BeachFNP

Our scheduler is trained to explain to people who they will be seeing when they come for an appt. this is usually only an issue with new patients, because once they are seen they prefer to stay with the same provider. In my practice we have 4 providers: 3 NPs and 1 physician. They are told "you are scheduled in the (location) office with (provider)." So it shouldn't be a surprise when they see who they were told they were seeing. You'd be surprised how people still react to it though.

I would definitely bring up your concerns to the supervisor. She is probably going to need a much longer orientation then they thought. I used to orient all the time so I get the frustration. My main thing was to keep the supervisor informed with specific examples of why a felt a person needed more orientation or if I honestly felt they were unfit to practice. All you can do is make your concerns known. I would also be up front with the orientee as well. She should know if she's not making huge progress or if she needs more orientation. That way she's not blindsided.

I get this occasionally. Mostly it's a sideways glance and a "is the doctor coming in?" If it's his day here I just hand them over to him and he is totally fine with it. Most of the time they turn out to be VERY self absorbed anyway so I'm glad to be rid of them. Occasionally it's a day that he is not here and I have to explain to them that he can't be in all 3 offices everyday. They usually let it drop at that point and by the end of the appt they ONLY want to see me in the future. Occasionally someone will get all indignant and reschedule with him. Fine by me. I've got enough to do than deal with your annoying ass.

I'm not offended- I actually thought the same thing when I wrote it. Honestly- in all the codes I was involved in we never had to actually wait more than maybe 2-3 mins for a dr, np, or pa to show up. It was a relatively small hospital so there was always someone within a few mins walk/ run of where we were. It usually took that long to get code cart, hook of defib, ect. So maybe I was just never in one where anyone had to actually make a decision prior to a provider showing up.

This is an interesting discussion. I only rarely prescribe for family/ friends. And I mean rarely. I have done a controlled substance ONCE for a friend who was having intense anxiety issues- but- told her if she needed any more she would need to follow up with her pcp. I occasionally prescribe for my son who has issues with repeated ear infections but I'm always discussing this with pediatrician prior to that. We have a good working relationship so he's always fine with whatever I want to do. He will be getting his second set of tubes in a week so hopefully I won't have to do this anymore here soon. I'm not sure what the regulations in my state are, but I will be looking them up now. Every provider I know is super casual about this so I can't imagine it's very stringent regulations.

And just to add... When I say "when I used my ACLS" I meant in a capacity as an RN. I'm currently an FNP but not in a hospital setting.

When I responded I was simply letting OP know what part of that scenario would have bothered me personally. I have ACLS training myself and know what it's for. I was just saying that I would have felt slightly uncomfortable about doing that with no further direction from a physician. When I actually used my ACLS training in a hospital setting we always waited for a physician to show up before actually administering any meds- we would always start CPR, ect if needed but never actually administered meds until a physician was present or gave orders. I understand in this situation that's not really feasible (although other posters have expressed that you actually can get orders from a physician on the ground apparently). I forgot to add to my first post that it sounds like a crazy situation and I probably would have done the same thing as OP. So kudos to you, OP, for helping that patient out of a tough spot.

Personally I would be the most worried that I gave epi without an order, even with ACLS training. If they were carrying epi on a plane who would be the person trained in administering it?? I guess I don't understand how they would even be allowed to carry it if the flight attendants aren't trained in it- but I don't really know much about what training they get.

That sounds like a really good idea. Thanks for this suggestion!!

Thanks. That's helpful! I'm relatively young (28) but I don't plan on working this much at my current job in a few years. I'm thinking getting my foot in the door this way would be nice to pull in some side money when my son is older and I'm not working as much (my husband and I plan on me cutting my hours so a parent can always be there for games, school functions, ect). So in the back of mind I'm thinking adjunct would be nice if I ever decided to completely stay home. I understand the always being on and available thing- although I'm not sure that particularly bothers me (yet). I guess I'll see how it goes and report back to you guys. Lol

It's all online. It's turned in through the schools online blackboard system- so yes, I'm thinking quite a bit of time on there, plus emailing and discussing things with students. I hadn't thought about the gas to get from site to site, so that will be something to think about. I have no plans to stop working at my current job- I love it too much. So anything I make doing this would be extra, which is nice but I'm not as disillusioned as my husband to think it's going to be some amazing amount of money. Lol

True- I hadn't really thought about that. None of the other NPs I work with work full time either (all by choice). So I never really equated what I make with a full time gig. I guess it makes sense that it would be around that much though for a specialty office. Like I said I have one friend working full time in long term care and she hates it with a passion but she stays for the money. She's always on call, making rounds on weekends, ect. Sometimes she gets calls even when she's not on call because the nurses know she won't bite their heads off like the MD she works with. I told her no money in the world is worth being miserable.

Thanks! I appreciate the response. I know for a fact I would not have any office hours or need to come up with teaching plans. Like I said, I'll be a clinical visitor. So I'm basically given a rubric to follow for grading of case studies and soap notes and have to check on the students at least once during the semester where they are having clinical rotation. Like I said, she asked me to co-teach an actual class and I said no. After reading that over, however, I'm beginning to think that a clinical visitor might not even be considered adjunct? I mean, I won't be actually teaching a class. Does that make sense? I'm sure I will have to deal with some students complaining about grading and things like that, which I think I can handle. But I think my husband is underestimating the amount of work load I will have. Depending on where they are in the program I might have 3-4 case studies to grade each week per student, which I'm now realizing is quite a lot.

That's awesome! I wish I made that much. lol We are a 3 office practice in a pretty rural area. We are pretty much the only specialty like this in the area, however it's not exactly like patients are knocking down the door. We are exceptionally slow at the moment, but come fall we will pick up again r/t asthma flares, allergy symptoms, ect. The other 2 offices are pretty busy, but they have established client bases and have for years. Honestly NPs don't really make above 100k in this area. But like I said, think exceptionally low cost of living. The only person I know making more than 100k (like 115k maybe) works in long term care and she HATES it. I'll take my cushy job and less money. I have no issues with that.

Allergy, asthma, immunology.