phosphorus

That's what I figured. I did an accelerated BSN and despite their reassurances I worried without my prior BA they'd reject it. The hardest part is reaching the boards of nursing so far just to see how they want it. I'm still nervous the schools and BONs won't follow through and it'll be left in limbo but we'll see. Thanks!

Kaiser treats you pretty well and pays excellent however they restrict NP practice in draconian and bizarre ways essentially because they are controlled by MDs and management trying to find ways around having to pay people for their work. NPs are basically assistants to MDs and spend much of their time answering patient emails. Colleagues tell me the same about Dignity and Sutter but they pay much less. Kaiser also gives strangely bad benefits for NPs until you build seniority. You start at 2 weeks vacation and no CME days or funds. The best organized FQHCs tend to pay surprisingly low but have NHSC scores that might get you loan reimbursement. The chronically disorganized ones... pay remarkably well essentially because they're desperate. At this point pretty much all the urban clinics have very low hpsa scores so nhsc funding is a pipe dream.

Hi all, I'm and Adult NP practicing RN since 2009, ARNP since 2014. I'm applying through NNAS to get licensed in Alberta ive been combing these threads looking for the advice on how to speed things along. How do folks recommend getting nursing boards and schools to send the documents? Do you pay postage or for couriers somehow? What is the best approach with nursing boards? I'm licensed in CA and FL? im sending it all but do they look at my MSN schooling? I completed a postbac accelerated BSN but they told me they don't need to see my BA or outside prereqs. Is that right? Thanks!

Curious for information on travel contracts (or individually arranged) to Australia and South Africa, ideally around Brisbane or Durban. Any experience with any particular agencies? The Australian np market looks pretty bad at present via indeed, but it could be I don't know where to look. I am a US adult primary care NP and would be looking for the same.

I'm an NP in an FQHC. I had pegged some hopes on NHSC funding, but essentially all the area FQHCs have pretty low score and that seems like a long shot now. As far as I can tell for primary care many places pay around 115k with 2wks vacation, but a good number pay 130+ with 1 mo and excellent benefits (Sutter, UCD, Kaiser, Dignity). My workload is quite manageable (15-30 ppd avg.ing 20-24) and I like my job, but I also realize I'm probably getting shorted 20-30k and 2 wks vacation of what I could get. Anyone local have good experiences in different systems? -Anyone get NHSC grants? Communicare clinics? -Hills physician? -I believe Kaiser and Dignity limit your practice significantly, and I've heard Kaiser and Sutter have brutal workloads. Haven't met any midlevels from UCD but UCD and Kaiser are union for NPs which is nice.

Expect to be slow when you're new. You'll get progressively better at your job and time per visit (if it's well organized) though I'd give it 1-2 yr. After a few months you'll get a groove. Utilize MAs and ancillary staff to the max. They often don't practice at the height of their practice and appreciate it like we do when people believe in them, train them to take on meaningful tasks, etc.

I left Florida for similar reasons, but it's worth noting anyone in major urban areas in general tend to spent 6mo-1.5yr unemployed out of school. It took me 9 months to find a job in Miami, which ended up exploiting me and using me in largely a bureaucratic + RN duties only. Most of my colleagues ended up working essentially on call with 12hr days 6 days a week for private MDs for 85k/yr. Florida definitely is the worst practice environment in the country as it is the only state where NPs can't write for controlled substances at all, and the lack of medicaid expansion has kept demand low relative to many other places. Pay is abysmal for the cost of living in the cities, and work load is much higher than other parts of the country where unionization and demand has kept working conditions safer. I ended up leaving for California just to get experience though I had two offers around Vero beach for 80k per year in primary care. I decided the extra 40k or so plus reasonable load and hours justified the sacrifice... but if I had an offer that was even half way decent I'd go back to Miami in a second. If you have to stay, you'll find something eventually. Expect to make big personal sacrifices the first two years and then move on. Generally I see places like rehab, home health, and private docs doing the hiring of new grads there.

Out of school in Miami most made 75-85k, which is what I made. I moved to California and make 115k. Likely with a little more experience I'll make more, but having state income tax cuts off ~12k of that out the door vs florida.

I had a similar experience with nurse corps but applying via a major urban hospital system as an RN. In general I believe it takes 7-10 months (took 10 months for me previously to receive a rejection). I'm not sure if nurse corps uses the same criteria or not, and not sure whether the volume is the same. I do get the impression though that those with higher income:debt ratios often have priority and most NPs I've heard of applying have around 100% (myself included) in the ballpark of 100k. Personally knowing what I know now I'd be weary of the promises of the NHSC as a debt solution. As a new NP getting into primary care is not as easy as it sounds and generally involves waiting 1-2yrs, though maybe in rural areas that's not an issue. It involves substantial time commitment without any guarantees with another year+ before you'll hear when trying again. All of this is predicated on continued funding which seems likely, but you never know when political winds can shift and austerity strikes. Avoiding debt for school in general seems best in this economic climate. Some states (generally progressive ones) have different criteria. California has one that includes clinics with lower HPSA scores if the clinic agrees to pay half the cost, but then you're limited to such clinics vs. the federal NHSC. There's give and take. In many instances you could actually make more money just choosing where you work strategically, unless you want to work with the underserved (which I do).

I'm looking for some advice. I recently started working at an FQHC who lured me and a number of practitioners with the promise of NHSC loan repayment. At the time I was a bit mixed up as California has a series of different programs, and I hoped the HPSA scores, which are only 12, would not be the only factor. As it turns out they don't participate in any of the state programs. I had been told other providers received the awards, but I've been hearing conflicting things. Has anyone had success getting the awards with 2nd tier HPSA scores? Do they factor FQHCs any differently? As I understand it, it also depends on how many people apply in your region since if few people applied then some from 2nd tier health centers may be awarded. Is that correct? Thanks!

I applied for my CA license by endorsement from FL in January. I got my RN as expected ~3mo later without incident. The NP license was a nightmare with them allegedly losing the check, then saying they disposed of all documents because it had been >6mo (it was 5mo when we got to this point because after remailing the check there's a 3wk waiting period for them even to cash it) and after resending everything I didn't get it till June... Now I've gotten a job in California and am trying to get my DEA which for those who don't know you have to apply for a furnishing license in CA before you get the DEA. I spoke with the DEA it's best to get the furnishing license first because the DEA is pretty speedy (only a week or two often). Here's the problem, so 6mo+ out I've sent everything in but CA BON tells me that there's a 2-3wk wait for the mail to get processed, 2-3wk wait for the check to be cashed, and another 4-6wk wait for processing. After getting the NP it could be another 2-3 months just for the furnishing license. I'm moving cross-country, running rapidly out of money, and my work wants me to start in a month or so. They may be fine with the wait, but for me it's really serious financially and I doubt I can find something on such short notice to sustain in between this and moving. Does anyone have experience with board bureaucracy and getting them to work with you? My sister is a lawyer and told me that some of the things they did were illegal by California state law during my NP app and I tried pressing call center staff who didn't respond. I'm waiting to hear back from a supervisor who is on vacation. Anything I can do?

I got an offer where they specify 5 days a month on call at 5$/hr and 60$/hr if I have to go in (wage around 50$/hr normally). Any tips for negotiating around that? Does that generally include when you are required to stay after or work additional days or would that be covered elsewhere in an agreement if at all?

Got confirmation from the board, you always need a collaborating physician. This leads me to suspect that there are agencies and NPs out there doing this type of work without following state regulations...

As I understand it, NPs must work under a collaborative agreement with a physician. I was contacted by an agency that does compensation type evaluations. They said that NPs don't generally need agreements if you're not prescribing, but I should look into it. Anyone have experience with this under Florida laws? It's unclear what the BON defines as "operation", does that mean anything? From the FL BON website: "According to Rule 64B9-4.010(1), Florida Administrative Code, An Advanced Registered Nurse Practitioner shall only perform medical acts of diagnosis, treatment, and operation pursuant to a protocol between the ARNP and a Florida-licensed medical doctor, osteopathic physician, or dentist.”"

Can you elaborate more on that? I know what you mean, I've worked in those environments but would we not be at least culpable from a health perspective or are you talking smaller things like living conditions?

I would imagine most are not. The only ones I've met are people working through agencies locum. Either way I'd guess the overwhelming majority are employees of some company that dictates a lot of your working conditions. Many NPs are members of unions at their jobs in hospitals and are much better off for it.

I've been working a year in the only place I could find: hospice/palliative admissions evaluations. The local job market is very rough. I've been talking to recruiters when things have been bad and contemplating moving/travel though I'd like to avoid it. They told me something interesting, apparently new grads are turning to locum as a way to transition to a first permanent job. That seems crazy to me, but I have gotten interviews and offers I wasn't qualified for that way. Any thoughts on this? Why would facilities be willing to hire untrained temp new grads? Sheer desperation? Anyone have experiences actually doing this without mentoring or training?

Unfortunately I was not denied for switching jobs since they never got to the stage where that would have been an issue. Instead they simply said there wasn't enough funds to make my case a priority. Remember that part of the deal brokered for the financial shut down was to cut HRSA funds....

There's not NPs (outside federal facilities in PR), but there are short term programs run out of nursing schools of liken 2wks-1 month. I was looking for longer options.

Interesting about not hiring NPs. I talked to other agencies and they will. Locum stuff would be ideal actually and I'm open. Many (most?) agencies require 2 years in your role to even place you. I've been trying with a couple ones and no luck so far actually, but they're just looking in Florida until my license clears elsewhere. Any recommendations on agencies?

Distinguished Nurse, there's a number of reasons why that's tough. Most states don't allow independent practice so you'd have to have a collaborative agreement. I've met Nps in Florida that have done that and hire an MD to collaborate, but it's not the same as what you describe since everything flows from the physician's license. Mostly that's how medicare guidelines are structured even when states do allow independent practice anyway since NPs get less reimbursement than MDs most practices will run things through the MD in this semi-complicated manner. The other thing is I have no interest in business. One of the great things about nursing is you can have a life outside of work if you want one. Adding managerial and financial concerns of a practice to me would be a big decrease in quality of life and increase in the amount of work and no amount of money is worth that to me :)

I am wondering if people know how much clinical hours are required for a similar ANP->post-masters peds certification? It's hard to find info on this for some reason. Also would if be cost effective to try and roll a post-masters certificate and DNP at any schools? I'm skeptical of DNPs because they are flush with largely irrelevant management classes for the most part, but if I could double up it wouldn't hurt perhaps?

I was denied saying "Our resources could not fund everyone who applied. Regretfully, your application was not selected to receive an award". I worked at the VA as an RN in Miami-dade, don't know the score (how do you find that), but I know Dade county in general is basically full of critical shortage areas, and my debt-to-income was probably nearly 180%. I switched jobs in the middle to an NP at hospice so would have been able to apply for the HRSA program for providers, but was also told if you switch midstream for nurse corps you become disqualified. Either way it took till late September to hear back which is ridiculous. In otherwords you have to stay put Jan-Oct more or less with no guarantees. Just a heads up for hopefuls.

I would like to study in Brasil, Argentina, Colombia, or possibly another Latin American nation for an extended period (at least 3 months, but hopefully 6mo-1yr). I am a ANP already, but could do a post-grad for my Family, Emergency/Acute, or a DNP. The job market is so utterly horrendous doing a residency or fellowship wouldn't really hurt anything and might help me if I could gain actual experience managing patients versus all the jobs that are more bureaucratic where I am at. I haven't found any longer term programs so am curious. Or could I do an online program but receive my hours abroad somehow? Thanks!

What happened locally is between entering school and completing my degree the bottom fell out. I was aware, but when I began major hospital systems were still hiring and there was demand. Ever since then it keeps getting worse with 4+ area universities pumping out graduates in a saturated market and very little demand. Additionally I had originally estimated I could get a HRSA PCP type job which when I first started looking were more plentiful, then the government shut down happened with cuts to those funds at the same time the jobs were drying up. Knowing what I do now, I likely would have tried to minimize debt and waited honestly.