Outpatient/primary care question: any opinion on pregnant patients seeking care through their PCP for illnesses further along in pregnancy? For example COVID infections, fevers, acute illnesses. Recently I have encountered the opinion of physicians who think the OB should address these things after 20 weeks. Do your offices ever question or push back on patients making appointments?

I just left my first NP job after 14ish weeks total and I feel like the light excitement and enthusiasm of this career was knocked out of me. I would love to hear about people that had a rough start and are happier, please. Low key considering getting into the admin side of things.

Any government employee NP’s taking this Fork in the Road offer?

Just curious to see if there is anyone actually interested if in a position where it is actually beneficial to them.

I’m needing some advice. I’m dealing with health conditions right now. Hyperaldosteronism, and causing me anxiety and depression. I have to drop my class. I’m also planning to shift program from AGACNP to FNP. Should I wait til I have my conditions well managed before starting class? And is FNP more doable since i’m dealing with mental and health conditions? Thank you.

Hello fellow NPs!

I am an FNP for 2 years. I have a cousin who just graduated from an NP program outside of California in Vermont. He just passed the AANP FNP exam! He is in the process of applying for a California NP and Furnishing License.

His application was partially approved. He has an NP License BUT NOT his Furnishing License. Because he took his course of Advanced Pharmacology outside of California, the State requires him to ask the Dean of his NP program in Vermont to sign a form called "Advanced Pharmacology Verification Form" (You can find it here). The Dean refused to sign it multiple times even though my cousin has tried several times proving his point that the class is aligned with the objectives listed on that form. He also provided proofs by showing the Dean that the class's objectives correlate with the requirements of the State. Without the form, the State won't grant him a furnishing license.

He is planning to take another Advanced Pharmacology course at West Coast University in Anaheim, California. That class has 3 semester units which correlate with the State's requirements. Do you think that after he finishes the class and sends the State his transcript of the class, he will be able to obtain the furnishing license?

He asked me how I would go about the issue in which I don't know how to help him which is why I am asking for your help!

Thank you so much in advanced for your help and inputs!

Just wanted to know what your experience was if you went here for FNP. I have infants at home and online is the best option for me but I like this layout better than Chamberlain. They have a more detailed application and they don't have rolling start dates. They also seem to require more clinical hours than some programs I have seen. I really like that they have a 3 day orientation and then a 5 day clinical bound session on campus.

I'm looking to transfer here and just interested in anyone's experience with flexibility, clinical, classes and advisors.

Thanks!

Looking ahead into the future I think I'd like to eventually open or aqcuire my own business one day and was curious about a few things. My state has FPA after certain hour requirements are met. I know without FPA a collaborating physician is required.

Does anyone have experience with owning a business as an NP and hiring other NPs or PAs to work within your business model? Do you pay your collaborating physician per NP or hire the physician on a salary? What if you expanded to multiple locations?

I've seen that depending on volume and the type of practice, collaborators are usually paid $500-$2000/month for collaborating with a single NP. How does this amount scale?

I know an option would be to advertise for NPs w/ an autonomous license at a higher pay rate as an incentive but that would make hiring more difficult, especially in smaller areas.

An example would be opening an Urgent Care: most are fully staffed by APPs, you would need a collaborator to cover all your APPs.

TIA

Does anyone have advice for getting back into practice as a FNP after an extended break? Straight out of school I worked in a specialty for several years before taking about 4 years off to be a stay at home mom.

I feel like I have A LOT of catching up to do in order to transition into more of a family practice environment. What would you recommend for brushing up on clinical guidelines, etc? Any other general advice you can offer?

I know this has been asked and answered before, but I can’t find it. I work in an FQHC, my malpractice insurance is up for renewal, and contemplating whether or not to really renew it. I do believe in the previous thread regarding malpractice insurance, that someone associated with risk management said it was not worth having malpractice insurance as you are covered by your employer, but to reach out to your risk management department for further information/discussion.

I don’t know that asking my risk management department would give me reliable information because I would assume that they would want me to use my coverage before they would offer to cover me if they knew I had insurance.

Also, I thought I read that it reflected on the provider poorly if they let their insurance lapse and so I don’t want this to be a sticking point in my history for future employment.

Appreciate thoughts and feedback.

I’ve been a nurse for about 4 years now. The past year and a half I’ve been per diem so I can take care of my 2 small children (2yo and 5 mo) full time while keeping my license. Recently I’ve been wondering about the NP route. I guess I just want to know if it’s worth it. I’ve heard it’s such an oversaturated field. Plus I’d really just want to do Emergency medicine but I haven’t seen many NPs in that field.

Anyone know of companies that allow you to start your own practice quickly? Similar to Mindful Therapy or Talkspace? I have my own panel and looking to start my own practice but I do not want to deal with the billing/insurance part of it.

For context, I’m FNP who has worked in psychiatry x5 years, but all of the psych companies with only allow you to partner with them if you have PMHNP, which is incredibly frustrating.

Any one know of any more generalized companies like these? Basically 1099 positions and you bring your panel they take care of the rest?

I’m interviewing for a new job and I was told that the doctors get free parking right outside the building but the NPs and staff have to pay $80 a month to park in the garage across the street. Apparently, there are enough spots for the 5 NPs, but that’s just how it is. This doesn’t seem right to me! Anyway, I’m asking for a salary that I’m comfortable with but preemptively thinking about negotiations. If they meet my salary request, I was going to ask for an extra $1000, which would equal the yearly parking plus hassle. What do you all think of all of this? I also feel really bad for the “staff” who make way less than us.

This has to be a joke lol

If not, then they better stay away from the nurses station.

That’s our “sacred place” 😂😂

See if I make another Doc a graham cracker pudding parfait 😂

I have 2 job offers - one is outpatient allergy, immunology and rheumatology, M-F 8:30-4:45. The second is inpatient ortho, Tuesday-Thursday 50/50 nights and days. I would have to obtain my RNFA for that position which they would pay for and I would do my training hours on the job. I have a 5 month old daughter at home and the thought of being away from her 5 days a week kills me, but I also don’t know if I want to go back to working nights and possibly holidays, as well as doing the RNFA program. I’ve also never been in the OR before so I’m not sure if I’d even like it. I’m so conflicted bc outpatient seems like a good gig, will probably be pretty cushy but inpatient has such a good schedule except for the nights. Which would you choose?

I’ve seen a ton of resources on the forum, but wanted personal opinions on a good study approach. Did you all just take notes? Make flashcards? Only do questions? Focus on memorizing info? I am currently in the middle of watching Sarah Michelle’s videos but unsure how to optimize it. I find that the questions are quite comprehensive, and so I’m unsure if I should maybe focus more on content review for now.

Any suggestions would be appreciated. Still trying to find my groove. TIA:)

I am beyond frustrated with how outpatient offices are managed. Too often, office managers have minimal qualifications—sometimes just a high school diploma or an associate’s degree—which, in my opinion, is not enough to effectively run a medical office. Managing a retail store is one thing, but overseeing a healthcare facility with real patient outcomes on the line is entirely different.

A perfect example: My office hired someone who struggles with reading and writing skills—simply because we were short-staffed. This is a direct reflection of poor management and a failure to maintain proper hiring standards. How does something like this slip through the cracks? And to make matters worse, it took forever to get rid of this person because management needed documented mistakes before taking action. Meanwhile, patient care continued to suffer.

These unqualified managers, in turn, fail to properly oversee underqualified medical assistants, leading to serious issues. Patients are left waiting over a week for simple medication refills—something that takes less than ten minutes to process. Delays in routing medication requests, unanswered medical messages/questions are all becoming far too common, and it's unacceptable.

Is anyone else experiencing this?

I’m still early in my career in the medical field, and experiences like this are already leaving a bad taste in my mouth. Very disappointing.

Hello! I am looking for some advice on treating patients for asthma. I recently took over a panel of patients and I am having quite a few few of them who are just on albuterol and some of them are also on fluticasone or other steroid.

A lot of these patients are taking their albuterol frequently and current guidelines say to prescribe a medicine like Symbicort and then have them continue with albuterol as needed.

I have lots of patience reluctant to make this change and just curious how other people have navigated this?

I've been thinking about going the NP route for a while. Probably either acute care or FNP but I'm also curious about psych NP. I'd appreciate any insight you can offer. What environments do each typically work in and what does a typical day look like? I live in Arizona and I know sometimes the answers to these questions can be state-specific thank you in advance

I don’t have much experience with peds so I’m not quite sure about FNP. But I want to know if AGPP NPs will be able to find jobs? Is it hard? Can you still specialize like FNP? Can you work in urgent care like FNPs?

I got accepted to a legitimate school (Ivy League), not degree mill so the name of the school won’t be an issue.

Hi my fellow NPs and PAs!

I am a relatively new FNP in California. Due to some unforeseen factors, the currently clinic is about to be sold to a corporate and the current staffs, including me, are being replaced by the corporate's new staffs.

I got a new job letter from a connection I know during work, and I need your *constructive* inputs, opinions, and thoughts to negotiate my terms next week.

Pay: 166K annually. Bi-weekly. The contract doesn't state potential yearly pay increase.
Shifts: 8-5 full time with 30min lunch.
Patients: Toddler to Elderly. 20 patients minimum in 8-hour shifts. Starting from the 21st patient, I get paid $35 per visit.
PTO: 7.69hr per pay period (bi-weekly). 200hr max a year. This includes paid sick leave and vacation. Must be notified at least 30 days to get PTO approved.
CEU: $1500 max per year. If I had to travel for CME, I must use PTO.
Insurance: group dental, medical, vision after 60 days. DID NOT mention mal-practice insurance.
401K: No 401K match.
Bonus: sign on bonus of 10K distributed in a year. If leaving earlier than a year the sign on bonus must be repaid.
Employment Status: (This is what scares me. I am stating this verbatim) "the position is exempt from the Fair Labor Standards Act, and employee is required to provide a minimum 60 days' notice of resignation for appropriate transition of patient care."

what are your thoughts on this job offer letter? Should I specify with the HR about the yearly increase, the malpractice insurance? If so, what should I ask them about the malpractice insurance? Should I ask if they can at least pay for it partially?

What about the "Exempt from the Fair Labor Standards Act"? Does it sound fishy to you? Does it mean that if I have to work overtime, I wouldn't get paid 1.5x my base pay? What should I go about it?

Thank you so much in advance for your constructive thoughts!

I’ve been a nurse for 6 years on a busy, chronically short staffed med surg floor with less than optimal management. I just got hired onto an inpatient surgery service at the same hospital, and I’m very excited, but I’m also incredibly scared. I want to be the best nurse practitioner I can be, and I don’t want feelings of burn out/moral injury to wear me down. For those with a similar background/experience, does it get better? Physically, I know being an APP is generally less demanding. I’m just scared that I’ll develop these feelings burn out again and that they might impair my learning and practice.

Edit: I did not become an NP to escape bedside. I genuinely love to learn and want to do more for patients.

Hi everyone! My MA takes on average 40-65 minutes to room a patient, she’s a new grad as am I… my visits are only suppose to be 15 minutes and I’m starting to get really stressed out about my schedule opening up. They tried to already, and we had to go back to the old schedule in turn making me look bad. Does anyone else’s MA take forever? Every time I go in the room to try and force things to wrap up, she gets pretty upset with me. So I’m just curious what the typical rooming time is? Or any advice? She already doesn’t alert me on abnormal vitals, and most heights are incorrect so I also spend my visit re-doing blood pressures/heart rates/getting a pulse oximetry/height. She’s lovely as a person, I don’t want to create drama or get anyone fired but my goodness I’m always behind/missing meetings which is making me look like a horrible new grad provider.

I graduated as an RN last year. My goal was to always become an NP working in a clinic setting. I’m planning on doing an online bachelor program this summer. I work in an outpatient pain management setting. It’s all procedural, so basically pre-opping the patient, caring for them afterwards, and sedating them when in the room.

I’ve heard mixed opinions about whether or not you need bedside experience before NP school. I don’t plan on working in a hospital once an NP, and my schedule with my kid won’t allow me to work bedside now.

The school (in person rigorous program - not a diploma mill) requires one year of registered nursing experience. Would outpatient experience suffice?

I’ve got an interesting opportunity that I’m considering taking but I’m curious if anyone has had a job where they see patients and keep a percentage of billing with the remainder going to the company that you work for. I currently work a side gig at an inpatient facility that’s cake. Super low acuity, 5-10 minutes per patient, split the billing 55/45 in my favor. The “group” I work for is a physician who owns the contract with the hospital. I’m 1099. Good business model for us both, passive income for him and easy money with low time commitment for me, able to see 15-20 pts in 3-4 hours in the morning on a day off. New job opportunity is working for the same physician but in an inpatient setting with much higher acuity with most patients being level 3. Complex notes and see all patients daily. On call overnight the days I work. Also 1099. Has anyone had any experience with a setup like this? My question is what is a reasonable percentage to try to negotiate? 55/45 is fine for the easy stuff but I feel like with a more complex job where I’m doing literally all of the work, (this is a 7 on 7 off gig) the split should be more favorable to me. To be fair, the reimbursement is nearly twice what the easy job is but I easily spend twice as much time per patient. Any advice would be appreciated.

Looking for words of wisdom, great books/apps to prepare. If anyone currently works in this subspecialty - tell me what their experience is like! Have my 3rd and final interview with a cardiothoracic group - non operative rounding in the clinic and hospital with room to learn operative. For background I have experience in ED and medical cardiology.

Any thoughts 💭 about FNP program at UWF

Hi everyone.

I recently started full time in an urgent care. I am a new grad. I am feeling so overwhelmed/burned out. I am regularly working 13 hr shifts and lots of evenings. Sometimes I have 7 hrs off between shifts before I have to come back. I usually stay 2-3 hrs after my shift to see patients that came in right before closing and to chart. My own family has been sick the evenings I am home, only 5 in a two week period. I see my husband 3 week day evenings and every other weekend in a two week period.

I genuinely like urgent care, it was where I wanted to be. I like seeing the patients for the most part. It is just really busy and I am having to take charting home because I’m slow. My manager spoke to me for being 2 minutes late one day even though I stay 2-3 hrs past the end of my shift regularly. Everyone keeps saying this year is worse than normal for illnesses. We are also short staffed. I just feel frustrated with my job right now.

Anyways, please tell me it gets better and that everyone’s first year or two or three is hard. Just feeling exhausted mentally.

I’m a long time ER nurse thinking about getting my ENP, but I’m also kind of over night shifts. At my hospital mid-level providers work 3 night shifts in a 2 month period. What do other hospitals do?

Exactly what the title says- wondering if anyone has a list of NP friendly countries and what you have to do to practice there. Also interested in anyone’s experience who has moved from the USA as a NP to another country

I'm in a small and new practice for geriatrics doing home visits. Currently we are using point click care EHR which is new and frankly, terrible. We are mostly in ALF and independent living facilities. I have used gerimed and really liked it. We want to be able to have the ability to do prescribing via the EHR. Does anyone have a similar set up and an EHR they like or that they know is not a good fit? Thanks!