Soliloquy

Do you own your own practice? I was wondering about that process and admittedly I haven't done adequate research to get credentialed with medicaid. Right now I'm credentialed through everyone except medicaid simply because my practice doesn't accept it but I would like to. It definitely gives more options for me if I do.

That's awesome! My current office doesn't really do Saturdays. Currently I work part time (21hrs) and I did ask for added hours: 1. for the consistency. Sometimes patients do ask when I'm available because they want to return and it can be harder to develop that relationship. 2. added exposure and experience for me. So I will be getting more hours in the next few weeks.

I like the volunteer idea as that Is a good way to generate business. I've never heard of MDsave.com. I'll look into it. Thank you

Thank you! I'm thinking about walking with my business cards and really putting myself out there to gain more business and just see how things go. My practice doesnt take Medicaid patients at this time but I'd be willing to as well. Doing my research.

I think you're doing just fine by setting clear boundaries. Helping out here and there is one thing but that's not your "job"/role and should not be the expectation.

I work in Primary Care Cdc vaccine and STDs guidelines Us taskforce app (AHRQ) Apea app Uptodate which gets all/most their drug guidelines from lexicomp ASCVD app Fp notebook for a quick and dirty for simple illnesses

I am a pretty new family nurse practitioner who works in a small Primary care practice. The goal is for me to see about 16 patients a day during my full 8hr days. The most I have seen is 14 patients. At this time I am building my client base so I receive many new patients looking to establish themselves with a provider. Often times with sick visits I will assess if a client is due for a physical and encourage them to make an appointment to discuss any further concerns, explaining that the yearly physical also allows me to refill any prescriptions they may need for the year. How did you build your client base as a new provider?

Thank you for this lovely post.

I am in my first clinical, about 7 weeks in. At the site I'm currently at(been there for 2 weeks) I was told that I still seem like a student and very "studenty". My preceptor wants me to seem more like a provider which, at this stage, I'm not really sure what that means or how to do it. My first question is this: what does it mean to seem "studenty"? My next question is: how much am I suppose to know or seem to know 7 weeks into my first clinical? I still research everything. I thought I was suppose to. :/

80-90k is an incredibly lowball offer for an NP. But maybe it's more accepted in areas where RNs are paid relatively less. In the east coast that is easy to make working PRN at some facilities with benefits included. To be honest, I haven't heard of any NPs who make that much EXCEPT online. Many of the new NPs I spoke to said that they were offered about 105 or somewhere in the 6 figure range as a start, even in states that had restrictive practice. I'm still a student and learning but I wouldn't want to work as a provider making that much knowing that my licensing cost and responsibilities are higher. That's stress.

Ok. Thank you. I agree, being a receptive and present provider is important. But I do feel there is a difference between being that and having the expectation that one is to continuously cater to your patient's every demand without being penalized for setting proper boundaries with a patient. But I see your point and I guess, yes, similar repercussions can happen to a provider for doing just that.

Honest question. My experience at the bedside, it seemed like hospitals always tried to shove down our throats the need to have a smiling, servitude style "Is there anything else I can do for you?" demeanor. In a more independent and authority role, do you find that you are also required and expected (I'm sure it can help) to have this demeanor as well?

That makes sense. There are online programs that offer lectures and find your preceptors but you have to find them and be accepted to them like every other program.

I needed this. Thank you :)

I'm prone to burn out! I did med surg, Neuro, surgical oncology, nicu, ortho... I think the best thing for me is finding a way to do different things and maintain control of my schedule. Keeps me away from the craziness all the time. So I'm trying to reduce the amount of time I spend in any one specialty. I've liked everything I've learned and understand the need to focus on one thing in the start but too much of a good thing....is too much. I also don't like the kind of adrenaline rush the hospital has to offer. Lol

LMAO! I remember that.

I meant the hospital setting (I'm looking into outpatient and gradually moving away from the bedside). lol But if I could just NOT work...I'd do that too. lol

Yes! lol

Gotcha. Food for thought. Also, with the added information from the OP, I can see why it comes off as "bullying" or singling a particular person out to do certain tasks and then have them be treated a certain way. I'd take TheCommuter's suggestions, OP.

Yep! It's fair. It was just another way of dividing the assignment. I remember once while I was a travel RN they put me to be a PCT on night shift because they had sufficient nurses but not enough PCTs and at first I was apprehensive but then I loved it. lol I went to work the next day praying I'd be a PCT again that night. lol And giving report to the oncoming PCT? I left the unit nice and early that morning lol

I'm pretty young. But I have been alive long enough to be apart of many online forums in my lifetime and I wonder...have forums always been this way? Has it always been about arguing one's point and trying to prove that one's view is more accurate, etc? It seems to me that as the years rolled by online forums have become less about interacting with others or sharing information and growing and more of a way of seeking confirmation for one's views. It doesn't feel like it's about expanding one's mind to other ways of looking at things. Is this the way the world is going? Even google tailors it's search to suit the viewer and online ads show up based on what one searches. Is anyone really learning anything anymore? I do occasionally come on to allnurses (more so lately as I attempt to figure out what other options are available to me as a BSN, RN (I'm losing interest in contrived social interaction like coworkers, social workers, managers, patients for 12 hours a day, etc) but because I'm aware that the online world has been tailored to suit the viewer, I find myself pulling back from it and becoming less trusting because I'm not exactly looking to be affirmed nor to dispel/embrace opposing views. I'm just looking to grow. What is your experience with this?

Lol You didn't strike me as old. But I know a lot of people who are in generation X complain about millenials and our attitudes, demeanor, etc. I've even complained about us while learning to embrace my own "millenial-ness". I think it's a common complaint that many will continue to have for quite some time until tolerance is learned. I mean really....who raised us? I think the difference is that we aren't all YOUR son or daughter so less patience/tolerance might be immediately extended as a result. I do, however, think that schools could do a better job at preparing nurses for the Np role. Particularly with finding preceptors. I turned down a DNP program for that. Maybe that's entitled mentality there too but I do expect a certain of education and want to know what I'm talking about when it comes to my patients. I also think that regardless of the years of experience one has before going into grad school that schools should be able to prepare you for the role by providing adequate clinical exposure and knowledge. I do understand that, however, that with most graduate programs regardless of the profession that it is advisable to have experience prior to attending and it definitely helped me solidify the information I'm learning but the way bedside nursing is going, I think we will see many running from the bedside much sooner unless hospitals decide to make a change.

Many of your issues with new NPs seem to have more to do with the riff between millennials and the older generation. It's a complaint older generations have about millennials across the board, in any profession.

When hospitals learn to treat nurses with the level of respect that they deserve, staff us accordingly, pay us fair wages, bring back the added work options, reduce their focus on patient satisfaction scores, etc, I think younger nurses will stay. But until they wake up...I don't foresee the issue resolving.

I initially wanted to be "just a nurse" because in theory it sounded like just what I needed to continue to focus on my own spiritual development. The REALITY of nursing is what drove me to further my education and pursue options away from the bedside.