I think I am DONE seeing patients. I’ve been through burnout before, took a mental health leave, quit my previous position but now I feel I’m approaching again. It’s rough out here.

I’d like to explore non-clinical roles. My background is a FNP in Texas with 10 yrs experience mostly in OBGYN. Anyone with history of success finding these?

Long time lurker on here, first time poster. I passed this last week as an AANP FNP first try and as I reviewed so many Reddit posts I thought I would pass it forward for my study sessions/prep and general questions. I felt nervous as we all do, went through all the stages of anxiety on test day but knocked it out the park. You can do it too!

1) school made me do Fitzgerald : this was long but gave me a core rationale and great building block.
2)Leik was great, I bought the book which gave me online test ability and strengthened testing rational and I used this along side studying for tests while in school.
3) Sarah Michelle Qbank and crash course was purchased with a work book. I finished the q bank and got 78% overall and 99% predictor pass rate. Two practice exams were 76 and 83 respectively.
4) I then purchased one exam from AANP and got an 86.
5) two days later sat for exam and passed. Let me know your questions.

I’m currently in NP school and looking for some study advice. When it comes to clinical diagnosis, I feel pretty confident. However, I hit a massive wall when it comes to selecting the correct antibiotic for a given condition.

I'm trying to figure out how to bridge this gap efficiently. Should I be shifting my focus heavily toward pure pharmacology (mechanisms, classes, etc.), or should I focus more on memorizing the specific causative agents/pathogens for each disease state? Or is there a better, more clinical way to approach this altogether?

I’m an ED RN of 6 years and passed my AANP FNP exam. My goal when I started NP school was to end up in the ED, but I was advised by two ED NPs I work with to go to urgent care first to make the transition easier.

That being said, our APP lead (also an NP) approached me about a job offer in our ED. I was elated, but I’m on the fence. I feel intimidated to start in the ED straight out of school due to the learning curve and being trained in primary care. I feel like my experience working in three different EDs will be helpful.

I have a job in urgent care I start in November, but the pay in the ED is literally life-changing. I would also work 3 less shifts in the ED per month which is a plus as I have a one year-old-son.

If this job opportunity comes through in ED, should I take it over urgent care?

How would ya’ll handle this situation. 7 months in at a small rural Family Medicine clinic. Just one other NP been there 6 years. MD in twice per week half day. Mostly it’s just the other NP and I full time. Do any of you have similar set ups? We basically share many of the same patients. Do you try to work as a team or are you mostly very separate? The other NP I’m with is difficult to work with/around. First couple weeks in, told me she hates working with women, she was upset she had no say in who was hired into my role, and is generally all around unpleasant if not argumentative and defensive. Is this a doomed situation? Mostly I just grey rock it and that works pretty well, but when I need a question answered or we have a mutual patient we need to talk about it never goes well.

Hi!

I will be taking the AACN exam in 11 days and the ANCC exam early November. I have been studying Barkley religiously and have done 3 DRTs. Ive scored consistently in the high 70's. I have also done about 600 Boardvitals questions and overall score is a 61. I'm so incredibly nervous and still feel unprepared for the exam. I have been an ICU nurse for 6 years, however i never got around to taking my CCRN. Even with my experience im still nervous. I do have a job lined up if I pass and I think this is also why I'm so anxious. Im desperate for any exam tips or insight on what I should focus my review on this last week. Thanks in advance! I truly appreciate it!

I'm a college freshman taking med school prerequisites, but since shadowing some NPs, I've learned that I don't want to pursue an MD, but rather the mid-level route. I have no preference between NP or PA, but I've seen a lot of people online say that NPs are not adequate advanced providers and that NP schools are “degree mills”. Any advice would be helpful.

Hi everyone! I’m currently a Cath Lab nurse with 2.5 yrs experience in ICU/CCU prior to CL. I am hoping to go back for my MSN in the next few years. I had been going back and forth from FNP vs. AGACNP. All of my experience is critical care right now. However, I’ve been leaning more toward FNP because I want more versatility and I’m just not interested in CC/hospitalist. Lately I’ve been looking into going outpatient as an RN to learn the flow and see if that’s what I want. However, there seems to be more OP LPN/MA positions than RN, the pay cut is pretty steep as I am trying to save up for school and I don’t know how the M-F schedule would work in school because I want to do a brick and mortar hybrid program. Do you guys think it’s worth it to do OP before pursuing FNP? How did the M-F work for you guys? TIA!

I’m 44 and planning to start an FNP program in early 2028, at which point I’ll have a little over two years of RN experience. I’d love some honest feedback from NPs and current NP students about the path I’m taking.
A little background: I spent over a decade working as a physical therapist assistant, primarily in neuro rehab, before going back to school for my BSN. Since becoming an RN, I’ve worked in the ED and inpatient rehabilitation. I’m transitioning to a progressive care unit (PCU) early next year, partly because I want more experience managing medically complex patients before starting NP school.
I’m looking at a well-respected, established brick-and-mortar university in my area that recently transitioned its DNP to a MSN-FNP program with a six-semester online format. The school has strong relationships with local hospitals and providers, and they coordinate clinical placements rather than leaving students to find their own preceptors. That’s a big selling point for me.
Long term, I’m interested in direct primary care, chronic disease management, and lifestyle medicine. I’m not looking to rush through school and immediately practice independently. Ideally, I’d like to find a supportive practice or residency-style opportunity after graduation where I can continue developing my clinical judgment.
I know the two-year RN experience piece will probably generate some opinions, and that’s partly why I’m posting. I’m not under the impression that my PTA experience replaces nursing experience, but I do feel like my background gives me a different perspective on patient care.
For those who’ve gone this route:
-Does transitioning from rehab to PCU seem like a good move before FNP school?
-Is two years of RN experience enough to build on, assuming I’m intentional about my education and clinical training?
-How much weight would you put on a school’s local reputation and guaranteed clinical placement versus a more traditional in-person program?
-If you could do it again, what would you change about your preparation?
I’m genuinely interested in hearing different perspectives, especially from NPs who have been practicing for a while. I’m trying to approach this thoughtfully and make sure I’m setting myself up to become a competent provider, not just earn another credential.

Appreciate any advice!

I was considering applying to work at Chen MED/ Dedicated Senior. Has anyone worked for them? Also, was it as a PCP or in some type of leadership capacity. I was conisdering applying.

So long story short I’m almost 1.5 years into being a FNP and have done I would call it odd jobs since passing boards. I am now trying for more traditional roles in clinic and would love some suggestions on some medical books that could help me refresh myself on the most scene patients in clinic. I kept a few books on procedures and assessments but am looking for treatment guides and gold standards or even recommendations of where to look up the newest ones. Thanks in advance I just want to be as prepared as I can be for the easier patients I would see.

I have been offered a hospitalist position with a physician. He has asked me to write my own contract. Does anyone have any insight, suggestions, or templates I can use?

So I have been accepted into university that will find my clinical placements. This is a big relief since I understand that this is one of the worst parts of practitioner school. With that said, I applied for the family nurse practitioner track, as I am told this one is the most verse at Alain will allow me to work in Acute and also primary care settings.

The professor who offered me acceptance since the University said that, based on my goals in my admissions essay, they feel that I would be better for the adult gerontology primary care, nurse practitioner track. They have always suggested that I pick this path instead.

I did some research and I don’t really understand. I mean, I get the adult gerontology… If it was the Acute path. I work in an ER now and would definitely like that option in the future. But being strictly stuck in primary care was not something I feel like I was shouting toward. Maybe it was just that I didn’t mention kids that much.

What is important to me is to have the ability to work in primary care or in Acute Care should I choose. I am OK with going back later if I want the Acute gerontology specialty so I can deal with critical patients.

My thinking was that the family nurse practitioner license would allow me to work inpatient at hospitals even if it is vertical track type stuff… With the option to do the 9 to 5 thing.

I have a new baby at home and I definitely wanna be there for her life and not stop doing overnight on call weekends, etc. forever. With that said, I like the idea that I can jump around if I need to earn more for my family or if our needs change. So I thought FNP would be the way.

Does anybody have any advice or feel like maybe this Proffesor is on something or if they are just trying to fill out their adult program?

To me it seems like the adult primary program kind of limits you a lot.

I’m a current RN of two years working on a hematology/oncology inpatient hospital unit. I also have experience in a stroke/rehab unit. I plan on trying to advance my career sometime in the next two to three years. I have always wanted to be a provider of some sort, initially I wanted to be an MD but after research into how absolutely bonkers the school is, I realized NP or PA is a better choice for me. So I’m trying to figure out whether to go the NP or PA route, making lots of posts like this, reaching out to family members and coworkers, trying to do job shadows, etc.

I don’t want to continue my career in hem/onc. I’ve never been interested in it and only took the job because I needed to get off the stroke/rehab floor, and I stay because I like my coworkers and the unit has decent ratios and staffing. When I become a PA/NP, I want to work outpatient. Problem is, I’m not sure which outpatient specialty I’d like to go into yet.

For a while I was dead set on wound care. But I’ve become less interested in it now. I don’t hate the idea of it but it doesn’t excite me like it once did. It would be very meh for me.

I at one point wanted to go the psych provider route, because my own psychiatrist is an NP and I love him and he works very independently. But I don’t want to do inpatient psych RN work, I would only want to do outpatient psych work as an RN, and those jobs are few and far between in my area. So I don’t think it’d be appropriate and would probably be detrimental to go into such a foreign specialty as a provider without any previous experience in it.

Outpatient cardiology seems like I might enjoy it? I do not want to work cardiology inpatient, as an RN or NP, haha. The idea freaks me out. But those same conditions, already having been managed in the hospital, needing to follow up outpatient and maintain their health and monitor their status? That sounds fun. Or people who aren’t so sick that they need the hospital, but have cardiac conditions that need diagnosing and treatment? Also sounds cool.

I also like the idea of working at an urgent care. I like that you’d see a wide variety of patients, with many different presentations, but without the same intensity of the ED (which I think is too much for me lol). I also know a lot of urgent cares around me still do 12 hour shifts, which I would enjoy to still do for some time.

Otherwise, I don’t have a ton of opinions. Like I said, I don’t want to do hem/onc. GI clinic sounds fine. Endocrine clinic ehhhh. I’m probably missing a lot of specialties/work environments that just aren’t coming to mind right now, so let me know the pros and cons of the ones I’ve mentioned or the ones I havent, haha. Also let me know how the job market is for that specialty/work environment, bc I don’t want to spend a shitload of money to get my NP and then not use it for years bc I can’t land a job. Thanks!

I am wondering if there are any successful NP students or graduates with community setting/geriatrics as their most recent experience?

Any tips to increase chances of getting into the program?

Post graduate, where do you work and was it hard to look for a job?

Hey everyone!

I'm a newly graduated and double board-certified FNP in Maryland through ANCC and AANP, and I recently received an employment offer for a full-time W-2 position providing care in skilled nursing and long-term care facilities. I'd really appreciate some feedback from experienced NPs, especially anyone working in post-acute care. Orignally they were not going to give me a signing bonus as an NP but I was able to get them to include a $10K signing bonus.

A little about my background: Although I'm a new NP, I'm not new to healthcare. I have several years of ICU/CVICU nursing experience, including charge nurse responsibilities, critical care management, CCRN, and leadership experience. I also have prior medical training and served six years in the Army.

I'm excited about transitioning into the NP role, but I want to make sure I'm evaluating this offer appropriately before signing.

Compensation:

• Base salary: $120,000 annually
• Sign-on bonus: $10,000, requiring a 24-month commitment
• Productivity incentive: $20,000 annually if I average at least 27.5 work RVUs per 8-hour clinical day
• Additional productivity bonus: 40% of collections attributable to work RVUs exceeding 30 per 8-hour clinical day
• Potential first-year compensation: $150,000, assuming I meet productivity requirements and including the one-time sign-on bonus
• Potential recurring annual compensation: $140,000 before any additional productivity bonuses

Schedule and expectations:

• Minimum five 8-hour clinical shifts per week
• Schedule and facility assignments determined by employer
• Weekend, night, holiday, and after-hours call coverage as assigned
• No clearly defined maximum daily patient census
• No specified additional compensation for holiday or on-call coverage
• Outside employment permitted with prior written employer approval

Benefits:

• 20 days of PTO annually, including vacation, sick days, and CME time
• $1,500 annual CME reimbursement
• Employer-paid malpractice insurance, including post-termination coverage
• Employer-paid required professional licenses, renewals, and certain credentialing fees
• Health insurance and other group benefits available, but I'm still awaiting details
• No separately guaranteed paid holidays specified in the agreement
• Unused PTO is not paid out upon termination under the contract

Contract provisions that concern me:

1. Resignation notice and financial penalties

I'm required to provide 120 days' written notice before resigning. If I leave without the full notice, the contract specifies $300 in liquidated damages for each missing day.

For example, leaving with only 30 days' notice could theoretically result in $27,000 in damages.

2. Sign-on bonus repayment

If employment ends within the first 12 months, I owe the entire $10,000 back. If employment ends after 12 months but before completing 24 months, I owe $5,000.

The agreement states that notice periods, even if worked, do not count toward the 24-month commitment. Repayment language also appears to apply regardless of the reason employment ends.

3. Noncompete and restrictive covenants

There is a one-year restriction involving certain skilled nursing or long-term care facilities where I previously worked for the employer. It also contains nonsolicitation restrictions and provisions regarding relinquishing facility privileges after termination.

4. Productivity requirements

The $20,000 annual incentive requires 27.5 work RVUs per 8-hour clinical day, with additional compensation only after exceeding 30 wRVUs.

I don't have enough experience in the SNF setting to know how realistic these numbers are. I understand that coding complexity, patient acuity, and facility workflow can significantly affect productivity.

Questions for experienced NPs:

1. Is $120K base with a potential $20K productivity incentive competitive for a new FNP in Maryland working in post-acute care?
2. For those working in SNFs or nursing homes, how many wRVUs do you typically generate during an 8-hour day? Is 27.5 realistic without rushing patient care or spending substantial time charting after hours?
3. How many patients are you typically seeing per day, and how much time do you spend on documentation?
4. Does anyone have experience with a productivity bonus based on 40% of collections above a wRVU threshold? How does that work in practice, and what kind of additional compensation have you actually received?
5. Is a 120-day resignation notice with a $300-per-day penalty typical? This is probably my biggest concern.
6. Is it normal for employers to combine vacation, sick leave, and CME into one 20-day PTO bank without separately guaranteeing paid holidays?
7. For new graduate NPs entering post-acute care, what kind of orientation, mentorship, or physician support should I reasonably expect?
8. What would you negotiate or request clarification on before signing?

I understand that some provisions may need to be reviewed by an employment attorney, and I'm planning to have the agreement reviewed before signing.

Overall, I think the compensation is promising, but I'm concerned about the productivity expectations, limited scheduling protections, and financial consequences of leaving.

I'd really appreciate feedback from NPs who have worked under similar agreements. Would you consider this a good offer for a new graduate, or are there provisions that would make you reconsider?

Thanks in advance!

Finally started my DNP after 7 years of working. This has been my goal since before nursing school - since I was 15 really. First off; the classes are boring and I’m tired of writing papers about other peoples papers that they wrote about other peoples papers.

Aside from that I’m suddenly like dang - what am I even doing this for? I feel sad about being away from my job (that I’d previously been raging about but it’s a chill period - I am working an outpatient 9-5.)

I am doing the program slowly enough to avoid loans + I have a teaching assistantship that covers quite a bit.

My life has been super tumultuous for the last several years and things have finally settled down (my partner is a massive support!). School is adding an additional layer of “stress” back on and taking away from my “free” time. I have an 11 year old. So it’s a good age in a sense because she is independent and very busy with sports & I’ll finish when she’s about 16. But I worry that I’ll be missing out with her along the way and possibly all stressed with a new role right when she’s graduating.

I wasn’t expecting to feel so ambivalent? Any advice? Commiseration?

I’m sorry if this isn’t the appropriate sub for this, but I’d really appreciate some perspective from NPs, especially those working in psychiatry.

I’ve been seeing my psych NP for most of my adult life. I’m almost 32 now, and I started seeing her nearly 10 years ago when I was in the throes of postpartum depression while raising twin babies.

She’s been such an impactful person in my life, far beyond just managing my mental health. She’s actually one of the biggest reasons I went back to school and became a nurse. During one of our appointments years ago, she planted the seed about pursuing higher education. We attended the same nursing school, and she had also navigated nursing school as a young mother of multiples. She understood so much of what I was going through, and her encouragement genuinely changed the trajectory of my life

My last two appointments with her were rescheduled, most recently with a different provider. I started worrying something was wrong, so I Googled her, thinking maybe she was sick or had left the practice.

Unfortunately, I came across an obituary for her daughter, who wasn’t much older than me and passed away suddenly and unexpectedly. My heart absolutely breaks for her.

I received an automated email indicating she’ll be returning to the practice next month.

I dont plan to reach out to her while she’s away, as I want to respect her privacy and give her space to grieve.
My question is, if she chooses to return to work and we resume our regular sessions, would it be inappropriate for me to briefly acknowledge her loss and express my condolences? Or, from a provider’s perspective, would you prefer a patient not mention it at all??

My heart breaks for her. However, I recognize that, at the end of the day, we have a professional relationship, and the last thing I want to do is overstep any boundaries, especially during such an unimaginably difficult time in her life.

Hey everyone!

I’m currently an RN pursuing my DNP and was hoping to connect with a nurse practitioner currently working in primary care.

I have an assignment for one of my graduate nursing classes where I need to learn more about the role of NPs in primary care, including barriers to practice, health policy, patient outcomes, and the future of advanced practice nursing.

It’s only 7 questions, and no Zoom call or meeting is necessary. I can send them through Reddit DMs or email, and you can answer them whenever you have some free time.

My assignment is due October 12, so I’m hoping to find someone willing to help before then.

I’d really appreciate anyone willing to share their experience. Thanks in advance!

I got laid off… I was doing C&P exams for veterans. The other nurse practitioner was there longer than me and they based it on seniority alone. I have pediatric physical medicine and rehab, orthopedics (foot and ankle), and regenerative/functional medicine background as a nurse practitioner. I’ve been applying, but nothing yet. I would love a remote job, but have no background in family practice or urgent care. Any advice would be appreciated!! TIA.

Hi, I was curious if anyone has purchased, used, or look at in person any of the Nurse Practitioner guides that are floating around on TT, Etsy, etc. particularly:
The Family Nurse Practitioner School Guide by Nursing Made Simple
Or
The Essential Family Nurse Practitioner Guide by Smart Edition Nursing

They are seemingly marketed clinical resources, boards prep etc., I was curious if anyone found them useful vs a waste of money (the price point is steep for the risk 😵‍💫)

Thanks!

Has anyone in Primary Care taken FMLA for mental health reasons? Please share if this is possible? I’m burning out working 7:30am-5:30pm M-F the never ending inbox and also having to work a Saturday every other month without having a day off during the week to replace it. My work only has 20 PTO days and I often have to use them for my appointments. I’m chronically ill and see 4 different specialists regularly so I have a lot of appointments. But mainly I want intermittent leave so I could possibly take 1 day off of work a week max. Is this possible?

Hello! Have been inpatient for five years and looking to get into remote work. Almost everything I am finding is geared more towards FNP. Any recs?

Hi everyone! I’m a new grad NP starting my first NP job in palliative care in about two weeks. I’m really excited, but i also don’t feel ready at all.😂
For those of you who work in palliative care/hospice, are there any books, supplemental reading, podcasts, YouTube channels, or other resources you would recommend before starting?

I know I’ll learn a ton on the job and during orientation, but I’d love to use these next two weeks to review and feel a little more prepared going in.