Travel RN to New FNP - Is it worth it?

Specialties NP Nursing Q/A

I'm a brand new FNP. Just passed boards, interviewing this week for multiple positions. Background is paramedic, ER nursing, flight nurse, and now travel RN in the ER. I am really struggling with the financial aspect of this change.

I am currently making about $3400/week working only 3 day shifts/week. This is a travel contract but I make the drive about 1hr 20 mins each day I work so I can get the travel pay (50 miles from your home or farther to qualify).

The money is nice, and the 4 days off a week is really nice, but I pretty much dread going to work. I am very burned out as far as bedside nursing goes. I'm tired of the usually short staffed days, 12 hours of stress and being behind on tasks, the monotony of the tasks each day (get an IV, label things, send it, get EKG, help patient to bathroom, beg for urine sample on everyone, hang antibiotics, rinse and repeat for 12 hours). I feel like I shouldn't complain because I am being paid nicely and I only work 3 days a week, but I don't enjoy the days I do work.

The NP job I interviewed for yesterday asked my pay expectations. I said $65/hr at least because that is what my base travel RN pay is (without my travel stipends, which I know I can't expect from a local NP job). They said $65 is the top pay they offer across the board for the position and would likely not be able to do that for a new grad. I have seen some positions offering around $45-55/hr on indeed for FNPs (Texas). I expected a pay cut to some degree because I am starting a new career essentially, but man I didn't think it would be this steep. A place today offered me a salaried job at 105,000 per year which they say is higher than they normally offer new grads because of my resume. I honestly don't think I could afford my current life with that (15 year mortgage based on previous RN earnings of 130K/year).

My question to all of you is, is it worth it? Am I looking at this the wrong way? Did anyone else in a similar scenario find a huge relief when they started an outpatient NP position and got away from the bedside and did not regret taking a pay cut? I am honestly stressed right now thinking about it. I spent a year working extremely hard (stayed full time at my flight RN position working 48 hours a week and did full time clinical hours) thinking there would be a pay off in the end. But all of the work and school dollars spent.... for a significant pay cut.

Thank you for any advice.

Specializes in SRNA.

You could always do 2 travel shifts/week and 1-2 shifts/week as a PT NP.

I'm currently in FNP/ENP school and also a travel RN and the money is too great to pass up even though I'm a few years out before graduation. 

On 1/12/2022 at 3:45 PM, londonflo said:

Scary. This is why I am avoiding seeing NPs. I was seeking NP care at least 15 years ago for all my healthcare needs....but my recent experiences (from several NPs)  have had me change my choice of provider. MD for ME

I did a year residency and trained alongside MD residents doing 90 hour weeks in addition to being independent for 2 years and having countless years of RN experience prior to that. I am not an MD but I am competent. You also completely missed my point.  What do you do again?

Specializes in oncology.
Numenor said:

I did a year residency and trained alongside MD residents doing 90 hour weeks in addition to being independent for 2 years and having countless years of RN experience prior to that.

Not the same as Medical School, Residency (you said it your self --  MD residents doing 90 hour weeks)  Training along with them? like osmosis your absorbed the knowledge

Insight and experience are important to patients and the outcome achieved.  Symptoms with different solutions will come into play here. Everything is not solved with a prescription and I find your comments appalling.  It is a "not all sizes fit all".

I went to a psychiatrist because I had gained weight, slept too much, was not active. Sounds like depression, Right?  Every visit does not need a psych RX!   Instead of a psychiatric Dx, he investigated my TSH etc. Got me into the endocrinologist in my city and I  am now back to my normal activity level. NO, NO, no writing an RX for me..... great accurate assessment and Dx. I think your understanding of the role of an NP is limited. I don't want to go to someone just  for RX

Let's just agree we have different viewpoints. 

Specializes in oncology.
14 hours ago, LibraSunCNM said:

Psych is a good example of this--in most outpatient psych practices, a psych NP and a psychiatrist are interchangeable in terms of their scope.  The MD is not performing any procedures or writing any scripts that the NP can't also perform/write.

So...to go to a psych NP or MD is just going for Psych medications? Any in-depth assessments?  Putting pen to paper is not what I think of first with a health care professional. 

Specializes in OB.
5 minutes ago, londonflo said:

So...to go to a psych NP or MD is just going for Psych medications? Any in-depth assessments?  Putting pen to paper is not what I think of first with a health care professional. 

No, I was just giving one example of how *scopes* could be the same for an NP and an MD.  

Specializes in oncology.
8 minutes ago, LibraSunCNM said:

No, I was just giving one example of how *scopes* could be the same for an NP and an MD.  

But for the other patients who need more than a cursory assessment and RX? You are at the wrong care provider. How do we tell patients this....... With NP saying they are interchangeable with an MD? The scopes are not the same..... I can put a band aid on someone's knee put it doesn't make me an ER MD or surgeon.

Specializes in OB.
1 hour ago, londonflo said:

But for the other patients who need more than a cursory assessment and RX? You are at the wrong care provider. How do we tell patients this....... With NP saying they are interchangeable with an MD? The scopes are not the same..... I can put a band aid on someone's knee put it doesn't make me an ER MD or surgeon.

Sigh.  When did I ever say an NP was interchangeable with a surgeon?  You criticized a poster for saying they were interchangeable with an MD *at their particular practice*, and I gave examples of how that might really be a true statement.  Of course I'm not implying *all* NPs have the same scope as *all* MDs.  And I'm sorry your experience with NPs has always been that of "cursory assessments and RX" but that's certainly not the norm.

Specializes in Psychiatric and Mental Health NP (PMHNP).
7 hours ago, londonflo said:

I went to a psychiatrist because I had gained weight, slept too much, was not active. Sounds like depression, Right?  Every visit does not need a psych RX!   Instead of a psychiatric Dx, he investigated my TSH etc. Got me into the endocrinologist in my city and I  am now back to my normal activity level. NO, NO, no writing an RX for me..... great accurate assessment and Dx. I think your understanding of the role of an NP is limited. I don't want to go to someone just  for RX

You didn't answer the question about your role.  What do you do professionally?  Are you a nurse?

What you described above is nothing special.  I am a PMHNP and I always check for physical, medical causes for psychological symptoms.  Our practice orders baseline and periodic labs if the patient does not already get those done through their primary care provider.

Frankly, I have seen many incompetent MDs.  There are also NPs that are not so great.  

The truth is, whether you happen to like it or not, that is actual practice, NPs and MDs are generally interchangeable.  I have a "supervising" MD, but he does no supervising.  I am essentially practicing independently.

My patients provide me with consistent feedback that I provide much better explanations than MDs.  In addition, I also go over nonpharmaceutical treatment options like supplements and lifestyle changes that most doctors do not.  In fact, the supervising physician refers patients to me for nutrition and exercise consultations!

I am sorry you have had suboptimal experiences with NPs, but please do not make such broad statements regarding NPs and the quality of care they provide.

I know this thread got a bit off topic, but I do want to thank all those who offered advice. Some of you gave me some things to reflect on and think about and I do appreciate it. I have had a few interviews and there are positions offering decent hourly rates ($65/hr with bonuses added for productivity and metrics which make it close to $70-75hr… plus benefits). Plus the opportunity to work overtime. I think the low salary was really getting to me but it doesn’t have to be that way if you find the right position. 

At this point I am just trying to be appreciative of the opportunity to earn what I am at the moment as a travel RN. I may not enjoy it or be excited to go in, but it is allowing me to save and pay off my loans. 

I just hope I enjoy working as an NP and it turns out to be a career that I can get up every morning and not dread going to (unlike my travel RN job). I also like the idea that one day I can potentially open my own practice as an NP (weight loss, mens health, whatever I decide I like), so I think that has some value as well.

Thanks again for your thoughts. 

londonflo said:

Not the same as Medical School, Residency (you said it your self --  MD residents doing 90 hour weeks)  Training along with them? like osmosis your absorbed the knowledge

Insight and experience are important to patients and the outcome achieved.  Symptoms with different solutions will come into play here. Everything is not solved with a prescription and I find your comments appalling.  It is a "not all sizes fit all".

I went to a psychiatrist because I had gained weight, slept too much, was not active. Sounds like depression, Right?  Every visit does not need a psych RX!   Instead of a psychiatric Dx, he investigated my TSH etc. Got me into the endocrinologist in my city and I  am now back to my normal activity level. NO, NO, no writing an RX for me..... great accurate assessment and Dx. I think your understanding of the role of an NP is limited. I don't want to go to someone just  for RX

Let's just agree we have different viewpoints. 

This is bare-bones basic medicine. Ordering a TSH is literally standard investigation I do every time I see weight gain, fatigue, cold intolerance, flat mood etc. Bravo. If you don't think overburdened PCP MDs miss hypothyroidism or other endocrinological or rheumatological disorders you are foolishly wrong. Wanna know how I know? I see it every day.

To be honest I have no idea what you are rambling about. I didn't just train alongside them, I did the same resident cirriculum, wards, specialty rotations, grand rounds/presentations etc. This wasn't a job shadow.

What do you do again? You seem a little over your head and you are doubling down. Never a good combo. You don't know what you don't know.

Let me break it down for you again. At my job, I AM interchangeable with an MD. We literally split the patient list regardless of difficulty and go about our days. They are there if I have questions. That's it. You are turning this thread into something its not.

1 hour ago, Tegridy said:

Well to bring it back on topic. Personally I would do traveling as it pays more than being an NP at least right now. By a lot at most places. I doubt traveling money will last but there seems to be a surplus or NPs right now and it will only get worse for them. Whether it’s ground in logical basis or not a lot of patients want to see a physician. Hence why we get offers for 300+ for the same outpatient pcp workload as an NP making 80-130ish. 
 

no idea where the future will head but I wouldn’t work for 80-130k as a provider. Not worth it after all the work and time we put in. 

To this, I agree. Honestly to all the travellers and staff RNs out there, milk the incentives from the hospitals for all they are worth. NP salary for the work is honestly piss poor and I grow envious of the staff nurses making more than me. Run with it as the nursing shortage isn't going away. People are realizing the job isn't all it's cracked up to be, but young women (and men to a less extent) are still getting swooned via traditional nostalgia into the teacher/nursing professions. They then subsequently dip out after a few years for a myriad of reasons.

Love or hate the job of being a RN you are not going to find the land of milk and honey with being a NP. Only mediocre money and the expectations that you are do MD work at the same.

You can't have your cake and eat it too.

Specializes in Former NP now Internal medicine PGY-3.
Numenor said:

To this, I agree. Honestly to all the travellers and staff RNs out there, milk the incentives from the hospitals for all they are worth. NP salary for the work is honestly piss poor and I grow envious of the staff nurses making more than me. Run with it as the nursing shortage isn't going away. People are realizing the job isn't all it's cracked up to be, but young women (and men to a less extent) are still getting swooned via traditional nostalgia into the teacher/nursing professions. They then subsequently dip out after a few years for a myriad of reasons.

Love or hate the job of being a RN you are not going to find the land of milk and honey with being a NP. Only mediocre money and the expectations that you are do MD work at the same.

You can't have your cake and eat it too.

People realizing there are better jobs out there in non healthcare sectors. Most healthcare jobs are just a protracted and expensive education to do something less than glamorous for a mostly unappreciative and uneducated  population. 

The worst customers are the ones who can't pay.

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