(At the suggestion of one of my clinic students based on this type of thread being popular on other forums.)
I am a (relatively) experienced NP in adult internal medicine/primary care with a primarily older and complex medical panel. I also have worked for many years with NP and medical students both in the lecture hall and in clinical practice.
Have questions about what primary care is like? What to expect as a clinical student? Ask away.
I think the two biggest questions are 1. what do you want to do and 2. what do you think?
It doesn't son'd like your faculty/preceptors have big concerns about you so I will assume that you aren't floundering in school or clinic. It is not uncommon for novice NPs to struggle with the role socialization be that with a lack of confidence or with imposter syndrome or role confusion or the like. The best counter for that is experience in practice in a structured environment.
If you want to work in primary care or an outpatient clinic I think most novice NPs are best served by starting practice in a structured environment with a good mentor(s)/support and slowly ramp up a patient load over the first year. I don't think a post-masters in ACNP would hurt you save for putting distance between what you learned for primary and primary practice, but it's not likely the best route for you at least on paper. If you want to work in-patient then its probably a worthwhile thing to do.
You are in control of your own preparation. I feel like a broken record sometimes saying it, but self-reflective practice is vital to being a good provider. If you can start practice with a lot of support and you are an active learner and engage in good self-reflective practice, odds are you will have a smooth transition into the role. Confidence comes with experience (or should come from experience I should say) and right now you need more experience: no novice provider, NP/PA/MD/DO enters practice fully ready and no provider is ever done learning and evolving.
I hope that helps you, best of luck. Feel free to ask away if you have more questions or if I missed the mark.
Dear BostonFNP:
Thank you so much for the reply.
I'm so glad I asked you because I realize that it's best I put my primary care skill set to work before moving on to acute care training - which I had thought would prepare for Urgent Care NP role, that I'm currently interested in. I feel like Urgent Care is a bit of a blend of primary care and acute care. I was thinking ACNP will help prepare me for Urgent Care NP via ER rotations which would be helpful for my Urgent Care NP role to insightfully know when to send pt to ER and when to discharge home. I also thought ACNP may help me later on if I would like to expand my role to work in nursing home or hospice. I was thinking it would solidify my skill set to be a knowledgeable provider.
However, I don't want to be in school forever. I really appreciate your reflective learning strategies and finding a good structured and supportive environment. This helps me be more reassured. I guess now my strategy would be to find a good place that would help me transition into a good NP.
I'm so glad I asked you because I realize that it's best I put my primary care skill set to work before moving on to acute care training - which I had thought would prepare for Urgent Care NP role, that I'm currently interested in. I feel like Urgent Care is a bit of a blend of primary care and acute care. I was thinking ACNP will help prepare me for Urgent Care NP via ER rotations which would be helpful for my Urgent Care NP role to insightfully know when to send pt to ER and when to discharge home. I also thought ACNP may help me later on if I would like to expand my role to work in nursing home or hospice. I was thinking it would solidify my skill set to be a knowledgeable provider.
However, I don't want to be in school forever. I really appreciate your reflective learning strategies and finding a good structured and supportive environment. This helps me be more reassured. I guess now my strategy would be to find a good place that would help me transition into a good NP.
Thanks so much!
You'll be able to handle Urgent Care with the FNP. You certainly won't be putting in chest tubes & art lines in an Urgent Care setting like you might with the ER/ICU
This is a great question because I worry about this for myself. I have an ICU background and studying to be an FNP. This thought has been on my mind for many months and I hope I don't find myself regretful that I didn't pursue acute care. However, in 10 years, I just did not see myself working in a hospital with hospital hours anymore. Plus, I wanted to be on the preventive side of medicine.
I actually read that most Urgent Care centers prefer FNP's because they are able to treat children as well as adults, including pregnant women. Overall, I think FNP's are much more marketable for Urgent Care and Fast Track ER's. It's a great mix of primary care and acute care, which is what attracted me to FNP in the first place. Best of luck to you!
I've been reading a bunch of posts on all the Direct Entry boston programs, and I am here for some advice!
I'm planning on going to Simmons for DE FNP program this September (already put my deposit down), and was wondering if you could give me some tips on how to go about getting a CNA job after my first semester. Is it best to bring this up during my clinicals at specific hospitals I would be interested in working at? Ideally, this could then transfer into an RN after I get my certification (high hopes). Would it be worth it for me to try and contact someone I know that works there now, over this summer, or try and volunteer at Brigham and Women's or Beth Israel over the summer?
I've been reading a bunch of posts on all the Direct Entry boston programs, and I am here for some advice!
I'm planning on going to Simmons for DE FNP program this September (already put my deposit down), and was wondering if you could give me some tips on how to go about getting a CNA job after my first semester. Is it best to bring this up during my clinicals at specific hospitals I would be interested in working at? Ideally, this could then transfer into an RN after I get my certification (high hopes). Would it be worth it for me to try and contact someone I know that works there now, over this summer, or try and volunteer at Brigham and Women's or Beth Israel over the summer?
Thanks for taking the time to help :)
CNA jobs won't be hard to come by, especially if you express interest during your first clinical rotation. If you have some contacts that work at the hospital I would wait until the middle of your first semester and then contact them and let them know you are interested. The only thing that can be difficult is taking a CNA job prior to finding out your schedule for your second semester clinicals as you don't know what days you will be forced to be at clinical and not able to work.
Volunteering never hurts, demonstrates that you are interested and invested in working at that hospital.
Thanks so much for allowing us to ask you questions! I find myself researching about NPs all the time and still getting no where. I am starting AG-ACNP this fall and just wondering if you have seen an increase in the job opportunities since being in the field for ACNPs. I search for job openings all the time and most openings are for FNPs, even in the urgent care settings. Also, I have heard that, even though this is an awesome career, to never accept salaried positions as an NP. Its always best to accept an hourly position because the MDs may take advantage of the NPs scope of practice in hospital AND outpatient settings. How do you feel about that?
Thank you for taking the time to reply all our questions !
I have been an RN for 6 years, I just turned 54 yesterday and I am in the AGNP program in California.
I am a bit anxious about the choice I made and the job market. People say FNP is much more
marketable , but although I love kids I don't see myself doing that everyday , at this point of my life I
am more into spending time with the geri population as I think they are the ones that need more help.
My concern is that being an AGNP might limit the amount of jobs I can get , and plus when I look at
the job market most of the offers and residencies are for FNP .
The job market here in CA shows that Hospitals require a year or more of experience so this is like
deja vu from when I graduated as an RN , nobody wants the rookies and the jobs you might get, pay you sub standard .
I don't really see a big difference salary wise from RN ( and I don't get pay differential or anything like
that as I work for a private venture )to NP , so I am worried that I won't get a job that will help save
money for my retirement .
Thanks in advance for your input .
There subtleties to every job market so it is very difficult to say what's happening by you (perhaps some local NPs and/or your preceptors may help to shed light on that for you) but I can try to address your concern in a general sense.
First of all, you are making a big life change and a big investment, moving into something that is different from what you are accustomed to, and it is only natural to have some anxiety about that transition.
Your pay starting out as an NP, in most cases, with be as much if not considerably more than an RN job. If you are fortunate to have a high paying RN job your start salary might be close (though I would certainly suggest that you aggressively negotiate) but I would be very surprised if your ceiling is not considerably higher as an NP. Negotiation will probably be a much bigger factor in considering NP jobs than it was with RN jobs. That all being said, my advice is to never go from RN to NP for the money. The ceiling for income is much higher (in most cases) but there is also significantly more responsibility.
As far as FNP vs AGNP on the whole there may be a broader market for FNPs but that doesn't mean it will have much effect on you if you are only looking for adult-geri jobs anyways; in other words, FNPs might have an easier time getting "any" job but not necessarily an easier time getting "the" job. If you can market yourself well, it probably won't make any difference at all.
I would give two bits of advice about the market looking for "experienced" providers: 1. just because they want it doesn't mean they get it and 2. don't work for substandard pay, know what your value is to a practice before you walk in to an interview.
Thanks so much for allowing us to ask you questions! I find myself researching about NPs all the time and still getting no where. I am starting AG-ACNP this fall and just wondering if you have seen an increase in the job opportunities since being in the field for ACNPs. I search for job openings all the time and most openings are for FNPs, even in the urgent care settings. Also, I have heard that, even though this is an awesome career, to never accept salaried positions as an NP. Its always best to accept an hourly position because the MDs may take advantage of the NPs scope of practice in hospital AND outpatient settings. How do you feel about that?
ACNPs are a relatively new commodity and I am not sure the market has really adjusted to that fully yet, and in-patient teams are still utilizing PCNPs fairly regularly but I am sure would be just as happy (if not more so) with ACNPs, especially in the intensivist role. I also feel that there are some rural/community facilities that just use FNP as a synonymous for NPs. I wouldn't hesitate to apply for any of those jobs with an ACNP.
Administrators (and some MDs too if they aren't being screwed over by admins too) will absolutely will try and take advantage of you as an NP. I guarantee you they know exactly how much an NP will bring into their practice/system, so you need to know that too. This is the big leagues so come prepared to play ball and negotiate negotiate negotiate. I am a believer in draw salaries (revenue less expense compensation) for providers, but that is hard for novice providers as they need time to establish themselves. I don't see any harm in being fully salaried as long as your contact states exactly what you and your employer expect.
I just figured out that you went to Simmons Direct Entry FNP program! I have some questions to ask you since I am thinking of applying to that program! (I can't message you for some reason) Could you message me??
Thank you for answering my questions. I am currently an RN working in a Neuro intermediate unit. Though I only have one year experience I am thinking to move forward to be a primary care NP. I want to work at a urgent care clinic or a specialty care clinic in the future.
My question: Should I go for FNP or AGNP-primary care. I wouldn't mind working with kids, but adult is my main focus. What is your insight? What is the job market like for FNP and AGNP-primary care. I searched for NP information all the time but I did not see a lot AGPCNP around, at least not on the internet. Which one better fits my goal of working at a urgent care or a specialty care clinic.
Also, another question of mine is if I want to work during my NP school, would you suggest me getting a position in the clinic setting or still working in impatient division as an RN. FYI, I am gonna relocate so the possibility of working in the same unit won't be a factor taken into consideration at all.
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nurse4life4ever
20 Posts
Dear BostonFNP:
Thank you so much for the reply.
I'm so glad I asked you because I realize that it's best I put my primary care skill set to work before moving on to acute care training - which I had thought would prepare for Urgent Care NP role, that I'm currently interested in. I feel like Urgent Care is a bit of a blend of primary care and acute care. I was thinking ACNP will help prepare me for Urgent Care NP via ER rotations which would be helpful for my Urgent Care NP role to insightfully know when to send pt to ER and when to discharge home. I also thought ACNP may help me later on if I would like to expand my role to work in nursing home or hospice. I was thinking it would solidify my skill set to be a knowledgeable provider.
However, I don't want to be in school forever. I really appreciate your reflective learning strategies and finding a good structured and supportive environment. This helps me be more reassured. I guess now my strategy would be to find a good place that would help me transition into a good NP.
Thanks so much!