NPjh

Are you working as an RN in the ER currently or have you previously? I had ER and urgent care experience as an RN, and I had an offer to work in the ER right after graduation because of this. Also, you may be able to do a certain number of your clinical hours in one of these settings, so check with your clinical instructor. You may have to set up these types of clinicals yourself, but it is worth it if this is your passion (do a little networking in your area).

Honestly no, I would not choose to be a PA. I have more autonomy in my state as an NP. Several of my colleagues own their own clinics. I would however look into your choice of NP or PA programs carefully. Our local NP program is more competitive than the PA programs here. Most employers in my area prefer NPs, so the jobs are limited for PAs.

I highly suggest a) re-thinking your views on programs that do not require experience b) actually getting experience. It will be much easier to find an NP position with experience. I had several offers without even applying for a job, because of word of mouth due to my background. Also, the schools with low expectations often provide sub-par education as well. Think about your program of study carefully.

I have heard of different places starting some NPs out as RNs and transitioning them after a certain amount of time/experience. Maybe you could suggest something like that.

I am not in your state, but I would contact your local or state NP organization. I suggest joining as a student NP. Our local organization lists all of us on their site, and lists if we are willing to be a preceptor. You can email any of us through the site. So, I would start there.

I did my homework and spoke with several NPs before I decided on a program. It has nothing to do with "luck." I agree that there should be standardization regarding admission criteria and clinical hours. However, there is also a lack of standardization in PA programs. I recently worked with some PA students from a Pennsylvania program. Their program sent them waaay out west at the last minute. They were completely lost when they got here (skills and knowledge wise).

I worked with a graduate of a Caribbean medical school. She worked as a medical assistant for several years, trying to get a residency. So, I agree with the previous poster on these medical schools. I have heard about an NP to MD program in Australia. Although, I have not heard good things about it. I am sorry that you feel your NP education was inadequate. I was very impressed with my program. I chose a program that required prior experience, a high GPA, and more clinical hours than others I looked into. I am not a fan of some of the programs that have low expectations. Good Luck

The NCLEX tests at the Minimal level for entry into practice. So, comparing the scores is a moot point. My argument for a push for a BSN for entry into practice has nothing to do with whether or not a BSN can start an IV better than an ADN. It is more complicated then that. We have fought for the validation of the nursing profession for how many years? I feel that a bachelor's degree should be the minimum. We are on a playing field with many different providers in medicine. We need to be able to justify our level of autonomy among other aspects of our career.

Thanks for the stats and advice. I am part time as well, so I am a little concerned about numbers. I will see if I can find David and some contract negotiation advice. I did enjoy the simplicity of a hospital based system, but venturing out into a private practice again is *hopefully* a good move.

Thanks for the responses. The proposal is 50% of the profits of billed services, and they want me to come up with an amount for base payment each month (what I think I should get). I am used to a system with RVUs, but this unfamiliar territory. There is also potential for ownership. @ DNP: I know a physician that is a machine like that, he can treat 'em and street 'em and his patient satisfaction is amazing. Although I would agree on the 99214 visits...

If you're wanting a position in an office setting after graduation, then I suggest more experience in that setting.

Are any of you paid on productivity. If so, what is your percentage? Do you also have a base pay amount?

That sounds ridiculously low. I made more than that as an RN. I guess it depends on where you live.