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Mr. Southern RN BSN

Nephrology/Hemodialysis
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  1. Mr. Southern RN

    The Next Step

    As always, thanks for the response @traumaRUs
  2. 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.
  3. 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.
  4. 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.
  5. Mr. Southern RN

    Graduating December 2019, looking for advice

    @traumaRUs It's quite alright, I never expect instant feedback at this point in my career and life. I have trained myself to be pretty patient. I understand that NPs can be lucrative for nephrology and combining that fact with the fact that I have been working in HD for 8 years seems to naturally lead me in that direction. My hope through conversing with you is to determine how lucrative I can market myself to be, as well as get an honest feel for the position itself. Now to respond to your points: 1: If my calculations are correct, if you are able to complete all 4 visits on 90% of your patients, you would be generating $391,068 just from outpatient HD visits. I know for most practices in our area (Georgia), the physician sees the patient for the first visit of the month, then, either another physician, NP, or PA tries to complete the other three. I'm not 100% sure if that is a regulation in GA, or if it is more of a "just the way things are done" situation. I'll have to do more digging to find that out. 2: I definitely understand the travel necessities. One question regarding that: do you get reimbursed for mileage, or is it considered a part of the expectations of the position and factored into salary? The practice I am hoping to onboard with covers a similar area to the one you describe. 3: This is interesting to know as an additional source of revenue that APRNs can contribute to the practice. 4: The practice I'm hoping to join hosts monthly education classes for AKI/CKD patients. Currently one of the physicians is the instructor for the class. 5: Would this be the TOC visits post-hospitalizations in-center or in-office? 6: I was ACLS certified while working in the hospital, but haven't been since being in HD. I have experienced the full gamut of events that could occur during HD and wouldn't expect re-certifying for ACLS to be too foreign. 7: This is a natural expectation moving into the APRN role. I have been through many difficult conversations with patients and families. Thank you for your response, it has covered a great deal of my questions. There might be a few more I have to ask, but some might be more appropriate for a private message. Thanks, again.
  6. Mr. Southern RN

    Graduating December 2019, looking for advice

    If all goes according to plan, I will graduate with my MSN in December 2019 and go on for FNP certification. I'm trying to narrow down my plans after graduation. I am also trying to determine which field I want to settle in for a career. I will likely specialize, but am not ruling out primary care entirely. I worked 2 years as an RN in CVICU before almost total burnout, then moved into working in hemodialysis (which I have been doing since 2011). My areas of interest include: nephrology, cardiology, endocrinology, and (just for additional options for consideration) gastroenterology or orthopedics. Nephrology would seem to be the natural choice since I have a great deal of experience and know of two nephrology groups that have shown some interest. However, I'm not 100% settled on the idea. I am hoping for some feedback from the allnurses community. Cardiology was of particular interest coming out of nursing school, but I think I overdid it in the beginning of my career. Endocrinology is a topic of interest due to some research into autoimmune diseases, etc. So if anyone has some advice, maybe some pros and cons to each specialty, I would love to hear from you. Thanks in advance. @traumaRUs I would appreciate your input since you have significant nephrology experience.
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