aprnKate

You can use NP-C or FNP-C. I use FNP-C for all my signatures so that people know I'm Family Practice. I didn't take the ANCC. I don't think you get hired more if you take one certification over the other.

I have had some patients that are do not want insulin. there's nothing wrong with putting them on oral meds. I actually use it as a bargaining chip.. I tell them that i'll put them on oral meds if they check with me every 1-2 months along with healthy eating and exercise. I've gotten patients down from >14% down to 7% in 4 to 6 monthw with only oral antidiabetics. Also, I explain to patients that there is a reason behind why I am suggesting for them to take these meds and I explain the function of each med so that they can understand. I also don't fool around and I go straight to the kidney failure talk and if they keep up a sustained high blood sugar that they will end up in kidney failure and will have to go to dialysis 3 times a week for 4 hours and the potential to lose their legs and eye sight. If still don't comply I document and then that's on them not on me. I just tell them that they have a chance to change their outcome and the outcome of their help is not on me. I just let it go after that, can't fix patients who think they don't need fixin.

3Rnet and New Mexico state are always looking for providers. Go rural, you will find a job.

lol... sounded like my first permanent job as a NP. loved the patients and co workers for the most part. hated the drama. there always has to be an office manager married to the boss and the boss having some type of affair with the front desk personnel/medical assistant. Ugh!not a good work place environment. I agree. Locums is the way to go if you are burned out. has some flexibility with schedule and you get to try out different places before you settle with one you like.

This offer is a JOKE! now go back and tell them this is a Funny Joke and ask them what they are really offering! because I wouldn't touch this package even if I was a new grad. Don't waste your time with this private company and take your awesome NP skills elsewhere where you will be considered a valuable asset and will be paid for what your worth! This job is low pay and you'll see 25 patients a day with call. sounds like a job where one can get easily burned, also i wouldn't do it for that kind of pay. They also forgot to put mileage on the 2 facilities that you will have to drive to. I get you are not impressed with your current employer but don't jump into another job where its also sounds like a total mess and this one definitely does.

If you plan to have a family... just be mindful that CNMs are on call a lot. I'm a FNP and have considered getting post masters CNM but then I saw a colleagues schedule and her schedule is 12 hour shifts and she is on call after her 12 hour shift. she does get called in quite a bit. I'm a FNP and i'm happy with having a no call schedule

There's a bunch of seminars on this topic on starting your own private practice if you just google it up. You can also probably ask your local state NP groups how they got started on this, I'm sure one of the NPs in your local have done it which requires you to form a LLC or S corp -- you can get an accountant to set that up for you. Hire a collaborating physician... and of course, a loan to start up your business... etc

Its great that you are putting out feelers out there. I guess it depends what you are looking for 85k plus RVUs/incentive 12 ppd..do they offer benefits? also is the 85k considered W2 or will you be a contractor 1099? if its 1099 i think this is low especially if they don't offer benefits. Also I would ask exactly what is the average number of patient the clinic sees per day because I used to work at a rural clinic that told me that if I saw x amount of patients beyond x number of patients I would get a bonus, I never got that bonus because the average amount of patients per day never did exceed the amount to get the bonus. Therefore, I was stuck with the base salary. 95k starting with AF is not bad for a new grad especially if this had benefits and your years for the govt will count. I currently work for the govt not at AF but IHS. I really like having benefits and retirement benefits which I did not have with my first perm job. Pain management clinic - i'm glad you like this because many people don't including myself. I try very hard to not put my patients on opioid therapy and also i'm trying to wean off patients on opioid therapy that i have inherited from another provider's panel and this is not fun because you face a lot of resistance from patients. One thing with taking a pain management job is that it is specialized so in the end if you don't like it anymore and want to switch to Family Medicine/Internal Medicine then you don't have that experience since you started with a field that is specialized. So think also about the skills that you should learn that will set a good foundation for your NP experience for future marketability. Good luck!

this whole situation is just real bad news. I really do hope you seek another job that is appropriate for your NP role.

Experience? He/she is not getting the NP experience at all by choosing to stay. Play nice and direct yes but I wouldn't stay for a RN experience unless of course you just want the RN role.

Find another job SOON first and get your ducks in a row and then quit. Hopefully you didn't sign anything that can tie you in. Just tell them that you either are a NP or your a RN but not both. If they don't listen to you, then they do not value you or respect you. No ifs, and & buts. Besides why stick around being a RN when you can become a NP. Why don't you tell those docs to recover their own patients as well? They are just really taking advantage of you. Trust me, I've been in the same situation once where they tried to use me as a RN. I didn't hesitate to say anything (but of course, I was traveling back then).

Sadly... I wish NP school curriculum was like that of the PA school as well but look on the bright side you don't have to necessarily to be under a physician to open up your practice in certain states. I guess that is one advantage NPs have. I am envious of those surgery and inpatient rotations though.

You'll get 4 seasons w/ ABQ and Santa Fe. Make sure to research what neighborhood you'll plan to live in. Some parts of ABQ are sketch. Nob Hill near the University is good and so are the newer neighborhoods towards that Petroglyph National Monument. Balloon Fest and Bacon Fest yearly in ABQ. Balloon Festival – I have never gone but heard is pretty awesome to go to from my co-workers. Santa Fe has an outdoor opera house in the summer. I plan to go this summer sometime. There is a light rail from ABQ to Santa Fe and vice versa. Both places are much more chill than the major cities in TX. I used to live in San Antonio but worked in rural TX. You'll work hard for your money in TX and do earn more. NM/AZ –I find that the weather is tolerable and is much drier, not much humidity so its tolerable to go outside and do hikes unlike TX.

What type of teacher will your husband be? If its K-12, I know that the Navajo Rez always need teachers but be mindful that its a rural area. I'm not sure if you are looking at being in the city.

It will only be hard to find a job if you want to stay in one place like a metropolitan area. Rural areas, I have found to be the best place for me in terms in being able to practice in full scope. Metropolitan NPs sometimes get stuck in a specialty. I love rural areas. there are so many great ones to explore and each community is different. Also becoming a traveling NP is also a really cool gig... I've only traveled and worked permanently in rural areas as a NP. There's nothing like it. I have MD and NP friends that have been traveling from 8 to 9 years. they don't pay PTO but you earn enough money that you don't need PTO, you can just take the time off. When I traveled I did 3 months on 1 month off. Some people did 3 months on/off, some did 6 months on/off and they used their off time to do volunteer in other countries or travel.

Where in Texas are you from? I'm from TX as well but I have moved to very NE AZ which is about 1.5 hours from NM and I have explored some of NM. What area in NM are you planning to go to? I have no experience in Washington state or NM but I have explored the idea in the future of going to NM eventually. I know both states are not part of the new eNLC. So you will have to apply for a separate license for it. As far as NM, NM is a considered a rural state in general, there are big cities and metropolitan areas but most of NM is pretty rural. ABQ/Santa Fe/Gallup area are the ones I've been to which I know have clinics and hospitals. They have NM state loan repayment for healthcare providers as well but you must be a resident of NM for at least a year and serve in what they would consider an underserved population/area to qualify. ABQ has UNM for university, Costco, malls, movies...etc. Santa Fe is about an hour away if you are artsy fartsy this is a good town to explore but the houses in Santa Fe can be expensive, its nice to visit. I go to ABQ every 2-3 months to go to Costco to shop. Santa Fe has Ten Thousand Waves hot springs which is really cool to go to in the winter, there is also skiing there.

jbrig, I am a FNP in the Navajo Rez. I do outpatient. I have worked here from 2015 to 2017 on and off as a traveling NP in Chinle, AZ area and Tsaile and Pinon, AZ. Then after much thought, I was offered a permanent job here and took it. I am a commitment phobe when it comes to permanent jobs. So its actually a BIG deal for me to settle. Basically, I have my check list and this job fits the bill. I work perm in Chinle. Outpatient is set up differently since this is the main clinic hub. I work in primary care Internal Medicine most days and school based Teen Clinic 2-4 times a month at the local high school which helps me fulfill my full scope (still working on how I can get my women's health in). By no means, its mandatory for me to do peds or women's health but I just like seeing every kind of population. I'm hoping to take over a specialty clinic once to twice a month as well for Hep C once I get the training done. I am also a Journal Club CME coordinator so I review all the journal club activities for our clinic site and make sure it looks nice and neat before I send it to be approved for CMEs in Phoenix. I know that this sounds like a lot but they actually give me time in my 40 hour work week to do this. So its not overtime for me unless of course there is a side project I want to do and I stay past regular hours doing them. My MD supervisors support MD/NP/PA staff if they want to start a specialty clinic here since we are so rural. Pinon and Tsaile Clinics are different. They are smaller clinic so FNPs do need to practice full scope, which can be exciting and not as monotonous. Its also great working there. I guess what I really like about the job is the community of people I work and live with. everybody is very supportive and really care about the patients and I don't have to worry about the number of patients that I see. Everyone aims to have better quality care here. I am also part of a local med staff band, so I have that as a side gig when I'm not working. We perform, mostly for free around the reservation and the 4 corners area when someone invites us to community events, arts festival, and school fundraisers. We performed at last year's Bluff arts festival which was really cool so I got to know the townspeople there. Pay is decent. I've gotten paid way higher elsewhere but I've found a balance here. I found this place to be healing and I know I know I have a purpose here (I know, I know... that saying sounds very new age-y but its so true)

I think working in the Navajo Reservation is great! I feel very valued here and I feel like I could take care of my patients well because they give me the time to do it. Living here feels like living in a different country but you are actually in the US. I also think doing Locums is great! I am permanent now in the Navajo Reservation but I still dream about my traveling NP days...makes my mouth water sometimes. There is something really cool about being able to live out of a suitcase.

Deciding factors for me are (which will be different for everyone): 1. Must be accredited school 1.5 passing rate for the NP certification 2. Flexibility because I wanted to work at the same time. 3. Cost of school. I am practical when it comes to $$. I didn't want to spend a Sh*t load of money, so I went to a state public school. I don't think its necessary to go to a Ivy League school for NP school due to the cost when you graduate you are just going to get paid the same amount of money. A new grad NP is a new grad NP. I would consider an Ivy League school if there was a particular program I am interested in where they did not offer it elsewhere. 4. Clinical practicums, you can set it up or have the school set it up for you. I found my own preceptors which worked out for me fine. Some schools set it up for you but my colleagues who went to these schools also said they didn't feel like some of their preceptors wanted to teach. I set mine up because I wanted to make sure my preceptors wanted to teach a NP student. There are pros and cons to both options.

Hi there! I think there has been a similar post like this in the past. Google up "What is your take home pay? all nurses" and you'll be able to find a TON of info and replies from everyone. There are many posts that are similar in nature as well.

I took Barkley and Hollier live review courses. I really liked them both. I prefer Barkley over Hollier because the book has more info. Both courses compliment each other. Hollier has a very engaging class and so does Barkley. I just think that Hollier gets you the basics and Barkley fills in info that Hollier doesn't have. If you just had to choose one you can't go wrong with choosing one of these. Hollier is very easy to listen to on the CDs. I also did Barkley DRT test and APEA questions on line and Leik book. Fitzgerald book was a good one too but I chose not to go to her review courses. I bought her CDs used and her voice was extremely monotonous and soooo hard to listen to and keep awake. She goes into way too much details which is good because it will help you once you practice but to actually review for the test I wouldn't choose her review mainly because she goes into too much detail and its hard to pick in the info she puts out what's really important.

Just be aware that you will be functioning as a NP not a Nurse. If you are the first NP they have make sure they don't expect you to function as both especially if you are short staff of nurses. Stick to your NP role. If they somehow expect you to see patients as a NP, work as a RN or RN manager to manage staff and do office manager work that's not cool. If they expect that of you then you need to stand for yourself in which role you want to function. Otherwise, I would ask them for more $$. A lot of new grads run into this situation where they function multiple roles in the clinic (which should not happen by the way) especially if the MDs don't exactly know you function as a NP. I used to work PACU as a RN and also rotated IR recovering patients. I would see a the NP there and that was all she did was pre-op and post op educatioin and educate patient on how to deal with their drains. Also she was doing case management and that is the job she has done since she graduated froom NP school. She graduated like 10-12 years ago. Her job did not seem very appealing to me since she didn't really manage chronic diseases. She did tell me it would be hard for her to go to back to primary care since she's been doing IR for many years. Not trying to discourage you to do IR but it is something to think about. I was offered a NP position with Surgery to do pre-op and post op follow up but turned it down just because I know it was easy peasy and it wouldn't really provide me with a challenging environment. So I went to rural health family practice. But if IR is your thing then go for it.

@ honeykrown, are you still in F. Defiance? I asked you a couple years back about IHS in Chinle. Just wanted to let you know after traveling multiple times in the Rez. I got a perm job here in Chinle. I'm really loving this 4 corners area.

Have you thought of maybe a babysitter that can stay at your home and baby sit your kids. Like an au pair

its a personal choice. I was a RN first before NP. Learned about PA's once I started working as RN. Didn't want a lot of debt just to practice medicine. so I became a NP because it was easier for me to get into NP school than PA school. PA school I still have some prerequisites to take before hand. NP school took me right away. My NP school was less than 30k. My new grad salaryy was 90k which I thought in the end NP school was worth it to me because I didn't spend a lot of money compared to other school's tuition. MDs have a lot of debt but they are trained well in medicine compared to NPs, so there is a downside to it that you will have to make up with experience.