My NP job search--Cue the crickets and tumble weeds rolling by..

TakeTwoAspirin, MSN, RN, APRN · Dec 17, 2013

Assuming you did well at your clinical sites, check back with your preceptors and see of they can help.

wildcatarnp · Dec 18, 2013

I wish I had advice. I am in a similar position. I notice most positions want someone with 2 or more years experience. When seeking a position, I know I will need support initially. Coding was not covered in my program, and most of the preceptors did not discuss it since the EMR system automatically did it. I have heard of a residency program for new FNP grads, however it is in Olympia, Washington.

automotiveRN67 · Dec 21, 2013

The problem is not that groups don't need the help. It is that they need the help. They are not looking for you, as much as they are grumbling "I wish we had someone else". My advice to new graduates may be a little different from the norm, but here is what I look for when I interview:

1) Someone who will treat this like a business, rather than a job. Most new NP's are working as nurses now. And they can't help but talk about their life as a nurse. Like you say.."I am happy being a nurse"..umm ok. NP is a role, not a job.

2) Pay: Don't act like you "should" make more as a NP than an RN starting out. Believe me. You will be a burden initially. You will not be worth much for at least 3-6 months. Take whatever they offer to start, within reason, with the commitment that you will achieve a workload goal by a certain timeframe. Be humble, but driven. Too many nurses have to say "man I can make that as a nurse"...again....ok.

3) Coding, billing etc. Its pretty easy in the office. Usually level 3 or level 4, with ICD 9 that you addressed. For instance. If I see a patient with CAD (414.01), atrial fibrillation (427.31) and I adjust their statin based on their recent labwork uns disorder of lipid metabolism (272.9), I will bill level 4, with those codes. If they came in the coumadin clinic at the same time, we bill for INR. There is no real need to know this going in. Just remember the rule. Level 3 is for routine examination with multiple diagnosis. Level 4 is examination with routine diagnosis that requires more thought, ordering test, adjustment of medication, etc.

4) Let the group know you consider your first year an internship, as an extension of your education. This means commitment. Imagine the hours they went through as a resident to achieve what they have. Just because you have paper does not mean much to them.

5) Cold call groups that seem busy. If you are working as a nurse now, you are probably seeing physicians and mid-levels every day. Ask them. Asking your preceptor or clinical site is usually a waste of time. They didn't hire you, for some reason. And they didn't pass your name on, for some reason.

Good luck.

anichka · Dec 21, 2013

@wildcatarnp - not to sidetrack the conversation too much, but where did you hear about the FNP residency in Olympia? I will try looking for info on my own, but a quick Google search just now did not turn up any info. Thanks!

allnurses Guide · Dec 22, 2013

Can you ask anyone who interviewed you why you were not successful? Otherwise just keep applying. Maybe try places you did clinicals with - I know most of my class had job offers before graduation from preceptors at clinical sites. If you're content being an RN, you may not be approaching the job search with the required enthusiasm/desperation!?

carachel2 · Dec 22, 2013

The problem is not that groups don't need the help. It is that they need the help. They are not looking for you, as much as they are grumbling "I wish we had someone else". My advice to new graduates may be a little different from the norm, but here is what I look for when I interview:
1) Someone who will treat this like a business, rather than a job. Most new NP's are working as nurses now. And they can't help but talk about their life as a nurse. Like you say.."I am happy being a nurse"..umm ok. NP is a role, not a job.
2) Pay: Don't act like you "should" make more as a NP than an RN starting out. Believe me. You will be a burden initially. You will not be worth much for at least 3-6 months. Take whatever they offer to start, within reason, with the commitment that you will achieve a workload goal by a certain timeframe. Be humble, but driven. Too many nurses have to say "man I can make that as a nurse"...again....ok.
3) Coding, billing etc. Its pretty easy in the office. Usually level 3 or level 4, with ICD 9 that you addressed. For instance. If I see a patient with CAD (414.01), atrial fibrillation (427.31) and I adjust their statin based on their recent labwork uns disorder of lipid metabolism (272.9), I will bill level 4, with those codes. If they came in the coumadin clinic at the same time, we bill for INR. There is no real need to know this going in. Just remember the rule. Level 3 is for routine examination with multiple diagnosis. Level 4 is examination with routine diagnosis that requires more thought, ordering test, adjustment of medication, etc.
4) Let the group know you consider your first year an internship, as an extension of your education. This means commitment. Imagine the hours they went through as a resident to achieve what they have. Just because you have paper does not mean much to them.
5) Cold call groups that seem busy. If you are working as a nurse now, you are probably seeing physicians and mid-levels every day. Ask them. Asking your preceptor or clinical site is usually a waste of time. They didn't hire you, for some reason. And they didn't pass your name on, for some reason.
Good luck.

This is all VERY very good advice.

allnurses Guide · Dec 22, 2013

Have you applied to community health centers? They are often willing to hire new grads. Pay is on the low end of the scale, but it's worth it to gain experience. Good luck!