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Long Term Care Job?

Specializes in ER.

My job search has been discouraging and the closest I've come to an interview (still waiting to hear back from a couple places) as a new grad without relocating is for a long term care facility in a very small town that would be an hour commute. So, two questions:

1. Any advice/opinions/concerns/questions I should ask about working in LTC as a FNP?

(I did have a semester of NP clinical in a LTC and actually enjoyed a lot of it).

2. Any advice/opinions/experience regarding a commute that long?

(I have a 2 year-old who will be in daycare but the director said the hours are fairly flexible as far as start and end time).

Thanks!

Jules A, MSN

Specializes in Family Nurse Practitioner.

If you enjoyed geriatrics I think it would be an excellent start. There is always a need in LTC for competent prescribers who enjoy that population.

I think in most urban and many rural areas a 45 minute commute each way is about average. I have commuted 90 minutes each way in the past and currently have one PRN job that is 90 minutes and while it gets old sometimes in a way I enjoy having the time to relax, regroup and listen to some raunchy heavy metal music. :D

Riburn3

Specializes in Internal Medicine.

Long term care is a great place to start as an FNP IMHO. I spend a portion of my clinical day rounding at these facilities and I feel like it has made me a better provider.

You will extensively utilize your primary care skills managing medications and doing physical assessments on a daily basis. With the patient population comes a huge variety of chronic conditions that require close monitoring.

You will also become skilled in treating acute issues similar to what you find in an outpatient clinic, and will need to be vigilant to more serious acute issues as well. I honestly feel like rounding at LTC facilities keeps me on my toes a little more than working in my clinic because the population base is older and more chronic.

In terms of your commute, it's obviously not ideal, but the experience will be worthwhile if they compensate you accordingly.

hunnybaby24

Specializes in Tele, Cardiac Post Op, ER.

Did you get special training for your LTAC rounding?

Riburn3

Specializes in Internal Medicine.

I spent a few days rounding with my boss in the facility and had some experience with it during my NP program. Having worked the majority of my career in critical care, it was actually easy in terms of treating acute problems. Managing the primary issues became easier as I became more confident in my clinical practice.

bethymaester

Specializes in ER.

So the preliminary phone interview went well and I have an in person interview coming up, so I didn't ask any contract type questions over the phone. I did wonder if anyone knows what a typical call schedule would be? I thought he said they are expected to work M-F, 8 - 5 but accept call starting at 7am up to 7pm . . . every day? That sounds strange to me, but I don't know. Also, is pay typically higher or lower for NPs in LTC?

Edited to add the orientation is 6-8 weeks of daily rounds with the collaborating physician. Since I would be the only provider on site 4 days/week after orientation, I guess that makes sense . . . does it sound like enough?

Edited by bethymaester
Added question

Jules A, MSN

Specializes in Family Nurse Practitioner.

6-8 weeks orientation? OMG I'd be in heaven. I literally had zero orientation and very limited electronic documentation assistance so I just can't imagine actually getting an orientation. Personally as in psych or corrections I would assume LTC pays extra because not many NPs embrace those fields.

IsabelK

Specializes in Internal Medicine, Geriatric Medicine.

My job search has been discouraging and the closest I've come to an interview (still waiting to hear back from a couple places) as a new grad without relocating is for a long term care facility in a very small town that would be an hour commute. So, two questions:

1. Any advice/opinions/concerns/questions I should ask about working in LTC as a FNP?

(I did have a semester of NP clinical in a LTC and actually enjoyed a lot of it).

2. Any advice/opinions/experience regarding a commute that long?

(I have a 2 year-old who will be in daycare but the director said the hours are fairly flexible as far as start and end time).

Thanks!

I'm in the middle of orientation for LTC. Been an NP for 4 years, spent two in geriatrics and two in acute care. I'm getting 6 weeks of orientation, then will be on my own. But on my own is kind of a misnomer because my company has a lot of NPs in the area and there will always be support even if it's "I'm gonna call someone with more experience". I have to be available 8 AM - 5 PM Monday through Friday at least by phone, no call. Pay is better than anything I've ever made. Flexibility amazing.

bethymaester

Specializes in ER.

I'm in the middle of orientation for LTC. Been an NP for 4 years, spent two in geriatrics and two in acute care. I'm getting 6 weeks of orientation, then will be on my own. But on my own is kind of a misnomer because my company has a lot of NPs in the area and there will always be support even if it's "I'm gonna call someone with more experience". I have to be available 8 AM - 5 PM Monday through Friday at least by phone, no call. Pay is better than anything I've ever made. Flexibility amazing.

Your schedule sounds nice! You don't have to be on site all day? If you're comfortable saying, is your pay hourly or salary?

Jules A, MSN

Specializes in Family Nurse Practitioner.

Your schedule sounds nice! You don't have to be on site all day? If you're comfortable saying, is your pay hourly or salary?

And how much? :) I know this can seem gauche but for the love of Pete it isn't taking any money from the NP willing to disclose and can help advance our profession if we are open, supportive and not willing to work for subpar wages.

IsabelK

Specializes in Internal Medicine, Geriatric Medicine.

I am salaried. The company I work for has a strict no disclosure policy about benefits. I will say I'm not hurting.

Jules A, MSN

Specializes in Family Nurse Practitioner.

I am salaried. The company I work for has a strict no disclosure policy about benefits. I will say I'm not hurting.

Thanks for the reply. Fortunately I haven't had a confidentiality clause in any of my contracts yet. I find it highly suspect and not at all employee friendly as I would imagine they don't want a discussion in an effort to not have to compensate others equally. :(

IsabelK

Specializes in Internal Medicine, Geriatric Medicine.

Thanks for the reply. Fortunately I haven't had a confidentiality clause in any of my contracts yet. I find it highly suspect and not at all employee friendly as I would imagine they don't want a discussion in an effort to not have to compensate others equally. :(

Actually it doesn't bother me. It's nobody else's business what I make. I don't need or want to know what my coworkers make.

Jules A, MSN

Specializes in Family Nurse Practitioner.

Actually it doesn't bother me. It's nobody else's business what I make. I don't need or want to know what my coworkers make.

Certainly your prerogative and if you are happy with what you make that is all that matters.

FWIW last year I caught up with a former classmate who was making $50,000 a year less than my base salary. I find that disgusting, there is no scenario that would make that palatable to me, unless of course the contract included a car and housekeeper, lol. My classmate used the information to make a positive change and are now thrilled to be making significantly more money with a schedule and staff they enjoy.

Riburn3

Specializes in Internal Medicine.

Certainly your prerogative and if you are happy with what you make that is all that matters.

FWIW last year I caught up with a former classmate who was making $50,000 a year less than my base salary. I find that disgusting, there is no scenario that would make that palatable to me, unless of course the contract included a car and housekeeper, lol. My classmate used the information to make a positive change and are now thrilled to be making significantly more money with a schedule and staff they enjoy.

I agree. While I think sharing salary with fellow coworkers in similar positions isn't good and can lead to unnecessary animosity, I find it helpful when I share this info with friends or individuals here on this site that are on the hunt. Had it not been for this site and a few of my friends ahead of me, I would have gone blind into the job hunt, not knowing what to expect. This is especially true for peripheral benefits like license and CME reinbursement, which I had no clue was common practice.

Why is discussing salary with other APNs so confidential? No one is asking anyone to disclose their salary/ benefits in details. Except your real name and social security numbers are displayed online; how will an employer even know one's identity? You are not showing your paycheck to a bunch of strangers; rather you are aiding in promoting standardized pay for APNs. And sometimes that is why union is great; everything is laid out bare! The inferiority/superiority complex in nursing will always keep nursing behind. Funny that people can discuss other private issues like grades and pass/ fail exams openly and then become relugious when it comes to money!

Edited by AllIcanbe
Just because I can...

sailornurse

Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.

I belong to a local NP group and we finally realized how powerful it was to know what salaries are locally.No one has to give exact numbers but you can give a salary range. We also have learned to discuss the other parts of NP contracts: CME days/money; vacation, being on call and what does that pay, mileage if you travel etc etc. When I first graduated, I had 2 physicians offer me $35 per hour which was my salary as a per diem RN. Locally base salaries range from $88,000-$100,000 as high as $115,000.

The amount you bring home depends on the Other parts of the contract.

athomas2244

Specializes in Oncology.

This is very unrelated to this post and I apologize for this. My question is directed at Jules A, I will be graduating from my NP program soon and I would like to PM you for negotiation tips when searching for jobs if you don't mind. I have 2 soft offers at the moment, but I want to go into a specialty, since this is what my RN and personal experience is in and I enjoy it. Do you mind letting me pick your brain?

Thanks

IsabelK

Specializes in Internal Medicine, Geriatric Medicine.

Certainly your prerogative and if you are happy with what you make that is all that matters.

FWIW last year I caught up with a former classmate who was making $50,000 a year less than my base salary. I find that disgusting, there is no scenario that would make that palatable to me, unless of course the contract included a car and housekeeper, lol. My classmate used the information to make a positive change and are now thrilled to be making significantly more money with a schedule and staff they enjoy.

I don't mind discussing salary ranges. For example, in my area of NYS starting NPs tend to make 75,000 - 95,000. More experienced NPs can make closer to 150,000. I make well more than a starting NP. When I took my current job, I got a hefty pay raise. But the particulars--still nobody's business.

Jules A, MSN

Specializes in Family Nurse Practitioner.

This is very unrelated to this post and I apologize for this. My question is directed at Jules A, I will be graduating from my NP program soon and I would like to PM you for negotiation tips when searching for jobs if you don't mind. I have 2 soft offers at the moment, but I want to go into a specialty, since this is what my RN and personal experience is in and I enjoy it. Do you mind letting me pick your brain?

Thanks

Wow thanks for thinking of me and I certainly don't mind PMs but for both your interest to get a variety of opinions as well as possibly helping our peers I'd recommend you start a thread. I'll be sure to check it out and throw in my two cents. :)

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