So here's the deal; I'm on year 3 as an FNP, working in a small family clinic owned by one doctor. Prior to that, I did 15 years RN in the ER/ICU/Cath lab.

Southern Louisiana. I love the office I work in and the doctor I work for. He is a great teacher and great person, but unfortunately he's very cheap. All of our ancillary staff are paid bottom of the barrel, and I'm pretty sure I am as well.

I get 50/hr with no benefits except 2 weeks paid vacation and he pays for malpractice insur. and licenses. No health, dental, or retirement. Thank God my husband has good benefits.

Mon-Fri, I see 8-12 pts/day and my client base is growing. Am I out of my mind to think I deserve more? Another issue is I'd be heartbroken to leave, I feel like I'd be abandoning my patients, some of whom love and depend on me. And I also feel like I'd be abandoning the staff at the clinic, who wouldn't have anything to do unless he were able to find a new NP to replace me quickly.

I feel undervalued and stressed and want to hear what ya'll think.

FNP here- I recently started in medical derm and feel completely overwhelmed with the depth of the specialty (I’m sure entering all specialties are this way!) FNP programs don’t prepare us to be specialists so I’m struggling to try to get up to speed. The more I learn.. the less I know. I did the AAD basic derm course. Are there any other resources that helped you when getting into the specialty? Any advice is appreciated.
Thank you!!

Anyone worked in a walk in clinic and then went to a primary care setting? First job as an np has been in a walk in setting. Been there over 3 years now; have a family and find home life difficult working 12 hour shifts. For the most part I love my job now. And nervous about being in a different setting but wondering if I could switch. I don’t want to be miserable but also don’t want to let my home life go. Also worried about pay and benefits changing for the worst.

Hello! I am a nurse practitioner in primary care and have about six years of experience. I'm curious about if anyone else has some concerns about the use of AI with the students they precept -- or if I'm just being old-fashioned.

Of course, I love open evidence as much as the next person. I love using it for differentials and red flags for complex patients in particular. But I've noticed the past few students Ive precepted use it constantly, for everything. And I don't mean that they'll come up with some questions to ask the patient and then double check it with OE to ensure they're getting the full picture. I mean, they'll put the chief concern in AI and basically get the visit spelled out for them.

I have a few issues with this:

1) straight up, AI isn't always right. And what I found, this is especially true in the plan.

2) medicine is more of an art than a science sometimes. I don't think AI really allows for a lot of flexibility yet. Of course, knowing when to be flexible comes with time; I don't expect students to have the skill yet. But my concern is, I've noticed that the students I work with really push back against deviating at all from whatever open evidence says. I feel like in the old days of looking things on UpToDate, there was more nuance.

3) and lastly, I don't think it's good to let AI do the work for you. It has a purpose, and I've really appreciated it. But I'm so grateful I had quite a few years without AI to really push myself to learn pattern recognition and get my diagnosis and plans down. I now use AI for stuff I legitimately don't know (vague radiology reads, for example), and to make my life easier.

Am I just being the ridiculous old woman I am? Or has anyone else had any concerns related to the use of AI? Both?

Thank you!

As title says, 30 yo RN and dad of one toddler. I’ve been an RN over 6 years now in the ER, have been planning on applying to medical school, prereqs done and scheduled to sit for MCAT next spring. As the process goes on I can’t help but feel guilty and like I’m placing a large burden on my spouse and kids to achieve this and wondering if pursuing NP school is more logical. Not super ego or money driven, have always just wanted to learn a deep breadth of medicine and take good care of patients.

Do have some concerns over the quality of NP programs from things I have seen and heard from my coworkers currently going through it.

Curious if anyone has felt this same way? If so, how did you decide? If you went the NP route are you satisfied with the education and scope? Thanks in advance for replies

Hi everyone. Have any of you made the switch from full-time to per diem NP and loved it / severely regretted it?

I’m in my mid-thirties. Married with no kids but anticipate starting a family in the next year or two (in which case, working less would be ideal). I work in critical care in Los Angeles. Been at it for 4.5 years. Salary-based, 12-hr shifts, 3-4 shifts a week, workplace and team are top-notch, and acuity is high.

The only downside is frequently having to rotate between day and night shifts. I am f\cking exhausted. Don’t wanna do it anymore, and there’s no end in sight if I stay.*

I haven’t been able to find a similar full-time critical care NP position that is strictly day shift. I believe this is just the reality of our specialty and need for 24-hr coverage. However, a per diem opportunity recently presented itself that I’m inclined to accept. I aim to work 2-3 shifts a week to maintain a decent income.

Pros: reputable hospital system, similar commute, similar autonomy, schedule flexibility, high hourly pay, solid team

Cons are obvious and the most daunting: loss of health benefits (I’m overall very healthy and could hop on husband’s decent plan), hours not guaranteed, first to be laid off in a pinch (maybe less of a concern due to unionization?)

My overall concerns are:
- Making the switch from salary to hourly
- Job security
- Loss of 403B and match

I need your input! Have I overlooked anything? Thank you 🙏

I’m planning to start NP school this summer and would love to hear from others who have navigated clinical rotations while working a traditional Monday–Friday, 8 AM–5 PM schedule.

My biggest concern is figuring out how to balance the required clinical hours with my current work schedule. I’m in a position where I genuinely enjoy my career and have a strong salary, so leaving my job, changing positions, or significantly reducing my hours isn’t something I’m looking to do.

For those who have been in a similar situation, how did you make it work? Were you able to find clinical placements that offered evenings or weekends? Did you use PTO, negotiate flexibility with your employer, or find other creative solutions?

I’m particularly interested in hearing about the challenges you encountered, what worked well, and anything you wish you had known before starting.
I appreciate any advice or experiences you’re willing to share!

Is anyone here a PMHNP who specializes in reproductive health? I recently learned about this role and wanted to see if anyone here is one and how you went about to become one. TIA!

Hi.
How should I write my title(New Jersey State)

What Should I do?

Jane Smith, APN
Nurse practitioner
General Surgery

Or

Jane Smith, APN FNP-BC
Nurse Practitioner
General Surgery

Hi! Requesting input from outpatient surgical APP’s. Are you all required to cover your clinics during the holidays? This has recently come up in our division that all three of us are not allowed off at the same time even though we work at three different hospitals, and this has never been a consideration before. We always have an on-call physician.
Thanks for any input!

I’ve been with my current company as an rn for almost 20 years between being an LNA and nurse. And now I’m a NP I find myself having a very hard time leaving. I work per diem still and a np job part time. Despite just starting my np job- I hate it. I just think I went back to school when I was in a state of burnout and midlife crisis thinking it was going to be the solution for more money and it’s actually not. I just want a schedule that I can see my kids, come home and be present. I think it’s the Bedside I’m truly burnt from. I just started this job and it’s small so It will absolutely screw them and the patients over. I also have Been without benefits for 4 years and think it’s time I start getting some and I just feel like I made a huge mistake

I didn’t pass my ANCC the first time. I was 20 points from passing. I was just a wreck that day. I did all the no no’s. Stayed up late cramming. Waited until the last minute. I only used Barkley at home review.

The at was in June. I haven’t had any motivation to study. I feel like such an imposter. I now have accommodations to test alone and have extra time.

How can I study differently? What other resources are there the SMNP only has live reviews for FNP and I’m AGACNP.

I have until December 19th to test. I’m open to all things except switching to other certifying body.

Appreciate recommendations

Hello!

I’m in a specialty (medical, not surgery or wound care, ex) and see residents in PAC/LTC facilities (99305-6, 9-10). I’m curious about others in a similar role and your daily/weekly volumes- targets as well as realistic benchmarks.

I work for a private company, and am salaried with RVU bonus. My benefits aren’t great but flexibility is unparalleled which is priority for me at this stage of life.

So— I’m curious to compare my structure and my company’s expectations with others, so I can try to gauge if what they’re asking is reasonable, generous, or cuckoo 😝

So, if you’re full time/salaried and in a similar medicine specialty role (psych, nephrology, endocrinology, cardiology, dermatology, eg) what does your volume look like? What are your goals/benchmarks and what are your realistic weeks looking like? Strictly visit numbers? RVU-based? (If RVU, what does that boil down to in terms of weekly visits?)

If you feel comfortable, feel free to share general location as well as specialty and salary too!

Thank you all!

Trained in AB, I completed the Adults NP program and have worked acute care ever since. I wrote the AANP-AGNP licensing exam which is technically adults&geriatrics primary care, but again only have practiced in acute care settings.

Looking for advice for the best route to transition from acute care to primary care. Would love to hear other’s experiences. While my goal is not necessarily pediatrics (I know primary care NPs and MDs who refer to pediatricians or elsewhere) I do intend on taking AthabascaU pediatric courses.

Also - from a licensing standpoint, our licenses have been grandfathered to “generalists” licenses without the adults only restriction. However, I would never feel competent at this stage to work family primary care, even for adults and especially without pediatric education.

Hi everyone, I rarely am a poster, but I want to see what thoughts are from those working as nurse practitioners in the field. I have been a nurse for about 2 in a half years in the inpatient rehabilitation field and honestly I really enjoy what I do and I feel I have learned so much, but I do have interest in becoming a provider so that I can get a bit deeper into the medications and diagnostics of what I do.

Now here’s an odd thing; I have been shadowing optometry a little bit because I only have 3 more pre requisites from my incomplete bio degree and I would be able to do my OAT and go to an OD school if I do well. This would be a complete career jump.

The other thing: I think I would enjoy the NP field more, but due to saturation and what I have been told by an NP in Sarasota, FL, I am debating whether it’d be worth it to go. I am definitely more rural (Florida panhandle) and willing to relocate if I did complete school.

The pros are definitely in favor of being able to get out of school, become more financially independent quicker for a house/family and such on the NP side. I also am married and I think it’d be easier on my wife in a lot of ways to do a shorter path as I already have my bachelors.

I suppose my biggest fear is unemployment with an NP degree, but it seems a lot of people get jobs as long as they are willing to tough it out and learn as much as they can their first few years.

Thoughts on prospects?

Up top, I'm not currently in practice so I don't need my certification to be active. I just need it back for the future.

I just submitted my application for renewal of my ANCC NP certification. I've been out of practice for a few years so had to do the 150 hours of CEs and just got done a week before the deadline. Then it took me a few days to figure out how to renew on the website, so now I'm down to 4 days until expiration. The last 2 times I renewed it only took a day or two after submitting the application to get approved, but now I'm reading that ANCC processing time is taking weeks or longer for renewals. The expedited service is "temporarily" unavailable.

My certification is retired so if I lose it that's it, no re-testing to get it back.

What happens if my certification expires while I'm waiting for renewal?

Just asking around seeing what the average successful applicant’s GPA is for NP. For context my final 2 years of graded coursework are a 3.38/4.0, with the second to last being a 3.11 and the last being a 3.5. My gpa is my weak point, I have a strong clinical background (critical care in a very well known hospital for approx 2 and a half years) with a lot of important leadership experience + good references.

As the title says, I'm curious to know what the average/starting pay for an AGACNP is. I understand that I can look this up on Google, but i'd prefer to hear from real people.

Primarily curious on pay for cardiology or inpatient hospitalst/intensivist, but i'd love to hear other settings/specialties as well!

I only ask because I'm juggling school with work, among other things, and need a reason to tell myself this will all be worth it

TIA!

Hey guys! Just graduated as a FNP 6 months ago. Got my interview finally at a new providence hospital tomorrow. It will be at an anticoagulant clinic.

I have work with Providence for and I have been a RN for 11 years.

Wondering if anyone have advance within this realm of questions?

Any advice would be helpful!

Thank you!

Looking for a great learning experience, been a nurse ten years, this is my second rotation. Would be happy to pay a fee. If I need to travel out of Denver area, it would be great to fit the hours into a single month. I need 90 hrs completed Feb-May 2027 with an NP with prescriptive authority or MD/DO/PA.

(Not sure if this breaks the rules, apologies if it does)

Been NP 5 years, RN 6, 8 months in at FM and starting to burn out already. Anyone here do medical device sales or medical sales in general? I used to do retail before healthcare and I’m great at talking with people and I love teaching. I’ve done a couple grand rounds which I think would be a plus for sales? What was the pivot like and what’s the pay like especially at places like Stryker, J&J…? I’m making 120K rural Illinois FQHC right now full time.

I need to vent. I'm really struggling. I feel like I'm giving everything to this job, my rest, my body, my mental health, even my marriage, and getting nothing back. Patients treat me like a punching bag and I'm constantly bracing for the next verbally abusive encounter / someone yelling at me. On top of that there's so much hate toward NPs right now, and I'm drowning in debt from ucla (go bruins). I am getting taxed up the butt. I miss being an RN. Some days it feels like I'm in an abusive relationship with this career. I'm working on it with my therapist and psychiatrist (forever grateful for my team helping me stay afloat), but my lord. There are times that I want to say F it. What’s the point. What difference am I making in this field?Where do guys find the strength to persevere after a time like right now?

I’ve been an RN for 11 years
I’ve been practicing as an NP for almost 3 years

started in Urgent care for the first 1.5 years
then remaining time with a cardiologist
part time in urgent care and this flu szn of antibiotics request is draining me.

trying to get something nice for the wife. she’s started a new job and the charting is absolutely killing her. the company got her the dragon software to help but I feel bad watching her voice dictate with her phone mic. does anyone have any recommendations on a dragon compatible mic Bluetooth mic?

Hey all. In the off chance there's any other UHC peeps here that work with the INSP SNFs...do you feel like our department is being closed? I've been working on the east coast with this plan for about 5 years and over that time I've noticed my caseload continuously drop.

On the one hand. - cool. Even though I work for UHC I realize it's an evil company. But I don't think cutting the providers to SNFs is a good idea.

On the other hand I do really enjoy this job and feel like I can help get care to my nursing home patients that would otherwise be auto denied.

TLDR; anyone feel like there's layoffs coming to UHC APPs? Or is this just the normal ebb and flow?

(Also please don't make this thread, "United healthcare is bad!!" I know this. I don't like the company either, but I do like my SNF patients)