Green turtle

I am also wondering if there are problems working as an RN with an APN. I have APN licensure and certification as an FNP, but haven't found a paying job as a new NP. I had planned to fall back on my RN experience and start searching for a prn job as an RN to pay the bills and the student loans.

Your deal sounds better than the offer I got. They offered you 2 weeks more vacation and a better tier for bonuses. The salary I was offered was similar, but the physician covered the expense of my training by saying he would only pay me 1/2 salary for a 3 month training period... He did not offer a $5000 per year raise. I am in a more rural part of the country than you, and was straight out of NP school when I recieved this offer. Did they include paying for your malpractice and CEUs? Also, make sure your contract states they have to give you notice prior to termination or reducing your hours. (Caution!! Make them put your offer in writing. My offer was verbal only and I paid dearly for being too trusting.) Good LUCK!

Bloviate, Thanks for the link! Softballmama, I was okay to suture or perform procedures when it was delegated to me by a physician in the same way medical students and RN first assistants in training are able to perform delegated tasks in this state... I think... Now I feel sick. You know that feeling you get when you are almost in a wreck, but aren't? That's the way I felt when I quit, like I had narrowly missed something very bad. I keep hoping that there is a way to "spin" my derm detour into a good thing for my career, but maybe it is best forgotten...

Jalexshoe, Thanks for the response. I appreciate feedback from someone with HR knowledge. My peer coworkers (NP and PA) from that job offered to give me good references. My former employer is not yet established in the area, but has some connections to local physicians. I think I will do as you said and emphasize my pre-derm nursing experience.

Carachel2, The physician did not let me practice autonomously. He saw every patient I saw and billed insurance/medicare under his numbers at his rate. He stayed logged into the computers and had me (and the MAs) chart in the electronic medical record under his name. He did assess and diagnose the patients, he just had me do procedures or closure after his procedure, and charting. This allowed him to see more patients in a shorter time and bill at 100%. As far as I know, that was a completely legal way around having an unlicensed NP.

Here's the short version of my story... I am an experienced RN, but a fairly new NP. I landed my first job shortly after being certified, but prior to being licensed in my state. I was was hired to open and run a new dermatology satellite clinic to be located in my hometown. I had to resign after 3 months because the MD that hired me would not sign a contract or honor the terms of what he offered me at the interview. He pretty much misled me about everything including pay. He gave a lot of excuses when I asked to negotiate a written contract - including saying that he was waiting until I had a licence and provider numbers. Even after I got my license and DEA, NPI, etc, he was unwilling to cooperate and refused to attend the scheduled contract meeting(s) with me and the office manager. While it is a fact that employees can't trust him (I gave you the short verson...there was a lot more), I respect his skills when it comes to patients. He gave me a lot of training performing cosmetic procedures like botox and fillers, and made me do the closing suturing on most of his outpatient surgeries. This was absolutely not what I was hired to do (not even supposed to be available at the new clinic)... but it made his day go faster to dash in and diagnose, or sell the filler/botox and then leave me to do the manual labor and chart. These are skills that few learn in NP school. I figure that they are valuable to many employers, right? What can I do now? I need a job, and I am not getting calls for interviews. Should I list this job as NP experience? Right now it is on my resume as "clinical experience". It can take months to get all of the licenses and numbers in my state. I figured that it would be an asset to have those. Does it look bad that I left so quickly? I got more calls right out of school in August.

Is the Stanford program mentioned earlier online or a typical in class type program? I am considering NP vs PA as well. I have a BS in Nursing and 9 yrs experience (varied, but mostly ICU and PACU). In Tennessee there is a critical shortage of professors to instruct in Nursing Schools. Could I teach with a PA or as a FNP if it is a masters level degree? Also, let's talk about pay. Does FNP pay better than teaching? I would hate to incur the expense of higher education to find I made the same amount as an RN and now have to pay loans back.

I have worked with some unbelieveably talented nurses who gave excellent patient care. BUT if things got slow they gossiped and connived and their bad behavior almost outshadowed the good. The best environments I've worked in had a good mix of male and female. The women don't act like cats with men around, and the men don't act like dogs if there are enough women. It's funny how we bring out the best in each other. The last two hospitals I've been at have had no male staff nurses in my area. It was not pretty. Seems like the other thing that makes nurses act back-stabbing and snotty is the idea that they have to claw and be ruthless to get ahead. There are plenty of nursing jobs around. If you hate the one you have you can have another in two weeks!