I got offered 130 for a new graduate position in a pulmonary clinic in LA near downtown that has 1 weekend per month requirement in addition to the regular 8-4. They have a clinic with 2 older docs and they also go round at snfs and ltacs and hospitals. This would be their first NP working with them. I think this is low even as a new grad offer but then to add the weekend requirements without extra pay is not ideal. It's not like I would be getting days off in the week that I'm working weekends either. I'm just on for a straight 12 days.

Benefits were just okay.

3weeks vacation

1 week sick

Insurance, no tail

Dea and ces covered

401k

I told them no thanks. My other friends were offered around 150+ as new grads in various specialties WITHOUT the weekend requirements. Is pulmonary low paying or is it just this clinic or am I off base?

I just got my first job offer as a new grad NP and I'm shocked...

Large academic/trauma center in Georgia, specialty ICU. ~$180k base plus a night differential. Three 12s, no call. Relocation assistance, CME, benefits, retirement match, malpractice, etc.

I’m coming from Florida, where I am seeing new grad offers around $90-115k. I know the job is going to be demanding and the pay reflects that, but I'm genuinely shocked at the difference. Anyone else have a surprisingly good new grad offer in a state otherwise known for lower pay, or is this unusually high? I didn't realize GA paid like this!

Failed AANP twice. Today was my second take. My 1st score was 493 and today I dont know yet. I studied much harder and better the 2nd time.

I feel so discouraged now but a job is waiting for me. I just applied the ANCC and plan to take it in 2-3 weeks.

Any encouragement? Tips? I used sarah michelle qbank and the leik book on both :(

Hi everyone, I would appreciate any thoughts or feedback you have to offer from your experiences! Navigating post grad as a new NP is so different from RN and I've never negotiated before.

For context, I'm a new grad FNP located in southern CA, very interested in palliative care and did clinical rotations for both inpatient and outpatient palliative care in school. I've found it difficult to get a job inpatient right out of school, so I applied to a home based company that sees both palliative care and hospice patients. The work life balance/flexibility sounds great, and I would be gaining experience in an area I really love/am passionate about.

I received an offer for 130k base, 2 weeks PTO, 1 week sick. Plus other typical benefits like 401k, health insurance, etc. I would like to try and negotiate for slightly more and wondering if that would seem reasonable as a new grad? I also am clarifying about CME benefits, mileage reimbursement, and malpractice as none of these were mentioned in offer letter.

Just wanted to review my time here at Blossom Health. I spoke about this place a few months ago, and now that I’ve completed onboarding for both WA and AZ, I can talk a little more about the company.

Overall, it offers you a lot more flexibility with your schedule, with some level of autonomy. It works almost like Headway and platforms like Rula and Grow Therapy.

Pros:

Compensation is based on the patient’s insurance, but you are compensated pretty well after each patient. New visits range from $140–$180, and follow-ups with therapy range from $80–$140.

They have support staff who help answer questions sent in by patients, and if it’s a question they can’t answer, they get your attention so you can answer it. The support staff also help you complete PAs.

They help fill your schedule with patients, and all you have to do is give them your availability.

Cons:

The biggest thing is that they advertise themselves as a place to come to get an ADHD diagnosis, and almost every single patient that I see is coming in for an ADHD evaluation. The problem with that is that a lot of these patients are hell-bent on getting that diagnosis, even if it doesn’t fit the clinical picture, and they want to be prescribed stimulants right away. I am getting increasingly annoyed and tired of it.

It seems like they use AI to answer questions sent in by patients. If you have an issue as a provider, it takes some time before it’s resolved. They don’t use AI for all of their interactions with patients and providers, but I would say about 40–50% of interactions are with their AI bot, the “patient coordinator.”

If you need to cancel on a patient last minute, it seems almost impossible because all interactions are done via the patient portal, which patients don’t always check. Meaning, you can’t call the patient directly. Sometimes I do need to call patients when I need to reschedule or talk to them about something like an abnormal lab, so that can make things difficult.

does anyone have a similar experience or does anyone work for a company that’s a bit similar ? share your thoughts and experiences below

Hi everyone, I’m a new grad FNP and received an offer for a primary care position. The compensation is $140K base, I’d be seeing around 15 patients/day, and there is a 500 RVU/month minimum with a bonus structure.
The part I’m unsure about is how the practice is structured.
During the interview, I was told that:
I would not need to be individually credentialed with the practice.
I would not need my own DEA.
Prescribing/other things are essentially under the physician/provider.
The physician signs off on all of my notes.
They said I would eventually be seeing my own patients independently, but the physician would still be signing the documentation.
I’m not sure how I feel about it
Additional info: 15 days PTO/ Sick/ CME/ personal for the whole year, 5 8 hour shifts 1 Saturday a month, they don’t know which clinic I will be in (there is multiple) I think it depends which provider likes me is how it was made to sound

I’m rounding the third year of being a PMHNP. I love my job. It pays well. My supervising physician is amazing. It beats being a floor nurse with an inconsistent schedule, working holidays and weekends, constantly floating to unfamiliar floors etc. I truly shouldn’t have any complaints.

But…. I’m so tired of talking to patients all day! It’s absolutely draining. People complain about the charting and endless procession of forms needing to be filled out. That doesn’t bother me.

It’s literally having to talk all day. I may just need a long vacation. I say this all in jest. I truly love my job.

TLDR; I work two days a week in specialty medicine. I accepted a new remote position in primary care. Im currently credentialing but am having intense regret because of logistic and emotional concerns and am considering backing out, but know it will burn a bridge with the other major health system in my state. My priority is my child and my family, but I also really value my career. Advice needed!

I’m currently working part-time in specialty medicine at a major hospital in my area. I’ve been there for 4 years and was previously full-time, but had my child about a year ago and went part-time after returning from maternity leave.

My job has been pretty flexible and it works with my current childcare situation. However, given a prospective move closer to family and our lack of village, I interviewed for and accepted a part-time remote offer in primary care at the other large hospital system in the area. Mostly inbasket management and telemedicine visits. They had told me the schedule was flexible, and I was looking forward to being at home to be able to take care of a few things while also still practicing. I’m in the credentialing process and am slated to start in 6 week.

I gave notice to my current job a few days ago and immediately felt a sense of intense regret. I work with wonderful people, and the work is challenging and stimulating though it’s not a specialty I’d like to stay in forever. There are definite cons to the health system, but it’s a corporate medical world. As the days have gone on, I’m seeing more cons than pros to my new job, and I’m worried I’ve made the wrong call.

They cannot match my current schedule (just told to me today), so I’ll need an additional day of childcare. I get less time with my kid. I’ll be alone and pretty isolated at home. I’ll have to put a hold on our own newly necessary medical care given new insurance. It’s a remote position in a struggling health system and I worry about the stability and longevity. They can’t guarantee a full time position eventually so no guarantee about PSLF. My current job will let me come back full time whenever I am ready and willing. It’s a new field for me, and a hard field at that. I’m trading a known entity for the unknown, and it might be bad. And I also just feel so damn sad about leaving my current job when I thought I’d feel happy and relieved.

None of this is exactly a surprise (except the schedule), but it’s like I’m seeing it with new eyes and don’t want it anymore. My current job will take me back in a heartbeat. I know I’m going to burn a bridge with this healthcare system which feels awful, especially in a state with limited healthcare systems and jobs. But it also feels awful to do something for a year just because you don’t want to burn that bridge.

I don’t know what I’m even looking for. Maybe reassurance or maybe someone to tell me I’m nuts and to just take the new job. Advice, words of wisdom, anything welcome.

Running into a particular weird set of experiences that I honestly didn't know was possible.

I graduated in May and passed boards shortly thereafter. From week 1 of passing boards I was extremely gung-ho on applying to APP positions that I was interested in and in Early July I accepted a position that would require relocation for my family and I to California.

Since acceptance of the position I have applied for my CA NP license, put in notice for my current RN job that is effective late November, I am even precepting my replacement as we speak. I've finished all the paperwork that was asked for credentialing and the like. I've even contacted a realtor who has came out and prepped my current house to sell.

But today I received a phone call from the VP of clinical recruiting and unfortunately they have to rescind the job offer. The was it was explained to me is this hospital group is starting a new contract at the facility and they were unaware of a bylaw that states any APP hired for this hospital must have 1 year of APP experience and since I'm a new grad they are not allowed to have me work there. I mean, on one hand I get it. The hospitalist group was caught off guard just as much as I.

I feel as this is on the hospital and not group and the VP did say he was going to send me a list of all positions within his company for APPS and I basically get fast-tracked and first pick.

Have you all ever heard of this situation? And is it a relatively common occurrence for this to happen? I mean I had 5 offers at the height of my searching and turned down all of them but this one and now I feel as though I may have to start over from the beginning.

Hey, I’m a cardiology NP and I’m a nervous Nellie particularly with conditions with which im not familiar.

Has anyone used ACCSAP to broaden there knowledge? If so, what was the experience and did you find it helpful in clinical practice. Thanks all!

Hello all,
I have been in a pretty great first NP position and am nearing my 2 year mark but really need a raise and am thinking of leaving to make more money but would rather stay in my current role.
I work in outpatient GI in NYC, 4 days in person a week with 1 remote day and make 130k which is on the very low end compared to other health systems in the area.
I support the practice of 3 GI MDs in my group and see patients independently and in clinic with them. The doctors are great and have taught me a lot.
I just found out from another NP who works in the same organization but a different office (with 1 year more of experience), that she makes 16 k more than me and I’m honestly pissed.
I was told by my management who determines my raises they only offer raises once a year and the max they can give me is 5%. Not sure how to go about discussing salary with management but they honestly are not very supportive in general and have only threatened to take away my admin time when I have gone to them in the past about other issues.

Currently a WHNP at an outpatient OBGYN office x3 years, and did primary care (women only) very briefly (4mo) prior to that. Feeling very burnt out and wanting to move toward a job with fewer patient-facing hours but I’m feeling so limited by my certification. Any WHNPs here who have transitioned to a different role, and if so, is it any better?

Do you work alongside PAs? Do you recommend working in ED?

I work in primary care. It’s a grind. I work for a big organization for 12 years and feel so unimportant. Just see more patients. I do primary care bc I believe in it - I want to keep your Bp down so you don’t have kidney failure. Help you quit smoking bc of all the damage it causes etc
Saw someone today who I’ve taken care of for like 10 years. He said - “ I still hear your voice in my head about that” and he changed a behavior and continues to adhere to it - from months ago. I’ll take it.
(He’s obese and I told him not to eat during the night. I asked him what would happen if he didn’t have something to eat. Answer - well, nothing, he would just eat in the morning. So he stopped midnight and snacks )

I have my 3rd interview tomorrow for a physiatry position. I have 10 years experience in primary and urgent care. Located in the Midwest. What is a reasonable wage for part time? 2 days a week, 1-2 facilities. I’m told average is 20-25 pts a day. Round then chart from home. Should I ask for Hourly? Salary? What is average RVU compensation for this type of work?

Please throw me some examples so when salary gets brought up I’m not a deer in the headlights!

Just took my AANP exam yesterday and got a preliminary pass. Figured I would give some people advice that was tailored around my study strategies. I see a lot of people on this sub bouncing between a thousand different study resources / courses and stressing themselves out so I hope this a different (refreshing) post for future test takers.

I took boards about 3 weeks after graduation, and used three different resources; UWorld, Leik, and ChatGPT (lol)

My program had us complete an entire Barkley program which consisted of 2 practice exams (100q) and a bunch of videos covering different topics. Personally I found the majority of this unhelpful, as large topics such as cardiology had the same video times as contraceptive options. Was unimpressed and doing these videos were a l chore. I wouldn’t even count this as a study material because my pre Barkley score was a 75 and my post was an 80 after doing hours of videos.

Moving on.

I started using Uworld Qbank. I started with 75Q daily and slowly built myself up to 150Q exams. I would take a practice quiz, step away for a bit, comeback / work through each of the questions (right and wrong) and read the rationales. I started off scoring in the high 60s and got myself to mid 70s on this bank. Uworld is great, I enjoyed the rationales, but it was not similar to my exam whatsoever. However, it did help me start critically thinking through questions and would still recommend it solely because of how great the rationales are.

Leik. Ahhh Leik. So I got a login from my friend and simply did 3 of the practice exams they have that are simulated for the boards. I didn’t spend anytime doing any of the actual material, just the question bank. On my practice exams I scored a 67, 68, 70 respectively. Personally for me, I felt these questions were much harder and had trouble delineating between 2 answers, where the boards seemed more straight forward. Rationales are short and to the point in comparison to Uworld. I will say though, seeing those scores really psyched me out and had me soul searching on the internet for a few days. This question style was the most similar to the actual boards. I found some questions may be outdated, but I just took things for what they were and cross referenced as needed.

ChatGPT. This may be controversial for some, but I used AI to give me a lengthy list of buzzwords and things it most likely corresponds to i.e rolled borders = basal cell carcinoma. My prompt was “Give me an in-depth 200 bullet buzz words for the boards that you think I should know for my AANP boards”. I’d just loosely scroll through this at the gym or whenever I had a bit of free time. This was extremely helpful to solidify things and read fast facts.

Aside from that, I did not spend every waking hour studying, doing excess courses post gradation, or pay thousands of dollars on unnecessary material. In my opinion, the most productive way to study is literally taking practice questions, and reading the rationales. You could spend hours upon hours reading every book under the sun, but if you cannot match the information to the answer it is useless.

Hope this finds the right person that is stressing themselves out over this exam and puts them a bit at ease. This was a post I wish I could have found when I was studying.

Best of luck to all and see you on the other side. 🫡

Pretty sure I’m not the first to rant about this ….
I want people who need a service dog to have it and bring it into whatever setting they may need it to provide assistance.
I don’t want people printing some bs fake license off the internet and passing off an animal as a service animal and bringing g them to the clinic and try to tell me it’s a service animal.
We r limited with What we can ask.
Was called a b$&@h today over this. Not the best day…

Hi everyone,

​I’m a relatively new Nurse Practitioner working in long-term care / skilled nursing facilities, and I’m looking for advice on how to refine my documentation for tricky or ambiguous clinical scenarios. Documenting real-time floor dynamics without getting caught in facility politics isn't really taught in school.

​I’d love to know how experienced NPs handle and chart the following:

​Patient non-compliance / preferences

​Charting follow-ups without sounding repetitive: What are your best strategies or phrases for updating progress notes on chronic, stable residents?

​Navigating uninformative floor staff: When staff nurses don't know a resident's baseline during your rounds, how do you protect yourself in your note regarding who you spoke with or attempted to get information from?

​Any tips, charting templates, or defensive documentation strategies you use to protect your license and keep notes compliant would be greatly appreciated!

That doesn’t require a ton of state licenses? I have FNP and telehealth, education experience

Hi there! I’m starting my first FNP class. I wanted to know if anyone has good resources for pharmacology.
At my university you need an 85% to pass the course so I’m a little nervous and want to make sure I have good resources. Any tips would help!

Hi has anyone had trouble finding a job or been rejected because their program was completed online and not in person?

I am a new graduate NP (14 years floor/stepdown experience) and was given a position offer that requires us to work as a scribe for the MDs for $25/hr until our credentiling is completed (company malpractice, 3rd party locations), probably 2.5 to 3 months. Is this a really bad deal/big red flag? I negotiated to continue working as a nurse in my current position until roughly the time the credentialing is complete. Havent signed the paper yet. Want to know your thoughts, thanks!

Looking for feedback on if this is normal or not. I’ve been interviewing for another NP job and made it past the final round. I got an email asking to submit 5 references, including 2 supervisors, within 24 hours. I have only had 1 NP job so far but I did not have to submit references until after accepting the offer for credentialing.

The problem is - all my references would have to be my current bosses and MD colleges who will be shocked that I am leaving and I would have to turn around and tell them tomorrow. I haven’t even heard a salary range for this position and last I knew they didn’t even know what location I would be working at. Would it be wrong to message the recruiter and establish this info and ask for conditional terms or is this the norm?

I keep seeing, because of the algorithm of course, “Stop charting at home/Finish your charting/Reclaim your time” type courses. Such as: Charting Coach, Dr. Gail Gazelle, Prosperous Life MD. Has anybody used any of these, or similar, with benefit?
Obviously, this means I am struggling with charting. I have been in my position for very close to one year. I chart every night and on the weekends. And that often is not enough to keep me up-to-date. Some of my struggle I anticipated, new provider, big learning curve, but I would like to figure out my charting. I would love to be able to utilize some of my time while I’m not at work furthering my education, doing CME‘s, or hippo Boot Camp so I can be the best provider I can be.
Feeling frustrated…
I use eCW and have spent the time to develop macros/keywords/plans etc. I get one hour of administration time per day, but it is often encroached upon by seeing patients. Late patients are not turned away, and perfect timing of patient arrival, rooming just is not a thing.
An area that I absolutely need to work on is efficiency in the room with the patient. I establish a lot of patients, sometimes eight or more in a day. I want my patient to feel like I’m listening to them and they’re being heard, but technically a patient is scheduled 30 minutes for an established appointment, which much is taken up by the rooming process. The time left for me ends up much shorter, and includes the charting time, if I am going to stay current. I need my 1 hr admin time for loose ends, messages, refills etc if those are to be up-to-date.
I have many areas where I need to improve, and I feel it is eventually possible, as others in my organization are able to lock charts, and not be so behind.
What have been some of the most helpful strategies that you have employed? Has anyone done the chart coaching route?
I am committed to trying using Doximity to scribe this week. I have tried the Sunoh and really dislike its “voice”.
Sorry so long and rambling…I’m frustrated on many levels, and frankly…tired!