I've been doing some minor looking into advancing my education after almost 2 years in the ICU as an rn with just an associates. I know BSN is practically useless for most practical purposes but I understand its a necessary stepping stone for further things in my career. What is the process like for moving forward as an ADN nurse?

I want to travel nurse for a few years after this year is up and ideally if possible do a large portion of the schooling online during that time. What would online NP school be like, is it a thing? How long should I expect to need to go from ADN to NP?

Saw this on r/nursing. https://archive.org/details/20250128-cdc-datasets

I an in a state where a non-medical person can own a practice. I am considering starting a concierge practice as an investment and to benefit the local community.

There are several practices like this in the area and they all have multi-year waiting lists. Because we are in a more sparse (but fairly affluent) area, getting on with a PCP is also a several year waiting period. Bottom line, there are far more patients than their are doctors or NPs.

NP have full practice authority in this state. I am considering making an offer to my PCP, who is an NP, to work with me on establishing a concierge practice. He is getting terribly burned out where he is and seems pretty miserable. However, he is excellent and really seems to care about his patients. He has greatly benefited me and helped me to make some significant improvements in my health.

I am curious, from the NP perspective, would something like a concierge practice be attractive? It would be fee based, probably $150/mo to be a member. No insurance billing. We would look to cap out at 500-600 members. Well-patient visits and some sick visits are included. If ill, we would guarantee to see you within 48 hours. Where we are, less than two weeks is almost impossible.

This is really in the preliminary stages, just an idea with some research right now, but funding is in place if I want to go forward. As NPs, what would make this attractive to you? Have any of you worked in a practice like this? What did you think of it, if you did?

*Edit* I think I was not clear what I was asking, my apologies. Not looking for an analysis of my business plan. I have an accountant, consultant, and attorney for that. What I am really looking for is the human element. What would make this attractive to a NP?

For primary care and post-acute care

I don’t see much discussion about them in this forum. Are you all sending scripts to (reputable) compounding pharmacies?

Has anyone ever been to a Pri-Med conference (in-person)? Do you know if you have to attend every single session all three days or can you pick a choose which course you’re most interested in. I’m actually thinking about skipping out on the control substance parts because I’ve already taken several for the DEA requirements. I rather be on the beach. 🏝️

Super excited to learn and have fun!

Hey all. Just curious, and for no reason in particular...do any of you know of any medical organizations that actually make a difference in the government? Like if there were any medically based organizations that actually make a difference and help hold the government accountable what would they be?

Thank you!

I'm totally burnt out, I don't know where to turn.

I'm trapped in a high acuity speciality with low pay. Yesterday I was just bombarded by consults when I walked in the door, and didn't stop the entire time. I didn't sit down beyond charting after I saw everyone. I didn't go to the bathroom. I didn't eat. The hospitalists were overwhelmed. Everywhere I turned there were errors from the primary team I was trying to fix. A person with hemoptysis on lovenox and aspirin. A person on Augmentin and Zoysn. A person who had maintenance IVF running for days and went from 2lpm to BiPAP and was obviously volume overloaded. The office kept sending me messages about patients calling in. I told the manager to stop sending me office call as I was running around like crazy in the hospital. I'm sick of working like this. As I walked out the door, more consults came in. I turned my beeper off, and signed out, and didn't care. I came home, worked out, and then just started at the wall, decompressing. I'm not getting any RVU's working like this. I'm just running, running, running.

Who else in America works like this outside of healthcare, the military, first responders and some front line service people? I don't mind working for my money, indeed I expect to-but why can't I just have a second to think, or say hello to people? Why can't I just have a moment to crack a joke, or eat? I know all professions have their downsides-there is no perfect situation. I'm tired of being told "You signed up for this." No, I signed up to help people, not to be abused and worked into the ground. The pathos in medicine to "suck it up" is just stupid and allows us to stay in a dysfunctional broken system. It's masochistic. The joy of seeing patients and working through a cool case is gone when you are put on an endless treadmill seeing sick patients without enough support. You focus on not missing anything and trying to help them without hurting them. You can't get the joy of working with them on their case and truly understanding their situation and constructing a detailed treatment plant to help them.

I'm trapped in a crappy region for NP's with abysmal pay. I'll have to move and start over in a region where I know no one if I want to ever be payed what I'm worth. There is no negotiation here. You either take a crappy salary or leave. My region is famous for being awful for PAs and NPS. I'm not young, but I'm not old. I'm middle aged. I'm scared if it doesn't work out when I move, I'll be stuck in a new area alone without help.

I oscillate between just leaving healthcare entirely and switching careers (not easy) or moving and starting over in a new city socially (Not easy).

I feel so trapped and defeated. Thanks for listening to me vent. I needed to tell someone. I'm not expecting consolation. If I am truly honest, I regret ever doing this. It's a dead end career with endless abuse. The only joy I get is from helping people and seeing a patient get better, I truly do enjoy helping people and protecting patients but I can't do it anymore. I just feel like I'm trapped in a cage. I know I have to save myself.

This is kinda a feeler for people with the job market; as a DNP-PMHNP student going through a large state university, my clinicals placed and all- still seeing mass gold rush of students going into Psych NP at easier programs online with no limits, and the saturation of enrollment & licenses being granted for it- and lack of job listings around compared to a few years ago.

Despite being a Psych nurse I’ve found many opportunities to also use my previous hand on skills with procedures to jump in first when IVs needed or minor procedure re-doing G-tubes- or trach’s as we take on a lot of the special / medically complex psych patients no one else will. And at a second job at LTAC I’m rounding on lots of severe injuries / trauma. I’ve wondered if perhaps it’d be more rewarding and available to switch to AGACNP in my school and pursue more opportunities with that as a Hospitalist; someday later add the Psych cert for my mental health passion. The enrollment and licensing for Acute Care seems to be amongst the lowest, and I figured it’s because wheras maybe the learning curve for entering an FNP or PMHNP program is low, AGACNP involves actual procedures you must practice and learn with little room for screw up that scare people away. And I myself would love to learn and excel with more procedures or round on complex cases. The most common job listings I seem to see for NPs around me are inpatient hospital or hospitalist groups- also primary care still but that’s more because no one will take them for RN wages.

Curious to thoughts.

Hey everyone! Circling back with an update on a post I made 3 months ago on this sub regarding anonymous salary-sharing for clinicians. Thank you to everyone that contributed your salary to the Google sheet…..SO MANY PEOPLE CONTRIBUTED that the Google sheet has become too big to manage (I think close to 10K people signed up across all professions and specialties, including students and residents!!) This really validated the need for something easier to filter and access (and optimized for mobile!) 

Fortunately, TA (anyone that did the Google sheet got an email from him) has a big tech background and was able to cobble together a team to create a working website for all of this data for us to use! 

I’m sharing the link to the website below, it’s still in beta so please provide any and all feedback! We expanded the specialties, and tried to ensure the quality of data by letting practitioners claim their NPI number. Like the GSheet, the website is still anonymous and free.

Check it out when you have a chance and let me know what you think. As always, if you find the data helpful, please share it with your colleagues so we can really help to level the playing field and improve salary transparency for everyone. 

www.marithealth.com

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.

Edit: yall, I have no desire to take the offer. Just wanting to see if anyone else is and what their situation is if they are. I have not heard of someone taking it.

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?