How much orientation is needed for a new NP?

Jules A, MSN · Jul 19, 2015

In my experience orientation is usually paid although I did do a 1/2 day shadow experience for free at one job where they were going to pay me top dollar coming in the door. Feel them out.

Although I never got a full three days I don't think that is excessive especially for a new grad. I would want to do a shadow day with more than one provider. Different approaches are great to see imo. If it isn't possible to spend time with both a NP and physician and I don't know either of them I would go toward physicians as in my experience the odds of getting a really sharp MD are better than the odds of getting a really sharp NP. Sorry folks just my experience.

How much are they paying you? Pass it along. :)

CocoaLoverFNP · Jul 19, 2015

In my experience orientation is usually paid although I did do a 1/2 day shadow experience for free at one job where they were going to pay me top dollar coming in the door. Feel them out.
Although I never got a full three days I don't think that is excessive especially for a new grad. I would want to do a shadow day with more than one provider. Different approaches are great to see imo. If it isn't possible to spend time with both a NP and physician and I don't know either of them I would go toward physicians as in my experience the odds of getting a really sharp MD are better than the odds of getting a really sharp NP. Sorry folks just my experience.
How much are they paying you? Pass it along. :)

Thank you so much, Jules! I really value your opinion.

They are paying me $60 per hour... But that's without benefits. Also plus bonuses, if I bring in more patients. For Southern CA, this is good! However, I'm a little worried since it's a weight loss clinic that may only care about bringing in more patients. I am shadowing the NP on saturday (5 hrs) for free just to see if this job is what i really want.

The highest offer I got for the family practice jobs that I applied for as a new grad was $46 with "some" benefits. $44 for the community. However, I recently applied for CVS since I heard they offer $50 for new grads. Hope this info helps new grads... At least in South CA area ;-)

Jules A, MSN · Jul 19, 2015

Excellent! I know nothing about the weight loss industry, I do it the old fashion way intake vs output lol, but if you are good at what you do and your patients respect you I would bet you will have no problem getting more patients via word of mouth.

I have a friend who started in an allergist's office and wasn't sure if she would like it but she loved it. Years later she makes great money and basically runs the practice herself.

Good luck and keep us posted. :)

CocoaLoverFNP · Jul 19, 2015

Excellent! I know nothing about the weight loss industry, I do it the old fashion way intake vs output lol,
Good luck and keep us posted. :)

HAHA! Too funny.

Will keep you posted! I am actually very excited to begin working ;-)

AllIcanbe · Jul 20, 2015

Congrats on your new job! I thought Ca has a high cost of living? I read nurses make abt $60-$95/hr in Ca. Why are NPs offered less/same pay as RNs?

Trauma Columnist · Jul 20, 2015

I think 3 days is totally fine. Although you are a weight loss clinic, having knowledge of general health principles might be a little more complex.

For instance, one of my pts (dialysis pt with HTN as the reason for her ESRD) was prescribed phentermine for weight loss (so she could get on the transplant list). Well, phentermine makes you thirsty, makes your HTN more difficult to control and isn't metabolized well by dialysis pts who are anuric. Result....fluid overload and an admission for CHF.

So...while weight loss clinics are becoming more popular, our obese population has more co-morbidities so you might be selling yourself short if you only ask for 3 days. I think I would be asking for more time....

CocoaLoverFNP · Jul 20, 2015

I think 3 days is totally fine. Although you are a weight loss clinic, having knowledge of general health principles might be a little more complex.
For instance, one of my pts (dialysis pt with HTN as the reason for her ESRD) was prescribed phentermine for weight loss (so she could get on the transplant list). Well, phentermine makes you thirsty, makes your HTN more difficult to control and isn't metabolized well by dialysis pts who are anuric. Result....fluid overload and an admission for CHF.
So...while weight loss clinics are becoming more popular, our obese population has more co-morbidities so you might be selling yourself short if you only ask for 3 days. I think I would be asking for more time....

Thank you, TraumaRUs! You are right and you gave me a whole lot to think about. I work at a cardiac floor and encountered patients who came in for new onset Afib after taking phen. I really have to study these meds and know their effects by heart. Now i don't feel so bad asking for 3 days of orientation (or more).

hunnybaby24, BSN, APRN, NP · Jul 20, 2015

Arent all those comorbidities reasons why you shouldnt prescribe phentermine for that patient? ...

CocoaLoverFNP · Jul 20, 2015

Arent all those comorbidities reasons why you shouldnt prescribe phentermine for that patient? ...

That's what I thought too. But I read the standard protocols that my clinic manager gave me and was shocked to see that the list of contraindications did not include dialysis or kidney diseases, electrolyte imbalances, etc. I really have to think critically to protect my license (and the patient, of course).

Trauma Columnist · Jul 20, 2015

Nope - you would be surprized what physicians, providers, etc., will give dialysis pts!

There is one chiropractor in my area that told one of my pts that they didn't need to continue to come to dialysis because they urinated and they could just take some holistic meds to keep their urine output up so they didn't need to come back.

I called the chiropractor's office to find out what holistic meds they were giving them but they threatened to call the police for harassment! I only called once!

Just FYI too - the FDA does NOT regulate herbal supplements so you really have no clue what you are getting and many supplements are contraindicated with certain disease processes.

Jules A, MSN · Jul 20, 2015

Nope - you would be surprized what physicians, providers, etc., will give dialysis pts!
There is one chiropractor in my area that told one of my pts that they didn't need to continue to come to dialysis because they urinated and they could just take some holistic meds to keep their urine output up so they didn't need to come back.
I called the chiropractor's office to find out what holistic meds they were giving them but they threatened to call the police for harassment! I only called once!
Just FYI too - the FDA does NOT regulate herbal supplements so you really have no clue what you are getting and many supplements are contraindicated with certain disease processes.

I get a fair amount of dialysis pts in psych also and have gotten to know the local nephrologists up close and personal. I have one's cell number in my phone. With that physician I usually know what I can add without upsetting the apple cart but I always give his office a heads up to med changes or additions and for anything unusual I speak to him personally-and document it of course.

To me it is both prudent and a matter of professional courtesy to touch base when adding something to the regimen of patients with complicated comorbidities.