Looking to start in sub-specialty

Specialties NP

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Since I have a decent amount of emergency experience as an RN (and actually started out in ED - I've never worked a day in Med-Surg in my life), I want to start out working an NP in the Emergency Dept. However, everyone seems to want NPs but not to train us - they all insist on a year of experience. How can I best find an "in" where someone is actually willing to train?

Again with the not reading...

It's "so hard" because the urgent cares are just as bad. They don't care about primary care experience. I could get 20 years of primary care experience and they wouldn't care - I don't have the 1+ years of emergency/urgent care experience, and my application still would hit the trash before anyone saw it.

It's also "so hard" because the chorus of "Why don't you start in primary care first?" is suspiciously familiar to the much older nurses who told my nursing student/new grad RN self, "Oh, you can't start in Emergency, you need to start in Med-Surg first," when nothing was further from the truth.

I know the trajectory I need to be on. I just need to find a first employer willing to train. And it appears that most of the readers of this sub-forum have reading comprehension issues...

It had nothing to do with people suggesting start with a to get to b. It has everything to do with getting experience. Any evidence that you are capable of working as a nurse practitioner to a degree they don't have to train you combined with your ed background would easily suffice since clearly np experience is the entry point. Some get LUCKY and find immediate access to all they wish in life while others have to take alternate routes. And congratulations.... At this point the latter is your likely path. What you "know"may not be what you *need*.

Specializes in Nephrology, Cardiology, ER, ICU.

I get your frustration. Have you tried to contact individual ED physician groups? Many EDs in my area contract out their ED staffing to individual MD groups. Have you tried more rural EDs? Critical access hospitals?

What about joining a hospitalist group in a rural area? Frequently (at least in my area) they cross-cover the ED at night in rural areas.

Specializes in allergy and asthma, urgent care.

I did not want to work in the ED, but did want to moonlight in Urgent Care. My primary care experience got me the interview, and I got the position and worked per diem for 4 years. You need to get that first job, and use that as a jumping off point to launch the rest of your career. You're trained to work in Primary Care, and that's likely where you're going to find the most opportunities. I would also recommend that you take an Emergency "bootcamp" type of course. Doing so will show initiative and that you're serious about doing what it takes to move into emergency medicine.

Specializes in Psychiatric and Mental Health NP (PMHNP).
It's not horrible, it's just irrelevant. I can work twenty years in primary care, and I won't have the year of emergency/urgent care experience they want. And while there may be Urgent Care facilities that hire new grads, I'm having problems finding one, which was the original point of this thread.

I'm not asking them to - I expect an employer who hires me to an ED/Urgent care position to send me to relevant training, or provide it themselves. And while I might be able to afford such as an NP, I need a job first.

I'm not making excuses. However, I'm getting quite annoyed at people who didn't actually read my initial question, or my subsequent responses.

I didn't show up here with the very tired question of "How do I make myself look better for employers?" I know that I am a decent candidate for an employer willing to hire new grads. Having talked to many ENPs and emergency physicians - including a past president of ACEP - I already know the difference between "sick" and "not sick," and that's apparently half the battle. My frustration comes in finding an employer willing to hire new grads, when everyone seems to want someone fully trained and next-to-no one-wants to do that training. I am looking for such needles in a haystack, and wanted help in that. I never said I wasn't willing to relocate, but I still need to know where to look first.

I think people are getting frustrated with you because you are being extremely picky for a new grad NP. I don't know your financial situation, most but most new grads need to get a job ASAP. So you may not get your perfect job to start.

There have been other threads on this forum about FNPs working in EDs. Find those, and then you can PM the FNPs that are working in the ED. One FNP said she was working in rural Michigan and the hospitals there hire FNPs. As another posted suggested, your best bet is rural hospitals.

Oroville Hospital in California (big hospital) does hire new grad FNPs for Urgent Care and trains them.

You are just going to have to put in a lot of work to find the hospitals. The Internet is your friend.

Again, it is is harder for a new grad NP to get a job. You may not get your ideal job right now.

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