Needing encouragement: I think I regret being an FNP

[Trilldayz,RN BSN]

I don't even know where to start, to be honest. So I will just ramble (bear with me).

So I was laid off 3.5 months ago from an NP job that I enjoyed, due to budget cuts. At that time, i wasn't too devastated because I always kept my agency ICU RN gig on the side, and I have been able to resume making a good income ever since my layoff. But at this point, I am beginning to grow really annoyed at the inability to find a respectable NP job.

I live in an NP saturated city, and even as an NP with over a year of experience, I have placed over 60 applications with very little call backs. I've only been called back 3 times. One was a cardiology NP job and I was passed over due to me having an FNP (I was crushed, even though he loved my Cardiac ICU experience). The second call back I thought I had it in the bag, went though 5 positive interviews, interviewed with the CMO, and they eventually dropped off the face of the earth (after they STRONGLY encouraged me to get my DEA prior to hire.... so I basically paid over $700 to be flaked on, which is my fault at the end of the day, but still... I felt so deceived), and LASTLY there is another job that I am interviewing for that I think is a joke. They are talking about paying $60,000 a year with a FIVE YEAR CONTRACT. I honestly don't know why I am still communicating with them, but at this point, I feel like ANYONE showing interest in me at this point is something, even if the job is pathetic .

Even all the Locum Tenens places I am looking at are asking for 2 years experience, and I am still not "qualified enough" at 1 year and 3 months. I recently just purchased a home with my spouse and moving isn't an option at the moment, as I help take care of my siblings.

The job I was laid off from was a low 6 figure income, great perks, etc. and I am angry and disappointed in the lack of options that are out there now for FNPs. I'm not asking for perfection, but i'm seeing too many 6 days a week jobs for 60k-70k a year, which I find to be simply unacceptable. I feel like I fell for the "FNPs can do anything" myth. It is NOT TRUE in my neck of the woods. When looking at jobs now, all that is out there are psych and Acute Care jobs. Even pediatric clinics and OB/Gyns here only want PNPs/WHNPs. There are SO MANY FNPs graduating in my city and many more moving in. I have already put in applications for a few Post Masters AGACNP programs for Spring 2018, to open up my opportunities. I'm even tempted to consider applying for Psych NP, mainly for the $$$ and job opportunities. I'm shocked that employers are even considering asking FNPs to accept $60-80k for 50+ hour work weeks.

At this time, I am loving my Agency RN work, I always have. At least while I search, I can make my own schedule, work 4 days a week, and take trips without worrying about scheduling. But I still get this sense of 'I NEED to find an NP job soon'. But even headhunters I have contacted have nothing to offer because of the saturation. And I don't want to just settle for ANY job (like the 5 year contract job) that I will absolutely resent.

Anyway, thanks for taking time out to read this. Is there anyone else that is regretting their FNP or hating the job market where they are and are unable to move???

Maybe I'm just impatient, or asking for alot, i don't know.

[JustKeepDriving]

They should fight for autonomy in all 50 states then... It's either they can replace PCP MD/DO completely or they can't.

In states that they are fully autonomous, they should not be looking for jobs. MD/DO PCP should since there is no difference in the care provided by NP vs. DO/MD in primary care and yet NP is way cheaper...

Why would an employer hire a MD/DO PCP over a NP in states where NP have full practice right?

Until APRN nursing gets it's collective stuff together in terms of training people I'd be absolutely terrified to have an army of NP's replacing primary care provider MD/DOs. There is just way too much variability in programs and the quality of NP's being pumped out of the market due to a failure to standardize and the zealousness of Universities to cash in on the advanced practice craze.

Why would an employer hire an MD/DO? Honestly all the 'employers' that have interviewed me since graduation were MD/DO's and a lot of them are catching onto the fact that NP programs come with insane variability. Not all MD/DO's are going to be amazing, but you can bet that they have very similar training across the board. Same with PA' for that matter.

Ever single day on this site you see, "What is the fastest route to NP where I can go online, have easy coursework and never have to work as a nurse!!!!". It's not... "Oh wow, I want to enter a career where literally I can make a mistake that alters someone's life forever, where I have a ton of liability, can get sued, or spend thousands on a degree and lose my ability to practice if I'm don't know what I'm doing... so please tell me which program, route, path offers me the absolute best and most thorough education!".

Yet there are totally school's out there that with "Just graduated with your BSN? Have No nursing experience! Able to set up your own unstructured clinical rotations where you basically just watch your doctor friend do H&P's for 500 hrs!? Well you're in luck! Boy do we have a deal for you! For just the small price of a black market kidney, you too can become an NP!".

The flood of providers and the lack of standardization hurts the NP profession - not the fact that MD/DO's do primary care.

[chiromed0]

Well, I would say first DON'T GIVE UP. Second, it looks like you're in Houston. I'm north of you and I DO NOT see the same job situation in other Texas metros. In fact, I see the opposite. A "normal" salary offer for a newby is this canned "$95K" to start which I heard everywhere and must have come from

some idiotic HR factoid resource. At any rate I would scoff at anything below $90K as an NP. I do agree that racking up more credentials is key plus years of experience and EXPERIENCE IN THOSE YEARS! They gotta be able to make money off of you or it just won't work. If you're being passed over then it may be worth while to get some head hunter feedback from the agency you're working with just to see if it's an interview thing you could

change. If not, then you only need one "yes" for now so don't get discouraged. I'm puzzled at an employer asking you to get your DEA registration, did you not prescribe in your last NP gig? That's a big deal if you didn't b/c I got asked that all the time. It's good that you have it so you can get up and running quick for a new employer otherwise it's sit and wait and they can't use you for much. At any rate, you probably know all that.

Contrary to what I am reading here I've had a D.O. internist tell me there is NO shortage of physicians really in major cities, just where nobody wants to live in the first place. Probably holds true for midlevels so looking outside the metro may be better. I'm sick of school but I am going to go back and get the RNFA done after having an ortho surgeon tell me that's the ticket b/c you write your own paycheck from billing and basically are a free employee to the ortho. That benefit should be transferable to any location, any state.

In a nutshell, don't give up just yet. I can see Houston being a little crowded but all Texas metros are getting that way. There are better paying gigs for sure but might take some networking. Get on FB and check some local PA/NP groups. I did and got a few knocks from just dabbling. I'm staying put for now but will use those sources later on. Good luck.

[MasterNursinator]

Try places you wouldn't normally consider, like a health department. Take a lower paying job for a year or two until you have that coveted experience. If you absolutely can't find one, get a post masters ACNP certificate and you'll be all set.

[starry_eyesgk]

I am an ACNP of 10 years, preparing to recertify and I have won multiple regional prestigious awards as well. I can tell you that big cities are saturated with NPs and it is hard for anyone to get a good position with experience less than at least 3 to 4 years in these cities. I have had difficulty obtaining a job that I really want in my home city, even with my experience, and am now working in another city 5 hours away where I'm trying to build a reputation for myself, using locums. I recommend getting out of the very large cities to extended suburbs to see if you can find anything that could help you. Even better, try calling the offices of the other MDs to see if they could use your help. Even if it is for a day a week, I'd take it, and work somewhere else for the rest of the week. What you're going to have to do is network and start low. Keep your expectations low. I did that the first two years of my career and I can tell you that I earned less than a patient care tech, but the experience and networking was invaluable. I have never worked outpatient, obviously, because I am Acute care, but it's a suggestion.

Best of luck with your search for a good job.

[traumaRUs, MSN, APRN]

And...if you do decide to relocate to an "outside the metro area," please don't look at as undesirable.

People live in more rural areas too. I live in a rural area near a fairly large city of 300,000. I practice at several small clinics in rural areas. I get loads of experience because my pts are too sick, don't have cars, can't drive, no mass transit to get to the "big city" (which isn't very big but I digress).

[gM_2010, MSN, PhD, RN, NP]

Healthcare systems are paying attention to the congruence of the education and credentials of APN applicants to the practice area closely these days. Potential graduate students need to think carefully and long term about what they want to do with their practice to get to the best graduate program. I ask people what they see themselves doing practice-wise in 5 and 10 years.

Essentially-an FNP could and probably should have difficulty getting a job as an ICU APN.

[ArrowRN, BSN, RN]

Until APRN nursing gets it's collective stuff together in terms of training people I'd be absolutely terrified to have an army of NP's replacing primary care provider MD/DOs. There is just way too much variability in programs and the quality of NP's being pumped out of the market due to a failure to standardize and the zealousness of Universities to cash in on the advanced practice craze.

Why would an employer hire an MD/DO? Honestly all the 'employers' that have interviewed me since graduation were MD/DO's and a lot of them are catching onto the fact that NP programs come with insane variability. Not all MD/DO's are going to be amazing, but you can bet that they have very similar training across the board. Same with PA' for that matter.

Ever single day on this site you see, "What is the fastest route to NP where I can go online, have easy coursework and never have to work as a nurse!!!!". It's not... "Oh wow, I want to enter a career where literally I can make a mistake that alters someone's life forever, where I have a ton of liability, can get sued, or spend thousands on a degree and lose my ability to practice if I'm don't know what I'm doing... so please tell me which program, route, path offers me the absolute best and most thorough education!".

Yet there are totally school's out there that with "Just graduated with your BSN? Have No nursing experience! Able to set up your own unstructured clinical rotations where you basically just watch your doctor friend do H&P's for 500 hrs!? Well you're in luck! Boy do we have a deal for you! For just the small price of a black market kidney, you too can become an NP!".

The flood of providers and the lack of standardization hurts the NP profession - not the fact that MD/DO's do primary care.

Totally agree. At this point I'm looking at NP programs. Just the variety itself is confusing as to which options to choose. FNP, ACNP, AGNP, AGACNP, AGPCNP, CPNP, Psyc/MHNP, NE/ANP, Educator NP, CNS, . what the heck? ANP's have some of the longest acronyms in the health care field. You go on a graduate college of Medicine site all you see is M.D. or Phd . I get that NP study "builds" or one being an RN/BSN but shouldn't there be a standardized Advance Practice Nurse training as a generalist and then once you get that, you move into specialization? not to mention direct entry programs that allow people with non-nursing degrees to get into ANP programs. What it heck? I actually just started a couple applications but then I read horror stories like this and seriously just considering going P.A route until graduate nursing programs get their act together. The only ones worth a dime seem to be CRNA's.

OP if you are in ICU, why not go back for your ACNP certificate? it might open more doors, maybe? But I of opinion that once one becomes an ANP, the ultimate purpose is to start your own practice.

[zedillo85]

I agree that standardization will probably fix many of the issues that APN are confronting now... No matter how we keep thumping our chest about equal outcomes, the public, and most importantly, healthcare organizations will never treat us like physicians. Why is it so hard for NP organization to come up with a standardized curriculum that mandate for all programs to have 1 year general education of basic science like: advanced A&P, biochemistry/genetics, advanced pharmacology, advanced pathophysiology, microbiology etc.... Another year should be just clinical. 2-year total in which everyone has the same training!

Everyone should be a generalist at the end, and then if you can spend another year to specialize if you desire...

[Trilldayz,RN BSN]

Well, I would say first DON'T GIVE UP. Second, it looks like you're in Houston. I'm north of you and I DO NOT see the same job situation in other Texas metros. In fact, I see the opposite. A "normal" salary offer for a newby is this canned "$95K" to start which I heard everywhere and must have come from

some idiotic HR factoid resource. At any rate I would scoff at anything below $90K as an NP. I do agree that racking up more credentials is key plus years of experience and EXPERIENCE IN THOSE YEARS! They gotta be able to make money off of you or it just won't work. If you're being passed over then it may be worth while to get some head hunter feedback from the agency you're working with just to see if it's an interview thing you could

change. If not, then you only need one "yes" for now so don't get discouraged. I'm puzzled at an employer asking you to get your DEA registration, did you not prescribe in your last NP gig? That's a big deal if you didn't b/c I got asked that all the time. It's good that you have it so you can get up and running quick for a new employer otherwise it's sit and wait and they can't use you for much. At any rate, you probably know all that.

Contrary to what I am reading here I've had a D.O. internist tell me there is NO shortage of physicians really in major cities, just where nobody wants to live in the first place. Probably holds true for midlevels so looking outside the metro may be better. I'm sick of school but I am going to go back and get the RNFA done after having an ortho surgeon tell me that's the ticket b/c you write your own paycheck from billing and basically are a free employee to the ortho. That benefit should be transferable to any location, any state.

In a nutshell, don't give up just yet. I can see Houston being a little crowded but all Texas metros are getting that way. There are better paying gigs for sure but might take some networking. Get on FB and check some local PA/NP groups. I did and got a few knocks from just dabbling. I'm staying put for now but will use those sources later on. Good luck.

Thank you!

[Trilldayz,RN BSN]

Thank you guys for your comments . At this time, I am backing off on looking for FNP work at the moment, for my mental health. Now I job search for an hour or so, 2 times a week, as opposed to all day, every day.

I had an interview last week and it went well. I will follow up this week. While I wait, I have decided to enjoy my flexibility and book some awesome vacations! I also happened to get accepted to a post masters ACNP program at a school in the Texas medical center for Spring 2018. I am no longer going to let this get me down too much.