Adam18

I suggest the accelerated BSN route. Some direct entry MSN are all or nothing without a step-wise approach. If you quit in the middle of the program for whatever reason even if you're close to graduation, you don't Leave with a BSN or MSN. You need to complete the entire program to get both from my understanding. It also helps to work as an RN while you're getting your MSN. I can't emphasize enough how it contributed to my knowledge base. The experience of a nurse is to see through the eyes of a patient and feel through the heart of their loved ones. You will experience things a doctor may never get the opportunity to see or understand and this will be to your advantage....Plus, you'll have some extra cash to pay toward your tuition. You won't understand how healthcare truly works for patients and how to work as a member of the interdisciplinary team without that experience as an RN before working as an NP. Most employers require prior experience as an RN before hiring as an NP

The doctor has yet to train me as a first assist, because he can't afford to pay me my salary and have me at the hospitals assisting in the bigger surgeries with him when he already has someone to assist. He says that he needs me in the clinic, but My training was expedited to help out as an ambulatory Surgery RN. I'm becoming more upset every minute that I think about this. The opportunity to first assist is a huge reason why I was sold on the job while interviewing. I have moved hundreds of miles away from friends and family.

I'm so thankful for all the replies that I have been getting. To answer some of your questions. It is written in my contract that I have to pay back my re-location if I leave before 2 years. I am working in a state where NP's are completely independent. whatever mistake I make falls all on me and me only. I have already started looking for a new job. The evaluation idea is clever! I hadn't thought of that. Sadly, I have not received one evaluation since I've started. This place feels like a complete dictatorship sometimes. We haven't even had one clinic meeting. The doc changes rules at the drop of a hat and doesn't inform all of his employees at once so no one ever knows what's going on. I never know I did something wrong until I hear him on the phone telling a patient that he'll have to have a talk with me about this or that and the discussion never happens. I'll probably have to draft up my own eval and have them fill it out. I also have not received my raise after my 6 month probationary period and without proper explanation except for not seeing enough patients and not finishing my notes fast enough. Keep in mind I have no dictation device, transcription service, or scribe, and all my notes are hand-typed. The NP and doc have it though. I have complained about this. I also see more patients than the doc's senior NP on average. I was in the process of scheduling a meeting with them to discuss why I am deserving of the raise and have typed up a long grievance letter where I also included suggestions on how to make the clinic more efficient. This is getting ridiculous, and I should have left a long time ago but since this is my first job in a specialty I have always wanted, I have been swallowing my pride. I hope this isn't happening to other new grads out there. I can't tell you how many patients have confided in me that they would rather see an NP than a doc because we're more thorough and careful and better at explaining. I'm proud that nurses have such a powerful lobbying group and continue fighting for what is deserved. I'm no longer going to be a pawn in this nonsense.

I'm happy to know that I wasn't ridiculous in thinking the same as you all have. This is a difficult situation because there is only one doctor and he is the sole owner of the center/clinic, 2 of us mid levels. The other has been with him over 15 years. They haven't been able to hold down a second NP in all those years. There is 1 MA, 1 office manager, 1 medical trascriptionist, 1 receptionist, and that's it. The last medical transcriptionist was also doing billing/coding and serving as MA checking in patients when the MA was out. She was MA and transcribing for all 3 of us providers and was fired because she Refused to serve as a scribe for the doc on top of what she was already doing. There is one Pre-op, one OR, and one post-op Rn. The same day surgeries are all simple ortho surgeries. In the pre-op RN role, I would have to start an IV, fluids, EKG, check if the consents are complete and all the pre-op paper work then in the OR, help the doctor scrub in and out and document the surgery. There are about 5 patients only a day. During post-op role, I have to explain home care instructions, Write the prescriptions for the pain medicine, vital signs, discarge Home paperwork. I don't know if this makes it any better. On top of that, I was urged to send the other nurses home as soon as I felt confident to do these tasks all on my own. It seems like I'm left to do the dirty work that the office manager should be doing. The nurses shouldn't be disposable.

I think their idea is that if they cut costs with the nurses, they will be able to train me. Furthermore, this is not a huge facility. It's the doctor that owns the clinic and enough employees to count on one hand.

Thanks for the quick responses. This is my first job as a new graduate. How would I go about looking for a new job without my current employers knowing or getting called. I want to make sure that I have something nailed down before I quit. I would also have to pay them my relocation allowance if I quit this soon. They would also probably blackball me if any future employer called. I feel like they do not care about my professional growth. I moved because of the opportunity to first-assist and they keep saying that they cannot afford for me to leave the clinic and stop seeing patients to scrub-in. They already have another provider assisting. I have talked to them before about having Dragon or some dictation device to finish my notes faster and they have refused because they did not want to pay for another Dragon certificate. Everything that I keep bringing up falls on deaf ears. I feel trapped, abused, and have been depressed about this.

I was hired to work as a nurse practitioner in an outpatient clinic/ambulatory surgery center. The nurses were going to be let go, and I was asked to serve as the OR and pre-op post-op holding nurse on days that there is surgery in an effort to cut costs. I will also be writing scripts for the patient's to take home after surgery. After the surgeries of the day are over, I'm expected to see patients as an NP until the clinic closes. This was not included in my contract, and I will be getting my same yearly salary instead of a hourly salary. Sometimes, the surgeries run hours past closing and there has been no mention of compensation for the additional hours. I'm also concerned about any legal aspects of serving in both roles and the confusion that it may bring to the patients. Have any of your employers ever used you in a dual role to cut costs? What do you think about this? I appreciate the responses.