How to get experience outside primary care

Specialties NP

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I'm facing a bit of a dilemma. I'm a new FNP grad (May of this year) and ended up with a job at the site I did my clinical rotation. For reasons that make sense to almost nobody, I refuse to quit my RN job (it pays very well, I get a pension, I have a flexible schedule) and want to instead work as an NP 1 day a week. My RN employer offered me a promotion to NP but because the NPs essentially do nothing but H&Ps and have to work 4 10 hour days for only slightly more money, I declined because I want more real experience.

The problem I'm facing is that I don't think I actually want to work in the family practice office where I currently work. As I'm only there 1 day a week it is difficult to establish relationships with patients, and even the new patients end up following up with the MD (he and I are the only 2 providers at this office). When I see the doctor's patient's it's usually for more trivial manners as his patients are not generally receptive to me significantly altering their plan of care for chronic issues (which I can understand).

I think my actual goal would be to work in an urgent care as they seem most likely to hire someone for 1 day a week and nobody really cares who they see at an urgent care. Unfortunately, I have very little knowledge of how to function outside a family practice office. My entire RN career has been at a forensic psychiatric hospital with very little "real nursing" and my NP school didn't force us to do rotations in specialties so 90% of my clinical experience was in an internal medicine office. As a result, I can't do many procedures well (if at all) and I can't read Xrays. I also have no experience treating people younger than teenagers as we don't accept them as patients at my office and my NP program counted anyone under 18 as pediatric.

Is there any way I can go about getting experience somewhere else? While it sounds crazy, I don't even really care about getting paid but I think if I walked into a specialty office or urgent care offering to "volunteer" they'd think I'm crazy. Any thoughts?

Specializes in Nephrology, Cardiology, ER, ICU.

Hmmm...now you've changed the premise of the thread. For this current scenario:

1. Try to get hired into a practice that offers extended orientation. Our nephrology practice offers 3-5 months customized orientation.

2. Apply to a teaching institution that would be willing to train you.

3. Obtain a post-MSN certificate with a concentration in that specialty and focus your clinical hours on that aspect of your education.

4. Volunteer with an organization that provides the specialty care - perhaps a missions trip, volunteer at a free clinic

I guess for me I'm still stuck on why you became an NP if you really enjoy your RN position? I really really loved my last RN position (level one trauma center ED). I only became an NP to give me more options as I got a little older. I do sometimes regret my educational choice but I'm kinda stuck with it too at this point.

Perhaps just use your NP education for volunteer activities in order to keep it current and stay with your RN job?

Specializes in allergy and asthma, urgent care.
Perhaps this is a better question. Pretend for a moment I was working full-time as an NP in a primary care office but wanted to someday work in a different setting (whether it be urgent care, dermatology, orthopedics, or wherever) but was told I lacked the experience in that specialty. How would I go about getting that experience?

Most specialties will hire someone with good IM experience and train them. You can also take CE courses on a specialty to gain knowledge on your own. I switched from IM to a specialty a number of years ago. I had done a lot of studying on my own and took CE courses, as I knew this was a specialty I wanted to pursue. I had also worked in research in this field in my previous career, so I had some baseline knowledge. Because of my IM experience, my employer didn't have to deal with a new grad on top of being new to the specialty. The foundation was already in place and that made me a very attractive candidate to prospective employers.

Stay there and get your experience. Patients will or will not want you. Move along. I have passed my boards eight months here in Florida and so far I have a hard time getting employed. I got lucky when one doctor offers to hire me for Fridays only. I jumped at the opportunity because I can get my experience and learn a great deal from him. Never look a gift hoorifice in the mouth!!!

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