Mr. Southern RN BSN

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.

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.

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.

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.

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.

And I'm with one of the big two. Glad I have ICU experience with all I've encountered in-center.