Your advice, please!

Trauma Columnist · Jan 7, 2018

21 pts a day for a new grad might be a lot. Is there an orientation to slowly ramp up to 21?

FullGlass, BSN, MSN, NP · Jan 7, 2018

Please give me your thoughts...
After finishing school in December, I have temporarily moved to Los Angeles and started looking for jobs. For now, I have two possibilities:
Â· A thirteen-week travel assignment (RN) at a hospital, where I'll be taking care of 4 Med/Tele patients at a time. Patients will be in an ER holding area (hallway). The hospital has a very busy trauma center, which means patients will be in and out of my care rapidly. The start date is 1/21, I have to make a decision by Monday, and the pay is as follows:
o $18/hr. + OT after 8 hours
o $1,100.00 weekly tax-free stipend
o $448.00 weekly tax-free M&IE
o Total weekly gross/before taxes, based on 36 hours a week: $2,304.00
o $400 travel allowance paid after completion of 72 hours
Â· A second interview (on Tuesday), with an FQHC clinic, the expectation will be to see 21 patients a day. We haven't discussed salary or benefits, yet, and I don't know when the start date will be.
I'm leaning towards the NP possibility, but what if I don't get the job?
I appreciate any suggestions.

If you are an NP, then you should work as an NP. There are other NP jobs in LA besides this one. As far as the NP job you interviewed for, did the FQHC indicate they were going to make you an offer? When you are interviewing for an NP job, you need to ask about the ramp up and orientation time. This is something you may need to negotiate.

If you need a job quick, have you considered doing some RN locum tenens work until you land an NP job?

Dodongo, APRN, NP · Jan 7, 2018

If you are an NP, then I would say working as a NP >>>>>>>>>> working as a RN. ?

SpankedInPittsburgh, DNP, RN · Jan 8, 2018

Yeah. I'd pull the band-aide off and do the NP gig.

allnurses Guide · Jan 8, 2018

21pts a day as a new NP in a complex medical population is going to be very difficult and time consuming.

Honestly, I'd look for other jobs at the NP role.

Neats, BSN · Jan 8, 2018

. It appears you have a lot of experience and more than likely should already know which direction you want to go. I would weigh each one carefully the pros and cons as to what your goals are. The one that matches your goals then that would it seems to me be the one you want to go with.

Lastly in California I believe they have patient ratios that are mandatory and I have always seen California pay is higher than say the rest of the United States, your scenario (to me) does not reflect this...but it maybe just me. Not sure if you are a NP but I would work in that capacity...again the pay does not reflect that though.

CardioQueen · Jan 10, 2018

If you are an NP then why would you work as an RN? I agree with other posters that 21 patients a day is a bit much for a new grad NP. It is a FQHC so a lot of episodic visits, health screenings, etc. and the complexity will likely be different based on geography. Negotiate the orientation period so that you may work up to 21 patients a day. It is possible if you develop a consistent, streamlined technique (which takes a little planning and time to master). Be an NP!

As a new NP I worked in an urgent care center that had similar requirements despite the 'walk-in' model. Some days I had 15 patients, other days up to 35.

I developed a plan that kept my clinic flowing. You just do what you must to give the best care to each and every patient...don't let the clock short change your care and work ethic (just my $0.02)