Need advice from FNP or PNP Please

Sheri FNP-C · Sep 26, 2009

I am an FNP working in primary care peds. Hopefully I can answer some of your questions.

You may want to talk to your own pediatrician/pediatric NP about shadowing. They may allow you to do so there or have an idea of who you could ask.

Thank goodness, my day is not entirely well child checks. I like the variety. I see well children, but also all sorts of sick visits for illnesses, rashes, injuries, suture removal, wound closure using glue, asthma management, ADHD medication management, developmental concerns, etc. The list goes on an on. I function just as the MDs in the practice. I make hospital rounds and take call. Basically, anything you would see your pediatrician for, my patients can see me for. If I don't know, I always have an MD in the office or available by phone for backup. However, this is very different than the office where I take my children. The NPs do not take call, make rounds, or do any chronic disease management. They basically do your physical and can check for an ear infection or strep, otherwise you need to see the MD.

For the most part I do love my job. I love being able to help people. It is sometimes very difficult to deal with non-compliant families. It is one thing if the patient themselves is non-compliant, but when the mother/father/caretaker just fails to bring a child in for necessary appointments or continues to give their obese child tons of chips and kool-aid it can be very frustrating. The other thing that I dislike is that it is not unusual for the office phone to begin ringing off the hook at 3:00 when kids get out of school. There are often sick kids that need to be added on. I like to get out on time (or actually even a little early) so this is not my favorite thing!

What is realistic as far as scheduling can very much depend on the area you live in. I work 4 typical days (8-5). This along with the occasional hospital rounds and on-call responsibility equates to a full time position. When I negotiated my contract, I am sure I could have asked for 5 shorter days. Actually, next year I just might do that! I didn't want to ask for too much in the very beginning. I was a new grad in an NP over saturated area. Next year, when I have an established patient base and am making oodles of money for the practice, I will be in a better position to negotiate.

Another consideration is that many school districts are employing NPs. What a perfect schedule for a mom with school aged children. This is something I may look into further, though I would really hate to leave my practice. I work with a fabulous group!

I hope I answered some of your questions.

allnurses Guide · Sep 26, 2009

Hi,

I'm an FNP working in an urgent care department of a low income urban health center. I only see adults over 18. The vast majority of my day is spent with sick visits, although I do the occasional work or school physical. We also do follow up from ER visits and some chronic disease mgmt, as the primary care care providers are usually booked a couple of months out. Like Sheri, I enjoy the variety of the patients I see. I see everything from sore throats to GI problems to derm and psych issues. I did not anticipate seeing so many psych patients, but there is such a long wait to see a psychiatrist that we often do the initial evaluation and start meds for depression and anxiety. I have a great deal of autonomy, but I also have a large group of other practitioners (MDs and NPs) to bounce things off of. My patient population is primarily comprised of recent immigrants, and I really enjoy hearing the different languages and learning about the health practices of the various countries. Again, I agree with Sheri in that the non-compliant patients can be maddening. It's frustrating when a diabetic comes in for a blood sugar check holding a Dunkin Donuts bag and their sugar is over 500, or when a COPD patient can't speak a complete sentence without gasping for breath, all the while reeking of cigarette smoke. Sometimes the best you can do is minimize the harm. I also get frustrated when treatment is dictated by a patient's insurance and not by best practice. However, overall, I think the work is very gratifying and fulfilling.

I work 4 10 hour shifts per week. It makes for a long day, but I have one complete day off during the week. I do not do hospital rounds or take call. Eventually I'd like to work in a college health service. I did that as one of my clinical rotations in school and loved it. That might also be a good option for you. You might be able to work 2 or 3 days a week, and could have summers off if the school doesn't keep a full staff during the break.

Becoming an NP was a mid-life career change for me, and I'm so glad I did it.

Hope this helped you. Good luck with everything!!

Hozgur · Sep 26, 2009

Thank you for taking the time to answer my questions I found them to be very helpful thank you! Do you happen to know more about NPs in school districts such as their responsibilities?

Remilekun · Sep 26, 2009

I hope I'm really not out of line for asking this but I'm curious. What is the starting wage for a FNP?

RN4NICU, LPN, LVN · Sep 27, 2009

I hope I'm really not out of line for asking this but I'm curious. What is the starting wage for a FNP?

That isn't a question that can just be answered as there is no "starting wage for NPs" - NPs all start out at different wages. It depends on what type of work you will be doing, call/rounds responsibilities, working hours, and the local market for NPs just to name a few things. All contracts are negotiated individually.

allnurses Guide · Sep 27, 2009

It depends......salaries vary greatly from region to region, and practice to practice. I've seen it range from high $50s to low $90s annually. You can look at the Pearson report (I don't know the URL but you can google it) to see what the median salaries are for every state.