5 8s, no thanks!

[ThePrincessBride]

Question: I am an FNP student who actually likes the idea of a three or four-day work weeks.

I know retail clinics offer 3 10s, but they are every other weekend (which I don't want). I know there are urgent cares. Any other ideas?

Or I doomed with every other weekend or five 8s? My dream job would have 3 10s or 4 8s...is that realistic?

[ThePrincessBride, MSN, RN, NP]

12 hours ago, FullGlass said:

One of the doctors in the clinic was very efficient and he was literally out the door at 5 pm and he also took a 1 hour lunch. He charted as he went. His chart notes were good, too. So it can be done, but that will take experience and practice.

But as a new grad NP, you are going to have a steep learning curve, so it will likely take you time to become efficient.

As others have said, Urgent Care seems to be a better fit with your desired lifestyle, but Urgent Cares generally do not hire new grads - most require 1-2 years of experience. However, there are exceptions.

The truth is, that as a new grad you aren't in a position to be real picky. The exception to this would be if you are in an area with a shortage of NPs. Then you would have a lot of negotiating power. You might want to start putting out feelers and doing research on the NP job market in your desired area.

NPs are professionals, and in California, where I am, they are very well paid. Professionals do not generally work only 8 hours a day. I used to be a business executive and I worked far more hours than I do now as an NP. You will need to devote some personal time to staying abreast of new developments and research. Personally, there were some patients that had very complex conditions that I took an interest in, so I would do research on my own time to improve my care and treatment of them. A new grad should expect to be doing a fair amount of that. For example, one of my patients was a paraplegic, something I didn't have a lot of knowledge about, so I did "homework" Part of it was also that he was young, had been through a horrible time, and I developed a personal interest in helping him and his family. The providers in my clinic would also occasionally visit patients that had to be admitted to the hospital. It wasn't expected, but we did it because we came to care for them. One of the doctors made house calls on a few elderly patients just because he is a nice guy and he knew it was really hard for them to get to the clinic. For me, I had about 5-6 patients that I put extra effort into.

Yeah, I realize I can't be picky and am willing to do just about any type of work so long as I have a flexible schedule with decent pay and benefits. I was thinking Corrections or Urgent Care or Retail health.

Here where I am from NPs get paid okay, but it is not anything impressive. And there are a bunch of crappy, for-profit NP schools pumping out new grad left and right. I am definitely willing to move for my first job.

How many hrs do you work now versus when you were corporate?

[ThePrincessBride, MSN, RN, NP]

12 hours ago, djmatte said:

At the end of the day, if you work in primary care or a range of situations where your are a provider, you own that patient. You are a gateway to their health improving or not. Too few people recognize this level of responsibility and think their time stops when they leave the office ( regardless of work being done well or poorly). Doctors In local clinics long before us and newer models of care did house calls, rounded in hospitals, and had exceptional rapport with their patients. If you want the responsibility of an NP, it’s that level of altruism you should strive for.

You haven’t even graduated yet and all I’m reading is me me me. At the end of the day, you aren’t just some nurse who can go home and maybe never have that patient in your care again. You will be responsible for the meds you prescribe, the labs you order, documenting patient responses to your therapy, and will go home hoping they got their son a cardiac echo because the dad Doesn’t believe you and thought it was a waste of time.

You won’t be able to do this profession during normal business hours only all the time because simply put there’s too much to keep track of. Be it labs, adequate charting, orders, paperwork, HRAs, refills, prior auths, fmla forms, disability applications, cme, And “oh by the way can you see Johnny while he’s here because he has a fever of 103 this morning and you were fully booked and I couldn’t give up my appointment“. This will be your life in most fnp jobs and it will spill over to your home life no matter how many days/hours you work. Understand this going in because the most egregious thing to me is patients suffering because their provider is too good to consider their work in their downtime.

See, I don't really want to work in a PCP office (and it seems NPs in my area who work for PCP offices are poorly treated). I want to deal with more sub-acute cases where I am not necessarily having to follow a patient for years at a time.

As for thinking about myself...that isn't necessarily a bad. Altruism exists for only the wealthy few who can afford to be altruistic. I can't afford to be altruistic...I have bills to pay and familial obligations....but that doesn't mean I want to do the bare minimum. I just don't want work to be my life.

[ThePrincessBride, MSN, RN, NP]

10 hours ago, myoglobin said:

I know that in the PMHNP world that four tens while not "common" also are not rare. I have had multiple places offer me a 60/40 split (1099) and advise me that I can "set my own schedule" working three or four 10's. Several said that their NP's earn between 150 and 220K working 4 10's. I just turned down a local offer in Florida (known for poor pay and worse working conditions) that would have been 4 ten hour days that paid a 125K base with about 15K in realistic bonus opportunity (and I'm a new grad). I believe that it can be done as an FNP. All it will take is an independent practice state (examples include Washington, Oregon Wyoming, Iowa, Nebraska, Arizona, Montana, Maine, New Hampshire) to name a few and an office that will pay you a "split" (which also means 1099). Even in a restrictive practice state all you need is a "collaborating physician" (usually available for about 10% of your gross collections). I honestly think that in the "right" market (say near Disney World, Vegas, or a big city like Seattle) you could do three 12's (say 9am to 9pm) on a 50/50 split and still earn at least 150K 1099. Many patients would appreciate being able to see a primary care provider "after hours". It is amazing to me that I live 20 minutes from Disney World and after about 5PM there are few options (for primary care) other than an Emergency room despite us hosting millions of tourists every year.

I am thinking about adding PMHNP for all the reasons you've listed. It will add an extra 1.5 years but I think I would be much more marketable instead of just having an FNP.

[FullGlass, BSN, MSN, NP]

3 hours ago, ThePrincessBride said:

How many hrs do you work now versus when you were corporate?

In the corporate world, I was typically working 10 to 11 hours per day, and usually a few hours on the weekend. I also had to travel a lot on top of that, flying all over the country (time which was not compensated and I was expected to work a full day on top of that). I was also always "on" literally 24/7 I had to be ready to take phone calls and messages INDEFINITELY.

As an NP, I work 9 to 10 hours per day, seldom on weekends. I don't worry about being on call or having to check messages. And the only traveling is occasionally driving to another clinic to cover if a provider is out.

[FullGlass, BSN, MSN, NP]

When I was looking for my first NP job, I had to turn down a couple of very nice jobs for someone who did not want to work long hours.

The first was to be NP at a community college. During the Spring and Fall semesters, it was 7 to 4 M-Th and 8 to Noon on Fri. During the Summer, it was only 4 days a week. The school shut down for 3 weeks over the Christmas break. And on top of that, 6 weeks vacation to start, plus the CALPERS retirement plan (awesome). Given the actual hours worked, it paid well.

Second was at a sleep clinic. Very straight forward, and the MD wanted part time 2 to 4 days per week. He paid well for that, too. He thought I would get bored, and he was right - very nice man.

[ThePrincessBride, MSN, RN, NP]

2 hours ago, FullGlass said:

When I was looking for my first NP job, I had to turn down a couple of very nice jobs for someone who did not want to work long hours.

The first was to be NP at a community college. During the Spring and Fall semesters, it was 7 to 4 M-Th and 8 to Noon on Fri. During the Summer, it was only 4 days a week. The school shut down for 3 weeks over the Christmas break. And on top of that, 6 weeks vacation to start, plus the CALPERS retirement plan (awesome). Given the actual hours worked, it paid well.

Second was at a sleep clinic. Very straight forward, and the MD wanted part time 2 to 4 days per week. He paid well for that, too. He thought I would get bored, and he was right - very nice man.

What?!? You turned down the School NP job? Nuts!!!

Sleep med sounds cool. Not too many postings for them.