r/NursePractitionerSub

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.

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!

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!

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!

I’d really love some perspective from Canadian NPs, especially anyone in BC, anyone who went through UVic’s NP program, or anyone who was already self-employed/running a business before becoming an NP.
I’m an RN in BC and currently work full-time in medical aesthetics. I’m self-employed and have built a busy practice that is doing very well. I have a two-year-old and am also at the point where I’m thinking less about simply growing my own injecting schedule and more about eventually building a larger clinic, developing other providers, and potentially having multiple locations.

I’ve been working toward applying to UVic’s MN-NP program, but I’m suddenly having a bit of a “what am I actually doing?” moment.

Becoming an NP would obviously give me significantly more autonomy clinically and prescribing authority. In aesthetics specifically, it could also reduce some of my reliance on another prescriber/medical director. However, under BC’s current rules, an NP responsible for medical-aesthetic orders still needs to be present in the facility while those procedures are being performed. So even as an NP, scaling to multiple clinics would still require other NPs/physicians or appropriately authorized providers to be present at locations where nurses are injecting. Becoming an NP doesn’t completely eliminate that operational issue.

My hesitation is the opportunity cost.
UVic states that each NP course requires at least 12 hours/week of preparation per course, in addition to class time and clinical placements, and specifically says working full-time isn’t feasible. I currently generate my income through my own practice, so reducing my clinical days for approximately two years isn’t just losing RN wages — it’s reducing time in a business that I’m actively trying to grow.

I’m also a mom. My son would be about three when I started and around five when I finished. Part of me thinks, “It’s two hard years for a credential I’ll have for the rest of my career.” The other part thinks, “Why am I adding a master’s degree and this much stress to my life when I could spend those two years scaling the business?”

There is also some time pressure. UVic requires 3,600 hours of direct RN clinical care within the five years before application. I’ve moved away from hospital nursing into self-employed aesthetics, so I can’t simply wait indefinitely without potentially having older qualifying hours fall outside that five-year window.

I’d especially love to hear from anyone who has completed the UVic NP program:
What did your actual weekly workload look like?
How much were you realistically able to work while in the program?

During clinical-heavy semesters, was working 1–2 days/week realistic?

How many days/week were practicums typically?
How much control did you have over placement location/schedule?

If you had young children, how manageable was it?
If you were already earning well as an RN or business owner, did the NP designation ultimately feel worth the opportunity cost?

Any NPs working specifically in medical aesthetics/private practice — did becoming an NP meaningfully change your ability to scale a business?

I’m not really looking at NP school because I want to leave my business and get a traditional NP job. I’m trying to decide whether the NP designation is strategically valuable enough for the business and career I’m already building to justify what I’d have to give up temporarily to get it.

Would really appreciate hearing from anyone who has been in a similar position — including people who decided not to pursue NP and are happy with that decision.