Hate my FNP job

[FNPCA]

Recently I took a position working in a retail clinic. Prior to the clinic opening I was placed in a doctors office (this Is a large company). So I am a brand new nurse practitioner. In the office I was not allowed to have my own nurse because "I would not have one in the clinic" I was told prior to starting that I would only be seeing same day sick patients. However, I was seeing everything and was not allowed to start my own patient panel but they kept making me see new patients and also patients who were not mine and managing their chronic illnesses. There was one time when the MD's nurse had gone on vacation and I was required to be his nurse, my own nurse, and a nurse practitioner.

Fast forward to now....I'm in the retail clinic. Where I was required to put together office chairs, vital signs machines etc. All the things I need are not in place yet. My height chart hasn't been mounted so I had to purchase a tape measure to perform a school physical. Then I was told when I'm not seeing patients I must log on to a Skype type platform and see patients via the Internet. I have told the administrator several times I'm not comfortable as a nurse practitioner seeing patients in the office (I have been seeing patients about 3-4 months which have been the bear minimum patients because the doctors in the office would double or triple book themselves so I wouldn't see their patients) so I know I'm not going to be comfortable seeing patients on this platform. So basically today after not responding to my email for about a week and a half, she told me well we keep your time at a minimum. But we need you to fill in occasionally.

I'm not sure what to do, what rights I have, I can't perform safe patient care if I'm not comfortable. When I took this position I was told things like I would only work every third weekend. I have worked every weekend since I have been in the clinic. Typically 5 days in a row. (8-12 hour shifts). I'm not sure how to approach this... Anyone have any advice?

[HBrnGirl]

Why is it exactly that they do? DO you think it's all about the experience? Or do you think that it has some to do with cheap labor and delaying entry to practice to keep salaries up?

How long have you been in practice? What do you think was the most difficult part of the transition? How would address it?

Do you think some use NP's as cheap labor? Why do you think there is such a push for independent practice? Why pay an MD to do the same job? Because NP outcomes are equivalent right. NP, PA, MD it's all the same.

To answer your questions: 10 years as RN, 5 years as a traveler, traveled all over the country, 5 years as PA-C adult critical care, most difficult part at first being responsible for someones life I was terrified, a residency program would have helped

[BostonFNP, APRN]

Honestly, a 1-2 year residency is a very reasonable compromise. After that they can have independent practice. It's crazy to me this push for independent practice from day one. Because if you think about it very few medical professions offer full independent practice day one. Most either require or highly recommend a residency program. Nurses need to understand the political forces behind this push for independent practice before automatically jumping on the bandwagon.

Something we agree on! Go figure.

I really like the NY system.

[BostonFNP, APRN]

Do you think some use NP's as cheap labor? Why do you think there is such a push for independent practice? Why pay an MD to do the same job? Because NP outcomes are equivalent right. NP, PA, MD it's all the same.

To answer your questions: 10 years as RN, 5 years as a traveler, traveled all over the country, 5 years as PA-C adult critical care, most difficult part at first being responsible for someones life I was terrified, a residency program would have helped

NPs (and PAs) are more cost effective healthcare absolutely. But with incident-to billing rather than saving the system money we are being used as a revenue generator for physicians.

[HBrnGirl]

NPs (and PAs) are more cost effective healthcare absolutely. But with incident-to billing rather than saving the system money we are being used as a revenue generator for physicians.

And your point is??? NP's need to understand, you are not queen bee of the medical community. Check the diva attitude at the door. You have significantly less education than an MD. Meaning you don't deserve equal pay or equal status. Healthcare is a business and capitalism rules. Because you have less education they will use you to do as much work as possible while compensating you far less. This is fair. Look at what you spent on your education. Look at your ROI. You are making out very well. Nurses should understand the political and economic factors of healthcare before they decide on NP. Nurses need to understand that some employers use them as skilled labors to generate money for the MD's/healthcare organization. Suck it up buttercup. It's the name of the game. If you don't like it, then please by all means go to medical school so you can be top dog.

[BostonFNP, APRN]

And your point is??? NP's need to understand, you are not queen bee of the medical community. Check the diva attitude at the door. You have significantly less education than an MD. Meaning you don't deserve equal pay or equal status. Healthcare is a business and capitalism rules. Because you have less education they will use you to do as much work as possible while compensating you far less. This is fair. Look at what you spent on your education. Look at your ROI. You are making out very well. Nurses should understand the political and economic factors of healthcare before they decide on NP. Nurses need to understand that some employers use them as skilled labors to generate money for the MD's/healthcare organization. Suck it up buttercup. It's the name of the game. If you don't like it, then please by all means go to medical school so you can be top dog.

That post is very strong on demeaning language but very light on facts or understanding. If you want to discuss the issue, please lets, but you can leave out the derogatory language and replace it with some facts.

First of all, you totally misunderstood my post. Incident-to billing I mentioned, do you know what that is, and how it effects healthcare costs?

Second, you honestly feel that even though "healthcare is a business and capitalism rules" that reimbursement should be done based on years of education? Seems like in a "capitalist" system reimbursement should be provided based on outcomes.

Third, as it is a business, it seem pretty clear that NPs would work towards independent practice, and (luckily for us) have been pretty successful in that endeavor. It puts NPs in a much better position than PAs.