any PNPs out there??

I am a PNP.

I would suggest you shadow a PNP before making a decision.

I have been a PNP for 18 years and have worked in a variety of settings--hospital based, specialty clinic, private practice--and currently work (for the past 7 years) in a group practice (3 docs and 2 PNPs) and I see everyone from newborns to teens. I do nursery rounds one morning a week in the hospital and see kids in the office the rest of the time. It is usually a mix of sick and well visits--I devote one afternoon per week to adolescent gyn exams since I like doing them and no one else really does :)

Not the exams per se--but the chance for some "girl" talk with girls I have known for quite a while.

Pediatrics is a seasonal business and the winter months are tough. The most patients I have seen in one day is 47 . I am very lucky that we have an excellent staff and a transcriptionist who make my job MUCH easier. I take (phone only) call 1-2 nights a week and some holidays and am paid a percentage based on what I bring in to the practice. No holiday or vacation pay but I do get a good annual CME stipend paid by the group and some 401K benefits.

I don't know what area of nursing you currently practice in but if you like NICU then a NNP might be an option for you since they are in HUGE demand. If you don't like cranky kids and crankier parents then you really need to look closely at the PNP role:twocents:

Pediatrics is a seasonal business and the winter months are tough. The most patients I have seen in one day is 47 .

Okay, I've got a question for you. I have a FNP friend with years of experience in pedes. She told me that she was going to start working with some doctor on the TX/MEX border and he's paying 120K per year (with bonus) for working 3 twelve hour days per week. On top of that, he pays full benefits AND provides a condo for her to stay in while she's there. Apparently, he already has 2 NP's working there and they love it. I almost fell over when I heard about this job, until she told me that the NP's average 100 pts per day! How in the WORLD can someone see 100 pts in a twelve hour day and provide good care? I think this is just flat out malpractice and I told her so. She says that 100 kids in 12 hrs isn't that big of a deal. I guess I'm just used to the elderly "train wrecks," because to me, there is no way anyone (doctor or NP) can provide decent care when they're seeing that many kids per day.

Okay, I've got a question for you. I have a FNP friend with years of experience in pedes. She told me that she was going to start working with some doctor on the TX/MEX border and he's paying 120K per year (with bonus) for working 3 twelve hour days per week. On top of that, he pays full benefits AND provides a condo for her to stay in while she's there. Apparently, he already has 2 NP's working there and they love it. I almost fell over when I heard about this job, until she told me that the NP's average 100 pts per day! How in the WORLD can someone see 100 pts in a twelve hour day and provide good care? I think this is just flat out malpractice and I told her so. She says that 100 kids in 12 hrs isn't that big of a deal. I guess I'm just used to the elderly "train wrecks," because to me, there is no way anyone (doctor or NP) can provide decent care when they're seeing that many kids per day.

There are a few issues with this that I can address:

First of all, the border clinics advertise CONSTANTLY offering high pay and great bonuses. Tells me something, since it would not seem that hard to fill those positions if they were worth having.

Secondly, your friend must be FLUENT in Spanish to even consider doing this since she will most likely see mostly Spanish speaking kids/families. I do know some Spanish and can often use another kid in the family to help but it takes a bit longer to get a straight history and give instructions. I have a nurse in our office that is fluent and she helps me as needed (right in the room with me:))

Third, many of the patient are illegal immigrants which presents certain other issues that your friend needs to understand. There may be no followup and prescriptions may not be filled unless you can provide them samples. Unless they are to the point that they need an ambulance to take them to the hospital, you will have no ability to follow them up or make a referral.

Fourth, 100 patients in 12 hours is insane. I don't care who you are. I worked last winter on a Saturday (we are open from 8:30 until we are done) and saw 31 patients in 4 1/2 hours. Keep in mind that we take only established patients for sick visits on Saturdays--my nurses do a rapid strep on anyone with a fever and sore throat/vomiting/rash, dip a urine on all urinary complaints and start breathing treatments/get a pulse ox on known asthmatics before I see them. Plus, I dictate my notes for the transcriber which cuts down charting time and have scripts that allow 3 separate drugs on one form. I could not see 100 patients in 12 hours.

Fifth, there are some nice places to live on the border but there is also a lot of crime, poverty, drugs, car thefts, etc. She needs to make sure she is comfortable where she is considering going.

JMHO, her MMV and I hope it works out for her.

Are there any legal nurse consultant out there?

There are a few issues with this that I can address:

First of all, the border clinics advertise CONSTANTLY offering high pay and great bonuses. Tells me something, since it would not seem that hard to fill those positions if they were worth having.

Secondly, your friend must be FLUENT in Spanish to even consider doing this since she will most likely see mostly Spanish speaking kids/families. I do know some Spanish and can often use another kid in the family to help but it takes a bit longer to get a straight history and give instructions. I have a nurse in our office that is fluent and she helps me as needed (right in the room with me:))

Third, many of the patient are illegal immigrants which presents certain other issues that your friend needs to understand. There may be no followup and prescriptions may not be filled unless you can provide them samples. Unless they are to the point that they need an ambulance to take them to the hospital, you will have no ability to follow them up or make a referral.

Fourth, 100 patients in 12 hours is insane. I don't care who you are. I worked last winter on a Saturday (we are open from 8:30 until we are done) and saw 31 patients in 4 1/2 hours. Keep in mind that we take only established patients for sick visits on Saturdays--my nurses do a rapid strep on anyone with a fever and sore throat/vomiting/rash, dip a urine on all urinary complaints and start breathing treatments/get a pulse ox on known asthmatics before I see them. Plus, I dictate my notes for the transcriber which cuts down charting time and have scripts that allow 3 separate drugs on one form. I could not see 100 patients in 12 hours.

Fifth, there are some nice places to live on the border but there is also a lot of crime, poverty, drugs, car thefts, etc. She needs to make sure she is comfortable where she is considering going.

JMHO, her MMV and I hope it works out for her.

My friend won't live there, she'll only travel there (2 hrs away) for those 3 days per week. She's accustomed to seeing Spanish speaking, illegal immigrants, so none of that is new. I just can't believe she would ever even consider seeing that many patients per day.

your friend who is seeing 100pts in 12 hours is doing one of two things - LIEING (yes, it is a big deal and pretty much impossible) or is providing shoddy care.

NO!! I am not asking if NP are licensed. Legal nurse consultant (LNC) this is a speciality in itself. Bullseye

I have continued to think about this and have a few more thoughts (I am a math geek so bear with me):

If your friend is earning 120K per year then this works out to slightly more than $2300 per week. If this is based on seeing 300 patients per week (100 per day for 3 days per week) then she is making $7.69 per patient seen.

In our office, I work on a percentage based on the amount of money I bring in to the practice. This is good because it shows the total amount I bring in and I have a computer log of all patients I see.

Once you have this figures the possibilities are endless...

As a math geek :imbar I did some statistics based on my earnings over a 3 year period and learned that I made approximately $18 per patient seen on the average. This is a mix of payors and a mix of sick and well visits and includes some inevitable write offs that occur when accounts go to collections. Surprisingly, Medicaid and CHIP pay more than many of the private insurers for the same service.

During the same 3 year period I saw an average of 28 patients per day and worked a total of 47 weeks (not paid for vacation time, sick days etc. So, this comes to an annual salary of $118,000 per year which is pretty close to what is being offered to your friend.

In her case, assuming anyone could consistently see 8 patients per hour, they should make $144 per hour so working 36 hours per week should yield $5184 per week/$269568 per year which is more than double what she is being offered. Hmmmm---someone is making a whole bunch of $$ here and your friend is only receiving a small percentage of that. Of course, paying for her lodging and whatever other benefits are provided would also have to be taken into consideration.

Hope nobody's eyes glaze over when reading this:D