britt_possible

So glad to know that I am not alone on this. I joined the public health association just to see whats out there. I saw a recent study that says obtaining an MPH doesn't equal increased pay if you enter public health with any other type of master's degree. Relief for me, i was dreading going back for MPH. May just go back for a certificate in public health just to get the basic aspects down.

any tips on how to break into that arena or even ideas for building the skills for writing?

Hi All, After 1 year as a MA, 3 years as an RN and going on 3 years as an NP, I am considering the next move in my career. I know many may criticize the idea that i keep changing careers, but i am 31 with no strings, i figure this is the best time in my life to move around. I've done some deep soul searching and i think that i would like to move out of direct patient care. Or at least spend less time in direct care and more time doing my part to help improve the healthcare system (which is a complete and utter mess, i know.) I am thinking of moving into preventative health education, developing community health programs, health consulting, health policy. I have a few reservations: 1. I am a specialty NP, I'm thinking hat any move from here may result in a significant pay cut, but can't prove this theory. 2. I am not sure where to start. who to talk to, who to reach out to, websites to help guide me. 3.I really don't want to go back to school on my own dime, I believe as a former bedside nurse and a as provider i have a place in other healthcare arenas without needing extra degrees, but again I can't prove this. Any words of encouragement, advice, ideas, thoughts would be helpful. Thanks!

This has been a issue for many years in middle Tennessee. Hard to get a job and if you secure a job the pay is below AVG. The Nashville metro area has a lot of NP programs plus a PA program, plus medical schools feeding into the area making it difficult. I was born and raised in nashville did my BSN and MSN there, but knew id have to move to get a job (professors even warned of this during MSN program). I graduated in 2016, found a job within 2 months of graduation on east coast. My classmate that stayed local waited 9 months. Another left the area for a year, came back after she gained experience. I do have a old RN college who was able to secure a job after graduation, but she had worked at the facility for 5 years as an tech/RN.

I graduated two years ago with my Adult Gero Primary Care cert and i work as outpatient cardiology NP. It was my goal when i started my NP program. During my NP clinicals i specifically requested cardiology rotations or internal med rotations. My entire experience as a tech/RN was inpatient cardiology (4 years total). I had two offers for interviews in outpatient cards with in 48 hours of applying for those jobs. I graduated from a well known brick and mortar which helped ALOT. i knew id have to move for a job, because my home town NP market is VERY saturated. I moved out of the region to the mid atlantic -- Cardiology NP jobs are plentiful here. The pay could be better, and i know i am low balled. But im making about $40K more than RN salary with better work hours, no weekend, no on call.

Thank you.

I am not sure how this commentary fits into my original question or fits into the narrative that follows.

Thank you all for a perspective i didn't know existed. I learned something new today. In thinking about the practices of the four physicians I work with, i think they are skirting the medicare fraud line, as in doing just enough to prove that its not fraudulent. Two of them will see the patient, discuss what I've discussed and leave the room. Their billing looks like "seen with the nurse practitioner, i agree with the note as written, additional comments are (enter a shortened version of my H&P). The other two are more of a "hi and bye" to the patient and then copy my assessment and plan with a few words changed.... Im not sure i have a legal leg to stand on, just getting the short end of the salary stick

Well, i can't speak for the inpatient side of things, but the MDs see the patient after me in the outpatient setting. I have 90% committed to leaving after my one year is up in September, but being that I am still novice NP, would like to know if this inability to bill is truly a red flag or not....

1st year New Grad- Outpatient Cardiology 94K in VA, 40 hours/wk with 20 PTO days, 1500 CME 2yr, 2nd job Outpatient Cardiology 95k in DC,40 hours/wk 20 PTO, 3000 CME

Hi All, i just wanted to get everyone's opinion regarding participating in a practice that does not allow me to bill. Heres the story... So I work in an independent practice state. I work in an outpatient clinic for a specialty clinic at a hospital. There are 8 nurse practitioners who are inpatient only. The inpatient NPs do rounds/consults, as well as manage the patients on the service, and are the pre/post procedure NPs. None of them are allowed to bill for their services. They do the work, the MD signs off on their notes and drops the bill. Same for me, i see about 10 patient per day in the clinic, i do the H&P, prescribe Rx, help formulate plan of care, write the note...the MD comes in behind me signs off on the note, drops the bill. I am also responsible for typical outpatient NP duties, such as responding to patient phone calls. I have a couple of qualms about this job (mostly because i feel like a glorified RN, i made anther post about it a month ago), but i am getting close to annual review time. It donned on me that not only am I under the hospital restrictions re: my pay increase, but i can't ask for an additional raise because i don't have proof of productivity because i don't bill. The docs here are bankrolling from the NPs while we are ALL getting paid the minimum by the hospital. While our director throws many a parties and talks often about how much the department makes, but the NPs never get a raise aside from the yearly 1-2% from the hospital. I understand that not all money made can be allocated to payroll, but does anybody see this as a little fishy? I previously worked at a practice where i did my own billing; i came to this job thinking i would have more support and eventually they would let me bill independently; but now im not so sure? Their reasoning for doing all the billing is that because they do procedures, the patient should always see the MD. Thoughts???

This may be a lengthy post, i apologize in advance. I graduated and received my AGPCNP certification September 2016. At that time i lived in a saturated market so I applied out of state for a job. I immediately got an interview for a job 1 day after i had applied for it in Virginia. I was flown up for the in person interview, my attending said" Hi , nice to meet you." Shook my hand while in the hall as he was going into a patient room..that was my interview. I was offered the job the same day. It was a General cardiology and EP job and since my RN background was exclusively cardiology, i thought it would be a great fit. I ended up leaving the job 10 months later because my orientation was 4 weeks long, my attending would give me about 10 seconds to ask my question otherwise he would rush off...just not a great environment for a new grad NP. Plus, the city was in the middle of nowhere and i am single with no children. I became bored and depressed. But on the plus side i learned skills quickly and had worked up to an independent clinic of 10 patients per day. So the second job i took (which is the job i have now) is EP only. I am the first NP ever in the outpatient only setting (there are 6 inpatient NPs). Which has been a huge adjustment for a staff that doesn't like change. I see the patient, then my attending comes in after me to see the patient again( really redundant and waste of the patient's time, but they won't want me to have my own clinic). I write the notes, put in orders, set up dates for the procedure and answer patient calls independently, but otherwise i have lost the autonomy that i had at the first job. I also don't love EP. I knew i didn't LOVE EP after i had the first job, but i really wanted to move to a bigger city and have a better quality of life. And i figured i might like EP if i had better training. The pay was the exact same. Its been 8 months and ..nope still don't like EP. I am not the biggest fan of the staff... My chief NP is great but she is inpatient only, so essentially she tells me I'm on my own with the clinic. I also constantly face negative and unnessary comments about my age and being a millennial (im 30) from attending and the other NPs. I got into a disagreement with an attending my 3rd week there because he said i was a millennial and I needed to learn responsibility and accountability (we saw a patient together, he said he would be right back with the plan.. 20 mins later, he never comes back with a plan, I told the patient i would contact them after i discussed with my attending. I let the patient go without scheduling a procedure first, so the attending got upset) Ive been keeping to myself and trying to just work and go home and last the office manager called me a weird millennial for it. I don't see why my age is an issue, especially if they think i am doing a good job. All of this to say that I am extremely embarrassed that I am ready to move on to another position, possibly out of cardiology together. Prior to becoming an NP i was loyal to every job i had and stayed for at least 3-5 years. Ive settled it up that i can try and stay to finish my year out at the current job. But i wanted to know everyone's opinion on how it would look on my resume to jump jobs again?? Am I being ungrateful? I'm afraid if i wait too long, ill be pigeonholed in EP.

Well, interesting twist of things.i ended up taking a job in Northern Va. It is a cardiology position and i wanted the specialty job more than i wanted to move to Texas...so here i am!

Hey guys this question is for ACNPs, and FNP/AGPCNP... I will be taking my AGPCNP boards this week but i started looking for jobs about a month or so ago. I would like to work in an outpatient cardiology clinic. I have 3 years of ICU cardiovascular stepdown experience but chose to do the primary care route to avoid working inpatient the rest of my life. As i am applying for the "outpatient only"cardiology clinics, i am noticing that the clinics only want ACNPs for the position. I was wondering why? I could take a crappy guess but i think id like the input from ACNPs as to why they are more qualified for the clinic only jobs. We learned 12 leads and basic management of complex diseases so im not sure why i would automatically be excluded from the position. Also, if anyone knows how i could reword my resume to get the recruiters to consider my acute inpatient experience before turning me down for being primary care, that would be great too. :-) Thanks!

Thank you for your input. I am finding more job listings in Dallas than Houston, but still no calls back. I think that might change after I pass boards. I would like to do cardiology since that is my RN background, but also interested in internal medicine. I am not entirely clear on scope of practice so I am hesitant to apply for hospitalist positions being that I am adult primary care. I was hoping to get into a clinic affiliated with a hospital, I think that might be easier since i'm relocating, rather than to aim for private practices that don't want to take a chance on someone who is not local. Am I correct in this thinking?