NPdancer

This is my current schedule as a Hospitalist NP. I work 7 on 7 off. My shifts are 10 hour shifts. Not too bad. I love having my 7 days off and have racked up so much PTO because I schedule my vacations on my off weeks when I want to take them.

I don't know what they could possibly be asking you for four hours! I think they may go through a series of interpersonal questions (to see how well you'll fit in with the team), maybe provide a few scenarios of "tell me a time when....", or maybe this time will include a tour of the unit(s), as well as meeting other providers/team members on the unit, and possibly shadowing someone? Also, I think six weeks is not enough time on orientation. What is your patient load after orientation? Will you be working alone or will there be another provider on site or available to you? Are you expected to do procedures (central lines, intubation)? My orientation was 12 weeks and I was an experienced NP (although, not THAT much experience) and I have weekly check ins with my collaboring doctor to talk about my cases. I also have 14 years of ER/Trauma background as a RN. If you don't feel this is the position for you, I'd keep on looking. However, I would still interview so you can atleast have the interview experience to land the position you really want.

Hello there! I have not applied or was interviewed for a ICU NP position, but I have applied and interviewed for a Cardiology NP position, a Rapid Response NP position, as well as three Hospitalist NP positions (which I landed two of those positions). I will tell you what my interviews were like. Hopefully this will help. The Rapid Response NP position: I was interviewed by the NP manager first. I was asked general questions pertaining to my background (ER/Trauma background), and then offered a second panel interview. In this interview, I was given three patient scenarios and asked how I would respond. This panel consisted of four NP's. I was asked specifically how I would respond to a sepsis alert, a code blue, and a new onset of A-fib with AVR. I felt the interviewed went well. I even wrote a follow up thank you e-mail but unfortunately, I did not land this position. I was told by the person who referred me for the job that it was between me and another NP that had ER NP experience and they went with them instead based solely on experience. Cardiology NP position: I was interviewed by the MD director. This was a medical school affiliated with a hospital system. I was asked how my current NP position was going and what my responsibilities were. I was told about the transition period the department was going through and the high need for NP's in the new phase. I was then offered a panel interview. The panel interview was via Zoom, and it was with two NP's and two Cardiologists. I was asked why I wanted the cardiology position. I was not asked anything pertaining to patient scenarios. To be honest, I felt they already had someone in mind and was just doing my a favor by interviewing me. I didn't feel that position would be for me, so I did the bare minimum in asking questions, and didn't even bother sending a thank you e-mail. Sure enough, they had already had a candidate in mind. Hospitalist position: first one was with a teaching facility. I was interviewed by HR first, asked about my previous nursing experience, and then told about benefits. I was then interviewed by the MD director and head NP. I was given specific patient scenarios, equipped with an EKG and vital signs. One was new onset of SVT (EKG), one was differential diagnosis (between sepsis or PE), and one was stroke. I had a colleague who interviewed with the same facility and was offered the position because they were both affiliated with the same system. Second Hospitalist position, I believe they were just desperate and would take anybody because someone was leaving. They didn't even bother asking me any questions besides can you start as soon as credentialing is done. Third Hospitalist position, I was very prepared, as I wanted to work for this particular hospital system since graduating. I did my research and I sent the HR recruiter my resume via e-mail asking for an interview for the advertised position. I was called the next day, interviewed with HR, and then set up on a panel interview a week later. I interviewed with the MD director, three doctors, and the lead NP. I was asked questions about myself, and I was told by the MD director they were going to start the interview off very informal, and wanted to know one thing about me that they couldn't get from my resume or CV. And that really set the tone. I was very honest and open during the interview. I also came prepared with my own questions and at the end of the interview, I was asked to provide three references. A week later, I was officially offered the job and this is where I am now. It has been the best job thus far. Sorry so long winded. I hope this helps you in any way. Good luck!

Thank you! I was just informed that my previous employer is under CMS investigation for possible fraud. I am so glad I left when I did (although under unfortunate circumstances).

Hello. Yes, things are going well. The update was nothing never came of it. I moved on to get another NP position directly with a respectable hospital system this time. My privileges are still good at my previous hospital and I was offered a position to work directly for that hospital on a PRN status. My charts were reviewed by the hospital committee and there was no patient abandonment. As for my previous employer, I have not heard anything from them. I was told by another provider that the last NP jumped ship due to "questionable business practices". I'm just glad to be away from that practice and to have this all behind me. This was definitely a lesson learned.

Thank you all for the advice. I have consulted with an attorney, currently awaiting reply. You are correct in stating I should not have taken this contract. Again, it was my first NP job, I was just excited to be starting my new career and given a chance after so many rejection emails and "wanting experience" emails. I asked about PTO and sick time during interview and was told although they don't "offer it", they are very flexible when it comes to switching days and providing coverage. Just so happen, they could not do so during this emergency that was completely out of my control. (let me add when someone wants to go on vacation, there's coverage suddenly). I'm not sure what will happen next, not sure if I will be faced with a lawsuit for breach of contract. I'm just preparing myself for the possible worse.

Hello. I am a NP that worked for a private hospitalist group. Due to a family emergency (family member critically ill/possibly death, coded, in ICU), I had to go home (reside in a different state). This was during my work week, I advised my supervisor the minute I was made aware of situation. I offered to make up days when I return. I went to work the next day, took a full patient load, and was given updates via Facetime throughout the day. Spoke with doctor caring for said family member asking for meeting with family to "make a choice to pull off vent". Purchased ticket for next day. I completed all patient notes at work, signed all orders, gave a patient handoff the next day while en route to the hospital straight from airport. I gave supervisor 48 hour notice about situation, asked if there was anyone to cover me, was told no. Company did not offer PTO or sick leave. Doctor owned practice with very limited staff (only 2 NP's that flip flop work weeks, that's it). Doctor was not able to find anyone to replace me for the next three days. I gave my resignation via email and went home to deal with situation at hand. Family member was pulled off vent, however, suffered stroke, placed in nursing home, made DNR/hospice. My contact states to give a 60 day notice. Due to my state of mind at the time (high anxiety surrounding entire situation), I gave notice immediately (was not sure outcome of family member, was told death was a high possibility). Former employer kept my last paycheck for wages worked, accused me of being unprofessional for quitting without notice (despite they were made very aware of the situation at hand). I read contract, it did not state anything about withholding paycheck for regular hours work if adequate notice was not given, it does state withholding any bonuses if notice was not given (which I did not qualify for). Also accused me of disrupting business practices because they had to find someone to cover my days (used the same NP that works there) and is threatening to report me for patient abandonment, saying because "I disrupted business practices". This is an in patient hospital setting. I am speaking with my malpractice company to see what my recourse is. Everything I have read regarding this states it's patient abandonment if there was patient harm or injury due to disruption of business practices (which is something they have to prove). I was not happy with this position and was intending on giving a 60 day notice, but was unsure how I would be treated going forward. I feel this is retaliation for leaving because now the doctor will actually have to show up at the hospital and take patients. This was my first NP job and I was fully taken advantage of due to my lack knowledge (nothing to compare this job to) What recourse do I have? Is this truly patient abandonment? At this point, I'm not worried about the paycheck they kept, I am more worried about my license. Thank you in advance.

Hello there! I started a new Hospitalist NP role last month. I have 13 years experience as an ER nurse. Let me tell you, this has been the most challenging transition I've ever encountered to date in my professional life. The learning curve is STEEP, and I was expected to take a full patient load (including admissions) within the first week of training. Mind you, I graduated in August 2020 and due to Covid, was not able to land a job. This is my first NP job and thank God I have a supportive team. I also quit my PRN job in the ER because I just could not function flip flopping back and forth between provider and bedside RN, not to mention, internal medicine and emergency medicine. All those little things that didn't matter in the ER, matters now once the patient is admitted. My schedule is 7 on 7 off. I usually arrive to work at 8:30AM and look up my patients, the new admissions from the night before, who I can discharge by 11AM, reviewing AM labs, scan results, contacting consults, draft all my notes etc. I usually start my rounding about 11AM, and I'm usually done by 1PM. I usually start with about 12-14 patients a day, and this doesn't include new admissions during the day. I also attend case management meetings every day usually for about 15 minutes giving them a run down on who can be discharged. I spend a lot of my time walking all over the hospital, as I have patients on several units in the hospital, not to mention, answering calls from nurses, pharmacy, other consults, etc. I'm usually done with my day around 5PM and I complete my drafted notes as I round. I do my billing from home. I spend a lot of time studying diagnosis and management of common diseases on my off days. I also give updates on my patients to the on coming NP for the week and I'm available for any questions she may have regarding the patients. Some days I feel like I got it, others I feel like a failure. My collaborating doctor tells me I'm doing great, but I just don't feel I'm giving adequate care most days. There's things I miss, or sometimes I make an unnecessary consult, which results in longer length of stay for the patient. Every day I go home stressed about missing something, or I'm worried about being called in the middle of the night by a nurse if my patient starts to circle the drain. These are things NP school just don't teach. I've spoken with other NP's who have made the transition from ER to Hospitalist and they all said it took months for the stress to go away.

Rosh review helped some with the ANCC, I had a 98% passing rate on the Rosh review and still failed on my second attempt with a score of 334. My first attempt was a 318 without Rosh. I passed on my third and final attempt by joining the ANCC Study Boards group on facebook.

OMG! I so feel you on this! I am an ACNP, with 13 years of Level 1 teaching/trauma ER experience as a RN. I am starting a new role as a Hospitalist NP. Totally different role than ER. As my credentialing is almost complete, I am freaking out! I have been ensured that I will get adequate training and not be expected to take on 20 patients out the gate. I am doing a lot of reading in my spare time and picking the brains of other Hospitalist NP's that I know currently. I made it very clear during my interview that I am a new grad with an ER background but I am willing to take the challenge and learn as much as I can.

Hello! I'm not sure if the AACN has changed the test recently, but in the past they provided some "study questions" and a study bank when you purchased your certification. I found Rosh Review to be more in lined with the AACN, along with Barkley and the study bank they provided.

No, you're not alone. I have been an ER nurse since 2009, graduated with my AG-ACNP in August 2020 and I have been applying for NP jobs and I'm unable to land anything. I have no choice but to continue to work as an ER nurse and travel to get the money. I've also been a travel nurse since 2014, so I know what the travel rates were pre-covid. This is a great opportunity to become debt free, which is what I'm working towards. I struggle with the longer I work as an ER nurse, the more I will not be "marketable" as a new grad NP. Right now, there's not many places willing to take a new grad. I primarily would like to work as a hospitalist, or be part of a CRRT, or work an adult ER, but I am not having any luck. I have submitted over 100 of applications, and landed two interviews, and was told in both they had over 50 applicants for one position. So, I decided to continue to travel, make the great money, save, invest, and take a month off between contracts for "rest and restoration". I thought with an influx of NP's leaving to go back to bedside for travel it would be easier to land a NP job. I have been told by other NP's that a lot of NP's are not leaving because they know a new grad will take their position and make less than them. So if they do leave to go travel as a RN, they will not have an NP position to come back to. At this point, I'm willing to take any NP job just to get my experience, but the thing is I can now afford to work at the NP wage because of the money I'm saving by traveling.

Hello there! My main travel nursing companies are Flexcare, Fastaff, and Kruical. I used Flexcare pre-covid and they had the best rates for CA and paid the highest at the time. I used Fastaff for a local assignment and was given great hourly rates, although all taxed. Kruical is the FEMA company that pays great rates and includes housing. There's also Angel Staffing and Favorite Staffing as well.

I've been an ER nurse for over 12 years, worked at several hospitals across the country due to being a travel nurse. Some of the most memorable ones: Pt comes in by ambulance. States he has a "funny taste" after eating something "my girlfriend cooked". Denies N/V/D. Denies abdominal pain. States to staff "My girlfriend watches SNAPPED. I would like to be tested for orificenic poisoning". Pt comes in by ambulance in the middle of the night. Chief complaint "abdominal pain after being assaulted". Pt claims that he was "walking minding my own business when I was ambushed by three big dudes and assaulted". Not a cut or scratch anywhere. Not a wrinkle in any clothing. Abdominal X-ray showed a "foreign object" in the rectum. Radiologist unable to determine "what it is". Went back to bedside and asked pt the "real story". He stuck with the assault story. We told the pt we are mandated to report to the police. He then tells the real story. He sat on a recliner chair handle. He had to go to surgery to have it removed. Pt comes in by ambulance, chief complaint "prolonged erection". Pt admits to taking "too much viagra" due to erectile dysfunction. States he even "jacked off" and it was still erect. Also states he visited a "lady of the evening", went to sleep for four hours and it was still erect. States he became "scared" and called 911. He presents to the ER with a blanket covered over his private area. He had a female nurse (me) and a female ER doctor. We called urology (female doctor) and he had to get his member drained by female urologist. All females at the bedside. He kept apologizing. States "I will never do this *** again".

Kruical just posted crisis needs again for TX this AM. Favorites is posting crisis needs for CA today. While I'm not happy about COVID, with each new variant, crisis rates will be around to stay. I'm personally taking a local travel assignment for $115/hr $172.50 OT. I'm a TX resident so no Kruical (this time around) and if I didn't have the local gig lined up, I'd been on a plane to CA. My goal for this time around is to invest in crypo and hopefully retire from bedside by the year's end.