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Mr. Southern RN MSN, RN

Nephrology/Hemodialysis
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Mr. Southern RN has 11 years experience as a MSN, RN and specializes in Nephrology/Hemodialysis.

Mr. Southern RN's Latest Activity

  1. Mr. Southern RN

    Post-interview update

    @AnnieNP I haven’t heard anything back yet. I’m supposed to hear next week either way. I’m still planning on passing on it and pursuing a position with a nephrologist. I’ll post with any updates.
  2. Mr. Southern RN

    Post-interview update

    @ArmaniX I agree with that. Live is way too short to sell myself short. Thanks for the reminder. @rnsrgr8t I think that’s exactly what they plan on doing with me and it’s not what I am looking for in a position.
  3. Mr. Southern RN

    First official NP job interview

    1. They say that 6 months would be the likely orientation period (but I did hear the second physician slip up and say "you should be good to go after a couple weeks". Not too reassuring, even though he would not be the collaborating physician. 2. It sound like it will be all hospital. They didn't really even mention seeing patients in the office. Other than if they physicians were tied up in procedures and they were going to be late for a clinic. 3. I checked with the hospital HR/Credentialing departments and they state that they do credential FNPs and once all paperwork is rec'd, it can take up to 60-90 days to become credentialed. They also stated that it is required that I have graduated and certified before this can happen. So I'm looking at probably more than 3-4 months after graduation for all this to be completed. Also, the office does have a person dedicated to credentialing, so I would be able to get help from them on the process. 4. The practice has never had a NP and the PA that works for them has apparently only worked as their practice manager (doesn't really make sense to me). It almost sounds like I would be a glorified scribe at the hospital based on the job description, but I'm not too familiar with hospital practice as a FNP. I have an old acquaintance who is a FNP at a cardiologist practice the next town over and I used to see him doing rounds when I worked at the hospital as a RN, but I wasn't really that familiar with what he did. I'm working on contacting him so I can some more insight into the position. 5. The practice boss would be the practice manager (who is a PA not being used as a PA). Not really sure how that situation works. The clinical boss would be the main physician who interviewed me. A pretty easy-going guy, amiable, thorough and detail-oriented. Doesn't strike me as a tyrant or a slave-driver. Seems like someone I can see myself working with. See my other post for the full update on the interview
  4. Mr. Southern RN

    Post-interview update

    So I completed the my first-ever NP interview with the cardiology practice today. It was interesting and less intimidating than I expected. The practice manager who began the interview gave a good bit of insight into the practice, but not much on expectations of the position. The main physician (out of two) who interviewed me would be my delegating physician with the other 4 physicians being designated physicians (according to the medical board in my state). He seemed pretty easy going, likes attention to detail, and seemed like he would be someone I can work with well. The practice has never had a NP before and apparently only used their PA as a practice manager (weird). The position they are offering is essentially covering hospital rounding on consults to sort of triage and prioritize who needs to be seen first, who needs to get cathed, etc. It is also to write progress notes, etc. Essentially my job would be to free up the physicians from time consuming documentation and seeing patients. I got the vibe that they kind of want to dump the busy work on me so they can do more high-dollar stuff. In particular, they mentioned that they would like me to essentially take over all the friday afternoon rounds at the hospital that is 30 more minutes away from where live. After hemming them in a few times to give me an answer, they claimed that the hours would essentially be from 8am-5pm, but from the little bit of research I've done on this, the hours could easily change to 7am-10pm. On a good note, they didn't seem particularly phased at the number that I was finally squeezed into giving up as a starting salary. Although I hope I wasn't low-balling myself because I haven't been able to narrow down cardiology NP salary numbers. I gave them range of 105-110k for a starting salary. They didn't even try to suggest anything else or act like this was an unreasonable number. So, it feels good to have an interview out of the way, but I don't know that I'll take this one or not. Any thoughts?
  5. Mr. Southern RN

    First official NP job interview

    So I have been applying to various jobs through several of the job listing websites in hopes of being ahead of the game. I graduate in December with my MSN, FNP specialty. As noted in previous posts, I have RN experience in CVICU and hemodialysis. One of the positions I applied to was for a cardiology practice. I got a call on Friday at 5pm to come in for an interview on Monday at 1pm. It seems a little short notice, but this is my first call for an interview, so I have nothing to compare it to. I have studied pretty extensively on interviewing, salary negotiation, etc. and feel pretty well prepared. However, I would like to hear from the AllNurses community of experience any tips or guidance that might help me as I get ready to enter this situation. For example, what are some important questions I should ask about the practice and/or position? Is there anything I should look for that would indicate the position is not a good one? I appreciate any help any of you can give.
  6. Mr. Southern RN

    Help with post CABG pts

    You're welcome. It sounds like you're off to a good start. Congratulations and good luck! On ABGs, it becomes very helpful to be able to determine whether it is respiratory vs. metabolic acidosis or alkalosis, and whether or not it is being compensated in one way or another. I can't think of the resource that I had for that, but I was eventually able to look at a few components of an ABG and know that it was a compensated respiratory acidosis, etc.
  7. Mr. Southern RN

    Help with post CABG pts

    Having the year of ICU experience beforehand will be helpful, but open heart patients are a completely different ball game. Hemodynamics is a critical component. Being able to read a cardiac profile from a Swann-Ganz catheter and knowing your ABGs thoroughly are two things you will definitely want to spend time learning. I would expect there would be reasonable amount of ventilator management from previous ICU experience. CRRT will likely come into play eventually, along with LVADS and biVADS, impellers, ECMO, etc. Not saying all of this to overwhelm. Just take everything in stride and apply yourself. It’s really hard work, but can be very rewarding once you’re able to start seeing the results of your intervention and skill.
  8. Mr. Southern RN

    Help with post CABG pts

    It depends on your facility. I went straight into CVICU after graduating from nursing school and had a pretty intensive 6-month orientation process. Taking your first post-CABG patient on your own is pretty exciting. Most likely you will have several co-workers to help support you.
  9. Mr. Southern RN

    Shoes??

    Brooks running shoes matched based on your arch. Helped me stop having plantar fasciitis. But there is honestly only so much you can do to combat pounding unforgiving cement floors for 14-16 hours/day. I also recommend compression socks. it will help prevent, but not eliminate varicose veins.
  10. Mr. Southern RN

    Presidential Executive Order about Kidney Care - July 2019

    I think the goals and timeline are a little lofty, but not necessarily a moonshot. I think it's a good start and a huge step in the right direction. One of the nephrologists in our area has already been doing everything he can to keep CKD patients from having to start dialysis (a rarity in the industry and really the only one in this area). He also tries to make sure that his patients are at least started in the process of getting a permanent access placed if they look like they are going to have to start dialysis. He will occasionally send us a patient that already has a permanent access in place. Unfortunately, as I'm sure you know, many nephrologists don't care to put in the work to keep a patient from progressing to ESRD and going on dialysis. Hopefully these changes will be the start of a transition in kidney care for our country. It seems like it might make my position even more valuable at a nephrology practice once I finish NP school in December. Will definitely be educating myself on the policy changes, etc., so I can market myself well.
  11. Mr. Southern RN

    Another consideration

    I'd like to pose another question to the community. While I'd like to go ahead and jump straight into working at the nephrology practice I've spoken about in previous posts, I have another option to consider. There is a family practice setting nearby that qualifies for APRN loan repayment. I believe the program pays $10,000 for each year working with them. All told, unfortunately, I'll have approximately $50,000 in student loan debt by the end of school. I used up pretty much every other scholarship/grant resource during undergrad years ago. It's definitely not an ideal situation, but I don't have any fears of not being able to keep up with repayment once I graduate. So I am wondering if any of you with experience feel it would be worthwhile to explore the option of the family practice to take some of the loan burden off? Or, would it be reasonable to use that as a negotiation point with the nephrology practice? Like I said, having, or not having, loan repayment is not in any way a deal-breaker. I just wondered what those with experience might suggest. Thank you in advance for any wisdom you're able to provide.
  12. Mr. Southern RN

    The Next Step

    Would it be best to deliver all the resumes in person, or just mail them with a cover letter? I do still plan to go in person to the practice with which I a hoping to get a position. One other point of interest. The physician for the group I hope to be hired with asked me if I would be interested in rounding on patients in the hospital. I told him I would not completely rule that out, but would probably prefer to start in the office to get acclimated to the practice and maybe move into hospital rounds after getting a little more comfortable. He also clarified that it would not be a definite requirement, he was just curious if I would be willing. The hospital part seems daunting at this point, although I wouldn't anticipate it being a problem after some experience.
  13. Mr. Southern RN

    The Next Step

    As always, thanks for the response @traumaRUs
  14. Mr. Southern RN

    The Next Step

    So I've made contact in person with physicians from each of the nephrology groups I am considering pursuing a position with after graduation (see my previous posts for the back story). All three have shown significant interest. I am not naive, I realize I have to take that with a grain of salt and it doesn't mean I have a job offer on the table. However, it is encouraging to see the amount of interest. The particular group that I am most interested in working with is in the process of losing the lead physician (to retirement) and the second-most tenured physician is scaling back his practice as well. So there are two younger physicians who are planning to carry the practice going forward. There is a PA and a NP working with the practice already. The physician who rounded at our dialysis center today told me that they just had a record amount of patient visits in the last month for the practice. So he tipped his hand a little in showing that they will be in need of a provider. The question I am currently pondering is when should I formally submit a resume in hopes of potentially securing a position with them after graduation? I am thinking that as soon as I get through the insanity of this summer semester, I will work on polishing up the resume a little (not much needed really, other than adjusting dates). I am considering scheduling an appointment with the office manager at the preferred practice to meet in person and submit my resume by hand. I have a couple things working in my favor: good rapport with all providers at the practice, good rapport with some of the office staff due to frequent communication, and 2.5 yrs CVICU experience followed by 8+ years HD experience. I did give the rounding physician my contact information to give to their office manager if they were interested in contacting me before I get to them. In hindsight, I'm wondering if this might hurt more than help. Too late now. So, any thoughts on the timing and method of resume submission? Thanks for any input.
  15. Mr. Southern RN

    Putting the feelers out

    Thank you all for your input. That is the general consensus I have heard from those around me. I will likely pursue the larger practice. I will begin reaching out to them more definitively beginning this fall with the hope of being able to interview sometime shortly before or after graduation. As is said before, I have a good rapport with all the providers in the group and even some of The office staff. Thanks again for everyone's two cents. I’ll keep the community up to date with how everything turns out.
  16. Mr. Southern RN

    Putting the feelers out

    So I've been testing the waters to see which of the local nephrologist groups might be interested in hiring a nurse practitioner early next year (I graduate with my MSN/FNP in December). Pretty much every group has told me I won't have any trouble finding a position right away, with only two of the groups showing actual interest. The issue I have concern with is: both the practices showing interest are smaller (one physician and one NP at one, and only one physician at the other) and both have their wives working as the practice/office managers. I have spoken at length with the new NP at the practice with 1 MD and 1 NP. She has no nephrology or dialysis experience and started at 95k. I have 2 years CVICU experience followed by 8 years of in-center hemodialysis experience. I have heard from several people at all levels that it is not advisable to work at practices that use spouses/family for practice/office managers. I take pretty much all advice with a grain of salt, but this advice has been fairly consistent. So what I would like find out from those with experience is: Is it all that bad to work at a small practice as described above? There is one larger group practice that I am interested in but have not spoken with yet that has 4 MDs 2 NPs and 1 PA. I have a good working relationship with the providers this practice and would likely be able at the very least get an interview with them. I am pretty confident that I can sell my experience and skillset in order to obtain a position as well. Any friendly advice for a soon-to-become NP would be appreciated. Thanks in advance.
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