Relocating to NC, need advice!

BlueDevil,DNP, DNP, RN · Dec 12, 2013

Raleigh-Durham-Cary is a very nice area to live in. We lived in MacGregor Downs, in Cary, and it was quite nice. I miss the golf. That is the only thing I miss.

NC is one of the very worst states in the country for advanced practice nursing, and if you have any other options at all, I would not move there. The state is also completely backward in may other ways, socially, politically. I strongly suggest you read old newspapers and follow the state legislative agenda to get a feel for what is going on there. It is essentially 1940 and getting worse, IMHO. Frankly, if you are not a White-Anglo-Saxon-Protestant, you would have to be out of your ever loving mind to even consider it- not to put too fine a point on it.

My wife had an outstanding job at SAS, but we still left 2 days following my graduation. ARNPs are hardly permitted to function as more than glorified triage nurses in NC. Granted, I am not a CRNA, but at least at Duke, the CRNAs were marginalized. They were relegated to the simplest outpatient cases, mostly eye and dental clinic. After resident hours were cut, they did get to work nights in the units placing arterial lines until TPTB decided it was cheaper to let respiratory therapists do it. They let many of them go after that. The large hopital systems at Duke, UNC, WakeMed, and (Rex to a smaller degree) are dominated by MDAs, even though Duke has an outstanding CRNA program! Go figure.

The real problem is the APNs have no voice and no strong representation and are governed by the BOM. There are several physicians in the NC legislature that have seen to it that APNs have been kept under thumb. I have been told that CRNAs do have more autonomy out in the very rural areas, Appalachia and very Eastern NC because those parts of NC are so very poor and desolate that there isn't a MDA for 90 minutes in any direction so the CRNAs operate with impunity simply due to pure necessity. Not so for NPs, so I got the heck out of Dodge. If you have to live in Charlotte or RTP area, I hope you feel ok about doing conscious sedation for root canals and shoulder reductions, that might be the extent of your professional practice. I have no idea what CRNAs earn in NC, all nursing salaries are pitifully low across the board in NC. My guess is 20-25% lower than you are hoping for.

We live in the NE, and my starting salary here was 2x what my preceptor (with 10 years experience) in NC was making. It is now more than 3x hers, and the cost of living here is a heck of a lot lower than Cary!

We still have a vacation home on Ocracoke Island, and the only way I'd ever live in NC again is if we retired to Ocracoke and ran a little coffee shop for tourists or something. I would never practice medicine in NC as a APN, but I won't practice anyplace that doesn't have fully independent NP practice authority.

scgamecock · Dec 14, 2013

Moving there next year too. When I went up I really liked the Northhills and six forks area.

manusko · Dec 17, 2013

I moved to NC in July. Great weather. Love my job. We do our cases mostly on our own. The MDA comes in for induction and they may come back for extubation but they don't interfere with my plan.

ssrhythm · Dec 30, 2013

Good to hear that morificeko. Everything I've seen and heard do not match what you are experiencing in your job. I moved to Indiana after graduating for exactly the opposite reason you want to move south! Maybe after living in the Midwest from birth to adulthood, the southern heat won't wear on you like it does those of us born and raised there. I'm from SC, but unless you live on the NC coast where you can count on the seabreeze or in the mountains where it is ~10 degrees cooler than in the flats, everywhere south of Virginia is swealtering hot and brutal from about mid May-September. I'll take single digits for a couple of months over five months of not being able to walk outside at 3am without being soaking wet before getting to your car. I love the south, but getting carried away by mosquitoes while duck hunting in December suuuuucccckkkssss! I digress...My parents are 75yo and we have given them their first grandchildren... two boys 2y/o and 3months old. I own a great house in Columbia, SC and I would love nothing more than to move back there so my parents and my children (not to mention me) can have as much time together as possible, as they are not getting any younger. Right now, I simply can not afford to move anywhere close to them. I'm making more in my second year out of school than the chief CRNA at one of the better paying facilities that we did rotations at...and he is over 70 and about to retire. He's the only CRNA that I discussed personal salary with, and maybe he was telling me a story, as he knew that I wanted to work there if a position ever opened up. That is SC...NC seems to be significantly lower than SC. Also, do not expect to be doing any PNBs or working autonomously. I'm sure there are exceptions, but I've not seen them. Regardless, you will be signing on for significantly less money compared to what is being offered in the midwest. Money isn't everything, though. I'm taking 5 of my 7 weeks of vacation and working locums for the next two years so that we can be in a position to take that paycut if necessary to move back and be closer to our parents, and I'd do it now...for them...if I could. It's going to be very tough going from autonomy to micormanaged...boo.