Unemployed Vanderbilt FNP

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Specializes in Tele, ICU, Staff Development.

Dear Vanderbilt FNP,

Congratulations on your accomplishments! You will get a job! It's just a matter of when and where. Never give up.

Not all employers view advanced practice registered nurses (APRNs) as overly qualified RNs. I work with several APRNs in my hospital who are employed in various RN roles. Here's the difference - many of them worked as RNs while going to school, and stayed in their RN role or used their advanced degree to promote within the organization.

If you get a job as an RN, keep in mind that an FNP working as an RN is held to the standard of care of an FNP in court. In an emergency situation, for example, that may mean practicing outside of the RN scope of practice for which you were hired.

While there are differing opinions on whether it is better to have RN experience before obtaining your NP and whether it makes you less employable, your problem is a basic one of landing a job without experience.

The principles of job seeking remain the same.

  • Compelling resume and cover letter
  • Interviewing skills
  • Networking

You say you are being given reasons for being turned down for both RN and FNP jobs, so I presume you are getting interviews? If so, that means your resume is effective in getting you noticed. Good job!

During an interview, you must stand out, and persuade the employer that you are a good fit for their organization. Be familiar with their culture, mission, service lines, etc. Be prepared to answer Why should we hire you?”

Start aggressively networking if you are not doing so already. Join local and state organizations. Ask every NP, MD, and nurse you know if they can recommend anyone for you to contact. Are you in touch with your classmates and former professors?

Consider relocating. Are you in an area with a poor job market for NPs? Research different areas and start applying.

Be patient and be persistent.

Your observation about PAs and NPs being held to seemingly different standards and perceptions is worthy of another post!

There are some highly informed APRNs on the site who I hope will chime in with insight from their experience.

Best wishes, friend

Nurse Beth

Just read a great article 7 Social Media Posts that Will Destroy Your Career and these related articles:

Top States and Hospitals for Nursing Jobs

Do you have an Elevator Speech? No? Why You need one

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Specializes in Nephrology, Cardiology, ER, ICU.

As an APRN in a market that might be unforgiving to an accelerated program grad, I endorse networking by using your states APRN organization or your specialty organization (in whatever specialty you would like to go into). I would also consider contacting past preceptors for possible openings. Have you considered non hospital jobs like NH, LTACH or clinic

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Specializes in ICU.

This is exactly why I tell people to not do those direct entry programs. I don't understand how one can earn their masters or doctorate in anything if they have never practiced. They only way you can master any subject is to practice it beforehand. I always wonder how someone can be considered an advanced practice nurse if the have never practiced the art of nursing.

physicians spend a number of years in residency before being able to independently practice. I honestly think that if someone who has the capability to diagnose and prescribe, it should be the same thing.

i am not saying at all that a FNP shouldn't have these capabilities, just that they need some solid years of experience first. Schools should not be able to offer these programs. I think that coming out of school with a FNP degree and no experience cheapens the degree and how people view nursing in general. I think more respect would be given from the rest of the medical community if these types of programs didn't exist.

I know many people will disagree with my point of view, but with NPs becoming a big thing over the past few years and pretty much the future there needs to be some good, safe practices in place. If I had spent the time and money to be a FNP, I wouldn't want to do bedside or work for the pay of a bedside nurse. And I am sure that is what employers are thinking also.

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Specializes in Nephrology, Cardiology, ER, ICU.

You bring up a valid point. However, since she is now an FNP...she is kinda stuck in the middle. (@OP (original poster)), please don't take this as criticism of your career journey, just that you might need to try some unconventional methods to secure your first position.

There are some threads on the NP forum also about home Medicare assessments - let me give you some links:

https://allnurses.com/nurse-practitioners-np/in-home-assessments-979696.html

https://allnurses.com/nurse-practitioners-np/united-healthcare-housecalls-770269.html

Hope this helps....please let us know how you are doing.

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In PA, the Geisinger system has a lot of APRN jobs, hospitals, outpatient offices, and even retal clinics for FNP. Good luck.

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aww :(

I live in Baltimore City it may be worth looking into--community clinics are always looking for FNPs.

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I would like to suggest working in a correctional facility as a NP. I this setting you will have the opportunity to work with inmates with chronic care. The inmates have many disease process you may never see in the community. Just a thought.

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Specializes in FNP: Urgent Care & Primary Care; RN: Med-Surg.

Dear Heathermaizey,

I have read your comments. Although, I am a bit confused as to why you would write to offer criticism instead of relevant advice. However, your comments are not unheard of and especially not new to me and my Vanderbilt cohort. Imagine working our RN clinical rotations with openly hostile nurses who were supposed to be teaching and modeling patient care. They instead offered disappointing and snarky comments for 12 hours. There were however, other nurses who modeled nursing perfection. They focused on the care of the patient and really cared about training another generation of RNs. I have the upmost respect for these RN's. They are what I want to grow into being

Yet, I acknowledge your concerns about my cheapening” the nursing career. I wonder as an experienced RN are you aware of the current ongoing controversy among BSNs, ADNs, and Magnet status hospitals. I digress. But I must ask. How much experience did I need as an RN before becoming an NP? What type of RN experience? Let's say I was a psych nurse for 20 years and I went back to become an ACNP. Would that be okay? If so, why? Wouldn't I needed to quit my psych RN job, work a year in med-surg so that I could qualify for ICU and then work in the ICU? How long should I stay in the ICU before it is appropriate to seek further education? Would it not also depend on the person? I see. I am an FNP. So I should have worked maybe 5 years as an RN? Certainly not as a bedside med-surg RN! Perhaps I should have worked in a primary care clinic? The only problem with that is, I don't know about your PCP, but with mine, the RN does not come in the room with the PCP. What to do?

Maybe I should have become a PA. That would have been okay. If that is okay by you, what would be your reasoning? Is it the one about they are trained under the medical model and NP's are trained under the nursing model. That's a very pessimistic view of NP's. For years we have been advocating about our safety and cost-effectiveness then in the same breathe say, But you should totally go see a PA because they have better training.” Am I the only one that doesn't understand? I suppose so.

A CNA that I work with told me one day that all RN's should have to be CNA's first. How far should we take this? Paralegal before lawyer, dental hygienist before dentist, teacher's aide before teacher. I fear that we are still giving pregnant women orange juice to induce labor and Castor oil for constipation. Since you are already an experienced nurse, you know that evidence has proved that Castor oil is Category X. Things change, evidence changes, practices change, traditions change.

I assume if you and other nay-sayers are still serious about this you can advocate through your local nursing organization. You could write letters to schools that offer DE programs such as: The University of Alabama at Birmingham(#13), University of California Los Angeles(#19), Yale University(#22), Johns Hopkins University(#2), Boston College(#34), Columbia University(#11), University of Pennsylvania(#1), Vanderbilt University(#11), Marquette University(#51), + many more. The numbering beside the name indicated the ranking with U.S. News & World Report, 2015 Best Graduate Nursing School.” I do not mean to insult your intelligence because I know that as a seasoned RN this is not news to you.

I hope you truly understand that I have absolutely nothing against an experienced RN, absolutely nothing against a PA. We do the same thing only on different levels and with different education. Direct entry NPs are no more or less an NP as one who had 20+ years of experience. We all take the same entry level exam. My cohort did not enroll in school with the intent of tearing down and demeaning experienced RNs. So, why do it to us? My degree does not negate your experience and hard work. On the same hand, your experience does not negate my hard work and degree. I do not like to tear down people who do not share any of my struggles and who do not learn the same way I learn. I wrote to Beth for legitimate advice, hoping readers could see me in themselves and offer heartfelt advice to help a fellow RN. I was aware of your type of bias; I did not however, imagine on this site that people would be rude to me. Besides being off topic, this was not the place for that. I don't understand why we cannot work together to build up the profession of nursing. Why would I want to pursue a career that I thought was cheap?” In your years of nursing don't you remember when M.D.'s said that NP's were cheapening” medicine? We are doing the same thing to each other, it's ridiculous, and it is time to stop.

I would love to engage you in real meaningful conversation. PM me if necessary.

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Specializes in FNP: Urgent Care & Primary Care; RN: Med-Surg.

I never thought about that! I could probably get an good understanding on HIV/AIDs and maybe Hepatitis. I will look into this. Thanks!

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Specializes in FNP: Urgent Care & Primary Care; RN: Med-Surg.

Thank you so much. I never thought of Housecalls. I honestly thought that maybe I didn't qualify for this. There is a local owned 'housecall' nursing business in my small town. I occasionally go to Bible study with an RN that works for them. Perhaps I will ask her about it.

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Specializes in FNP: Urgent Care & Primary Care; RN: Med-Surg.

Dear traumaRUs,

I wanted to tell you that I sent in my resume to my local hospital. The hospital administrator called me for an interview!! He said that he was very impressed and thought that it was such a lucky coincidence that I lived so close with my education. He offered me the next FNP position! He stated that one longtime FNP is leaving and that I was welcome to train with her before she leaves. In the meantime, I am working as an RN at that hospital. He told me I could start that day! Jokingly of course. I want to personally thank you for being open-minded about me and my situation. It means a lot for someone of your experience to help me just starting out. Your support is immensely appreciated. Is your specialty trauma? I would love to pick your brain sometimes. I work with an RN who has been an ICU RN sine 1975!!. She came to our floor to work out her last years. She is always telling me stories about her experience. It is fascinating! I don't think I'm in the trauma/ICU mindset, but it is great that she is willing to teach and share her experiences with me. You guys are the type of RN's that I look up to. Thank you so much again!

Regards,

AnaLong

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Specializes in Long Term Acute Care, TCU.

Reminds me of a bodybuilder quote "Everybody wants to be a bodybuilder....Don't nobody wanna lift no******* heavy weights."

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