Agree with above. Professionals do not punch time clocks, lol.
I LOL'd about working for a different pimp. Very true. As a NP you will have to worry about money/billing, I don't have any NP colleagues who don't except those in free clinics, and they have a different set of money problems. Grant writing is a pain in the patoot, and there is never enough money to go around! It is different being a provider than being a nurse. You don't get to mitch and boan about not having supplies while "the man" gets his bonus, because you will be the one, while still needing supplies, wanting your
own bonus, lol. It is a different view of providing care: conserving/allocating resources, earning money- issues that probably don't affect the day to day practice of most RNs very much, but that direct the practice of most APNs, and it can be frustrating. There is no getting away from it. A very little bit in the University systems, but even there money is going to be at issue as departments fight over budgets. One department will argue that their Charlson, Higashi, or Total Illness Burden Index score is higher than another's, and the other department will argue that that metric shouldn't be used because blah blah blah. They will fight tooth and nail for peanuts, becuase ther isn't enough to go around. The department that publishes the best research will get the most in the end, because most of the money comes from grants and donors. So just being out of for profit health care won't save you. And that is my least favorite reality of my job, and it is never going to go away.
I have never given much thought to being sued, probably because I never have been. Once it happens (not if
, when) I'll worry about it more. I try to document well and hope for the best. I have a colleague who was told by a patient recently, "Gee doc, I really like you, and I hate to do this to you, but I need a new roof, and my son is going to college soon, so, sorry man."
I get crazy sometimes. I go off on tangents when I just flat out refuse to indulge people for weeks at a time because I get so irritated at the lack of accountability and intrinsic motivation. During that time I don't always like my job or all of my patients. I lose faith in human nature. It happens if I just see too many people taking advantage of the system, too many people refusing to make any effort at all, too many abused children, too many neglected elders, too many narcotic seekers, too many liars, too many demanding jerks, too many whiners, too many entitled losers, too many know-it-alls, too many prior authorizations, too many charts back from medical records for review, too many forms to complete, coupled with too few pleasant patients for respite in between, all within a short span of time. I'm human, it happens.
I have these mini freakouts about 1-2x a year, and they last about a week or two. It means I need a vacation, or some validation, small reminder that what I am doing does matter. I get one or the other and I usually all right again.
What I love about my job- I do what I want to, for whom I want, when I want, how I want, if I want to. I make my own schedule, can come and go when I please. If I decide to have breakfast with my son, I call and say, cancel the 9:00, I won't be in until 10, or I can not call and just saunter in at 10:00 if I want to, lol. I wouldn't do that because I think it rude, but if I did that, no one would say boo to me about it. I have office mates who do, our practice manager makes petty remarks to the other providers about them behind their backs, but she doesn't say anything directly to them, she is not big on confrontation, lol. My point is, if something important comes up and I need to change my schedule, I have the freedom to do it on a moment's notice and I answer to no one but my own conscience. Now, do it too often and the money issue will come up again, lol.
I love that I get to choose how I practice. No one tells me how to provide care, what kind of patients to see/not see. I was free to determine how to shape my business and if I decide to change it, that too is up to me. If I decide tomorrow I don't want to see females, or anyone under age 14, or over 65, etc, fine. If I decide I want to do some cosmetic derm, I could do that. I decided last year to stop doing IUDs, for instance. Takes too long, I need a chaperone, and they are expensive devices I have to order and have lying around. Not worth it, I'd rather refer that out. I like that I get to decide that on my own. No one tells me "you have to do this," "you can't do that." To me, that is an extremely valuable aspect of independent practice.
I control my day. I control my career. It is up to me. All of it. I never enjoyed that kind of autonomy as a Nurse and I relish it now. Of course, it is tremendous responsibility as well, and not everyone would find it worth it. Some people just want a job they can go to, "clock in" and go home. I wanted a real profession I could steer myself, so this is an ideal fit for me. I wouldn't change a thing.