Locum tenens for 3 mo as first PMHNP job?

[spooner2014]

I just received two offers in advance of graduation from a PMHNP program in Boston. It was great to have two companies bid for me, but it was confusing as well.

Obviously, all job offers hinge upon whether I pass the board exam for PMH-NPs. I'm not worried about that. Both offers were in the $110-120K range, in So Cal which I am targeting, and offer great supervision, CME and paid time off with no call.

My locum tenens recruiter recommends that I hold out for his 3-month LT assignments in MA, work for three to six months, and then get a better starting salary from Barton's permanent placement department after working for 6 months, since it will show both experience and ability to quickly adapt to busy workloads.

Here are my questions:

*Is locum tenens the way to go? I'm confident in my prescribing ability but wanted to hear from other PMHNPs who have some experience.

*Have PMHNPs conducted early job hunts for southern california... and how quickly did you get a DEA number and national provider ID (NPI) so that you can bill insurance?

*Is 110-120K enough to live on near San Diego (not downtown, but in a 15 mile radius of the city)?

* Should I ignore the siren song of the locum tenens recruiters and just go my own way? They offered to pay for the DEA # and arrange for expedited PMHNP credentials in CA, citing the usual wait is 2-3 months. With increased familiarity with CA board of nursing from the volume of their placements, the firm said they can fast track the process down to 30 days.

Could someone here please advise me on their experience in this realm?

Thank you.

[Jules A, MSN]

I have no info on CA and am surprised the rates are so low but its becoming more supply than demand unfortunately. As for locum work if you are like you said confident in your prescribing and hopefully also diagnostic ability a locums job would probably not be different than a permanent job. Check into it what the permanent job work load expectation will be because although there are some places around here who have recognized the deficit in many new grad NPs and have started offering remediation upon hiring but in my experience all my jobs as a new NP expected me to start managing a full patient load with no orientation other than the general employee computer class so again not any different than locum.

[RunNP]

I can not imagine having my first job be a locum. Good luck!!

[BCgradnurse, MSN, RN, NP]

Also, keep in mind that the recruiter does not necessarily have your best interests in mind. He needs to fill a position and does not get paid until that position is filled, so of course he wants you to hold out for his position.

I wouldn't want a locums job as my first NP position. You're pretty much on your own with little support. Not what I would recommend for a first job, no matter how confident you may be.

[Psychcns]

I have been doing locums for the past few years as a Psych APRN. I am expected to assume a full pt load with minimal orientation and to be able to navigate the system to complete work.

I think a regular job in a collegial environment would be much more supportive. I think the first few months a new PMHNP should have a reduced workload to have time to consult and look things up though I suppose not everyone needs this.

[Jules A, MSN]

I have been doing locums for the past few years as a Psych APRN. I am expected to assume a full pt load with minimal orientation and to be able to navigate the system to complete work.

I think a regular job in a collegial environment would be much more supportive. I think the first few months a new PMHNP should have a reduced workload to have time to consult and look things up though I suppose not everyone needs this.

It might becoming more available now that employs are realizing many NPs are not able to practice on a basic level upon graduation although in my experience there were few places that didn't expect a new psych np to be competent and able to handle a full patient load upon graduation. What you suggest would be ideal but in my experience and the experiences of the friends I graduated with we were all shown our office and hit with a full patient load sans hand holding so locums wouldn't have been any more challenging imo.

[rn_patrick, NP]

No don't do it. I was in a full time job with minimal to no clinical supervision and it was horrible, dangerous, and very ahrd to get up to speed.

[Jules A, MSN]

No don't do it. I was in a full time job with minimal to no clinical supervision and it was horrible, dangerous, and very ahrd to get up to speed.

I appreciate your honesty and reflection but can't help think what a disgrace our schools don't prepare "independent practitioners" to practice independently upon graduation.

[Meriwhen, ASN, BSN, MSN, RN]

I can't speak for the advanced practice nursing, but I can speak for the SoCal cost of living.

$120k/year isn't going to get you a beachfront house or let you afford more than a shack in the highest-end communities. But you should be able to survive in several areas of San Diego County on that salary. The further south and/or east you go from downtown San Diego the further your money will go in terms of housing. But you also have to factor in the costs and hassle of commuting, especially if you are moving too far south/east from your future job.

Given that you are coming from Boston, you shouldn't have that much sticker shock though, when it comes to everyday expenses. But be prepared to invest in a car/truck, as SD's public transportation system is nowhere as good as Boston's.

And Jules, it is definitely a supply/demand issue in these parts.

[spooner2014]

I appreciate your thoughtful response.

I have been doing locums for the past few years as a Psych APRN. I am expected to assume a full pt load with minimal orientation and to be able to navigate the system to complete work.

I think a regular job in a collegial environment would be much more supportive. I think the first few months a new PMHNP should have a reduced workload to have time to consult and look things up though I suppose not everyone needs this.