ArmaniX

*Takes off “I’m a HERO” t-shirt* ?

The offer seems.. low for the area but I am not certain. As a new grad > 2 years ago I was offered 90K annual for a well known hospital in the south (ICU - lots of responsibility). Another new grad offer in Maryland (~105k, ICU). After a year I moved to the west coast and now make 200k (ICU). But much higher COL. Your experience, while annoyingly (kidding) superb, does not hold much weight in making you ‘worth’ a higher dollar (my opinion). I relocated for my past two jobs and it took a lot of work on my own to determine if the salary was appropriate for the area. Also consider what you will gain from that first job and how it will benefit you in potential future jobs. Don’t accept dirt offers, but understand right now you are a new fish in the pond. Also from experience it is very difficult to negotiate salary for hospital inpatient jobs. The more ‘famous/known’ a hospital the less they think they need to offer you to get you to sign.

Yes

You sound like someone who has absolutely no idea what they want. Which is fine. But, also not the ideal time to consider investing $$$ into a path you’re not certain you want to take. I would get some good psych experience before committing to PMHNP; pediatric patients attempting suicide, abused, depressed does not seem enjoyable to me for a daily encounter so I’d be very sure before committing to this path. I also am not a PMHNP but I do not believe they have a role in the ED. Patients coming through the ED are seen by an MD/FNP/AGACNP and triaged accordingly and sent to whichever service appropriate, possibly the psych unit. Adrenaline junkie and psych unit.... again no experience but I feel the absolute absence of adrenaline inducing events would be the goal. Consider trauma/critical care/ED. Also consider a life full of adrenaline and high pressure events at work for 40+ hours each week... is this your idea of enjoyment when you’re aged? The desire to be in charge is... a desire. The RN answers to the Provider. The NP answers to the MD/admin. Do you want the life/death decision and potential fallout/liability to fall on your shoulders as the NP or do you want to be the RN that can rely on their provider when things get tough? Adrenaline inducing events often include risky procedures/decisions and they have consequences. I want to say money should not matter but we are all adults. I will say think clearly before letting a $ sign excite you. You should have 100% certainty which path you want to take. You should research local job opportunities and what is available. California is not the easiest place to find a job as a new grad but location may give varying results. Good luck in path and just know that it is absolutely OK to remain a RN. Not everyone needs or should be a NP.

Do not pay for a colleges name. Find the cheaper options.

Know your worth and know your bottom line. Perhaps you could’ve entertained the idea for negotiation if only to detail why you deserve a pay in the range you wanted.

Do you want to continue working in the hospital? Consider acute care cert. The pandemic has slowed hiring in a lot of areas. But ignoring that. Perhaps the areas you’re searching or willing to work are the problem and you need to simply expand this search. I do feel your FNP in the hospital role is limiting your options as a lot of facilities are not hiring FNP in the acute care setting, or such is rumored.

Pure speculation but I feel you would be fine to continue working in the peds pulm clinic with your acute care certification. I am an adult acute care NP and while I practice in the ICU. If I ever made the choice to specialize and just do adult pulmonary or even burns, I would be fine. That would include seeing patients in the inpatient and outpatient setting. Perhaps the caveat would be that I am working as a specialist (pulm, burns, neurology)... to manage the care for those special conditions. I do not manage the patients HTN or diabetes etc, that would be a skill for their primary care physician/NP.

Just play your cards right and balance it. Would be unfortunate to leave one job offering you RN pay for another job that may find they don’t need / can’t afford you in a month when income is down and then you’re just .. unemployed.

I only list the important stuff. Armani MSN CRNP AGACNP-BC Honor Roll Student (2nd grade).

Anyone here do the ANCC field testing of new test questions? Just looking for experiences, seems worth it for the 15 continuing ed hours.

I paid out of pocket as I worked and went to school. Graduated with no college debt. Was the right choice for me as I do not really care to have to be “tied” to a job in order to get/fulfill reimbursement rules.

Solid organ transplants. Free, on the black market.

Started directly in an ICU with 3 month orientation. Certifications, experience (RN) all very much do have weight as a new grad NP. Your timing is unfortunate (pandemic), but I would consider casting a wider net. I graduated in Florida and moved 1000 miles for that first job. It was not ideal but a very reputable organization and great orientation. After a year I was able to secure a job in a location I wanted... another 3000 mile drive. I knew as a new graduate I wanted to be in an ICU in a teaching/trauma 1/academic center. My desires made my options of available jobs smaller and smaller, hence I opened up my search to the entire US.

Start by looking at your local colleges and programs they offer. Then do some research. These questions are what commonly get asked by individuals with no idea what they want to do but have the feeling they need to do “something”. There are plenty of threads on this topic that already exist on this site.