Stuck in an NP Speciality Role

[psych.nurse]

I worked as an RN for 6 years before becoming an NP.  I went back and forth trying to decide between an FNP/Adult NP and Psychiatric NP track.  I chose an FNP program, because I thought it would lend itself to a broader scope of practice and more job opportunities.  A lot of my RN experience was in psych (I did some home care, too).  

My first job out of NP school was at a practice that provided psychiatric and dementia care for nursing home residents.  I did this work for about four years, then left clinical practice to complete a PhD in nursing.

I want to return to clinical practice, but the perception among prospective employers seems to be either that I'm a psych NP, or that I don't have med surg skills.  One place actually hired me and then rescinded the offer once I reiterated that my certification was FNP, not PMHNP (I can't believe they didn't realize this; I had already told them, and it was on my CV).

So, I'm wondering if anyone has suggestions on how to break into a new NP role that is not psych related...?  

I'm also trying to figure out what to do about my malpractice insurance.  I bought my own policy when I got the job offer (that was rescinded), and I've been paying a lot for it, but not practicing currently.

 

Grateful for any insights.

 

Thanks!

[aok7, NP]

I think your post should be considered by students and those wishing to become NPs and so is much appreciated.  The steps taken toward a NP career are critical, as each job we take kind of etches opportunities and, sadly, can close other doors.  

I wanted to be a nephrology NP with a passion but was with more geriatric/internal medicine RN then NP experience.  I pretty much paid (right) to get a preceptor in nephrology and seriously would have volunteered in a dialysis clinic if I had to in order to get where I am.  To many this would seem insane, but nursing competition (for the ideal jobs and highest paying/best experience jobs) is not unlike law or business.  

There's a RN working in dialysis who is in NP school with the plan to be in women's health.  I beg her to get a job in the hospital in ob/gyn or the like.  She is certain (per her school, jobs abound LOL) that she will be hired in ob/gyn without the RN experience.  

You might have to put in some time which is less than ideal but more aligned with your goals.  Doors will then open, you'll meet people who help direct you, and before you know it this current situation will be part of your character and history.

[Tegridy]

I think psych has better job opportunities if that is the area you want to stay in. Post masters in psych possibly?

If no interest in the above just apply for NP jobs that are in the specialty you want to practice essentially.

[Polly Peptide, BSN, MSN, RN, APRN]

As far as how to get a job NOT psych-related, I honestly can't imagine that would be too difficult.  Consider that you are 1) FNP-certified and 2) experienced.  Many of those you will be applying against are NOT.  You will just need to focus your applications towards areas where you have skills, unless you know someone who can refer you or you have another in.  For example, if you worked with dementia/geri patients in your prior role, apply for jobs as a visiting PCP, seeing patients in nursing homes, SNFs, ALFs, memory care facilities, etc.  There are lots of job openings for those kinds of positions in my area, which would be ideal for an FNP with geriatric experience.  Work on your resume' so that it highlights your experience with that population rather than focusing on "psych" experience.  Even if that's not what you want to do, you could use it as a bridge to a future role.

Secondly, for prospective NPs reading this thread - to reiterate what AOK said above, I do think it's important to obtain nursing experience in your intended NP profession, as it will set you apart during the interview and hiring process.  Or at least, it may prevent you from being looked over for that reason.  There was a specialty which I REALLY wanted to get into as an NP, but I did not work in it as a nurse.  I had a peripheral role, so I was familiar, but not direct.  I did my clinicals in my MSN in that specialty so it landed me a couple of good interviews.  But I could not get past the "no experience" part.  Ultimately, I did land an excellent job in a specialty in which I have NO experience (ironically)...I had a good referral, recommendations, the stars aligned.  But on multiple occasions prior to that, I was turned down because I either had "no NP experience" or no experience in the field.  They wanted at least one or the other.

[traumaRUs, MSN, APRN]

I was an experienced RN when I went to grad school: 10 years in a level 1 trauma ED, 2 years in ICU, 2 years in LTC. I interviewed with several practices/hospitals and got a nephrology job. Now, I had basically no dialysis or nephrology experience. However, what I did have was excellent assessment skills - the ability to tell sick from not sick and the ability to make decisions accurately. 

So - don't discount specific experience. Instead focus on what you DO have: assessment skills, communication skills, ability to educate pts/families. These skills are not necessarily specific to one specialty