After two years of hard work, I passed the AANP boards May 27th and am only waiting on the board of nursing to approve my license. Living in the Southeastern region of the U.S. I was prepared for a long wait before attaining interviews or job offers. So far the "interviews" have been really disappointing.
Interview #1- "screening interview" with large clinic in northern part of the state (more expensive) Asked the typical interviewing questions and afterward sent information about salary/benefits. I stopped really reading after I saw 70k for the position, its a M-F position
Interview #2- interview with MD, not really an interview. MD acted as though I already had the job although I never accepted or led her to believe this. She's going to Atlanta but would like to keep current practice open. I told her 80K and she said she would speak to her practice partner about it. I would be the only practitioner in office with minimum training and would have only a receptionist and medical assistant in the building. Let's not mention medical assistant will soon be made "office manager" and she hasn't even told her staff she is leaving yet. She leaves in July. After speaking to one of my classmates I found out that the MD had offered her the position as well. In the words of my classmate the MD "stalked" her even after her refusal of the position trying to get her to take the job. I could tell the MD was desperate, but she really had no knowledge of what the benefits package would be. The ONLY good thing about this job was that it was Mon-Thurs.
Interview#3- I drove 1.5 hours to this interview. It is in rural GA but an easy commute from a bigger town with an excellent school system. Again this was not like any interview I was used to as far as asking the standard interview questions. I was told about the office, the typical patient population, and what was expected of me. MD basically wanted a second provider in the office so that she could see less patient load and be able to go to the hospital to see patients. I would be alone in the office at times, but would be built up to this. She asked me what I was looking for in a salary. I told her that 80k was the average but I was open to negotiation. She basically said she paid her last NP 67K as a base salary but there were incentives for completing charts. Benefits included the usual (vacation, health insurance, etc.) EXCEPT malpractice and DEA would be paid for by NP. If practice paid for such it would be taken from base salary and it would only be for the first year. According to the MD, NP left after 3 years and was making around 85k at that point with incentives. Again this practice is Mon-Thurs with Fridays being used to catch up charting. Rarely there might be patients seen Friday but its only a half-day either way.
Today I have my fourth interview in my actual hometown. After speaking to my former preceptor yesterday, he assured me that the job was mine. The only problem is they have big dreams and visions of opening up a lot of outpatient clinics and possibly an urgent care center but no big dreams of paying better. The FNP currently working there has been employed a little less than a year. She was employed solely for the family practice making 70k per year. Well she is now running a wound care clinic two times a week and has increased business to the point that they would like to open it 5 days a week. She does not receive a differential for the days in the wound care clinic although she performs about 12-15 minor procedures a day. They recently started a breast clinic which allows women to get a clinical breast exam performed by a midlevel and if any problems are noted an U/S is performed which could lead to a biopsy performed by the surgeon the same day!!! If CBE is normal, regular mammogram is performed with results handed to patient before leaving. I LOVE IT!!! They've increased from just 3 patients a day to 13-15 just with word of mouth alone. My preceptor has been the vehicle for all these changes and I love his vision. He states all the mid-levels should be paid more but of course he is not the CEO of the hospital. I would love to stay here for another 2-3 years gaining experience, but the current mid-level is locked into her contract at 70k for 3 years despite the extra responsibilities she has taken on. Today is my day to bargain and I feel 75K is reasonable. I will be cross-trained for wound care and breast clinic. He also wants me to be the lead NP for a weight loss clinic in the community (still an idea, non-existent). I think differentials should be paid for different areas. And if an urgent care is opened with the extended hours (Mon-Fri 8a-8p, Sat 8-4), there should be some kind of increase in pay. I feel as though the CEO is not going to budge and neither am I. I want 75k with the benefits and some kind of room for an increase in pay or differentials for different areas. I'm not signing a 3 year contract unless I know there is a guaranteed increase in pay over 3 years. The current office hours are 9-530 Mon-Fri. My preceptor states that the CEO should offer some way for us to bring in extra income by picking up extra shifts in different areas (such as ER). He feels like since we were floor nurses and able to do this that this would be a great for retention. What he fails to realize is that floor nurses work 3 days a week and pick up shifts NOT 5 days a week. If I take any position for 5 days a week, I don't want to necessarily work a 6th day for extra income, I feel my base salary should be enough or else why take the position? At this point, I am so disappointed with the greed in the rural area, I'm ready to leave the southeast completely. Its quite clear to me that these MDs or hospitals are trying to use mid-levels to stuff their pockets.
