Graduation to practice

WKShadowNP, DNP, APRN · Nov 20, 2016

Results vary from clinician to clinician. I applaud your initiative to go to a live review as I feel attending one helped me (as well as home review with other resources.)

Some individuals secured employment prior to graduation or certification, others afterward. It differs depending on the job market and need where you are, the volume of advanced practitioners seeking employment there, and agency requirements for experience or not. I'm sure there are other variables affecting your job search.

The best thing I could recommend is to just put yourself out there. I caution you about posting a resume on a job site because you will be inundated with recruitment calls several times a day for months. It's not a bad idea, just be prepared for the onslaught of solicitations to help you find employment.

For me those calls resulted in 75% or more of dead ends as they were for areas I had no interest in (region wise...I am not willing to relocate) and experience wise (almost all postings were for NPs with experience). However, three resulted in interest. Three calls. Out of several dozens.

Take the test when you're ready. Don't rush it thinking that you'll run out of time in getting done and hired. I graduated in May, took my test in October and that's fair. I'm still working as an RN until I move to whichever new job I choose, so I do not have the pressure of needing employment that some might face. (Of course that might need to be taken into consideration with your need to find employment)

If you are in that boat (not working at the moment), it appears then that your time for studying is a given (more or less). It could make it easier for you to be prepared to test sooner than I was. (Full time student, full time employee, full time mom/wife/everything).

Good luck in your pursuits. Congratulations on nearing the end of your journey (even though the real journey is just beginning.)

Advanced Practice Columnist / Guide · Nov 20, 2016

Which exam are you taking? ANCC or AACN. It probably doesn't matter but the delay really ends up being the wait for eligibility to take the test which hinges upon your school sending the forms to the certifying body. That took at least a couple of months for me but that was in 2004. After that, you'll have to wait for the certifying body to send your passing status to your state BON in order to get an NP license. Then, if you're trying to get privileges at a hospital, you'll have to wait through credentialing. I'm in California, but whenever we have new grads hired, the whole process of getting the offer letter and start date can take up to 6 months.

WKShadowNP, DNP, APRN · Nov 20, 2016

One interview I went on told me their credentialing can take 90 days. 6 months sounds like such a long time! I guess results vary on that too.

I can't apply for prescriptive authority until I have an employer and my collaborative physicians sign the application. But then there is the DEA license (700-800 bucks!), malpractice insurance, vetting by the agency and determining what within my scope they will allow me to do.

Juan, what else do they do for credentialing? I think I'm leaving things out.

It can be time consuming.

All the more reason to apply for testing now and look for jobs now.

Advanced Practice Columnist / Guide · Nov 20, 2016

Juan, what else do they do for credentialing? I think I'm leaving things out.
It can be time consuming.
All the more reason to apply for testing now and look for jobs now.

As one of our analysts in Medical Affairs put it, credentialing is basically applying to be included in the provider panel of a hospital and requires putting on a portfolio that makes you stand out. In most cases, forms just need to be filled out and documents sent.

Typically, the credentialing body looks at your educational background, licenses and certifications (including ACLS and BLS if required by role), CME's, and academic activities (if any). You also need professional references (again!), must declare any past malpractice policies, and whether you've had any legal histories related to your provider role. You also state the specifics on the privileges you are seeking - doing admissions, writing orders, doing conscious sedation, placing lines, etc.

Depending on the facility, the medical staff board meets every so often to review applicants. The schedule can be once a month or twice a month. The delay can happen if your documents (licenses, certifications, references) are not received by the board on the day they meet. That means your case won't be heard until the board reconvenes (which could be next month).

Nolagrace1202 · Nov 20, 2016

Thanks for the feedback. So it does appear it will take months. I am attending school out of state and plan to move closer to family after I graduate. Should I try to get hired as an NP at time of graduation or should I apply for RN jobs to tide me over until I get credentialed? I have already stopped working to full pursue school and I do not want to remain unemployed any longer than necessary after graduation, but I need to be settled (in our new town) before the school year starts for my children.

Advanced Practice Columnist / Guide · Nov 20, 2016

Thanks for the feedback. So it does appear it will take months. I am attending school out of state and plan to move closer to family after I graduate. Should I try to get hired as an NP at time of graduation or should I apply for RN jobs to tide me over until I get credentialed? I have already stopped working to full pursue school and I do not want to remain unemployed any longer than necessary after graduation, but I need to be settled (in our new town) before the school year starts for my children.

We've interviewed applicants who just graduated or are graduating. If the employer is really interested, they understand the process and the time it takes for the NP to start practicing so it will not be a problem. However in today's reality, more frequently than not, there are applicants who already have the required licenses and certifications and just need credentialing making them more attractive and practical for hiring.

Jules A, MSN · Nov 20, 2016

I graduated in May and started working as a NP at a hospital in July. I also applaud you for getting on the stick now as imo every week I was making RN wages instead of NP wages it was costing me serious money. For me the biggest stressor was the school's lack of urgency, I was on them like nobodies business to sign off my form so I could send it in to the ANCC and didn't leave campus the last day without hunting down the person who would sign it. I tested about 3 weeks after graduation and as I recall was able to apply for my DEA and CDS as soon as I had passed the board exam. I had a job lined up and since it was with a hospital they had a credentialing department that basically sent me a stack of papers to sign so no biggie there either. Good luck!

AtomicWoman · Nov 21, 2016

Hopefully, your state BON is not like mine, with a v-e-r-y s-l-o-w process. In fact, when I was licensed 4 years ago, there was exactly ONE person at my state's BON who processed new NP applications. It about drove me crazy, as I already had a job offer. Hopefully, your state is quicker than mine.