SN2751

@NPdod, I'm really sorry you're experiencing this in your very first NP job—this is definitely not normal and sounds like an unhealthy work environment. Expecting you to manage patients without any questions on just your second day as a new grad NP is completely unreasonable. It sounds like they not only lack concern for your growth, but also for the quality of care their patients receive. If you're not asking questions, you're not learning, and if you're not in a supportive environment, it will only hinder your development as a provider. It's clear they aren't prioritizing patient care if they expect 45 patients to be seen in an 8-hour day in primary care. That's not only unrealistic but also unfair to both the patients and you. Providing quality care in those circumstances is nearly impossible, and it puts your well-being and ability to practice effectively at risk. In my experience working with numerous primary care providers, the average patient load in an 8-hour workday is typically between 14-20 patients. While a few might manage slightly more than 20, I have never—never—worked with or seen a PCP take on 45 patients in a single day. The response from your office manager is especially frustrating. Saying you "should have learned those things in school" shows a lack of understanding. Every provider, whether NP, PA, MD, or DO, commits to lifelong learning. No one, regardless of their education, leaves school knowing everything. Transitioning into real-world practice comes with a steep learning curve, and support from colleagues is crucial for success. My advice: Have a direct conversation with the doctors who hired you to express your concerns. If they can't offer the support you need and are already pushing an excessive patient load (14 patients in your first week is far too much), it might be best to consider other opportunities. Feel free to DM me if you need more advice or support!

@RNrdj21 I should clarify that both are great options, it really just comes down to what works for you! Feel free to message me if you have any other questions.

@RNrdj21 So...I actually started at UNCG and went there for one semester, and then decided to switch to UC online. Pros UNCG: -they find your preceptors Cons UNCG: -the program is AGPCNP (you can only work with ages 13+ and this really limits your opportunities in the job market) -they only had a DNP option, so the program is 3 years -it was a far drive from where I live -even though they find your preceptors they can't guarantee it will be close to where you live -no part-time option -if you need to take any time off (potential pregnancy/newborn was my concern) then you have to take off an ENTIRE YEAR before continuing the program As you can see, the con list ended up being much longer than the pro list for going to UNCG for me. Also, in the 2nd semester clinical rotations start and my first rotation was in Greensboro. So I was going to be driving a very far distance from where I live (1 hr 45 mins in one direction) at least twice per week. This ended up being too much for me with my schedule. I had deferred my acceptance at UC, so I started there the following semester. I have had a great experience, and I highly recommend the program. I will go over the pros and cons for UC. Pros: -part-time option -flexibility -master's option (2 years full time) -FNP (can work with all ages) -ability to take time off if needed (again was considering pregnancy/newborn) Cons: -they don't find your clinical sites -no in-person labs/hands-on training on campus Honestly the reason why I chose UNCG initially was because I let the people in these forums get to me. Are there things about NP programs that need to change? Absolutely! However, the argument that you need to go to to a brick and mortar program vs. online is simply an unfounded opinion. The truth is I've been to both, and from an educational perspective there was very little difference. The ONLY thing is that we did get hands-on experience at UNCG prior to starting our clinical rotations, and we were able to do ONE PAP, beast, DRE, and testicular/penile exam. I should highlight we only did this ONCE. So, at the end of the day did that ONE exam make me feel more prepared, not really. The fact of the matter is no matter where you go for NP school you get out what you put in. NP school requires a lot of self-teaching. Also, I know some people have a hard time finding clinical rotations, but in all honesty if you put forth the effort it is not that difficult. UC has a list of preceptors that have been used before within your area/state with contact information. I formatted an email with my resume attached, and sent out probably close to 50 emails to all the places where I was interested in doing clinical near me + all of the preceptors that had previously been used on the list. I personally think cold calling/showing up unannounced is a waste of your time and the providers (if you even get that far). A lot of people will not respond, but remember you only need a few. I ended up getting responses from more than enough preceptors who were willing to work with me. Just be willing to expand your search slightly beyond the city you live in if absolutely necessary. If you need more advice on finding clinical sites let me know and I'll do my best to help (especially if you live in NC)! Let me know if you have any other questions or concerns. Best of luck!!

My thoughts exactly...

I wish that method had been used. I uploaded a picture to show where the injection site was -- I double checked under the bandaid as well to make sure the injection site was actually there.

My husband was able to get his COVID vaccine today, and he got home and his injection site was so low. It looks like it hit around the brachialis muscle. I'm really hoping it actually went into the muscle. I am so frustrated that they are not training people properly to administer these valuable vaccines. It is imperative that they are given properly or it could mean decreased efficacy. I tried to research accidental IM injections in the brachialis, and I can't find anything. Should I be worried? I have NEVER seen a vaccine given so low in my nursing career. I wish I had been there to stop her. I'm considering calling the vaccine location tomorrow to notify a manager about the improper administration - not in a berating way, but to notify them, and hope it results in better training.

I see that most of the discussion here is about ACNP residencies. Does anyone have experience with FNP residencies/fellowships? I am interested in applying, but am curious about how competitive these programs are, and what they're like?

Hope you're feeling better today! That sounds like quite the ordeal - I'm so sorry you experienced that reaction ?

I started NP school in the fall of 2020, but shortly after I began my program I started to doubt my career pursuits. I am so worried about 1) not finding a job in a saturated market, 2) being overwhelmed with the amount of responsibility, and 3) fear of imposter syndrome for years before I'm comfortable with the job. All of these things have me questioning my path, but at the same time I have NO idea what I would want to do otherwise. I have no interest in continuing as a bedside nurse until retirement, and I have always wanted to have the ability to diagnose, prescribe, and work with patients on a long-term basis. NPs reading this - how much stress do you truly feel on a daily basis? Is it manageable? Do you ever regret your career choice? I understand stress is inevitable to some degree with any career, and especially when you are responsible for people's lives, but I am just trying to gauge (to some degree) stress level among NPs. Also, how many years did you work as a NP before you had a good grip on your knowledge in the field and felt confident in your diagnoses? Thank you in advance for any advice or answers to these questions!

Just a heads up regarding Simmons, I saw this blog today and she talks about Simmons having only found two of her clinical sites for her. Just might be something to think about before making your decision.

I came from med-surg, and recently started in same day surgery. It is a GREAT job! It can get hectic at times, but we ALWAYS get a break, and we even have some down time here and there. However, from a learning perspective, if you're looking for higher acuity patient care you won't get that in same day surgery. In other words, if you're looking to advance your skill set as a nurse, I'm not sure same day surgery is for you. I'm learning a lot, but only as it pertains to preoperative and postoperative care. I feel like I'm still using my skill set to a degree, but it's nowhere close to what I was doing on my old med-surg floor. I feel like endoscopy is probably similar, so you probably already have an idea of what same day surgery would be like already.

UNCG finds your clinical preceptors. It is an adult/gero primary care program though, so once completed one can only work with ages 13+. It is the only program I know of within driving distance of me that finds your clinical preceptors.

I am wondering what kind of jobs are out there for adult gerontology primary care NPs? I know there are many family practices out there that prefer FNPs so they can treat all ages. Are there family practices that will hire an adult gero NP and just have them work with ages 13+? Curious because I am about to start AGPCNP school next month, and this has been a concern of mine.

With Simmons having about double the tuition rate per credit hour as the University of Cincinnati, I would say UC is the better option between the two. I do not know much about Simmons, but I did look up the tuition prior to responding to your post. I was accepted at UC in their FNP program for the fall semester. I am worried about finding preceptors too, but I don't think paying twice the amount in tuition would be worth it. From the people I have spoken with thus far who have had to find their own preceptors, they say it is difficult but possible as long as you start looking far enough in advance. I have also heard that you may have to pay some clinical sites to precept you if you're desperate. However, it still only averages around $10-$12/clinical hour from what I've seen, which would be way less than what you would spend on the additional tuition at Simmons. I think paying for clinical sites seems outrageous, but I guess it's nice to know the option is there if you find yourself in a bind.

Barcode120x thank you for your response! I will definitely make sure that my clinical sites will be found for me prior to choosing the hybrid program. And if I choose UC, I will also start asking around my network to see if I can find preceptors. Unfortunately I am not close enough to Cincinnati to use any of the program's faculty as preceptors, but hopefully I will be able to find some connections through my workplace. The organization of the online setting with firm due dates does sound nice. I also love the idea of not having to travel to campus (1.75 hr trip for me) weekly to UNCG if I were to pick the hybrid option. Plus, being able to work more like you said is a major perk with the online option. However, UC's program has zero campus visits, and I'm not even required to go for orientation. I do wish that I had the option of going two weekends out of the semester like your program. I'd like to be able to establish a network there in person rather than fully online. That's one of the downsides for me, but still so many pros over cons with that program. Lots to thinks about! Thank you for your help!