Avenger1

True. About turning down a patient assignment. I guess I just didn't want to be "that nurse" turning down assignments while collecting premium pay. But you're right. So I'm not totally off base thinking he could at least submit me for these jobs? I think the phrasing "there are stronger candidates" irked me. I can work those units no problem. I think my resume shows that. Plus when the jobs are still posted a week later... Thanks for the advice. I'm going to politely say something to him.

I am a 12yr nurse. I stared in the ED got my CEN, moved to SICU, got CCRN then moved to ICU float pool so that I could work all ICU's, step downs and ED. I have been working with a recruiter for about a month now and cannot find a contract. I am being picky trying to stay within 100 miles of home and day shift. I have also ruled out ICU as I don't want to get in over my head in case it is cardiac or neuro specific and while I can handle MICU/SICU well the specifics of those units lend me to think others would be best served. I have found a number of PCU/tele or even med surg jobs that I am willing to work. The recruiter keeps telling me "there are stronger candidates that do med surg or tele only". That seems out of line that I have CCRN/CEN, can and have worked virtually every unit in the hospital besides L & D and OR but I am not a strong candidate compared to a med surg or tele only nurse? So I have worked LVADs and swans but that's not enough "tele" experience? I'm a little frustrated but admit I may also just not understand how traveling works. This is my first attempt while I finish school but feel it won't be a problem as I've been float pool for so long and my last job was 3 campus's and 16 units total. Any advice is appreciated. This is through TNAA a friend used this recruiter and spoke highly... she is also a tele/med surg only nurse. Thanks in advance!

What happens if we all quit? We all die. The PPE shortage sucks. So does short staffing BEFORE CV19. So did the lack of armor on our humvees as we stormed into Iraq. "You go to war with the army you have, not the army you wish you had." CV19 is a war and like any war the few will fight and sacrifice to protect the many. It is up to each individual to decide which group they are at peace being in.

I would love this email. I have been in talks with an agency for $5226 gross/$3878 net a week for ICU in Manhattan. I took a full year off nursing after burn out and let my license lapse. I am just awaiting my emergency reactivation hit before going to NYC.

I read the first page of this thread and the OP summed up my thoughts about NP's and NP education pretty well. As I am about 75% through NP school I can say I am disappointed in it and understand exactly why some physicians prefer PA's and why NP's get trashed on SDN. There is far too much theory and far too little hard science. They stress the difference between the role of a nurse and that of a provider but give far too much credit to bedside experience which in the instances of many of my student peers is irrelevant to their graduate track. 720 clinical hours are required at my institution. How long does it take a PGY-1 EM resident to hit that... 3-4 months??? And there is zero residency requirement for NP's following graduation. I used to drink the kool-aid and support NP autonomy. At this point I can say I am wholeheartedly against it. Until nurses demand their education to be on par with their peers the level of respect and responsibility will rightfully be diminished.

I had almost the EXACT same experience when I switched to SICU from the ED. I was CEN and CCRN before ever stepping foot in the ICU. I was not some new nurse. But riight from the beginning I heard all sorts of moaning and snarky comments about the ED, the exact same sink or swim threats and a preceptor who I did not get along with. I was told "there are lots of tough personalities here and you better have thick skin." Please lady, I'm a former infantry Marine with 2 tours in Iraq where I lead 17 Marines into the worst fighting of the war. Get out of my face. I was EXTREMELY turned off by the arrogant, snotty attitudes displayed just as I had heard they would be. I wanted to leave and go back to the ED but but I remembered why I wanted to go to a Level I SICU... to learn to take care of some of the sickest patients around. So I stuck it out and it did get better, a lot better. Sure there was still lots to learn but that's what I came there for. And there are still some people I can't stand but I started to meet more and more cool people and great nurses. I won't be arrogant and I say I am the best critical care nurse alive but I learned a tremendous amount and still do. The worst offenders learned not to mess with me and I earned my keep amongst everyone else. Hang in there. It will be worth it in the end.

Any ED I have worked in ONLY hired FNP's due to the necessity to see kids. And nowadays ED Fast Tracks and sub-acute areas (where most ED NP's are working) are many people's primary care. You will be well prepared as an FNP without a fellowship or residency.

To piggy back off my post about fellowships I wanted to ask about the Duke specialty certification programs to see if anyone here has completed one. Duke offers 8 credit/200 clinical hour "specialty certifications" that can be taken as electives for NP students at Duke or non-degree classes for students of other NP programs and practicing NP's. Ortho, HIV, onc and cards are offered. I just wanted to see if anyone had any experience with these, specifically the ortho, to see if they were worth it to pay $15,000 out of pocket for. Orthopedic Nurse Practitioner Specialty | Duke School of Nursing I found a 2yr ortho fellowship at UNC but am not sure I can commit to moving there for 2yrs. 1 probably but not sure about 2. I found this and wondered if it may be helpful education wise and to gain a leg up on an ortho position.

Just getting back here. So much good information and thoughts from everyone. I love the idea of a fellowship. It is unfortunate there are only about 30-35 that I have been able to find. I believe, like everyone else, that the training, experience, knowledge and confidence gained would make a tremendous difference moving forward into practice. The lack of fellowships offered and their geographic locations makes it a double edged sword… Completing one may not be the easiest thing to accomplish but those who do would really be set apart from their new grad peers. Carlton, good info on Carillion.

Is there value in doing a post-grad fellowship or residency? Let me expound, I see obvious benefit as far as knowledge expansion and skill enhancement. But I have just started reading about more of these begin available for NP's and PA's yet have not spoken to anyone who has completed one. For example the Carilion Clinic in Virginia offers an Emergency Medicine fellowship for NP's https://www.carilionclinic.org/emergency-department/fellowship Would completion make the post-grad a much more desirable candidate? Would there be a salary increase? Certainly scope of practice or role in the care team would be the same regardless. There are 20 some other's in multiple specialties that I read about. Some very specialized such as Hepatology. Thoughts?

I just saw this post and want to offer my thoughts as I am a career firefighter and RN. I spent 4 years in the infantry in the Marine Corps. After getting back from Iraq the second time I got out and took some gen ends before applying to nursing school. While waiting to be accepted I took a fire exam and was offered a position. I turned it down to go to school and used the GI Bill to pay for it. By the time I graduated the bottom fell out of the nursing market and I had a tough time finding a good job. In the mean time the department was testing again and had 35 spots open. I scored 2nd with my veterans preference points, took the job and went to the academy. After that I took a PT spot in a trauma center ED while I finished my first 3 years on the job working a lot of 4 on/4 off and finishing my BSN doing most of the work at the station. Bid on a job, and now work either 24 on 24 off 5 off or 48 straight and 6 off. I do 2 12's a week nursing still and have a year until starting NP clinicals. Again I do the bulk of my school work at the station. That's my path. I am very, very lucky. I make well above what I would doing either job individually, the VA is paying for grad school and I get to do most of my work at the station. Firefighting is the 2nd best job out there after being in the infantry. I tell anyone that asks how I did it to join the military. Any branch. Just get those veterans preference points. Soon career firefighting and police jobs will be next to impossible to get without them. And you can't beat the Post 9/11 GI Bill. Good luck on both careers.

Carachel You summed up my exact thoughts for considering passing on going back to school. Glad to know it isn't as cut and dry as some have suggested to me (in person, not on here).

I hesitated to say it directly and instead said I enjoy leading a team but your point about being the "go to guy" is very much how I feel. I understand staff nurses can do that in many ways. I thoroughly enjoy when I have a student or oriented or even just being able to offer insight to a peer when asked. However I absolutely love being the go to guy. I lead 17 Marines into Iraq twice. Being the guy people turn to when tough stuff happens is what I thrive on. Not because of a power trip but because of the satisfaction of helping guide them and the dedication and commitment to learning all that is necessary to get to the point where one could be in such a respected position to have such trust placed in them. I hope that makes sense. Thank you very much for your insight.

I posted my schedule because if I had told you I worked 72hrs a week you wouldn't have understood and thought I was insane. However I can assure you it is quite a fortunate situation. And I mentioned money because I feel it is a unique circumstance different from many fulltime staff nurses who pursue advanced practice. This site always seems to fault people for considering the monetary value of a higher education. I enjoy nursing but do not wish to volunteer. I want to maximize the value of my education regardless of what level that is. I am drawn to advanced practice because I enjoy theory, knowledge and not just the whats but the whys. I am comfortable making independant decisions and leading a team. Furthermore I question if when I am 50 if I will want to be hunched over beds boosting patients, fighting to restrain them and starting IV's. Like I said, I understand there are many benefits to higher education with financials only being one consideration. However I also understand I am in a very fortunate and unique situation and was curious what others thought.

I just received my acceptance letter to Drexel's FNP program. Great news. However I am a little conflicted if I want to pursue my MSN due to my unique circumstances. Let me explain in hopes of hearing your thoughts... I work full time as a paid firefighter. The second highest department in the state. We work 24/off/24/5 days off. A great schedule. I work 2 12's a week as a PRN staff RN in a an ED. PRN pay puts me >$35. Combined with the fire department I make in excess of $100k/year working literally 50% of the days in a year. Regardless of my choice about an MSN I will not leave the fire department as I can retire in 18 more years at 49 years old with a 70% pension. Plus it is a fun job I enjoy. The VA would pay 100% of an MSN. However as much as I would enjoy the work I am unsure if I want to commit 3 more years of school to make a negligible amount more money. Currently I am outside of Philadelphia but know I could make even more (50ish) if I went in the city. Plus, my wife begins grad school this summer. I know there are many reasons to continue your education with money being only one. However I know I am already in a very fortunate position financially and because I do not work full time as a staff RN I feel as though I do not burn out the way some bedside nurses do. I question whether the work and sacrifice would be worth it in the end. I have 45 days to decide and change my mind every other day. Thoughts?