California NP

[Dominic0414]

I currently work in a medical/surgical/transplant ICU in the top hospital in the Seattle area. I have been accepted into a DNP FNP program in the Seattle and will start in the fall. I am from the bay area and would like to return once I finish school, but I am unsure if that is a wise decision based upon some the things I have read regarding being an NP in California. I have not accepted the position yet and was hoping to get some input from some current CA NP's before accepting. The questions I have regard pay, scope of practice, practice setting, and job satisfaction. I appreciate any responses.

[Corey Narry, MSN, RN, NP]

Pay would be commensurate with the high cost of living in the area.

Scope of practice is not independent and requires "Standardized Procedures" which is basically a document with protocols as to how the NP is to manage patients under his/her care signed with a collaborating physician. The document tends to be generalized in language. That said, there is no requirement for physician presence at all times. I know there is a way for primary care NP's to be designated as independent PCP's for patients insured under Medi-Cal (the state's Medicaid program) but I'm not familiar with that process.

Practice setting is as diverse as any other state. You will have a tough time finding an ICU NP position in the Bay Area as an FNP even with your ICU RN experience. The hospitals that have ICU NP's are dominated by ACNP's who are reluctant to open the groups to other types of NP's. You can find specialty positions in both in patient and out patient settings easily, however. Primary care jobs are going to be scarce in the private practice setting but non-profits and FQHC's do have primary care openings from time to time (maybe with lower than average pay).

Job satisfaction? I like my job for sure.