I'm a new NP, graduated 1.5yrs ago and have been working in hospice for 6 months. I was applying for positions a few months before graduating and ever since, including across the country when I worked at the VA. I live in South Florida which anecdotally I hear is one of the worst markets for NPs in the country. The NPs I know and folks I graduated with mostly work for private MDs inpatient 60-80hrs/wk for minimal pay (80-100k) and become slaves to their work. The only leads on jobs I've had have been similar ones in internal medicine from private MDs with minimal benefits and back breaking work. My current position seemed ok at first, but it became clear that they wanted me to do primarily nursing and administrative work with only minimal NP duties and no management of patients (on top of unpaid overtime due to salary). Down here bureaucratic non-patient care jobs are very common for NPs. There's next to no hiring in primary care, major hospital systems, and with sane hours. Doing the math everyone I know makes significantly less than a comparable RN with pay for overtime and the quality of life is much less with essentially unending responsibilities to the job, inflexible schedule, minimal travel opportunities, etc.
I'm contemplating going back to working as an RN and per diem NP until the situation improves or permanently, and I wanted to get some perspectives on that. I imagine things get easier with experience, but I'm not seeing very many people willing to train without 60hrs of work/wk, oncall, and rotating weekends which is too much to ask for me personally (respect to those who are willing). Right now my plan would be to try and keep per diem assignments for hospice evaluations or h&p type stuff that's easy to acquire per diem, and work agency or travel to pay down loans. The only lingering worry I have is about my resume and if things improve in the future what the outcome would be. Thanks for any insights others may have....
OKay. Entrepreneurs aren't for everybody. While I was in school, I had my own phlebotomy business, and it's not hard to manage at all. You keep a tally of your income and expenses, and write that off as an independent contractor/partnership/small corporation. Don't want to do it, hire a tax preparer. I file my own taxes every year, so the filing of business taxes is just another click of the button. But I'm sure you have to keep documentation for you to file your personal taxes every year. It's really not that complicated, but extremely simple, since I like to keep things as simple as possible. Well, good luck!
Well, I just learned recently that American Traveler (and possibly others?) will not hire RN's as RN's with NP education due to legal, liability issues.
What about locum tenens? Alaska short term assignments? Something to build your experience without completely relocating?
Interesting about not hiring NPs. I talked to other agencies and they will. Locum stuff would be ideal actually and I'm open. Many (most?) agencies require 2 years in your role to even place you. I've been trying with a couple ones and no luck so far actually, but they're just looking in Florida until my license clears elsewhere. Any recommendations on agencies?
Hi phosphorus, I realize this post is not a recent one, but I'd like to ask if you'd mind sharing with me what your outcome on this situation was? I am considering doing the same and would love more insight. Thanks so much
Hi phosphorus, I realize this post is not a recent one, but I'd like to ask if you'd mind sharing with me what your outcome on this situation was? I am considering doing the same and would love more insight. Thanks so much
If you mean that you are thinking about doing locums work as an NP I can give you some tips, as I did locums for a while towards the end of my time working for other folks. It is definitely better to work as a locum and travel to areas outside of south Florida if you get the opportunity to do so. I understand the OP's post well. I am from that area, and I know exactly what he was talking about.
University of Miami
Barry University
Florida International University
Nova Southeastern University
South University
Florida Atlantic University
Kaiser University
St. Thomas University
University of Phoenix
Chamberlain University
and the list goes on a lot longer...
In the 78 mile radius from Miami to West Palm Beach there are way too many NP schools putting out new grads every 6 months. The jobs just aren't there to sustain it. There are MANY NPs there who can't find jobs. When an opening does pop up there are typically dozens and dozens of applicants. They pick people who have experience and who are willing to work for low pay. Its a very tough place. Salaries and working conditions are usually not good. Some NPs are not going to tell the truth about this, but I know it for a fact. I used to be one of them, and I have many NP colleagues and friends in the area. Many have left the area and moved on to greener pastures in other states. But not everyone can leave---for various reasons.
The southeast Florida area sucked so bad that I did exactly what the OP did and got into locums work. But that has its pluses and minuses, too. Locums NP opportunities and pay have also declined significantly in recent years. I watched that happen also. There used to be plenty of jobs. Now there aren't that many anymore, and I mean nationwide. The recruiters (if they are honest) will tell you that the employer prefers somebody local because they don't want to pay for the logistics. The contracts often have an escape clause that allows them to terminate, and if they find somebody local they may cancel your contract. It allows them to save thousands of dollars on what they would be paying in housing, rental car, and air travel for a locum. This actually happened to me once. It taught me how to better prepare the next time.
You may see lots of listings on the job boards but some of the jobs posted on those boards are duplicates, expired, or never-existed. Always a good idea to have at least 2 or 3 recruiters with different agencies looking for you (some of these agencies are owned by the same company). And have some savings set aside to tide you over between contracts because there will be times when things are totally dead. And you have to start looking for your next contract right after you start your current one. Credentialing times for a position can be be quick but it is often very long----sometimes it takes several weeks or even months.
Not telling you these things to discourage you, but to prepare you for what its actually like. I liked working locums elsewhere better than working for doctors as an NP in south Florida. Its wasn't just because of the money, its about respect also. Locums work is a great way to see and experience different parts of the country, and to expose yourself to better opportunities that may arise if and when your circumstances do permit you to move.
Specializes in in primary care pediatrics and NICU.
Phosphorus, I can TOTALLY relate! I live in Miami and the market is saturated! Leaves new grads fighting over horrible jobs that pay less than experienced RNs, with worse hours and high liability. It's an insult. Florida is ranked as one of the worst states to work as an NP for good reason. I too am a new grad primary care peds NP and hesitate throwing away my RN benefits for garbage offers. (see my post "Second thoughts on leaving bedside for NP role") -I should've just participated in this thread instead. Now considering keeping RN part time while doing a p.t. NP role. Seems like a reasonable compromise before really taking off the training wheels for a potentially negative career move. Trying to weigh the Pros and Cons can be really distressing. Has been for me. Listen to your heart. Do what works for you in the end. People who say working as an RN negates your marketability must not work in So FL. We all have bills to pay at the end of the day. Be proud you have an advanced degree- you'll always have options at least. Maybe not in traditional roles, though.
Specializes in in primary care pediatrics and NICU.
It's funny, I read an article in So FL newspaper 3 years ago that stated the NP needs analysis will be 100% fulfilled (i.e. ZERO need) by 2020. I think they undershot by 2 years. Lol.
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CriticalCareRN1
99 Posts
OKay. Entrepreneurs aren't for everybody. While I was in school, I had my own phlebotomy business, and it's not hard to manage at all. You keep a tally of your income and expenses, and write that off as an independent contractor/partnership/small corporation. Don't want to do it, hire a tax preparer. I file my own taxes every year, so the filing of business taxes is just another click of the button. But I'm sure you have to keep documentation for you to file your personal taxes every year. It's really not that complicated, but extremely simple, since I like to keep things as simple as possible. Well, good luck!