Adenium

Sadly the primary pay was about $70k, not $100k. I paid out of pocket at a state school and spent plenty. Wanted to recoup some and start real retirement savings. With the DNP push NPs' education will be even less cost effective The powers that be seem too focused on educational quantity over quality.

Just keep in mind there are reasons why MDs and PAs and often many NPs are choosing specialties over primary care......you need to know a fair amount about a lot of things, see many patients in a day in short time slots, and you generally get compensated less. I would have loved to take the primary care spot I was offered, but when I was offered at least $35K more elsewhere plus better schedule and benefits it was tough to justify.

If it was an office where I interacted with a lot of the MAs, secretary etc I brought in Dunkin Donuts or baked goodies or got a big Edible Arrangement. If it was really just the preceptor, I got a gift card for places they liked (Dunkin etc.) or a smaller Edible Arrangement. Also a nice thank you card telling why they'd been so helpful. My school gave no compensation, so I felt like they deserved something nice. Oddly, two preceptors gave ME a card and gifts. It was a little funny, and I'd have felt horrible not having anything for them! Not everyone did preceptor gifts when I asked my classmates.

It is actually possible to get AANP approval quite early. I had my authorization to test within a week of finishing....the AANP lets you send in an application with an official transcript prior to completion of the program - it just has to show progress up to that point. You can't actually TEST until you've graduated and sent your final transcript, but they can have the app ready to go. You're supposed to get their letter and then Prometric approval a week later, but they came within a day or two of each other for me. The early birds get processed much faster, before the onslaught of May grads. You can apply up to 6 months before graduation. I waited to test so I could take the Fitzgerald review and study for 6 weeks, but I certainly could have tested much earlier if I'd felt ready. Confidence-wise, I needed the study time. In reality, I probably would have passed anyway as I felt like the exam had a LOT of things I'd never seen in a review book as well as some things that were very basic and that I'd known from prior coursework. At a level of gee what electrolyte would you check a week after starting an ACE inhibitor....but obviously I wasn't taking chances with something so important and a job waiting.

The AANP will send a letter with your score and a listing of categories like planning or diagnosis or evaluation that really aren't helpful at all. Mine listed from strongest to weakest. Did you start your reapplication and CEs, or are you going to try ANCC instead? I think the Leik book is a good idea. I would also suggest either the APEA/Hollier Qbank or book of questions. For me, that was the most similar to the exam, but many people say Leik is very close as well. It just doesn't give you as many questions. I had the APEA book only - they told me when I called that buying the Qbank or predictor tests would really give me the same questions. I found them helpful, though yes there will likely still be things on the exam that you don't recognize and haven't seen in a review. I think they plan it to be that way, and expect you'll have to make your best guess or a well-reasoned answer. Maybe you just had bad luck in the mix of questions that particular day, and happened to have more that you didn't happen to be familiar with. I'm not sure how much they vary from one exam to the next, but hopefully the next one will be it.

Sorry to hear that! Did you feel there was anything in particular that was tougher? In any case the letter from AANP will only give you vague categories for weak areas like assessment/planning/evaluation so if you want to retake AANP I'd just get started on the 15 CE credits or whatever they require. Were you able to get thru the study materials you had? I didn't have time for Leik but it's highly recommended. Did you feel when you were going thru questions that you understood the rationales or why they selected the right answer? I know it must be discouraging but that doesn't mean you won't be successful on a second try. If you felt up to studying research/ethics/theory you could register for ANCC and see if that exam style works better for you.

So true Cardiac-RN. I'm so excited to have 4 weeks vacation and actually have a prayer of taking time! With the hospital it was always such a coverage issue - most of us just had to give up some of our PTO because it didn't roll over and we couldn't get a chance to take it.

Good point elkpark. I have heard of that happening with some schools - my own happens to view PhD and DNP as adequate. My MSN professors were required to get the DNP if they didn't have it already.

I did not take a pay cut, in fact I got a decent jump in pay, but I joined a large organization that could afford to pay well. The primary care office I interviewed at gave me a very low offer (close to RN pay, though with added productivity bonus after a year and with excellent mentorship). I was a hospital nurse for 5 years, worked some of the time as rotating shift, some as night-shift, most as day-shift. Every other weekend, every other holiday. So I wasn't earning poorly but not pulling in 6 figures either. I did not choose to do overtime, and that was a limited option at my hospital anyway. I have classmates that did a combo of per diem jobs, or worked as nurse coordinators, etc. who did get similar pay as NPs or sometimes slightly less than they has as RNs. They were willing to bite the bullet to get good experience, knowing they'll get higher pay down the road. For me, even if I'd been offered less, I'd have taken it. My back pain was getting terrible from Q2hr turns, and I was sick of using my body all the time instead of my mind. My husband hated the weekends and my family hated the holidays. It's worth it for me to be done with that, though there are nursing jobs away from bedside if the physical labor is the only concern. Everyone has to look at what's available in their market and decide if it's worth it to them. There are plenty of better ways to make money than being an NP, but no one need fear starving if they become one. I'm not sure what will happen in the future as there will likely be a fairly saturated market, but it will continue to vary geographically as it does now.

My school was one of those that went to DNP-only and ended up switching back - there's just not enough interest as it means more time and money spent getting the degree, but no better clinical preparation or difference in pay. When I went looking for jobs, no employer seemed to know anything about DNP vs MSN or to care what degree I had. They were only concerned with employment background and clinical preparation, along with (obviously) my licensing status as an APRN. The only thing that gives me pause is that I'd like to teach one day, preferably at the graduate level. That will require a doctorate, and I'd thus be excluded. But that would be well down the road, after I'm experienced, and if I need a DNP at that point I'll look at the reimbursement options. I also think I'd be better prepared for the research projects involved once I've been in practice. If I were to do it now, I'd have no idea what direction to go. How can I have an area of practice I'd passionately like to improve before I've actually been a practitioner? I'm sure I could do it, but it'd be a long arduous road and I need to be certain where it will take me first. I'd suggest identifying where you'd like to work, and talk to some folks in those places or shadow. Find out what they're looking for in hiring, now and into the future. Also talk to program directors at schools you're interested in, and see if they have plans to switch. However, if you start an MSN program they shouldn't be able to change the rules partway through the process.

I found going thru APEA sample questions to be the easiest/most helpful thing to do as I got close to the exam. It was more pleasant to do that than try to reread study material which got harder and harder to concentrate on. That and looking over abx tables for common conditions which I had trouble memorizing. Flashcards of stuff I kept forgetting too. Just know you'll probably see some questions on things you aren't familiar with, but that it's OK. I was afraid I'd fail if I didn't know everything in the review books but I passed anyway.

I'm in CT, I would think OH would have something similar?

I graduated in May and am lining all this up now though it may vary a little by state. Passed AANP 2 weeks ago but waiting on my letter. The state DPH site lays out required steps...mine requires an application with passport photo, bank check, transcript directly from the school, verification form for pharmacology hours from school, and the letter from AANP. So, boards are first, though I have classmates that submitted their state APRN applications before they had written confirmation of passing boards. Once you get your state license you can proceed. NPI asks for an employment site and I think DEA may as well. For my state you need state drug license before federal. I start my job in a couple weeks so they'll help with some of this. You'd think schools would help more with this...we had to did a final project outlining steps but it was still murky and it would have been nicer to just get a list of steps from people who'd recently done it!

You will get there! Keep at it and good luck. Soon it will be in your rearview mirror.....

I always kept an NSO policy as an RN, and I think I'll probably get one as an NP as well. Yes my employer will cover malpractice, but I think you need someone really covering YOU and your interests. When I looked at the basic policy it cost about $1200/year.