horror stories--are they true?

Jo Dirt · Mar 13, 2009

I'm almost set to start school to become a FNP and I'm kind of worried myself. I've been having a lot of doubts. I want to help people. I thought I may be useful in a rural area, maybe near an Amish or Mennonite community, where I could have my own office and see patients for cash at a reasonable fee, people would come in and I could maybe even sew up minor lacerations and injuries, I would do physicals for truck drivers, establish a clientelle and get to know my patients...but fantasy rarely transforms into reality...I don't want to stagnate as a bedside nurse but don't want to spin my wheels, either.

I'm trying to think realistically now. More than likely, I might find a job at the county health department (if they ever lift the hiring freeze) and deal with people who won't pay attention to a word I say to try to help them, or if I was lucky I'd find a job in a crummy medical clinic having to deal with drug seekers and whiners and people who are willfully sick because of their own irresponsibility and then expect medical technology to fix them...I'd have to see cases of child abuse and realize childrens' services can only do so much and most of the children will be doomed to stay where they are, in misery...

You are not alone in your apprehension.

VivaRN · Mar 13, 2009

I think that just like with RN jobs you have to find the right place for you. I work at a safety-net HIV clinic and we are not pushed to see large numbers of patients. The philosophy of the clinic is my philosophy, and as soon as I found it, I knew it was "right". If you know what you want, go get it. I work M-F and the benefits are quite nice.

*RN123ABC* · Mar 13, 2009

having to deal with drug seekers and whiners and people who are willfully sick because of their own irresponsibility and then expect medical technology to fix them...I'd have to see cases of child abuse and realize childrens' services can only do so much and most of the children will be doomed to stay where they are, in misery...
You are not alone in your apprehension.

ugh, stop GL, you are scaring me. :eek:

Seriously, these patients are the main reason I want out of the hospital. I am sure they will always be around, but at least in my area, the NPs here can discharge drug seekers from the practice if they can't make any headway with them. As the bedside nurse, not only do I have to deal with them, and the constant parade of borderline personalities who make puny suicidal "gestures," but I get the privildege of waiting on them hand and foot. These same people might walk into my office and they get 10 minutes, no enabling, no backrubs, no waitressing, and no sponge baths!! Just a proverbial boot in the rear if their behavior is really eggregious.

The reason I want to be a NP is coach people to healthier choices and a better quality of life. And that isn't just my answer to the admission committee, lol, it is how I really feel.

Trauma Columnist · Mar 13, 2009

I think you have to be realistic. As an APN, yes, I do impact pts health and yes, I educate regarding healthy choices. However, my job is still to be a billable entity and for that, I must crank out the pts. That is the reality of the healthcare system in which we reside.

Its not a horror story by any means, it is what it is. It is not always holistic or fun. However, I can pay the bills!

Mike L. · Mar 14, 2009

I work as an an FNP (Gerontology) for the Federal Government, and it is satisfying and frustrating. You will never stop 'being in school'. And you will not get rich on this job, but you will gain more independence and have the opportunity of using clinical judgement in the role of APN. Is the responsibility worth the effort and expense? So far, for me it is. You will find 'bad' physicians and 'good' physicians everywhere. There might be more job opportunities in your area for a more acute care role, but your training will depend upon your mentorships and personal drive.

sandnnw, BSN, MSN, EMT-B, APRN · Mar 14, 2009

Got,

I think you need to be realistic. It's not going to be like walking into into a hospital and expecting to get your first or second choice of locations. Granted, according to the research, there is a "national" nurse shortage, but that isn't in every city across our great land, nor is this true for APNs. I'd venture the problem is much worse for faculty in entry level programs.

You may have to do some work to get that right job. I had to wait nearly NINE months to get into a federal clinic position. Now granted, I could have gotten a job sooner if I wanted to work in a rural clinic. My clinical preceptor site wanted to hire me and even offered a nice starting salary. But that is not what I wanted. I already have a job as a critical care RN, pulling down about 96% of what I'd make as a new NP, so I can afford to be choosy. Others may not have that luxury.

I'd guess the APN shortage is not as critical as the RN one. So, between marketing and selling yourself, it may take some time and elbow grease to find that perfect job. As far as calling it a "horror story?" No, doesn't even come close.

Sheri FNP-C · Mar 15, 2009

I think it depends on what you call a horror story. I graduate in May and am scared to death at the lack of jobs. I will be giving up 8 wks paid time off and over $70,000 annual salary if I worked full-time. I also get amazing medical, dental, vision for my entire family including $1 prescription co-pays at the hospital pharmacy. However for my reduced NP salary of approximately $50,000-$60,000 I hope to not work every other weekend or every other holiday. I hope to never again miss Christmas or Easter morning. I will always get fresh Turkey on Thanksgiving, not the leftovers. Most importantly, I am sure that I will enjoy working as an NP significantly more than as a nurse.

My husband, the bean counter type, thinks this is absolutely horrific. Knowing that I will be working for at least he next 30 years, I think job satisfaction is priceless and am willing to sacrafice some money and benefits to get it. So I guess only you can decide if it would be a horror story for you.

JDCitizen · Mar 15, 2009

Probably wont get rich and your first job as an NP will probably be just that your first job as an NP.

My first job as an NP during my interviews the doctor in charge of the group kept telling me one thing and it never ended up being what he said....

A good part of the population does not have insurance or has limited insurance goes to the ERs, neighborhood health clinics or does without. The part of the population that has insurance and/or can afford to pay for their care are going to the nice comfy doctors offices the same offices that will dump them when Medicare starts paying their health bills.

State laws/regulations, hospital regulations, patient preference, geography, market need all can add up to affect your paycheck. My class alone there is 50K+ difference in some of out salaries (not a mistype 50K+)....

Now some of the things I have now as an NP: I don't have to put my name on a list stating which holidays I will work. My staff does not get pulled. My phone doesn't ring on my days off with the guilt trip about being short staffed. I have all federal holidays off. I do have input into my patient load. I can rearrange my schedule. I have my own office. I work four ten hour shifts than I go home for my three day weekend. Also when a doctor yells or is not professional I hang up or walk away; I don't have to put up with it. I also have what I call memo power. If I see a perceived problem with the functioning of the office and/or patient care someone will look into it and get back with me.

Some of the things I put up with: Noncompliance, lying, very-very sick, manipulative medical population. Poor peer review (it's either by a doctor or an RN).. Manipulative supervisors (memo power works both ways).

So "horror story?" Probably depends with what you have to compare it to.

To borrow some lines:

1) (traumaRUs) Its not a horror story by any means, it is what it is. It is not always holistic or fun. However, I can pay the bills!

2) (Mike L) It is satisfying and frustrating..

sandnnw, BSN, MSN, EMT-B, APRN · Mar 15, 2009

JD, sounds like you work at a VA like me! Don't you LOVE it!??!

JDCitizen · Mar 15, 2009

Nope state but am attempting to do the VA thing. It's close by have friends that work there, I don't want to move and I'm too old and falling apart for active duty :-)

One thing I found out about nurse friends: Keep them. Nurses know other nurses and we are all the time sharing... Sort of like a virtual allnurses.com

That last line is to see if I can get a moderator to bite :-)

sandnnw, BSN, MSN, EMT-B, APRN · Mar 15, 2009

To old??? at 46? Jeezzz, that's the new 36! You're in your NP prime! Agree about allnurses, this place is addictive.