Middle Tennessee has no Midlevel jobs

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I have been searching for a new position in the middle Tennessee area. I know this area is so saturated with midlevels that each family could have their own private PA or NP and an RN to assist. I am just so sick of reading the ridiculous job descriptions and what the reimbursement is for that position.

Example: Nurse practitioner needed. DNP preferred with 10 years clinical experience, 10 years as a Registered Nurse, 10 years as an educator, Must possess unrestricted license for this plus all surrounding states, possess a DEA for those states. BLS, ACLS, PALS, DOT certified, certified diabetic educator, certified as a Legal Consultant, pain management, case management, utilization review and lymphedema. Must be proficient in all Microsoft/Apple software, proficient in all EMR software on market today. Must possess certification in Emergency Care, Acute Care, Experience in retail health, urgent care, and occupational medicine fields, as well as family medicine, geriatrics, pediatrics, womens health, male health, palliative care and psych. Must have working Knowledge HIPAA, OSHA, HR and billing/coding requirements, case management. Must have working Knowledge of State and federal laws governing medical services. Must have working knowledge of CMS, NCQA, HEDIS, URAC measures and all national standard guidelines.

Position is for 40 hour week, 30 minute lunch break each day. After hour call 4 days/week and every other weekend. Will be responsible for holiday coverage. Eligible for 40 hours PTO after 24 months of consistent employment. Must have own health and . Provide own otoscope, other medical equipment, audiometer, lipid testing, Aic testing etc *****Reimbursement: $60K-$65K annually. Yes, I am being sarcastic, but this area is so saturated with NPs, we are like Kleenex to the employers. No respect, use and throw away. I am so disgusted. I had a PA friend who was beautiful and superbly skilled..spent 8 months trying here and finally took a job making half what her colleagues in Memphis made. Moved to Washington State, making three times that now.

I have all the letters, certifications, experience necessary but I am one of many. I get along wonderfully with both patients and fellow workers. Personal appearance neat, clean, appropriate. Resume and cover letters have been approved/critiqued to be well done. I have placed at least 20 applications and you all know how long those are-10/15 pages. Responses from the bigger companies polite but no jobs. Some dont even respond.

Had a phone interview scheduled I had set aside for time for this morning. Waited, waited...no call. I finally emailed the rep. response was overwhelmed with so many applicants and she would let me know something in a few days.

Am I just being overly expectant or is anyone else out there on middle TN experiencing same thing???

Specializes in Vascular Neurology and Neurocritical Care.
On 5/2/2019 at 3:35 AM, Jory said:

I once sent an email to a recruiter because their listing contained a job title and requirements that doesn't exist.

There is no such thing as an OB/GYN Nurse Practitioner.

You can have a CNM, a WHNP, a FNP working in an OB/GYN office.

But there is no OB/GYN Nurse Practitioner.

Position also required PALS certification....but the office didn't see babies (CNMs can see them up to 28 days of life and some clinics do see them for continuity)..so I asked...Uh...WHY?

They also had a ton of other things that had zero sense written in the job description.

These job descriptions are written by recruiters that are clueless. I spoke to one about a month ago and I could tell she had to be brand new....I spent 30 minutes explaining to her on the phone about the differences in nurse practitioners. She had no clue...and had been doing recruiting for these jobs for six months for a MAJOR company.

My favorite story from a co-worker: Hospital had a hospitalist position open to work in-house in their L&D Unit. She's a CNM. She applied for the job and the recruiter (for the hospital) sent her an email back two hours later, "This position is only open to advanced practice registered nurses". The position had been open...not even kidding, three months. Explaining herself got nowhere. It was like the recruiter wasn't even reading her emails. She eventually decided to call HR directly and speak to the director. The director was FLOORED the recruiter had been telling applicants that. Oh..and in the end got the job!

I don't see anything wrong with writing "OB/GYN NP". It's just announcing the specialty. It's no different than advertising that you're looking for A Neurology NP for your hospital or practice. Otherwise, your requirements wouldn't be clear. Plus with limited spacing (or the need to use keywords to increase match rate) in the title of the posting or newspaper ad, you have to be concise.

Otherwise, I agree with you that recruiters are often clueless.

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Specializes in Vascular Neurology and Neurocritical Care.

I don't mean to sound cold, so please don't take it that way, but pursuing further education such as NP education has to be considered like a business venture. When contemplating such a move, one should think about what the demand in the area is. For example, if you want to start a business, you have to ask yourself if there is local demand for this service.

If not, it makes no financial sense to start said business in that area. Either pursue another area of business or open the business in an area where the demand exists. Likewise, before becoming an NP it is wise to determine if there are NP jobs in the area for when you finish school. Otherwise, the situation you described will afflict you. There is so much more to NP school than just going and I always stress to people to figure out what they want to do with the education before going and make a post graduation plan, including on job hunting before going. It saves so much headache.

Alternatively, move to an area where there are NP jobs, if you're set on being an NP. Physicians usually have to move somewhere else for residency and fellowship and often move again after training is over to find a job. NPs should consider the same.

Unfortunately, there are just places where the job market isn't good and it's often necessary to entertain more drastic options.

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Neuro Guy, you are absolutely right on! On every point! I did not even consider researching this area for NP need or saturation of midlevels. I am from a southwestern state and received so many offers as a new grad. It just never occurred to me to look at all aspects of my letters, practice acts, number of schools and new NP/PA grads each semester, NP/population ratio, salaries, benefits etc. So many mistakes! Ignorant little country girl!

I am now finding that a huge percentage of new grads here are still looking for jobs 18 months after graduation. Many leave the state. Experienced working NPs in this area go far beyond their job description in uncompensated hours worked, patients per hour, and tolerate very poor pay, benefits and working conditions that NPs in my home state would walk straight out the door to another job that respects their letters, skills, and experience. And ones here cling to their jobs like a leech, knowing if they lose it, they face very limited options.

I appreciate your words of wisdom and truly hope other NPs/PAs reading this will take them to heart. PS you have my dream job! NPs like yourself were responsible for saving my daughters life in neuro-ICU. Thank you for all you do for other families.

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Specializes in Vascular Neurology and Neurocritical Care.
14 hours ago, momofm1998 said:

Neuro Guy, you are absolutely right on! On every point! I did not even consider researching this area for NP need or saturation of midlevels. I am from a southwestern state and received so many offers as a new grad. It just never occurred to me to look at all aspects of my letters, practice acts, number of schools and new NP/PA grads each semester, NP/population ratio, salaries, benefits etc. So many mistakes! Ignorant little country girl!

I am now finding that a huge percentage of new grads here are still looking for jobs 18 months after graduation. Many leave the state. Experienced working NPs in this area go far beyond their job description in uncompensated hours worked, patients per hour, and tolerate very poor pay, benefits and working conditions that NPs in my home state would walk straight out the door to another job that respects their letters, skills, and experience. And ones here cling to their jobs like a leech, knowing if they lose it, they face very limited options.

I appreciate your words of wisdom and truly hope other NPs/PAs reading this will take them to heart. PS you have my dream job! NPs like yourself were responsible for saving my daughters life in neuro-ICU. Thank you for all you do for other families.

Thanks for taking my reply in stride. I was a bit worried at first, but it is good that you took it as intended.

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Specializes in Nephrology, Cardiology, ER, ICU.

I agree that it is very important to scope out your prospective future PRIOR to engaging in education. Great post NeuroGuy

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I feel as though the market is saturated, especially in the southeast. I'm sure you can find jobs sprinkled through out middle America where they would snatch you up in a heartbeat, but overall the market is flooded. Unfortunately there is no end in sight. This is a money making proposition for the universities and as long as people are willing to fork over their money for a degree, the universities will oblige.

We (APRN's) have to band together and start being more unified as a force. I am an FNP for an anesthesia department at a large teaching facility in Alabama. It is amazing how much more the CRNA's are unified in voice, legislation, practice, etc. We as NP's need to follow suit. I know from the day I started NP school in 2010, until now I have heard that "NP will become doctorate level only" program in the future. Yet here we are, 10 years later, and rather than it becoming more difficult to become an NP, Universities such as Baylor and UAB advertise there is no graduate entrance exam required. NO GRE/MAT, just make the grade, pay your money and you are in. This is a problem, not mention all the online programs that have popped up across the country.

I tell anyone and everyone that will listen, NOT to go to school to become an NP. I'm very proud of what I do and the profession that I am in, but the market continues to become watered down. People are willing to work for chump change and it is ridiculous.

Based on sheer percentages, an NP nationwide salary average should be 30-40k higher than the average salary we are getting paid.

At an urgent care, most insurance companies agree to pay a pre-negotiated flat fee. Most all insurance companies fall within 10-15 dollars of the same price. Example, at a local urgent care in Alabama, BCBS pays $150 for an office visit to the doctor and $125 if the NP sees them. This is your basic 85% rule that medicare applies as well. Based on the fees collected a physician makes about 67% off the basic fee of a visit (the first visit of each hour) That translates to $100/hr. Some docs make more depending on experience, but this is the going rate. Basing the $125 fee the UC collects on us (NP) seeing patients. We should get about $83/hr. Does anybody her make $83/hr?........(rhetorical) I dare say that most NP's make about half or little more than half that. This is a problem. Until we make it stop, it will only get worse. Get involved with local and state NP organizations. We are the voice, squeaky wheel will eventually get the grease, but it is up to you and me to make it happen.

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Specializes in Vascular Neurology and Neurocritical Care.
18 hours ago, Dougefresh said:

I feel as though the market is saturated, especially in the southeast. I'm sure you can find jobs sprinkled through out middle America where they would snatch you up in a heartbeat, but overall the market is flooded. Unfortunately there is no end in sight. This is a money making proposition for the universities and as long as people are willing to fork over their money for a degree, the universities will oblige.

We (APRN's) have to band together and start being more unified as a force. I am an FNP for an anesthesia department at a large teaching facility in Alabama. It is amazing how much more the CRNA's are unified in voice, legislation, practice, etc. We as NP's need to follow suit. I know from the day I started NP school in 2010, until now I have heard that "NP will become doctorate level only" program in the future. Yet here we are, 10 years later, and rather than it becoming more difficult to become an NP, Universities such as Baylor and UAB advertise there is no graduate entrance exam required. NO GRE/MAT, just make the grade, pay your money and you are in. This is a problem, not mention all the online programs that have popped up across the country.

I tell anyone and everyone that will listen, NOT to go to school to become an NP. I'm very proud of what I do and the profession that I am in, but the market continues to become watered down. People are willing to work for chump change and it is ridiculous.

Based on sheer percentages, an NP nationwide salary average should be 30-40k higher than the average salary we are getting paid.

At an urgent care, most insurance companies agree to pay a pre-negotiated flat fee. Most all insurance companies fall within 10-15 dollars of the same price. Example, at a local urgent care in Alabama, BCBS pays $150 for an office visit to the doctor and $125 if the NP sees them. This is your basic 85% rule that medicare applies as well. Based on the fees collected a physician makes about 67% off the basic fee of a visit (the first visit of each hour) That translates to $100/hr. Some docs make more depending on experience, but this is the going rate. Basing the $125 fee the UC collects on us (NP) seeing patients. We should get about $83/hr. Does anybody her make $83/hr?........(rhetorical) I dare say that most NP's make about half or little more than half that. This is a problem. Until we make it stop, it will only get worse. Get involved with local and state NP organizations. We are the voice, squeaky wheel will eventually get the grease, but it is up to you and me to make it happen.

Speak for yourself on not making the $83/hr issue.

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Neuro guy, are you telling us that you are making $83+ hr as NP??? In Alabama????? I know so many NPs in Ala telling me that if they can get a job there, pay is never over $48hr. Ala is listed as one of the least friendly states in America for NPs. I was offered a locum tenums there at $40hr. Figured I would just stay here and make that. Tell us more, how do we achieve this without criminal activity. There has got to be more to this story....,

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Specializes in Vascular Neurology and Neurocritical Care.
2 hours ago, momofm1998 said:

Neuro guy, are you telling us that you are making $83+ hr as NP??? In Alabama????? I know so many NPs in Ala telling me that if they can get a job there, pay is never over $48hr. Ala is listed as one of the least friendly states in America for NPs. I was offered a locum tenums there at $40hr. Figured I would just stay here and make that. Tell us more, how do we achieve this without criminal activity. There has got to be more to this story....,

Yes, though I never said I live in Alabama. I live in the northeast. I'm a professor and researcher in a medical school (affiliated with my health system) and while my clinical practice has transitioned into leadership at the hospital level, I do still practice Neurocritical Care and am involved in the teaching of residents, medical and NP students as the rotate through Neuro ICU. If you earn the right credentials, being an NP can be quite lucrative. I own my own practice as well.

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