Jobless FNP

  1. I graduated 1 year ago and still have not found a meaningful NP position. Just about every position that I have applied for, I have either gotten no response or a generic email stating that I am not a candidate for this position. I had no idea when I graduated that I would have such a difficult time finding an NP position. I was expecting to find a position within two months of graduating, but here it is a whole year and I am basically unemployed. I lived and worked in Texas for eight years, but after graduation I relocated to Las Vegas to be closer to family. The job market doesn't seem to be better anywhere, just about all my classmates that I graduated with still living in Texas has not found positions yet. I am currently working doing health risk assessments, however this is not a reliable source of income . You can make up to 2500 a week, but you can also make $200 a week depending on the time of year, cancellations and no patients to schedule. I did get a job offer at a private pain management clinic with an offer of 125,000 per year, no health insurance, paid CME, Paid time off, 6 paid holidays, and two weeks vacation the first year. I did shadow the physician for a couple hours and the demographic Of patients seem very difficult to deal with, and I am also expected to see up to 38 patients ppd. This is a Monday through Friday position 8 AM to 6 PM and some Saturdays. The worst part is that it requires a two year contract. I did accept the position with a heavy heart, because I am desperate to find something full-time. I was waiting on credentialing to be completed, but I have not heard from the physician so I think he changed his mind about hiring me. I refuse to call him because he has given me several start date so far and I keep calling to figure out what's the hold up and he keeps changing the start date. I did get a second job offer this week at another pain management clinic. I asked for 125,000 but he said he couldn't do that and offered 115,000, this job has absolutely no benefits except for paid holidays and two weeks vacation the first year. This office is very nice, it's in a nice part of town, Monday through Friday 8 to 430 with 30 minutes for lunch, and the demographic of patients seem to be much easier to deal with. There is no contract, but I am expected to see 40 patients a day, With 70% being medication refill. The physician appears to be very easy to get along with. I am really considering this position, because after a year I am ready to work. My plan is to stay for a year to get my experience, and then possibly do locum tenem. This journey has been a very unpleasant one and I would like to hear any feedback or recommendations. BTW I am an FNP.
  2. Visit Nicola301975 profile page

    About Nicola301975

    Joined: Mar '12; Posts: 11; Likes: 6

    42 Comments

  3. by   Oldmahubbard
    Pain management? 40 patients a day? Mostly refills?

    Heather Alfonso, a CT NP, is getting ready to do 5 years of prison for a similar job.

    I wonder how many people she personally helped kill.

    My first NP job was very, very far from ideal, but you need to get experience under the belt.

    In my opinion, 38 ppd is a ludicrous expectation, especially for a new NP.

    You are getting nibbles, which is encouraging, so keep looking.

    Are you working as an RN? I had to do this for several months to have an income.
  4. by   ICUman
    Still in Las Vegas?
    There are several positions open to inexperienced NP's on craigslist, and the Indeed job board for the area.
    Some state they will hire new graduates.
  5. by   Dodongo
    Where did you attend school?

    Any networking you did during clinicals that may be able to pull some strings?
  6. by   FullGlass
    I have written extensively on this forum about new grad NP job search in the Western US. You may want to read my article and posts. There are hundreds of NP jobs going begging in the Western US. They may not be in Las Vegas. In addition, you may need to revamp your resume. There is a huge demand for FNPs.

    New Grad NP - How I Got Multiple Job Offers
  7. by   Nicola301975
    I am oblivious as to what you are talking about. Pain management is a specialty just as any other specialty. Heather Alfonso was convicted of receiving kickbacks for prescribing a specific drug. Receiving kickbacks is illegal regardless of what you do to receive the kickback, hence her conviction. Both clinics has been in business for many years, I am more concern about the lack of benefits, not the fact that it is a pain specialty. As long as you practice within your scope, using recommended guidelines and in an ethical manner then you should have nothing to worry about. There are people that suffer from chronic pain as there are people that suffer from hypertension, diabetes etc. I do agree that 40 patients is a lot, but if a provider can see 25-30 patients in a family practice/internal medicine setting with as many ailments and complaints those patients have, 40 patients in a pain management setting is feasible. You are only assessing pain, ordering MRI or procedures geared towards pain relief anything else is referred out.
  8. by   Jules A
    Quote from Nicola301975
    I am oblivious as to what you are talking about. Pain management is a specialty just as any other specialty. Heather Alfonso was convicted of receiving kickbacks for prescribing a specific drug. Receiving kickbacks is illegal regardless of what you do to receive the kickback, hence her conviction. Both clinics has been in business for many years, I am more concern about the lack of benefits, not the fact that it is a pain specialty. As long as you practice within your scope, using recommended guidelines and in an ethical manner then you should have nothing to worry about. There are people that suffer from chronic pain as there are people that suffer from hypertension, diabetes etc. I do agree that 40 patients is a lot, but if a provider can see 25-30 patients in a family practice/internal medicine setting with as many ailments and complaints those patients have, 40 patients in a pain management setting is feasible. You are only assessing pain, ordering MRI or procedures geared towards pain relief anything else is referred out.
    Be very, very careful. Pain management is a specialty fraught with stumbling blocks and even the most ethical and educated can run into difficulties. I'm assuming you know there is absolutely no data that indicates opiates are effective long term for pain control and that unless this is a new age holistic type practice that will be the bulk of your scripts. What this means is many people do not get better and as their tolerance and dependence increases so does their pain and requests for more medication. It can be a vicious cycle. In my opinion this is not a job for the faint of heart.
  9. by   Nicola301975
    As a practitioner, you have to set boundaries. You are treating them, they are not treating them. If they are not happy with the provider, then they seek care elsewhere.
  10. by   Nicola301975
    You have to take into consideration that each position has many applicants. I have been to interviews where there were many resumes along with mine on the desk. I have literally applied to hundreds of positions. If it was as easy as applying for a position and getting a job offer, this wouldn't even be a topic. The fact is, it is becoming more and more difficult to find nurse practitioner positions. There is an influx of NP graduates, therefore the job market is extremely competitive.
  11. by   SopranoKris
    What was your background prior to becoming an NP? Did you work in acute care? Any contacts from your time as an RN? Use the networks you have available.
  12. by   FullGlass
    Quote from Nicola301975
    You have to take into consideration that each position has many applicants. I have been to interviews where there were many resumes along with mine on the desk. I have literally applied to hundreds of positions. If it was as easy as applying for a position and getting a job offer, this wouldn't even be a topic. The fact is, it is becoming more and more difficult to find nurse practitioner positions. There is an influx of NP graduates, therefore the job market is extremely competitive.
    No, there is no problem finding NP positions in the Western US. As I previously commented, I have written extensively about this on allnurses. You have to be willing to go where the jobs are. Maybe there aren't a lot of NP jobs for new grads in Las Vegas, but I received 9 job offers in January as a new grad AGPC NP. If I had an FNP, I would have received more offers. The offer I accepted pays extremely well and is in a low cost of living area.
  13. by   djmatte
    The hard part about specialties is they don't give you any more expertise in family medicine/Primary care than you had before. So later on you will still find the same hurdles you had before. 40 patients per day is excessive and there is genuine concern when it's stated up front the majority of you job will be med refills. As an RN, I've had extensive pain background and I've received many requests to consider pain positions because of this. While they're tempting and could land me some new skills, I'd rather not pigeon hole myself out the gate. I haven't checked Vegas, but as suggested above there are lots of jobs out west. Check out practicelink. That website's been the most productive source for me.
  14. by   Rnis
    Quote from djmatte
    The hard part about specialties is they don't give you any more expertise in family medicine/Primary care than you had before. So later on you will still find the same hurdles you had before. 40 patients per day is excessive and there is genuine concern when it's stated up front the majority of you job will be med refills. As an RN, I've had extensive pain background and I've received many requests to consider pain positions because of this. While they're tempting and could land me some new skills, I'd rather not pigeon hole myself out the gate. I haven't checked Vegas, but as suggested above there are lots of jobs out west. Check out practicelink. That website's been the most productive source for me.
    This! This isn't going to solve your problem. I understand your frustration but definitely don't lock yourself into a 2 year contract. At 40 patients a day.......they are making a killing off you if they aren't providing benefits. If you are willing to move, there are jobs out there. Best wishes.

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