Not every job is terrible. But, I do believe that most are. Some are more terrible than others. There were 3 staff positions that I had that were excellent as far as clinical stuff, pay, and benefits go. What ruined them was the office politics and the unrealistic expectations and the excessive number of unpaid hours. In one situation the doctor's family members were the staff...his wife was the office manager, his daughter was the assistant office manager, his son was the administrative assistant... And all of these people felt that they had to tell me how to be a nurse practitioner and what to prescribe for my patients and when. I was the 4th NP he hired in less than 2 years. It didn't take me long to see why the others left. I lasted there 8 months. I'm surprised I stayed there that long. There were a LOT of unethical and illegal things that that doctor was allowing his family members to do---including logging on to the EHR with his password and writing electronic prescriptions for patients under his name. I didn't yet have another job lined up when I left that place. But it was scary dangerous. I heard that the NP who he hired after I left stayed there less than a month.
I had another staff position with a specialist. Brilliant doctor, very nice guy too. But he had just recently married the office assistant (who he was having an affair with while he was married to someone else---and the someone else was the office manager). I did not know what I was walking into when I accepted that job. At this place there were 2 NPs working there who abruptly resigned shortly before I was hired. It didn't take me long to find out why. They were both young, attractive women. And the doctor's new wife didn't like that at all. It was drama and fireworks every single day. Big fights and screaming between the new wife and the former one---in front of the patients. And they were trying to get me to get involved in it and to take sides. The administrative assistant was the doctor's niece and the the biller was the doctor's sister, and both were loyal to the former wife and were always trying to involved me in petty gossip. When I refused to get mixed up in their nonsense I was targeted for being 'anti-social'. I had to leave that place too. Those family members were ridiculous. On top of that, he expected me to round in 4 different hospitals all over town then come in and see a full roster of patients everyday while he and his new bride would cruise. They often left the office on extended lunches and at time just disappeared together. I had a ridiculous patient load everyday and was having to stay hours after the office closed just to get caught up with documentation.
I had yet another position with an internal medicine practice. Again, I did not know what I was walking into. It just seemed too good to be true. I was suspicious that there were 3 other NPs who left the position within the past year. I later found out that this doctor had a penchant for getting into relationships with his staff. He was involved with the previous office manager who had also just left, and he was involved with the current office manager who used to watch my every move and was always trying to tell me what to do as a nurse practitioner even though this person had no clinical background whatsoever. But things go really weird there. And I am pretty certain that that doctor was on drugs. He often called out from work, or came in very late, or suddenly leave very early. And I was often having to take care of both his patients and mine. At times he would come in looking disheveled and smelling like he hadn't showered in days, and obviously stoned. There were days when we had the waiting room full of patients and I would walk by his office and see him just sitting at his desk, burning incense, listening to music, and staring at his mood lights like he was in some sort of trance. There were a lot of things going on at that place that were questionable and illegal too. After that I decided that locums was the way to go. If the place sucks you only have to put up with it for a while and then you move on to the next gig.
A long time ago, when there weren't that many ARNPs our profession was treated with more respect. Now, the hospitals and doctors that most of us work for take advantage of us because they mostly view us as lackeys, or, in the vernacular, the doctors' [b-word]. We are expected to accept being taken advantage of and remain silent about it because we are supposed to be grateful to even have a job at all. I've seen this in most jobs I've had as an NP, and I have done both staff and a lot of locums in different parts of the country. Its much better in the more rural areas though since you're less likely to encounter the over-aggressive, self-important personalities. The low pay is just a part of it now. To [them] you are 'just a nurse' no matter what title your education or qualifications bestow upon you. Interestingly enough, in an increasing number of areas you will find that certain RNs are earning more than NPs. The reason is because there now is a real shortage of experienced RNs in many places. Many of the older ones among us are retiring, and many of the rest are becoming or have become NPs. I haven't worked as an RN in years, but I still get emails from RN recruiters and some of the specialty positions in some areas pay more than what I was earning at my last few locums NP jobs. Locums NP jobs used to be plentiful and they used to pay better. But that has mostly dried up too. As far as the money goes, I believe that we're going to continue to see stagnation and in some cases even a decline in pay across the board. They can do this because they have many NPs to choose from.
If you like ER but don't like the hospital set-up then you might consider working in an urgent care. Similar activity but when the day is done, its done. Last patient in by a certain time---unless its a 24-hour operation. You might go over a little bit but this is generally strongly discouraged. If you decide to do locums urgent care you will find that there are plenty of options for experienced NPs.