Newbie Questions About NP Career

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Hello.¬† I am a nursing student starting this fall for an RN diploma program so I'll be an RN in less than 2 years (god willing ūüôā¬†) and long term I've been interested in becoming an NP.¬†

I am just wondering, for NPs what are the work hours like? I've talked to a few NPs at urgent care and they told me they work 3 12 hour shifts which seems awesome. But what other NP jobs have good work life balance?

I have heard an NP can work as a hospitalist, and they work 7 on 7 off? Is that true? What experience do you need as an RN before doing that? Would it be ICU experience?

I'm also very interested in outpatient work like as a FNP. What is their schedule typically like? is it always a 5 hour work week or could they do like a 3 12 hour shift type of thing?

I know these things are very location dependent, but I'm just asking in general. What experience should I shoot for as an RN before moving into one of these positions later in my career? Thanks! 

allnurses Guide

BostonFNP, APRN

2 Articles; 5,581 Posts

Specializes in Adult Internal Medicine.

I can answer on the outpatient side as that's where I have spent most of my career. I started in a small independent internal medicine practice, became a partner in that practice, and then merged the practice with a big hospital system. 

Over my career I've worked mostly 4 days a week in the office averaging 9-10 hours a day, though at times the days can be longer. I will say I have become more efficient with my time over the years and it was a bit more in the beginning. I don't take any call any more nor do I moonlight. I take about 4 weeks worth of vacation time a year (I could take more but my patient panel is so large now I'd have trouble with having enough spots for patients) plus one week a year of CME time. I have a good work\life balance and I love my job. 

Most big systems now use a 32 clinical hours to 8 administrative hours per week schedule which is 4 days in clinic and 1 admin day. 

For a primary care job, you can pull from all sorts of RN experience: inpatient, ED, home care, primary care, SNF, case management are probably the most applicable though. 

JBMmom, MSN, NP

4 Articles; 2,467 Posts

Specializes in New Critical care NP, Critical care, Med-surg, LTC.

I'm a new NP hospitalist and my current job is 3 12s a week 7p-7a. In my health system there are inpatient and outpatient NP jobs. I am obviously inpatient and there are inpatient night positions in hospitalist and ICU that are 3 12s, then day positions with most specialty units (cardiology, CT surgery, heme/onc, palliative, nephrology, etc) those positions are generally 4 10 hour shifts per week. 

The outpatient NPs are usually M-F 8-5, although some of those are also 4 10 hour shifts depending on the office. 

One thing you should clarify before you start your NP education is whether you are targeting inpatient or outpatient. More facilities these days are NOT hiring FNP prepared NPs for acute care positions, they want acute care prepared NPs. 

Just like with RNs, there are many options for NPs out there. I know that in some places there appear to be a glut of NPs with people having trouble finding a job. I'm in the northeast and the job market appears to be pretty good here right now.

As far as experience, almost any RN experience is going to be beneficial as you advance your career. I'm a huge proponent of med surg for everyone. I know that not everyone likes it but I found it to be a place where I learned a lot and got a chance to see a little bit of everything. 

Good luck with whatever you decide. 

fishguy909

9 Posts

2 hours ago, BostonFNP said:

I can answer on the outpatient side as that's where I have spent most of my career. I started in a small independent internal medicine practice, became a partner in that practice, and then merged the practice with a big hospital system. 

Over my career I've worked mostly 4 days a week in the office averaging 9-10 hours a day, though at times the days can be longer. I will say I have become more efficient with my time over the years and it was a bit more in the beginning. I don't take any call any more nor do I moonlight. I take about 4 weeks worth of vacation time a year (I could take more but my patient panel is so large now I'd have trouble with having enough spots for patients) plus one week a year of CME time. I have a good work\life balance and I love my job. 

Most big systems now use a 32 clinical hours to 8 administrative hours per week schedule which is 4 days in clinic and 1 admin day. 

For a primary care job, you can pull from all sorts of RN experience: inpatient, ED, home care, primary care, SNF, case management are probably the most applicable though. 

That is very interesting. I never knew an NP could make partner somewhere.  Is that pretty rare to do so? and would your salary go up upon making partner? 

fishguy909

9 Posts

1 hour ago, JBMmom said:

I'm a new NP hospitalist and my current job is 3 12s a week 7p-7a. In my health system there are inpatient and outpatient NP jobs. I am obviously inpatient and there are inpatient night positions in hospitalist and ICU that are 3 12s, then day positions with most specialty units (cardiology, CT surgery, heme/onc, palliative, nephrology, etc) those positions are generally 4 10 hour shifts per week. 

The outpatient NPs are usually M-F 8-5, although some of those are also 4 10 hour shifts depending on the office. 

One thing you should clarify before you start your NP education is whether you are targeting inpatient or outpatient. More facilities these days are NOT hiring FNP prepared NPs for acute care positions, they want acute care prepared NPs. 

Just like with RNs, there are many options for NPs out there. I know that in some places there appear to be a glut of NPs with people having trouble finding a job. I'm in the northeast and the job market appears to be pretty good here right now.

As far as experience, almost any RN experience is going to be beneficial as you advance your career. I'm a huge proponent of med surg for everyone. I know that not everyone likes it but I found it to be a place where I learned a lot and got a chance to see a little bit of everything. 

Good luck with whatever you decide. 

I am from the northeast as well and in my college class my professor is an NP and according to her, in my area, and FNP can work as almost anything (ED, family practice, inpatient or outpatient). 

Your schedule seems great! If for example you later in life wanted to move to outpatient family practice or an urgent care for example would you be able to or would you be locked into inpatient hospitalist work? 

Trauma Columnist

traumaRUs, MSN, APRN

97 Articles; 21,237 Posts

Specializes in Nephrology, Cardiology, ER, ICU.

Nursing is a second career for me, I've been an APRN for 16+ years now - all in nephrology. Our role in a very large nephrology practice has evolved over the years. I've worked in-pt, out-pt, dialysis units and also telehealth. I'm a CNS but I'd advise you NOT to follow my path. 

I will add that I live in the midwest and in our area FNPs are NOT hired for inpt care. Something to consider because your state may change the way you would be credentialled. 
Best wishes - you are very smart to ask questions prior to embarking on your educational path

JBMmom, MSN, NP

4 Articles; 2,467 Posts

Specializes in New Critical care NP, Critical care, Med-surg, LTC.

It's going to depend on the facility. We have a couple FNP hospitalists but my understanding is that facilities are moving away from hiring primary care prepared NPs for acute care positions. And really, that makes sense because you're seeing two very different patient populations. Of course facilities are often willing to train someone and some may not even take the difference into account, but if a primary care prepared NP was called into court over mismanagement of a patient's acute condition, I don't know that the facility would stand behind them. It's just not something I would feel comfortable with for myself. I'm trained in acute care, and it is my intention to stay there. 

My only intention was to pass along what I have heard and read, I do not have enough personal experience to speak from yet. 

londonflo

2,711 Posts

Specializes in oncology.
On 8/2/2022 at 4:24 PM, fishguy909 said:

I am a nursing student starting this fall for an RN diploma program so I'll be an RN in less than 2 years (god willing ūüôā¬†) and long term I've been interested in becoming an NP.¬†

Before retirement, I taught for 40 some odd years.  Ever since the NP practice came on the horizon, I have been told by 75% of the incoming class that their end goal is NP. Talk to your classmates as someone surely has investigated the possibility of  becoming  an NP in your area. 

masafnp

12 Posts

I am an FNP. Unless you know you want to do acute care, or ER/Peds or another specialty specific degree only, I suggest doing family as you can treat cradle to grave. I only do locums work. I recently licensed in 2 other states, although at present have only worked in GA.  I love the flexibility of being able to work when I can. I suggest working for at least a year in one place to get experience under the mentorship of someone before going out on your own though. You won't get benefits, but are paid more per hour, and if flexibility is important to you, the trade off is worth it.

Guest1144461

590 Posts

On 8/3/2022 at 12:33 PM, fishguy909 said:

I am from the northeast as well and in my college class my professor is an NP and according to her, in my area, and FNP can work as almost anything (ED, family practice, inpatient or outpatient). 

Your schedule seems great! If for example you later in life wanted to move to outpatient family practice or an urgent care for example would you be able to or would you be locked into inpatient hospitalist work? 

Your professor is not correct. Go look at job postings. Some FNPs with inpatient experience will get grandfathered but the vast majority of hospitals will not hire FNPs for Hospitalist type roles.

I worked as one by the way…

fenix

4 Posts

Hi, I'm working in the southeast at a larger hospital and what I've seen around here is that if you want to work in an urgent care or minute clinic type set up, they hire FNPs & PAs because you need to be able to see all ages. Hospitalist around here are a mix of PA, FNP, and ACNP.  I see more PAs working in the hospital in specialty groups and some FNP as well. The problem with APRN in the hospital is that certifications are focused on age and that does not work well for some of the specialty groups such as ortho or neuro who need to be able to care for all ages. Yes there are specific peds neuro surgeons and orthopedist, but you never know what's coming in when you're the one on call.

I do see ACNP in critical care (Internal Med/Intensivist group) and some with Trauma. Though I would think Trauma could cause problems for the ACNP when children come in. Not sure how they handle that within the group. 

PAs seemed to be preferred in the hospital due in part to their training in inpatient/outpatient/surgery/some specialty exposures. It's one stop shopping hiring a PA.  NPs are very nuanced and divided into so many smaller subspecialties and scope limiting practices (in comparison to PAs) it significantly limits options. I think it also confuses docs and hiring managers on what the certifications mean and who they can hire.

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