Riburn3

Pretty much why I joined the State Department. Collect a nice US government paycheck and get to live and travel all over the world.

Yeah. There are a few remote jobs out there but most are fairly competitive or are sort of shady where you end up prescribing some random branded drug to a patient you do a phone consult with.

Taking a shot in the dark if anyone out there knows of remote employment opportunities for NPs while living abroad. My family and I currently live in West Africa. I am an NP working for the U.S. Department of State. My wife is also an NP, but due to strict government nepotism rules, can't work in the same embassy health unit as me because I supervise the unit. Shes currently working a job in the embassy unrelated to Healthcare but I was curious if any NPs out there have managed to find work while living outside the U.S. One of the big issues seems to be Medicare requires yoy to be physically in the U.S. even if working remotely. Thanks!

Thanks. I had to crawl through the muck before I got this job, working for a large volume practice, seeing 30+ patients a day all over a decently sized city, and barely was scratching 6 figures. It prepared me very well for my job, but it's proof that experience pays off. I would have never landed my current gig as a new NP, and it's important to remember for new NP's out there, that their starting pay out of school will most certainly not be what you are making down the road. Even in saturated markets, practice groups and larger companies will pay for experience.

I didn't feel uncomfortable (but also not really "ready"), but I also was very aware of my weaknesses and not afraid to look things up or ask questions. My first job was in a large IM practice that I did a huge chunk of my school clinical work in, so I already knew the charting and system well, so the tedious new job stuff was out of the way. Looking back now I can think of dumb things I did, or how I used to manage some things, and think to myself that I was really ignorant, but I wasn't dangerous. Nearly 7 years into my NP career, working in an inpatient environment, I always am still looking things up, asking questions, using my resources. There's not a day that goes by where I don't learn something. I think it's important to lay the groundwork of curiosity and know your limits. It is so crucial to get that first job in an environment where questions are encouraged. The worst providers to me are the ones that act like they know just about everything, and can never admit with they are wrong or don't know.

Hospitalist NP in Southern, NM employed by a large national physician practice. We work independently within our group and admit to ourselves with no physician oversite. NM is a very NP friendly state. -$171k base (have to give fourteen 12 hour shifts a month, at $85/hr). I typically work 15 or 16 shifts a month so haven't taken home less than 210k a year in the nearly 4 years I've been here. -RVU and Quality bonuses equal another $20-30k a year -4% matched 401k -Solid Healthcare -No PTO, but schedule is week on, week off, so I have over half the month off and can work the schedule between months for more time if necessary -Holiday differentials -2k CME (licensing can be covered under CME, as can scrubs and stethoscopes, supplies)

Both of you sound like you’re putting in the effort and are on the right track. I scored all over the place on practice exams. The Barkley practice tests are in my opinion much harder than the real deal. Keep doing what youre doing and maintain a positive positive mental attitude and you’ll succeed.

Meh, our group did fire a physician because they were a giant dumpster fire and couldn’t punch their way out of a paper bag. They were a hangover of the previous hospitalist service. They never quit, but at least the NPs knew it wasn’t the right fit for them and didn’t need to be fired.

I think the issue is the person that edited the article is a preferred editor, sooverriding him/her is more difficult. The article also has a soft lock until November.

There are tons of discussions about this over the years on here. Youll see posters say that experience matters. You’ll have some that didn’t have any experience and say it didn’t hurt them. My personal belief is that its helpful in many ways. I felt very prepared in my program because I had 6 years of ICU/CCU when I started, and didn’t struggle in the program like some folks with less experience That experience also left me with better connections for employment, and my first job out of school was a direct result of having experience. Many in my class likewise.

To be honest I don’t know. It’s still not a very large sample size and it’s just now only being tried in other places I also mentioned earlier it was really tough finding the right NPs to fill the role. In the first year, 3 NPs essentially left only a few months in because they didn’t feel comfortable operating so independently in a state that already has had independent practice for a long time. As proud as I am, you don’t really experience that from physicians freaking out and quitting. Not that these NPs were bad, and some were already hospitalists before, they just weren’t quite ready.

Well it is True True, but I admit one of the program struggles initially was getting the right kind of NPs into the job as it requires a very high level of autonomy and critical thinking (we cover ICU as well). Once we found our core, it’s been smooth sailing, but we did burn through a couple folks quickly that weren’t ready for it. I also dont disagree with your comment about precepting. There are certain schools I won’t precept from, and I usually now only agree to take student that I know.

Hmmm you sure like to just make up a lot of bologna. My comment on consults was in regard to you saying they would run away at an NP run hospital. My point is lots of NPs isn’t scaring anyone away, we live in an underserved area so many consultants come here to finish their visas, then end up staying. You seem to live in the world and have a mentality that if you haven’t heard of something happening or seen it , then it must not be true. What’s it like being so omnitient?

It’s sort of funny you mention “an NP run hospital”. I work as a hospitalist in a group that is 50/50 physician and NP hospitalists. We are part of a pilot program by our company to determine if a larger pool of NPs in a group is effective and safe. Effectively our company wants to know if they can get away with this model because we are paid a lot less than the physicians, so it’s a big cost saver. We split the assignments, admissions, acuity, hours worked, committee memberships, and everything else evenly. It’s an independent practice state so there’s no co-signing. After two years, the NPs as a whole have a better satisfaction rating, lower readmission rate, equal length of stay, equal consultation frequency, fewer adverse outcomes, and fewer core metric fallouts. As a result, several of our sister hospitals are eliminating physician positions in favor of more NPs in the practice group. Since our group started this we surprisingly have more consultants that have moved to the area. No one has fled!

So because those are the only studies you’ve seen makes it definitive I guess? Many states have had independent practice for over 20 years. You’d think it would be all fire and brimstone there with how terrible NPs are. Look at a map of states that have independent practice, and they coincide with some of the healthiest states in the country. Look at the most restrictive practice states ( the south), and you have some of the most unhealthy states in the country. I’m not saying NPs are the cause of that either way, but it’s clearly not a detriment, and just perhaps patients that have greater access to more providers is a good thing, and a net positive. Lets not beat around the bush. Physicians against independent practice are worried about their bottom line. Plain and simple.