So, my department has had an open position for an NP for 18 months! I just became involved in the interviewing process about 6 months ago, although I knew the previous RNs/NPs in the role (one left to industry, and one went to have triplets and doesn't work FT anymore!).
It's a really interesting position, very busy but a lot of room to make the role their own. There is acute inpt stuff, patient/staff education, outpatient clinic, clinical research/study involvement. Really a varied position, with a very interesting patient population. The CT surgeon who'd be the collaborating physician is good to work with and personable, as are the other engineers and nurses in the team.
The employer is a huge hospital system, with what seems to me to be average-good pay for this area. We're willing to train a new graduate if they are the right candidate.
I guess what I want from you, experienced NPs, is to know what we're doing wrong!? We often get people interviewing/shadowing, then calling to say they're not interested. I assumed NPs would be type A personalities who weren't so intimidated by a busy job... but maybe we're scaring them off? [it's an artificial heart program, which scares some people although it's basically advanced heart failure/device management].
Surprisingly, a lot of candidates admit they didn't want this job in particular, just "any" NP job - I can't believe they admit that to an interviewer! One even emailed saying her preferred job "fell through", so now she's interested in an interview (she had turned an interview down when we initially tried to schedule one after she applied as she was interviewing elsewhere).
What makes you say "I want to work THERE"? Any pointers? (I know it's hard without knowing the people involved).
Thanks for any help! (And if there's any NPs with an interest in cardiac/HF/mechanical support, PM me!).
Thanks Trauma - I think it would be. I would love to do it once I graduate from my ACNP program! There is definitely flexibility in hours, provided that the work gets done. There's noone monitoring when you do your stuff. We prefer 5 days/wk over 4x10 (have tried both) because a lot gets missed on the days you're not there.
Pinoy, it disappoints me to hear your experience of VADs - things are not nearly as dire as they seem! We are implanting better, smaller devices much earlier these days. I have a patient right now who is going home, POD 13. The only reason it took this long is to get his INR up and to train him on the device. I do agree that there's a lot of poor patients on Medicare/Medicaid who have trouble with drug coverage, dressing equipment etc. A lot of the nurses' job is case management.
Specializes in ACNP-BC, Adult Critical Care, Cardiology.
Pinoy, it disappoints me to hear your experience of VADs - things are not nearly as dire as they seem! We are implanting better, smaller devices much earlier these days. I have a patient right now who is going home, POD 13. The only reason it took this long is to get his INR up and to train him on the device. I do agree that there's a lot of poor patients on Medicare/Medicaid who have trouble with drug coverage, dressing equipment etc. A lot of the nurses' job is case management.
Well, our elective HeartMate II's do a whole lot better post-op and do go home following the usual pathway. We are approved to implant Thoratec HeartMate and IVAD's only. Right, we rarely if ever implant the larger HeartMate XVE's anymore. We use Abiomed devices for our temporary VAD support patients. You probably work for a larger center that is approved for clinical trial implantation of a host of other devices, we're not.
I guess my point is the high level of expertise and resources required for a transplant program to run is not cheap and hospitals are not necessarily raking in the big bucks for running such a program. In our case, it's more of a prestige thing being only one of two programs in the state. By the way, I forgot to post that the VAD/heart transplant position posted for a NP has been filled - by a PA-C who also cross covers the lung transplant service. The person was hired internally and was a surgical PA prior to joining that team.
Great, glad your position got filled. You are absolutely correct about the personnel and monetary costs to run a transplant/VAD program! I think most of the money we make comes from contracting our VAD expertise to industry and other upcoming centers.
Great, glad your position got filled. You are absolutely correct about the personnel and monetary costs to run a transplant/VAD program! I think most of the money we make comes from contracting our VAD expertise to industry and other upcoming centers.
I think that if you are a large center then it is revenue neutral. The issue is that if you don't have a VAD program you don't get the referrals. The competing center in our town isn't doing many VADs and their list has decreased dramatically. I think that to be competitive you have to offer VAD to the patients. And when I say offer I mean do a bunch not just have the ability.
I work in central IL and you can't get a VAD inserted except in Chicago now - the tertiary hospital here stopped doing VADs and heart transplants about five years ago because they couldn't do a high enough volume.
Specializes in ACNP-BC, Adult Critical Care, Cardiology.
I think that if you are a large center then it is revenue neutral. The issue is that if you don't have a VAD program you don't get the referrals. The competing center in our town isn't doing many VADs and their list has decreased dramatically. I think that to be competitive you have to offer VAD to the patients. And when I say offer I mean do a bunch not just have the ability.
David Carpenter, PA-C
You can't keep a VAD/heart transplant program without having the minimum number of cases each year. Medicare requires at least 10 heart transplants a year for a center to remain in operation. Add to that is the close scrutiny of your heart transplant morbidity and mortality. You can not run a heart transplant program without a VAD program. They go hand in hand. Michigan has two heart transplant centers including the one I work for. Other hospitals in the area can implant temporary VAD's but the patient needs to be immediately transferred to either one of the two centers in the state. Our setting is an inner city hospital and we do get the sicker and underinsured more than the other center located in a college town and is university-based with a higher percentage of patients with good insurance.
I was thinking about this post today and wanted also to say that one of the things I value at my current position is the ability to have a flexible day. I am required to work at least 40 hours and do so every week. However, I do like to work 10-12 hours on Mon-Tues and then take off early on Friday. So....this is one of the intangibles of my job.
Personally, I think the job you are talking about sounds wonderfully interesting.
I totally agree about the 10-12 hr days. I'm not a Mon-Fri 8-5 kind of person. This has been a problem with the primary care clinic where I work 4.5 days per week. We usually start at 8:30, then an hour off for lunch and sometimes I leave early if the schedule is light. The problem is that I don't even get to put in an 8 hr day. However, I can make the time up at the UC clinic...but then I'm working all the time! Also, this clinic is a 40 minute drive one way, so I'm having to pay a lot of $$$ for gas.
I've been offered a job with EMCARE (anyone heard of it?) and they cover ER's at 3 local hospitals - it's in the fast track. The shifts are 10 or 12 hrs, depending on the hospital. I would only have to work a minimum of 10 shifts per month in order to get full benefits. I'm seriously considering making the switch. I'm going to see if I can still work one day a week at the primary care clinic, but I'm going to tell them I need to be guaranteed 8 hrs. I need to keep up to date on all the primary care issues, b/c they are so broad.
The pay at the ER job is $60/hr for part-time and $65/hr for fulltime. They said I could do either. They require 2 years of urgent care experience and thankfully I now have that! I'm just waiting to take my ACLS class and we'll go from there.
For the work u are describing.....I would think the pay should be in the 6 figures to make it worthwhile. It is a lot of work doing inpatient coverage... let alone all the other stuff to boot.
We have made an offer to the last candidate we interviewed, so we'll see what happens. As I mentioned, I don't think salary is the issue, but rather the intimidation factor. This NP is apprehensive, but excited about the opportunity. I'll take that over experience.
We have made an offer to the last candidate we interviewed, so we'll see what happens. As I mentioned, I don't think salary is the issue, but rather the intimidation factor. This NP is apprehensive, but excited about the opportunity. I'll take that over experience.
Once again, that NP should be pulling in over 100k annually for that job. You can bet they would pay a doctor more than twice that for the exact same duties!
Just an update - that candidate I mentioned was offered the job and accepted - she is starting in about a month! We are SO looking forward to having her on board.
Also, one of the PAs we interviewed who was put off by the research requirements in our job also interviewed for our stepdown floor and started work there today to replace the NP who left recently!
Thanks everyone for suggestions on how to not scare our candidates off!
.thumb.gif.11fa0ddb3aacfb1b3953bc671abcfb7e.gif){kind=avatar}
ghillbert, MSN, NP
3,796 Posts
Thanks Trauma - I think it would be. I would love to do it once I graduate from my ACNP program! There is definitely flexibility in hours, provided that the work gets done. There's noone monitoring when you do your stuff. We prefer 5 days/wk over 4x10 (have tried both) because a lot gets missed on the days you're not there.
Pinoy, it disappoints me to hear your experience of VADs - things are not nearly as dire as they seem! We are implanting better, smaller devices much earlier these days. I have a patient right now who is going home, POD 13. The only reason it took this long is to get his INR up and to train him on the device. I do agree that there's a lot of poor patients on Medicare/Medicaid who have trouble with drug coverage, dressing equipment etc. A lot of the nurses' job is case management.