lannisz

Hi, I just returned from a month in Uganda working (volunteer) for CURE international's pediatric-neuro hospital. Amazing experience - life changing in fact. As an FNP I was feeling pretty burned out. Being there restored my faith and my calling to the nursing profession. CURE has hospitals all over the world. Just google CURE international and you will find them. Good luck!

Hi, I am currently doing a Locum Tenens position (i.e, Travel) as a nurse practitioner. I have been an FNP for 3 years and have experience with all ages. My current position is covering for an NP on maternity leave for 3 months. This has been a great experience: The staff are thrilled to have another provider as they have been short handed for awhile, and the patients are grateful as well. I am paid a higher hourly wage than a perm position, and they pay my travel and housing as well. I plan to continue doing Locums work. I enjoy the variety and am well paid. I see my husband on the weekends as I am 4 hrs away from home. I would not recc doing this as a new grad, as you are expected to hit the ground running and see a full pt load from day 1. You need your experience to fall back on. There will always be new things at every assignment since every clinic has different paperwork and procedures. So get a few years exp as an NP before trying travel, also, have a broad range of nursing exp as well. Hope this helps!

Hi all, I have been unable to find a full time/perm position in my area and have always wanted to try Locum Tenens. I have found a position 3 hours from home in a family practice clinic. They need an NP to fill a temporary need while their NP is on a 3 month leave of absence. I will work during the week and come home on weekends. My brother and his wife live there where I would be working and have offered to let me stay there. I have offered to pay them from my housing allowance in order to rent a room as I certainly don't want to impose on family for 3 months! Anyway, it seems like an ideal way to get my feet wet and try out Locums. I am so nervous... I definitely had my confidence shaken at my previous position (see post) and my self esteem took a beating. I have worked in pediatrics for the past 2 years, birth to young adults. I am an FNP, but worry that I have not worked with older adults in 2 years nor with chronic diseases. The clinic MD knows this as i did discuss with them, but I am so worried I'll be in over my head. The last position i held was extremely stressful and I saw 30-40 pts per day. The clinic I am going to now expects me to see 20-24 pts per day (much more reasonable!) and describes their office as "very laid back". They use paper charting (I am used to EMR). Any advice on resources/books for family practice? Have any of you done locums before? I would appreciate your input! Thanks for listening.

Thanks for all your supportive comments guys...it is difficult not to take it personally. Rejection is tough. Especially because i know I did my very best and worked my A** off. I felt strong initially and that I was doing the right thing by resigning, but I'm really struggling emotionally this week. I have applied for a couple positions locally, but nothing that I'm really excited about. Thanks to all of you for helping me with this.

Hi All, I haven't been on the forum for awhile. 2 weeks ago I had my yearly evaluation and I felt like I was ambushed. When I walked in the room to meet with my supervisor, I was surprised to see the clinic director and office manager in the room as well. The first thing out of their mouth was " We don't think this job is a good fit for you. It's just not working for us." I was floored. I asked them what wasn't working and they could not give me any specifics other than I "didn't ask enough questions." ??? That blew my mind - I thought if they had any complaints it would be that I asked too many! I have been working at this clinic for two years, never called in sick, worked every weekend and every holiday. I thought things were going well. I liked my schedule and the staff and the patients. I never got any complaints. I brought in a ton of patients to the clinic. They said they would give me 30 days to try and see if they could make things work. I took a deep breath and said - "I have been here two years and never had a poor evaluation, as far as 'fit' I think 2 years is enough time to see if someone fits or not and I don't think 30 days would make any difference". I gave my 2 week notice on the spot. As soon as I told them I would be leaving they said "oh, we are so sorry it didn't work out...the patients are going to be so sad, they just love you and we have never had any complaints about you, you're productivity is great, you come in early and leave late, your charting is always complete, blah, blah, blah. I'm not sure what the problem is. I've never had anything like this happen before. I can't believe this has happened. I feel like such a failure - I don't understand what I did wrong. My self esteem is in the crapper. I feel like I just can't even look for another job because I must not be a good enough FNP. Yes, I am definitely having a hard time with this. Has this ever happened to you? Any advice please?

Thank you. You are so right that I need to clarify my role and scope of practice with them. I'm just not sure where and who to start with. The practice seems to decide everything "as a team" and there is no "top dog" to go to. I had to have 7 separate interviews (1 with each doctor) before getting this job. They wanted everyones opinion on me. Guess that should have been a clue about how things worked around here, huh?

Yes, I am a new grad. However, I have been told there were other NP's who have worked there in the past and left because of this type of treatment. They didn't like feeling so controlled. Sometimes the hovering makes me feel more secure, but other times seems downright excessive. And I want to know there's an end in sight at some point? In terms of the PA, he is male and has worked there longer than any of the doctors! They seem to let him be. He does see tons of patients and seems to be very efficient. However, He was supposed to work with me this past month on the weekends so I could see how things are supposed to run....he would leave exactly at 5 pm even though there were still patients to see. He just left me alone to finish working. Also, he would disappear at random times for long periods during the day - only to be found watching football in the breakroom! Patients have lodged numerous complaints about him. Maybe that's why they are being so careful with me... because they have had some problems with him? It's just frustrating to be trying and working so hard to be really good at this. Maybe i am just too sensitive in feeling that the "feedback" is "criticism." Thanks everyone for listening

i am an fnp who graduated last june. as a nurse i worked in peds, nicu and ob/gyn.

I still don't have a contract. I keep asking about it and keep getting told it's in the works.....?

Hi all, I started a new NP job back in December working for a pediatric practice. There are 7 physicians who all seem like very nice, dedicated people. I took the job knowing my expected days of work would be Fri 9-7, Sat 9-5, Sun 12-5 and Mondays 9-7. Believe it or not, it seemed like the perfect schedule for me. Primarily I see acutes or walk ins. I deal with everything from newborn wt checks to 22 yr olds needing GYN exams. I am an FNP who graduated last June. My previous jobs in nursing and before becoming a nurse really gave me some great experience with peds population. However I have some concerns about the way the doctors treat me. In short - I feel like I'm being treated like a student again! They review ALL my charts and each day I work I am "assigned" to one of the physicians. I have a weekly mtg with one of the docs where I am "drilled" basically on different patients and why I treated them the way I did. I have to justify everything. They also bring me tons of journals and reading material that I am expected to study on my days off! At first it made me feel secure knowing there was someone I could go to with questions, but I'm wondering how long this "hovering" over me is going to last. I don't pretend to know everything or be an expert and I am good about asking for help when I have questions or concerns. I am seeing about 20 patients per day. I see them on my own, write my scripts etc. If I have questions I do go to one of the doctors and ask for help. I am not used to being treated like this. It's starting to get annoying. They use to have a PA work their weekend clinic and he worked alone. They will have me working weekends with a doctor, and starting next week they may be coming into the room while I see patients. This just feels odd to me. Do any of you practice this way? I am used to practicing independently (I am in Oregon where we are not required to have MD supervision). Also, I have no point person to go to with issues or concerns. Whenever I ask about my contract (which i still don't have) they say "we will discuss this at our doctors mtg next week." EVERY issue has to be discussed as a team at the mtg and I never get any answers. (I am not included in the mtgs.) Do any of you work like this? It just seems very odd and strange to me.

Very true, thank you...I am writing a letter to her doctor with details about the home situation. He won't give me any info about the situation due to HIPAA, but at least I can inform him about what's really going on at the home of his patient and how it is affecting my parents (also his patients.

Thank you. It's so true of my situation as well that advice is met with hostile ("how could you even suggest such a thing...she's your sister!") reactions. They refuse offers of help. Still, I struggle every day with guilt.

I have a family situation that I am extremely concerned about and don't know what to do. I could really use some advice. My parents are in their early 80's and took my older sister (age 47) into their home 5 months ago to care for her. My sister has Lupus, but 1 year ago she really went down hill. She took to her bed and stopped eating. She refused to go to the doctor. Her husband finally took her to the ER after she fell down the stairs and gashed her head. At the hospital they found stage 4 bedsores on her sacrum. One was the size of a silver dollar and down to the bone. She developed osteomylitis. She weighed 100 lbs. She was put in a nursing home and after six months used up all the insurance benefits (it was a very nice one in California.) Her husband said he was unable to care for her so my parents took her in (they live in Oregon.) She starting receiving excellent medical care, was put on Lexapro and seemed to be getting better. However, any time anyone would mention "wow, you are doing great." or tell her she was getting better and start expecting her to do more things, she would suddenly take a turn for the worse. Examples: She was unplugging her wound vac and her sores would get infected again...she developed pancreatitis and diverticulitis but would refuse to eat right and then end up back in the hospital...she won't do PT because it "hurts too much" and was still using a walker after 5 months. At Thanksgiving when we were all together and the walker started getting too easy and my brother mentioned that perhaps it was time to graduate to a cane, she had a "fall" and is now back in a wheelchair. She won't even use her arms to move the chair, she insists my parents push her! She uses a bedside commode. If she had cooperated with PT she should be getting herself to the bathroom on her own by now. A few weeks ago the hospital discharged her to transitional care in a nursing home because she needed IV antibx Q 6 hrs for yet another infection. She called my parents at 6 a.m because "she couldn't stand it and wasn't getting any sleep." They immediately went to pick her up and take her home. My mother would get up at night to administer her antibx. My sister "was too squeemish to twist on the cap". When i visit my parents I see how exhausted they are. I've offered my help whenever I'm there and tried to tell them they need in home nursing care or she needs to be in a nursing home. I thought of moving her in to my home, but I have 3 kids, a full time job and a very small house. And My husband refuses to even be around her. Plus, She would have to establish with different doctors if she was here. It's like she WANTS to be an invalid. Her wounds are healed, her weight is normal her labs are good and she's on the right meds. Why does she keep making herself sick? Why does she refuse to do anything to get better? My parents refuse any help! They think they can do it all themselves. "We're family - it's our job!" So, they too are part of the whole sick situation! Please, have any of you ever encountered a situation like this? What can I do?

Please, don't rush to make a decision! I made a mistake and took the first position I was offered because I felt I had to get an NP position right away. I knew the place had a bad rep but took the job anyway and I ended up in a very bad position and had a really rough start. I had no orientation and was "thrown to the wolves." I should have stayed in my OB nursing position while I looked for a better position. As others have stated, take your time and look for something you can feel good about.

Don't give up! Think about what type position you really want and send a resume/cover letter there. I was interested in working with peds and even though I am an FNP I have a lot of work experience with the peds population. Anyway, I went through the phone book and found the listing for every pediatric clinic in the surrounding area. I then sent my resume and a cover letter expressing my interest and telling them why I thought I would be a good fit. I got one response where they had an unadvertised opening - a staff member was going to be retiring soon but they had not yet advertised the position. I got that job. I don't know where you live, but you might even want to try Craigslist. No kidding, I saw two openings in my area for FNP'S! Have you tried some of the placement agencies for NP's? Comphealth, advancedpracticejobs.com and NPjobs.com have listing and recruiter contacts. Maybe that would help?