced nps in the unit. maybe not "fair," but her loyalty to the system was rewarded (they also paid off all of her tuition loans, which is a very nice $65k bonus, lol).

    2. what do i need to ask about the training process/educational development? is there anything you wish you knew before you started your first job? conference or ce money etc? it varies from $1500/y on the low end to $3,000 on the high end. everyone seems to get about one week off paid to do cme activities. find out if it rolls over or disappears at the end of the year. i get $2200, reimbursement, not upfront. i only went to one conference and it didn't cost that much so i was able to negotiate to donate the unused cme dollars to the charity of my choice.

    3. how much more money per hour should i expect over rn rate? i know the position has a salary range and their offer is right in the middle (and right where i indicated would be my minimum acceptable pay rate). i currently am salaried but the offer works out to be about $5/hr more than i make as an rn... just doesn't seem much. cant answer that, it depends on your area, just know your market. advance for np/pas just released survey results a day or two ago that said the avg starting np salary dropped from 80k to 70k in 2011 and more decrease was expected in 2012. this may or may not apply to your area. it is actually pretty on target for mine. the last data i had from the aanp (2009-10) for my area said the avg salary here was about 84k, and that is exactly what i was initially offered actually, but we are hiring in at 76,400k now, and it is nonnegotiable for new grads. our practice does not recognize rn experience at all in salary negotiation. 2 weeks or 20 years, it's all the same. we do have a pay scale ladder for experienced nps, but i don't think they really negotiate much, just nickle and dime a little. i was able to wrangle an extra 3 days of paid vacation, lol, but no additional salary. i did strike a deal for patient satisfaction bonuses. i have made a killing in patient satisfaction in the past, lol. they love me. i don't treat chronic pain at all and so don't get a lot of the problem pts that often lower scores in the first place. the other np in my office made $24k in productivity bonuses last year. we have very different patient panels. she sees about 24-25 pts a day, mostly chronically ill adults. she does some outstanding documentation to code everyone up to a 14 or 15! i'm not as fast as she is, seeing about 18-20 a day, mostly young families, infants and kids and i end of with a lot more 13s and wouldn't bring home that kind of bacon based on productivity. the point is, figure out what kind of practice you think you are going to develop and what it's potential is, and negotiate toward your strength. mine is pt satisfaction, hers is productivity. mostly, know your market!!!

    the good thing is that they really want me, and i know they need several nps and are finding it hard to find suitable candidates. i think they are willing to negotiate at least somewhat.

    thanks for any guidance. i am really torn about staying in my current dept or leaving for this new opportunity. i love where i work but the role there would not be as challenging as the new job offer, and i love a challenge!

    good luck

  • Jan 11 '12

    I graduate after this semester and have been offered my first job after graduation. I have a few options, all of which are different. Money is not my greatest focus but rather finding a placement that will teach me and support me as a new grad NP. Having said that:

    1. What do I need to ask about the job conditions? They are offering an hourly rate and "usual" benefits. It is the same organization I already work for.

    2. What do I need to ask about the training process/educational development? Is there anything you wish you knew before you started your first job? Conference or CE money etc?

    3. How much more money per hour should I expect over RN rate? I know the position has a salary range and their offer is right in the middle (and right where I indicated would be my minimum acceptable pay rate). I currently am salaried but the offer works out to be about $5/hr more than I make as an RN... just doesn't seem much.

    The good thing is that they really want me, and I know they need several NPs and are finding it hard to find suitable candidates. I think they are willing to negotiate at least somewhat.

    Thanks for any guidance. I am really torn about staying in my current dept or leaving for this new opportunity. I love where I work but the role there would not be as challenging as the new job offer, and I love a challenge!

  • Aug 28 '11

    Don't worry, AACN wants BSN to be the entry level to nursing and have for the last 30 years! Is it a reality?? Uh nope!

    Don't sweat it - head on over and get your MSN!

  • Aug 28 '11

    Thanks for all the advice, guys. I start my first semester of FNP school in two weeks, and I'm SUPER excited/nervous. Keep all the good info coming!!!

  • Aug 28 '11

    Be organized and ask for help early if you need it. Most of the professors want you to do well and will go out of their way to help you. If you get overwhelmed, talk to your school's counseling center - they are there to help you.

    Agree re not getting behind. I am a BAD procrastinator, always have been. I really find it difficult to study even if I sit at my desk with my books in front of me, unless it's close to the due date. That doesn't work when you work full-time and have school part-time like I do, it's impossible. The sheer amount of paperwork, lecture material and reading you have to do is incredible. The best ways I have found to keep up:

    1. Read the slides/handout/readings that are posted before the class so it sounds vaguely familiar at the lecture.
    2. Make sure you print the handouts right before and take to the lecture. Sounds stupid, but lecturers often change them right before the class. Some students just take their laptops and read on there but I need paper.
    2. Record the lectures if possible. Then actually listen to them! I find it handy to have them going in the car all the time.
    3. Make sure to have a mark/highlight that you put on the handouts where the lecturers say "you should know this", "this is important", "I would know this for the test" etc.
    4. Pay attention to the lecture. Again sounds stupid but it's amazing how many other (adult) students do online shopping, talk, text, play with their phones etc during class.
    5. Soon after class (I took the night of my class off for a break and did it the next day), re-read your notes, and do whatever you do to study effectively eg. rewrite, summarize, make flash cards, highlight etc.
    6. If you have a prof who gives you study guides, use them closely. If not, check your notes against the detailed syllabus that shows what you need to know at the end of the semester.
    7. It is very tempting to focus your study on things you're familiar with. Don't do it. If I am experienced in a certain area and not in others, I choose the most unfamiliar area to study first. That way if I do start running out of study time, I only have to re-read stuff I already partially know.

    Edit: Oh, couple more.

    8. If you're working, take the opportunity to use the information you've learned in class and learn more. Eg. if you learn about renal function in class, check your patient's labs, fluid status, etc and mentally formulate a plan. Think about your current patients and do some differential diagnosis in your head. Read clinician notes, a lot of them - I learned a huge amount by reading other people's assessment and plan, and their medical decision making processes. You also learn what you like to read and what you don't like to read, so you can incorporate into your own notes at clinical.
    9. Get through clinical. If you have a crazy preceptor who likes you to write in purple pen, do it. If they like you to recite the alphabet in the morning, do it. Kidding, but you get the picture. You may not do things the same way when you graduate, but do what you have to do to get through it. Spend more time with good preceptors and seek out learning opportunities.

  • Aug 25 '11

    Hi all, I'm going to TWU's Denton campus this Fall for my FNP too. Glad to know we have a little group going on here!

    I checked Blackboard, and saw that there would be a lot of work to be done this semester. Good luck to everybody!

  • Aug 24 '11

    I think its a good thing to have a year or 2 of nursing experience, no offense to Physician Assistants, but I think that is one benefit to patients with a NP is that they have previous nursing experience dealing with the entire patient. Also once you get into NP school, you generally work part-time or full-time somewhere as a nurse, so the 2-4 years you take to finish the NP program you automatically have extra experience under your belt.


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