Advice?? Having trouble finding NP job.

[seibeb2012]

Hello. I'm sure I'm not the only one, but I am an Ohio NP having trouble finding a job. There are lots of jobs out there and I am applying for just about everything. I am even willing to move! I am a new grad and so many postings say that they want experience...but how are we suppose to get that! I have worked for my current employer, a small community hospital, for 17 years and, while they have no openings right now, they say "just be patient, we're working on some things." I can't wait for them forever but it's looking like I have no other choice.

I have the Adult Gerontology Primary Care NP certification - I did not want peds and/or OB. This is the population I work with the most and am most comfortable with. I have found that many jobs say either family or adult certification, so I don't think that it's my specific degree holding me back.

For those of you who had trouble... how did you get through it? Do you have any advice on what more I can do? After I apply, I typically get an email saying "we'll contact you if you meet our qualifications." And some say do not call us. So I have avoided calling anywhere.

I'm so frustrated right now! And since I have worked for the same company and did all of my clinical time with NPs and a Dr at my facility, I don't know anyone at any other facility!

[gettingbsn2msn, MSN, RN]

If you were in Atlanta I would want to meet with you. I've started a micro business and would like a NP partner. I have a few patients and am growing. We do not see anyone under 21.

[bbcewalters, NP]

You should look at Acute Rehab facilities, while these are "inpatient", you provide the medical management of the patient in a transitional care environment. The majority of the patients (90%) are over 65. While caring for the patient you are considered the PCP and medicare doesn't allow the patient to see their primary care provider while in one of these facilities. These are "stable" medical patients that lack support at home and sent to rehab. They have multiple comorbidites like DM, CHF, HTN, A-fib.....and the list is endless..... It is not a nursing home!!!! I LOVE THIS JOB!!! Good Luck!

[Skippingtowork]

Jules A said:

My guess is you did nothing wrong other than to buy into the hype that there is a shortage of NPs when in fact the number graduating and attempting to practice are increasing in numbers such there is no way it will support a decent supply vs demand scenario. That and the fact that so many have no nursing background or ability to practice competently after graduating from HackU that employers are being far more selective now than in years before.

For NP students the most helpful strategy in my opinion is to have a job lined up prior to graduation from one of your clinical sites. I always advise selecting your sites as potential long term job interviews rather than just taking whatever site you can get. Of course many students now, not directing this at you 2bNotAnotherMaleNurse7, don't even know a single NP and have no professional contacts prior to forking out large sums of money for school which makes it difficult and in which case I would treat whatever site you get stuck with as an informal interview for possible employment after graduation.

My guess is this will only continue to get worse.

There are tons of jobs out there. You just have to be in the right area. And nobody cares about the school you went to. When I interviewed for my first job, they only asked me where my clinicals were. They wanted to know that my preceptors were good. Now that I'm adding additional credentials, the job offers don't stop. I have been lucky to have very good preceptors. I am around PAs and NPs who were educated all over the country and no one knows their schools, just that they passed their boards. Some were from B&M and some on-line programs from B&M schools. The fact is some areas do not have high needs for new grads because they are saturated. Others really need NPs, PAs, MDs. Another thing, it's too bad that there are so many practicing NPs who do not precept even one day. The only way to produce good NPs is to have excellent clinical rotations. Didactics are great, but application is very important too. It also does nothing for the public perception of the profession if one NP calls another NP program HackU. We're all lumped into the same barrel. In addition, all undergraduate programs are not the same and nursing experience varies regardless of the number of years in the profession. I know a for-profit school whose nurses pass the NCLEX at a higher rate than the recognized schools in the state. And I've worked with some, and they are excellent. It should also be noted that hospital systems are not the largest employers of NPs. Most NPs are in the community. A hospital hiring only from certain type of programs can do that because they only need a few, compared to the other establishments. Most NPs in hospitals are hired by the department or physician group. If they like you they like you. If they know you and you graduated from XYZ in Tootsie Land, you have a shot.

Lastly, if you accept less than you wanted, don't sign for more than one year. Make a good impression on other doctors that you come in contact with so that you'll be attractive to them. Beware of the non-compete clause.

[Jules A, MSN]

Stepney said:

There are tons of jobs out there. You just have to be in the right area. And nobody cares about the school you went to.

I'm sure it does vary by area however where I am they are increasingly aware of not only of our education but also our experience and are hiring or not hiring accordingly. I suspect this will continue especially as the large numbers of NPs from schools with virtually no admission requirements hit the market and the public becomes more aware of the NP vs MD debate.

[JellyDonut]

Jules A said:

I'm sure it does vary by area however where I am they are increasingly aware of not only of our education but also our experience and are hiring or not hiring accordingly. I suspect this will continue especially as the large numbers of NPs from schools with virtually no admission requirements hit the market and the public becomes more aware of the NP vs MD debate.

The first thing we look at in deciding to interview an applicant is where they earned their NP then their RN experience. If you send me a resume of an applicant who graduated from a for profit online program he/she better have a mess of experience or it goes in my not a chance pile. We have interviewed for-profit online grads but only if they have substantial RN experience. It makes a difference when I have to orient them.

[Skippingtowork]

JellyDonut said:

The first thing we look at in deciding to interview an applicant is where they earned their NP then their RN experience. If you send me a resume of an applicant who graduated from a for profit online program he/she better have a mess of experience or it goes in my not a chance pile. We have interviewed for-profit online grads but only if they have substantial RN experience. It makes a difference when I have to orient them.

Yes, but there are major top schools that have online programs. Many people who are returning to school cannot move out of the area to do so, but they are top notch. And how do you determine who is for profit? High cost does not equal for profit. Not-for-profit can still equal high cost and on-line. Generalizations, but not based on evidence. If your area is saturated you always discriminate according to your own standards. That's how markets work. That's how it works in all businesses.

[aok7, NP]

Anyone in the business knows the difference between the for-profit online schools and an established university with an online program.

[AtomicWoman]

ghillbert said:

I think adult-gero primary NP is limiting - its very specific, and most outpatient primary care clinics want FNP. You could try long term facilities or home visits to get some experience.

I see a ton of jobs in Pgh but almost all ACNP or FNP. You could consider a post masters FNP or other cert if you need to broaden your marketability. Network also- contact local NP associations, your alumni assoc from your school etc for job opportunities

I disagree that adult-gero primary care is limiting (yep, I am an AGPCNP). True that the retail clinics want FNPs. But adult-gero NPs can work in internal medicine (including endocrinology, cardiology, nephrology, etc.) and around here, many family practices hire adult-gero NPs because parents take their kids to pediatricians, not the family doc. They can also work in rehab facilities, as another poster pointed out. I get job listings sent to me every day, and there are plenty of jobs for AGPCNPs.

[aprnKate]

just sign up for indeed.com and post your resume and you will get calls. Make sure you have your NP license and certification already most will want that. recruiters most of the time, can't present you to a client unless you have your license and certification.

Also, if you are willing to move all over the US you will be able to find a job. Just don't expect urban/metropolitan areas because most of those areas are over saturated w/ NPs. Try rural areas. I've always worked rural areas and have liked it. will probably not go back to the city

[mcaselogic]

The way I got my job was to speaking directly to the rounding doctors. Now I'm with ID. You have to be EXTREMELY persistent until you bother someone so much, that they end up giving you a job. Good luck if you are still searching!

[ToFNPandBeyond]

Jules A said:

I'm not really seeing as many NP jobs being posted as compared to a few years ago and from what I know the reasons places aren't hiring new grads includes that the majority have not been prepared by their schools to practice to their full scope upon graduation. Even the teaching hospital where I work has tightened their precepting requirements. If a NP student isn't already working in the system or has their own inside connection willing to precept they aren't welcome due both to the overwhelming numbers and poor quality of students recently.

Not that a new provider won't need some support but the expectations of long orientations that also require another member of the staff's time to basically teach the newbie their entire job is unrealistic in my opinion.

Jules, I've read a lot of your comments on different threads and with all due respect, I find your opinions regarding NPs with no RN experience, who seek orientation, to be a bit crass, inaccurate, and uncalled for. Please note two things:

1. Medical students get years of residency (aka orientation) before they become practicing physicians, regardless of specialty. Residencies for NPs are just starting to emerge, but they are few and far between. Therefore, it is not unreasonable to expect a lengthy orientation. It ensures a new provider is able to provide safe and competent care.

2. Most NPs serve in primary care settings as there are a shortage of providers in these settings due to physicians going into specialty. In saying that, RN experience is irrelevant in this specialty. Yes, there are a few specialties where RN experience is required (acute care, neonatal, ER), but nursing schools will REQUIRE that you have nursing experience within those specialities before they consider you in those programs.

So please lay off on shaming NPs who haven't worked as an RN. It provides little for those who are looking for genuine support and understanding.

[djmatte, ADN, MSN, RN, NP]

ToFNPandBeyond said:

Jules, I've read a lot of your comments on different threads and with all due respect, I find your opinions regarding NPs with no RN experience, who seek orientation, to be a bit crass, inaccurate, and uncalled for. Please note two things:

1. Medical students get years of residency (aka orientation) before they become practicing physicians, regardless of specialty. Residencies for NPs are just starting to emerge, but they are few and far between. Therefore, it is not unreasonable to expect a lengthy orientation. It ensures a new provider is able to provide safe and competent care.

2. Most NPs serve in primary care settings as there are a shortage of providers in these settings due to physicians going into specialty. In saying that, RN experience is irrelevant in this specialty. Yes, there are a few specialties where RN experience is required (acute care, neonatal, ER), but nursing schools will REQUIRE that you have nursing experience within those specialities before they consider you in those programs.

So please lay off on shaming NPs who haven't worked as an RN. It provides little for those who are looking for genuine support and understanding.

I didn't see anything in that post shaming anyone for not working as an RN. If anything it reiterated what many people here feel about the status of np education; it is lacking and certainly isn't preparing most NPs to really work to their potential out the gate. Especially to the level many national bodies are advocating for. This is hugely frustrating to potential recruiters and probably why we see many jobs that have in caps "no new grads!!!" or "experienced only!!!". But to request she doesn't state her opinions on a subject on a public forum where people state their opinions regularly is counterproductive.

You readily admit that a new NP with no previous RN or medical background *should* be expected to need more time to get their bearings and thus is where some people have their opinions. Lots of studies have been posted regarding the abilities of inexperienced direct entry to meet expectations In school and in some areas do better than people who have taken more time off from school. But there's nothing that supports one being superior or even equal either way regarding actual clinical practice. There is still debate on the impact of RN experience in primary care, but it is hardly settled. So while her opinions may be disagreeable to you, it's inappropriate to suggest that she not vocalize them. Until her opinions are actually invalidated, they are no less correct than yours.