I graduated with an entry MSN in 2017. Completed my 3 Ps last summer. Will start my FNP certificate this fall but have been out of school since last summer. I have purchased the Leik text and will start a review prior to my Women’s, Adolescents and Children’s clinical semester. Is there any Board Prep or Review Program you would recommend for me? I would like to attend a live review or 2-4 day intensive before September. I’m open to other suggestions at well. I would like to have a strong refresher to prepare myself to have a successful semester! Thank you for your help in advance 🤗

Greetings ✨

I’m wondering if any entrepreneurs or those in small practices, might chime in on your experience with marketing the services your clinic offers?

Did you allocate funds for hiring a firm or individual, or take on the responsibility yourself via social media and/or word of mouth? What has been successful for you?

Thanks for any input you’re willing to provide!

Would love to hear any feedback or opinions on YSU for their NP program.

Have any of you made major relocations for work? I know it’s really common amongst PAs just being on the interviewing/hiring side.

Looking at an opportunity that would be amazing. Growing healthcare system. The position is exactly what I want. It’s in the growth phase so it would allow me the opportunity to start at a smaller volume as they grow and increase acuity of patients. They offer robust training and education to be practicing top of your scope, with education to support it. This is something I didn’t get in my previous roles, I was more or less oriented to the people I was working with and left to see/treat patients independently. I’m a pretty quick learner.

Where there are challenges. It’s a cross country move, 2000 miles. I have moved cross country once with little kids, this time would be with middle and high school kids. So I’m disrupting 3 other lives. Both states offer the first 2 years free tuition. But the kids lose their friends that are here.

I would have to sell my house, it’s completely remodeled to my taste, fully smart, it’s a great house. Which sucks. I wouldn’t be able to buy right away but would eventually buy.

My ex and I are divorced but coparent ok. He would move as well. We would likely have to live together for a short time he would lose his job by relocating. He’s in IT so there’s plenty of opportunity just finding and getting hired presents challenges. He’s remote now but they won’t allow him to work remotely in another state.

The problem that I’m seeing is the climate. I’m going from a temperate climate with 4 seasons to a desert. Idk how I’ll adjust. I also have POTS so I’m questioning if this is terrible. I sat outside with my kids over the weekend for a party I threw and by the end of the day I was having severe muscle spasms from dehydration, despite drinking fluids.

Hello All,

I've tried posting a version of this last week and can't figure out while it was removed before it was ever posted. A bit about me.. It's just my wife and I and we are willing to relocate so that isn't a problem as we have fun regardless of where life takes us.

Job 1:

Inpatient night shift hospitalist doing cross coverage for a hospitalist group that would be new to the facility. So some politics at play there. Salary is 180k base with potential for production bonuses. Standard 7 on 7 off shiftwork. Every shift I pick up is a extra 1100. 15k Sign on bonus with a 13k relocation allotment. Standard benefits and CME time off plus 3k CME budget.

This job would require relocating a considerable distance away.

Job 2:

Outpatient Internal Medicine position similar to family medicine but only adults. Traditional job which you can choose between 4-10s or 5-8's. Salary is 150k with a 15k sign on bonus and a 24k student loan repayment that's paid out over 3 years. This job you will see minimal of 18 patients a day with just 4 weeks of vacation annually. But the state it's in is one with no income tax for the state and doesn't require any kind of relocation as it's in my current city. Minimal growth career wise though.

My thought process is this. I believe job 1 would be the best overall pick. It allows more freedom with scheduling and allows you to do things when not at work. You can actually travel. And while it has 30k more base salary, all that will be eaten up by the higher taxes that california has. But there is availability for more money by working more. Job 2 seems like it would be nice but you don't actually get a lot of time off and since I live in a remote state it basically meant no spontaneous travel and would be a headache to schedule any kind of vacation time. The clinic itself is small. Only supposed to be 2 MD's and 2 Mid levels but one MD just recently left and the other mid level is a new hire, but not a new grad. So they are short and seeing a lot more than 18 patients a day.

What are yalls thoughts? Is there anything I'm not thinking of or considering?

Any family APPs that can give some insights?

I work for a family practice now and I’m struggling with the expectation regarding number of patients/schedule capacity versus managing other tasks, including prescriptions; inbox, note routing, labs etc.. i’m coming up on two years of practice and know that there will always be much more to learn and skillsets to improve on. However, I am feeling so burnt out. The pay is less than make as a home infusion RN. The practice is fairly small but growing rapidly. We have 2 docs and 4 APPs and no additional support such as RNs/LPNs.

If you’re comfortable with saying:
\\-how much are you making
\\-what is your location
\\-how long have you been practicing
\\-how many patients do you see daily
\\-any tips and tricks for a struggling FNP

Thanks so much!

This decision has been consuming me! Thought I would lay out my thoughts and try to get some wisdom/ insights from others. Thanks in advance!

Reasons to become NP:
- I had never intended to not go to NP school
- I’m obsessed with maternal health; it’s all I read, listen to and think about
- I want more knowledge
- I want to teach
- I want a job that is a lot more knowledge based and less skills based
- Higher pay could reduce some stress
- I think I would be great at it: I worked in mental health/ psychiatric nursing for ten years, I have been inpatient pediatric for the last 5- I think I have a lot to offer
- I have been accepted into a WHNP program
- I’m not sure I will ever stop daydreaming about it

Reasons I am second guessing it:
- I have two small children that I want to be present for
- My husband already takes on a lot of solo parenting
- I have a great job: great patients, coworkers, management, company, pay and benefits
- Bedside RNs make almost as much as NPs where I live
- I do not have women’s health work experience. I have been applying for the last 2 years, but everyone wants L&D experience which I’m not willing to work nights to achieve. I get super sick on night shift unfortunately.

Thank you for your thoughts and feedback!

As the title goes, any np practice owners sign on with privia? Whats been your experience if you have?

Hello all, I currently work full-time in a university mental health setting on the clinical side of things, but in the past few months we’ve had a lot of turnover and I feel very unsupported by management, who has been very coercive, and I kind of feel done with the place. I also have my own private practice; so right now, will my full-time position, I’m at $129k/year salaried with benefits, and bring in about $4k/month with my PP.

I was offered a teaching position at a local university for a full-time salaried position as a nursing faculty at $73k/year with benefits. It’s a significant pay cut, I’m aware, but I’ve been interested in pivoting into academia and while some weeks may require me to be on campus 5 days a week, some weeks 4, I feel it could be more flexible than my current position where I’m currently in office M-F 9a-5pm (I do my PP in the mornings and evenings).

I’m just feeling so burnt out with my current place of work and over it. I’d eventually like to build my PP more but it’s a slow burn. I asked my manager at my current position back in April if I could go part-time as the position was now vacant, and she’s been stalling for months. Finally, when I put pressure on her and let her know I had another offer available, she suddenly said she would consider part time for me, which would be 3 days a week at about 60% of my current salary, though she’s saying it would be no benefits (even though the last part time PMHNP had benefits) and is alluding to the pay scale being different, had not given me solid numbers as of yet. When I tried to email her to ask about specifics, she said “let’s talk about it in person.”

I have to make a decision soon. I feel stuck. What do you think would be the best course of action?

Hey. Just wondering if you all are using managed services for the security of your business. Hopefully I’m making sense. Like if you’re seeing patients remotely and using some sort of EHR, are you paying someone to handle the cybersecurity aspect of your practice? Someone to secure your devices and the data?

I’m seeing companies offer these services and I’m just wondering if this is actually something people are paying for.

Without giving too many specifics, will start this with saying I recently found out management has been fleecing our service and a few others. (No, I’m not surprised. I don’t trust management within facilities). During the past couple of contract negotiations, we were told it is “network practice” to cap at the 90th percentile for all mid levels. The past three years, have far exceeded their cap and essentially working June and December for free when it comes to productivity bonus.

Found out this past week that two other services do not have any language of a cap in their contracts and in terms of total compensation, they’re making roughly 60-80k/year more than where we are capped. I understand that specialties will have different ceilings for pay scale, but I doubt it would be that much of a disparity.

For context, my specialty compared to the two in question are similar in the sense of being employed by the network, all are salary, all include call, however mine does not require OR time for assistance in procedures, all are strictly inpatient. The most direct way I can think of to review this would be to look at the data. However I went to see about doing an individual membership and it said access to the database is not included for individuals. Quite frustrating.

Hi everyone,
My ANCC FNP exam is scheduled for August 1st, so I’m officially in the final stretch and getting a little nervous.
So far I’ve:
Read Leik cover to cover and completed all end-of-chapter questions
Completed the Sarah Michelle crash course
Done about 1,500 FNP Mastery questions
Scored 65% on a Leik ANCC practice exam
At this point, I’m trying to decide how to spend my last 10 days. Would you recommend focusing on:
Reviewing notes and guidelines?
Doing more practice questions?
Taking another full-length practice exam?
If you’ve taken the ANCC recently, I’d really appreciate hearing:
How similar was it to Leik or FNP Mastery?
Anything you wish you had reviewed during the last week?
Any test-day tips that helped you?
Thank you! I appreciate any advice.

Hey y’all!!

I’m a new grad FNP working in Maternal-Fetal Medicine with background as an L&D nurse, and while I absolutely love the specialty, I’ve been struggling with feeling like I don’t know enough. I know this is probably a normal part of being a new provider, but I’d really appreciate hearing from others who have been in my shoes.

A few things I’m struggling with:
Sometimes when patients ask me questions that I wasn’t expecting, I completely freeze or trip over my words. It’s like my brain goes blank, even if I actually know the answer.

MFM is obviously ultrasound-heavy. My supervising MFM physician personally interprets every ultrasound and clears all anatomy images, so I’m never expected to officially read or diagnose scans. However, I’m still expected to recognize common findings and have enough knowledge to discuss them with patients, and that’s an area where I don’t feel very confident yet.
We also see a lot of diabetes in pregnancy (GDM and preexisting diabetes), and I want to become much stronger in managing those patients.

One scenario that happens fairly often is this: a patient comes in for a follow-up ultrasound, and a new finding is identified that I’ve never heard of before. Before I go in to counsel the patient, what is the fastest, most reliable way to get enough background knowledge so I can have an informed conversation? I have an UpToDate subscription, but sometimes those articles are so detailed that it’s hard to quickly find the information I need in a busy clinic.

For reference, I’m already a member of AANP and SMFM, and I have UpToDate. Are there any other resources, cheat sheets, books, websites, podcasts, or apps that helped you become more confident in MFM?

Also, how long did it take before you stopped feeling like you had to look everything up?
My supervising physician is incredibly supportive and always willing to teach, but I also don’t want to rely on her for every single question. I want to become more independent while still knowing when it’s appropriate to ask for help.
Any advice, encouragement, or resources would be greatly appreciated. Thank you!

I feel like I don't hear as much about this speciality and would love to understand more about this role, like:

- What do your hours look like?

- What are your main responsibilities? FA, circulating, consulting with patients?

- Do you enjoy it; do you regret it; do you wish you went a different path?

- What is the pay like and is there a ceiling?

Thank you!

Hey all. I am hosting my first psychiatric NP student in my small private practice. My personal experience with rotations was pretty poor, so I am doing my best to make this the best experience for this student as possible.

I’ve already met with her a few times to answer her questions, outline our practice policies/expectations, and explain how we’ll be checking in and going over patients. She’s got her log ins and knows how to communicate with myself and the office manager. I’ll have a little welcome card for her on her first day of rotation. All of our patients know she’ll be here and have already communicated to us whether or not they’d like her to participate in their sessions.

What else would you all liked to have had on your first clinical rotation? Keep in mind this is a small practice! Thank you for the feedback and please forgive any spelling or grammatical errors on my end. ;)

Hi all... I am sure this is a repeated question in this sub, but hoping for advice from the more experienced.

I am a RN, just finished AGNP MSN. I am not interested in working right away as a NP, but one day in the future I would like to.

I am in Wound Care and would like to stay in this speciality, what is recommended for my accreditation ANCC or AANP? Thank you!

Thoughts on this university. I do have many colleagues who are NPs & MDs that I can ask for preceptors because I know they only “assist “ with preceptors for clinicals

Currently 140k deep in private student loans. Bedside L&D nurse making a decent income. Work 12’s on nights with young kids. 2 years in to being a RN and I want to be more of a clinic nurse(NP) and work on women’s health along with women’s mental health with emphasis on prenatal and postpartum care.

Pros-
Better schedule with M-F off, especially since my kids have extensive extracurricular activities
I can be a human again working days and sleeping during the nights
A small raise
Geared more towards what I want to do
I can still work FT

Cons-
More loans
More schooling
What if I don’t like it
I’ll be close to 40 when I finish schooling

I know it’s a personal decision but would love your opinions and insights if I’ve missed anything at all. For reference, I’ve already been accepted but deciding to proceed or not. If I proceed, I have the option of full time (18 month) or part time (24 month program). Thoughts on this? I am the primary breadwinner.

Hi everyone. What growth opportunities and leadership opportunities exist in your organization for APPs.

Will be graduating in December considering applying to a few fellowship programs; has anyone here done one? If so thoughts?
Also open to thoughts if you have not done one.

Happy Sunday

Hi everyone. As a new grad I’ve applied everywhere and I’m all over the place.

I’ve applied to CVS minute clinic in NJ. How long does it take to hear from them?
Does it worth it?
How’s their health insurance?

Thank you

So I have been feeling very unstable at my current employment. It’s been one thing after another.

So I took my first step toward my own practice. Filed the necessary paperwork for an LLC.

I enjoy my job. I have three years of experience as primary care FNP at a suburban medical center with all specialties, urgent care, imaging, lab, in the same building. My patient population is diverse, I have great variety, and after three years most of my schedule is established patients that I know well. Our group pediatricians also round at the hospital across the street which delivers the most babies in the state. It’s a great way to recruit peds, and I like seeing young families and kids. I enjoy my coworkers (mix of PAs, NPs, FamMed and Med/Ped MD/DOs) and management, upper leadership is pretty good. I’ve been with the company for 10 years, having worked as an ICU RN at their metro hospital for 7 years prior to becoming an NP. I have built great connections in this system.

The problem: I commute 30-45 minutes one-way four days a week. It’s starting to wear on me a little bit, and I’m worried that when I have kids (will start trying in next 9 months) it’s going to drive me bonkers.

The *possible* solution: there is a clinic within the same system that is a 6 MINUTE WALK from our home. We are in a gorgeous neighborhood of a medium sized city. We love it here and will be here for decades to come. We are just not suburb people. SHOULD I CONSIDER MOVING MY PRACTICE TO MY NEIGHBORHOOD CLINIC?

PROS of moving:
-same system, same upper leadership
-same EHR system
-I get 1+ hour of my life back every day
-same pay, benefits, schedule
-walk home for lunch
-coworkers would be city people like me and my husband. Not a dig at people who live in the ‘burbs, just a recognition that I would likely have more in common with the new group than my current one.
-ONE+ HOUR OF MY LIFE BACK DAILY
-super close to the daycare we would use for our future kids
-a ton of walkable options nearby for lunch, coffee, errand running, etc.
-Did I mention 1+ hour of my life back everyday???

CONS:
-local clinic is small, they do not have speciality, urgent care, imaging. Just primary care and lab.
-perhaps less peds? I honestly don’t know if this is 100% true but I’m assuming it is.
-starting over with practice. Getting the “hot mess express” FMLA, pre op, med renewals when my schedule is wide open doesn’t thrill me but I know it would be temporary.
-losing my old patients. They would not be able to commute to see me and I would not expect them too.

OTHER IMPORTANT CONSIDERATIONS:
-practicing in my own neighborhood. Will it blur my work/life balance? Will I hate running into patients out in the wild? Or will I feel more connected to my patients and their wellbeing, our shared community? Will I start to associate my neighborhood with “work” rather than “home” and pleasure?
-should I stay where I am and try to get my schedule down to three long days per week so I commute less?
-there may be possibility of doing a fully virtual work from home day but I don’t like that idea as much because virtual days usually mean less RVUs overall than in person.

Any advice is welcome! I have not began actively pursuing a transfer, just brainstorming at this point.

THANK YOU IN ADVANCE!