Chronicles of a VA APRN Resident

Specializes in MSN, FNP-BC.
Chronicles of a VA APRN Resident

I interviewed today and was offered one of six resident positions. I lost it. The panel laughed and said my reaction was the best one so far. ?

I was asked nine questions. They were along the lines of "Tell me about yourself; How will you contribute to VA care; Flexibility and describe a time when it was required; Career goals; Rate yourself 0 - 10 in the following aspects, etc.". I was sweating the whole time, but displayed a cool (I think) exterior.

It starts towards the end of September, so plenty of time for me to go over all my material from school and beef up my knowledge so I don't look like a total dunce.

I will periodically update this thread with all my trials and tribulations for those who are interested in applying for a spot in the future and want to know what the year will look like.

195 Answers

I read a story about VA Residency for APRNs a few weeks ago for a class.  It seems they are very supportive.  It's definitely one place I would consider applying to after I finish my program.

Looking forward to hearing about it and good luck! ?

Specializes in Psychiatry.
Mergirlc said:

For those of you who chose to do this residency instead of just going straight into a non-residency job:  Did you decide on this route because you felt your school did not give you the best training?  Or you felt "okay" but wanted to go into your first non-residency job, after the VA, more confident?

It's my understanding everybody comes out of FNP school feeling less than prepared for the most part.  I guess I'm just wondering the pros and cons of going through a residency, such as the VA, versus getting employment (less practice) right away and "hoping for the best?" 

It's a totally different experience. No, NP school does not do a good job preparing students for practice - PAs and Medical Students are terrified and fumble for months in residency/first jobs and they have 2,000-4000 hours of clinical. The requirement for NPs is 500 hours, much of it ends up being set up by the student and can be as simple as "shadowing." The first job for many NPs has no support and they are just expected to learn on the job, despite having no mentor or someone to tell them when they are doing something correctly. 

A residency is NOT like a first job- there is no "quota" they are trying to hit or make sure you are profitable out of the gate. In my VA residency program, I was assigned an MD and worked with him everyday, 9am to 4pm, seeing patients. At first, I shadowed him and asked questions. After a 2 weeks or so I began seeing his patients while he watched and corrected. After a few more weeks I saw patients alone, then presented to him the findings and my plan, he would then go see the patient and verify and we would talk it out. He helped me learn when to order tests, how to read them. Eventually I started to have my own "roster" of patients and by the end of the full-year residency I had acquired an almost additional 2,000 hours of directly supervised clinical hours and was working independently with my own roster of patients but given 45-60 mins per client so I could take my time and learn and full access to an MD who had signed up to teach and was not at all concerned with profitability. I also got to rotate to different specialities for a while. On top of all of this was didactic experience with experts explaining common pitfalls, treatment algorithms, etc. I learned 10x as much during my residency as my entire NP Program.

On 12/24/2022 at 4:11 PM, Tegridy said:

Yes it’s the VA. Literally the most inefficient hospital system in the county full of red tape and admin who collect w check for nothing. I dress the two months a year I have to spend there versus the private hospital systems. 

That’s your opinion but not fact. All I’ve seen is providers going above and beyond for Veterans and caregivers. We have financial freedom to order labs, imaging, consults, etc. When compared to the private sector, that is way less red tape. Yes it is socialized medicine so that comes with barriers but if anything the ability to consult all specialties and disciplines (OT, PT, speech, pharm, etc) under one roof is unmatched. 

I think the ultimate goal for everyone is to employ the residents. It really sucks if that doesn't work out because it is wasted time all around for all involved. I will say I have noticed they have employed more RNs recently into NP positions. So they are VA RNs without NP experience getting hired in the departments they are working in. They have been NPs awhile but working as RNs. Do I think that's necessarily fair? Not exactly. At the very least we should have been allowed to interview for that position along side them. But it is what it is. I know that I've gotten as far as I have from networking from my brick and mortar grad school. Mind you I am still waiting on a formal salary offer and am supposed to start the end of August. It's just the way it is with the federal govt though. .If that's going to bother you, than this isn't the place for you. Out of 9 of us, 4 have jobs to my knowledge.  We are starting our last month! 

12 hours ago, Freckledkorican said:

UPDATE:

I have been working on completing HR paperwork. Also, trainees have to complete an online course to access the VA system.

Nothing exciting, but I am still on cloud 9. My end goal was acceptance into a residency program, specifically VA, before being set loose as an independent NP and I reached it?.

Sending out good vibes to all who have a similar goal. Don't give up! 

Sometimes all the HR paperwork is the most challenging part!  ?

Good vibes back at ya'!

Specializes in Psychiatry.

Paperwork for VA residency is insane. It took months with all the background checks etc. The residency experience was amazing though, as was being a gov employee with 40 something paid PTO days to use during my residency plus every federal holiday off. The medical residents were so jealous! LOL

8 hours ago, MentalKlarity said:

Paperwork for VA residency is insane. It took months with all the background checks etc. The residency experience was amazing though, as was being a gov employee with 40 something paid PTO days to use during my residency plus every federal holiday off. The medical residents were so jealous! LOL

Were you able to get hired on after?   I'm curious if after residency, are the residents shoo-ins to get hired within the VA system somewhere?   

Or would you say this program is excellent to get your feet wet as a new grad, then move on?

I've heard/seen where people say the government/VA doesn't pay as well as outside jobs, but the benefits and time off are outstanding.  I suppose it depends on what's most important to the individual, whether government jobs are worth going to

Specializes in Psychiatry.

There’s no preference for jobs after the residency and you still are considered an external applicant. Lots of vacation and job security but very low pay. I thought I wanted to stay on but after seeing the politics and pay scale and getting a job offer for literally 2x the VA salary I happily moved on. Great experience though!

49 minutes ago, MentalKlarity said:

There’s no preference for jobs after the residency and you still are considered an external applicant. Lots of vacation and job security but very low pay. I thought I wanted to stay on but after seeing the politics and pay scale and getting a job offer for literally 2x the VA salary I happily moved on. Great experience though!

Thank you for the response!  Your answer about the pay is exactly what I've read here on AN and heard from others.  That's too bad the VA pays so low.  Sounds like it would be an awesome job to hold onto,  if they had competitive pay.

2 hours ago, Freckledkorican said:

UPDATE:

Hello all!

Today, we had a virtual meet and greet/Q&A with my cohort, some preceptors, director of the program, and current residents. Essentially:

- HR will email us our official employee packet soon (hopefully). I guess they move at glacial speed.

- The first three days of the residency will be orientation at the hospital; learning how to navigate the EMR, etc. After that, we head to our respective home sites.

- Each of us are assigned a home site with a 1:1 dedicated preceptor. We will each travel to different outpatient clinics and the hospital for our specialty rotations throughout the year.

- We will not be thrown into a full patient panel. We will shadow for a long minute and then slowly build our patient load. We will start with one patient per hour and then slowly add more patients (max two per hour) as we build experience and confidence.

- Mondays through Thursdays are clinical days. Fridays are dedicated to didactics.

- We will rotate through specialty clinics, such as cardiology and GI. We will even participate in an ER rotation!

- We are expected to present a QI project at the end of residency.

I still cannot believe my good fortune! Blessed! I told my fellow residents I must’ve been a pity pick. On of them said, “Doubtful, but who cares. Take advantage of it.” I agree.

Congratulations!  This residency sounds very well-organized.  This is exactly what a new grad FNP needs in order to be successful.  I wish all organizations were like this!

Does the VA help with relocation?  Or are you totally on your own if you decide to apply out of state?   Also, you stated you're assigned to a home site and then farmed out to various other clinics or hospitals for your training.  How far are these other locations?  I guess I'm wondering if you're traveling 100+ miles away or are most of these other locations within 10-15 miles or so.

Specializes in FNP.

OK Thanks have applied in awaiting acceptance letter it is taking so long.

Specializes in MSN, FNP-BC.
Hotlando said:

OK Thanks have applied in awaiting acceptance letter it is taking so long.

At the end of my interview, they offered me a position and I received the acceptance letter the next day. I guess every VA residency program is slightly different. Hopefully, you will receive yours any day now.

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