r/nursepractitioner

I work in a small urgent care clinic and we often have situations where a patient's family member is also in the room talking, or a nurse pops in to ask a quick question mid-visit. I've been looking into ai scribe tools for a few weeks now but I genuinely cannot find a clear answer on how they handle that kind of overlapping audio.

Most of the marketing material just says things like 'captures the entire conversation' but that doesn't tell me much. Like, does the tool try to separate speakers? Does it get confused and start attributing the wrong statements to the provider versus the patient? Or does it just transcribe everything as one big block and leave you to sort it out?

I ask because if the notes come out a mess whenever there's a third person in the room, that's going to create more cleanup work, not less. And for us that scenario comes up probably a third of the time.

Has anyone dealt with this specifically? Would love to hear from people who've actually tested this in a real clinical setting, not just a quiet solo visit.

Bedside nursing for example: as soon as you clock out, everything becomes someone else’s problem and you have zero worries in the world. What specialties are like that?

Hi everyone!
I’m a FNP student in my first clinical rotation. For one, I had to pay for this rotation thru NPHub, and I live in a major city so….it was not cheap.
I really liked my preceptor the first couple of shifts. However, the last 1-2 shifts there’s been a change in the energy a bit. It’s not just me, it seems like she has an attitude with all of her staff, so I don’t think it’s related to my work… I feel pretty confident with my training thus far, although…she’s not exactly teaching me much anymore? I’ve done 4 shifts so far. I’m basically already operating on my own, and then going to her for confirmation of what I think I should order. I don’t feel like I’m being taught much. She has her own practice, so it’s just her and sometimes another NP is there, but that’s it. She’s basically catching up on other work while I see the patients. So I’m essentially paying HER to act as her employee…great, right?!

She gets very irritated when I ask questions that are in this 20-page packet that she gave me. She doesn’t have any MAs or phlebotomists or anything at all, just front desk staff so I’m also doing all my own vitals and labs. I’ve never had to spin the blood tubes before, etc…but again, it’s in the packet I guess lol. But I’m sorry, the amount of time it’s going to take me to flip through these 20 pages to figure this out is just wasting time when you can give me a 2-second yes or no answer. The way she spoke to me last shift though was overall really off- putting. She treated me like I was an idiot when I wanted to confirm with her about what I needed to do with some blood tubes. Then I was letting her know that I wasn’t familiar with the EMR software she uses and that it’s a little hard to navigate sometimes (obviously with the point of, I’ll just need to get used to it), and she goes, “it’s actually not that hard.” Like ok, lol. There were other comments but that’s the general vibe.

So last shift she tells me that she’s not going to be there one of the days in the upcoming week because she has to testify in some court case (not healthcare related I don’t think, but still wtf lol), and she goes “you’re still gonna be here seeing my patients though”. I kind of laughed and said ok because I didn’t know how else to react in the moment.

I thought about it when I got home, and obviously there are multiple ethical issues here…for one, I’d basically be operating without a license. And also, I think it’s not fair that clearly she’s going to be charging these patients as if she’s the one seeing them, when she’s not even on site. Not only was she not going to be on site, but clearly unreachable since she’s gonna be in court…lol.

I ended up not going to clinical this past week because I was really sick, but I’ll be back this week. So this date has passed already thankfully since I was sick. I don’t want to jeopardize my hours, but I feel like I should make it clear that I’m not comfortable seeing patients when she isn’t there.

Am I crazy, is this normal?! Should I say something now, or wait to see if she tries to put me in that situation again? I also don’t want to come across as accusatory, I’m pretty sure she’s not going to react well at all to that, clearly! 😬 thanks for reading!

I just joined a family medicine private practice (I'm an MD; I didn't see any rules prohibiting me from posting with this question, but if I was wrong I apologize - please delete). I read on another subreddit about a unique model where nurse practitioners do only medicare wellness visits. I am drowning in medicare wellness visits and this really piqued my interest. I only have 2 extra slots in clinic, so this would be a 4 or 8 hour a week position. But I envision the nurse practitioner only doing Medicare Wellness visits, no additional concerns addressed during the visit, no call, no lab follow up, nothing.

I wanted to see if anyone on this sub had any insight into whether:

1. This sort of part time, hourly position would be even remotely attractive to any nurse practitioners in general? Are most nurse practitioners interested in full time, salaried work?
2. Where one posts job positions for nurse practitioners? Is there a website or facebook group or professional organization to contact?
3. How does one find out the hourly rate for nurse practitioners in their area? Is there a website.

I apologize for being completely clueless. I earnestly want to make this happen, but I don't know where to start. Am I way off base? Is this probably not viable?

Edit: Thank you so much for your responses. This gave me great starting points and I am feeling really hopeful!

I currently work as a NP in an UC setting. In the agreement I signed they’re requesting a 90 day notice. I believe the agreement doesn’t have any specific punitive actions if there’s less than 90 days given and I also believe it’s an at-will agreement.

My current plan is to go back to bedside registered nursing, to a job where I wouldn’t need any 3 month credentialing. (I’m just not sure being an NP is my passion, which is a conversation for another day).

Due to this, I’m a little torn with how to proceed in giving my notice with current no job lined up.

To me, giving the notice now seems better? — if I get a job sooner than that I can always adjust the notice, or ask for an extension?

Or, do I wait until I have a legitimate offer and then give however long notice then (even if it’s 2-3 weeks).

Anyone been in a similar position with the 90 day notice and starting a new job that doesn’t require credentialing?

I don’t want to burn bridges but this is for a company I’m certain I never want to work for again.

Hi hi! Sorry for the long post. Title kinda says it all, but I’ll break it down a bit.

I’m considering NP school in the not so distant future, and would love to hear from other NPs about what they love (or don’t) about their fields, or just give general input.

Current experience:
10+ years bedside total, mix of med surg, cardiac stepdown and ICU (kidney/liver/pancreas transplants, neuro, mix of a lot of things).

Ideal shifts:
3 12hr shifts strongly preferred, no weekends or holidays preferred but that’s flexible
Do *not* want 5 days a week
On-call not ideal but doable for the right job

Pace of the work:
Flexible on this, but wouldn’t want either extreme (SUPER fast paced or SUPER slow).

Population:
I’d consider *almost* anything with adults. In-patient or out-patient or a mix. Would consider telehealth aspect to the job but like hands-on work.

Do not want:
ICU NP/hospitalist NP or L&D

Procedures would be cool, but not at all a requirement. Good pay is a big consideration if I’m being frank, but I have to enjoy the work.

Considering:
Derm (willing to cross train aesthetics for variety wouldn’t want to ONLY do that)
Urology
GI
Women’s health (not midwife)
Psych (likely not first choice but not off the table)

I would love to hear from other NPs about their thoughts!

Thanks so much!

Hi all

So I know that technically/supposedly the school you are educated from does not relly count in hiring. I partly agree with this as past experience significantly plays a part. Now that this was stated. I would like yall honest opinions for both employment and clinical rotation securement:

Would you guys rather hire someone/ accept as a student someone from Emory or Vanderbilt? If it matters the track in post masters AGACNP. Both are supposedly finding clinicals. I don't trust that. So again when it comes to the schoolwhat guys do you think would be the tendency?

Thanks for your feedback

Has anyone had a recent barrage of anti ANP patients ? I have been in advanced practice since around 2010. This week has been the first time patients have got shirty when they have been told they are seeing the nurse practitioner. The weird thing is three patients complained. In two shifts. Yet nothing for the previous 16 years ?

I’m more than happy for them to see a doctor and honestly the first patient who asked to see a
Doctor really didn’t bother me I’m all for advocating! Maybe I did t explain something well. Maybe the trust was not there. So I went and pulled the doctor who said the same thing as what I had said. She phoned up the next day too apologise. It really was no problem. I Was not offended, surprised maybe as I put a lot of effort into my clinics.

Today however two male patients were rude with it. Im not sure what the deal is has there been som
Campaign against us ? They had not spoken to me or seen me. Both were more than suitable for my clinic. ( both left happy and declined to see a doctor) but it was initial rudeness that surprised me and made me re think things.

Just wondered if anyone else had noticed a
Change

Hello everyone and happy fourth. I am currently an FNP and have been working in pediatric primary for the last couple years. Thinking of switching to a family clinic because I miss working with adults (outpatient clinic as an RN previously) as well as use my training to a better capacity AND it also opens more doors in the company for specializing down the road. The company I work for has both pediatric and family/internal med locations and it should be an simple transition, assuming interviews go well.

Has anybody done a similar thing, switching from peds to family or vice versa? Are you much happier? Do you regret it? Advice welcome.

What is your take on the job market rn, especially based on where you live & what specialty. I've heard the CNM market is pretty competitive but PNP is oversaturated (midwest)

Edit: does anyone have any thoughts on why so many places are over saturated when there is said to be such a need for providers?

Do any of you have any experience with a DEA license that has an MOA? I sent in my DEA application but I have had felony convictions over 10 years ago that involved a controlled substance so I imagine my application is taking longer because it’s getting reviewed a bit heavier as it should be. I’m really just curious what the process looks like if they don’t right out, accepted or rejected. I put in my DEA application on June 20 and it still says processing.

I have been an NP for a year and a half. The first job I had was at a clinic where I did my student clinicals. It was a small private clinic, they began to have serious financial problems, they failed to make payroll (for everyone) for two months straight, I left, they closed down shortly thereafter. I got another job at a large VBC company. That clinic insisted that providers see upwards of 30 patients daily. Almost all of these were multi-morbid, very complex patients. Providers rarely left the clinic before 8pm and very few slept more than 3-4 hours at a time. I left that job after finding out about some illegal activities there. A large telehealth company “hired” me, we signed a contract last January. Since then, I have been stuck in “insurance credentialing”. At this point, it seems they have just ghosted me. I am trying to scrape by doing asynchnous telehealth. It pays very, very little. I have applied to every job that I might possibly be eligible for in a 70 mile radius. (I cannot relocate at this time.) So far, nothing. I don’t mean to sound naive, and I am not looking for sympathy. I am genuinely confused. Is the job market this rough for everyone? Have I had a run of bad luck? Am I an idiot? Am I just supposed to give up now? I honestly do not know. This situation has been so depressing that I am having trouble seeing this objectively. I appreciate any insight.

New grad NP here, I’m about 9 months into my job as a NP in a hybrid urgent & primary care within a community health setting. It’s a high volume job with complex cases and little support and resources.

I was hoping to stick it out a year to see about where I could go to next as a NP, as urgent care was my original goal. However, 1. The job market sucks! & 2. it’s made me rethink wanting to be a NP altogether.

I’m thinking of going back to being a RN just to get out of my current job until I can perhaps be more selective with whatever NP job I land upon next.

Is there anyone here who has bounced back and forth between being a RN & NP throughout the years? I’m worried I’ll get comfortable as a RN and not ever go back to being a NP.

(If anyone can provide any specific advice, I’m currently wondering about getting some ED nursing experience before jumping back into wanting to be an urgent care NP… however I am open to any and all types of RN jobs)

I'm studying for ANCC AGACNP boards and will be taking them next week. The questions on practice tests that I struggle with most are choosing an antibiotic. It seems like I will just have to straight up memorize which antibiotics are prescribed for which infections, but it feels like too much to memorize/keep straight, especially when my resources list multiple appropriate choices for each condition. Does anyone have any tips/tricks for remembering which antibiotics are best for which infections/organisms?

My fiance has been an NP 2.5 years and currently in a private practice with her 60 day notice in.

Since then, due to her colleagues time off and the owner (physician) deciding not to come in - she has 27 pts scheduled today with walkins available.

We foresee this continuing to happen until she leaves. Frankly, this doesn’t seem like a safe work environment in my opinion.

If she quits, she has a to pay an asinine amount of money.

We have entertained the idea of emailing him concerns about patient care but, we believe it may fall on deaf ears. Is a lawyer worth it?

Is this just the nature of the game? Any advice on how to handle this would be appreciated.

Sorry if it’s not a direct ask, I just feel awful. She’s been at work for 40 minutes and has called me bawling and I really hate to see it.

I just accepted a new FNP position in a functional medicine clinic to be their primary care provider. This will be a new role in their practice, so it will need some development as it rolls out in the next few months. What are some facets of your PCP clinic and practice that you think are great? What are some that you would avoid as you were building something from scratch? For example, would I take patients on controlled substances? Would I agree to take over prescribing them? Thanks for any input!

Looking to make a move, I talked with my partner years ago about potentially needing to move because the market I am in is saturated. There are literally no jobs in my area that I am qualified for being AGACNP. I was previously working in rehab and enjoyed it but they replaced the medical group and brought in other providers for their facilities...I have been applying to anything I see that pops up, but the posts come down pretty quickly (I assume they are getting filled quick). I have worked in surgery and post-acute.

I dont have licensure in other states I have applied to Cali and TX, previously worked in TX as a travel nurse and enjoyed it. I What I am looking for:

-possible academic medical center

-hospitalist role, open to ICU but I have not worked in ICU solely, I co-managed patients in a closed ICU

-relocation bonus

-lower cost of living (homes around $500k)

-4 seasons

-maybe some kind of loan forgiveness opportunities

-bonus* activities in the area

I have previously lived in WA-loved all the outdoor activities, family friendly, but the city has changed since I lived there. Florida-way too hot/humid, contemplated moving back but my kids are refusing.

Maybe even a rec for a recruiter.

Hi community!

I'm posting on behalf of my SO who is planning to apply to DNP programs/RN positions around the US in pediatrics. She wants to do a DNP in Pediatric Acute Care. Our situation is complicated by the fact that I'm applying to residency this year which means we will have little control over where I match. However, given that we can signal, we are wondering which top academic hospitals have reputable DNP programs. We have a strong interest in California, Texas and Chicago.

Hey all! I’m an RN with almost 5 years in, mostly med-tele and step-down. I’m looking to go the acute care NP route. Not interested in the ICU as a provider, but I’d love to stay in step-down, med-tele, and similar inpatient service lines. (Honestly wouldn’t mind doing a year in the ICU as an RN first just to get the experience, just not something I want long-term.)

From what I understand, a lot of places require NPs to be acute care certified to work inpatient, so going FNP could really box me in.

So my big question, does anyone know which programs actually help set up your clinicals? It blows my mind that so many NP programs just leave you to find your own placements. Feels backwards for a field that’s so hands-on. Would love any recommendations or experiences!

Side Note: I am open to any programs in the US. I'd prefer if it's MSN-NP programs. Tysm! ❤️

ETA: If there’s a reddit post that has a similar question could you direct me to it? I looked on this subreddit and I haven't seen any posts that are similar to mine.

Took the AANP FNP board exam this am. Takeaways in case anyone else is like me and was scrolling Reddit looking for advice on what board prep to use and/or likelihood of passing based on scores.

Background: nurse for seven years in ER and family medicine. I was an A student in undergrad and grad school.

Prep: I started board prep shortly after graduating. I got my approval to test about 14 days post graduation (slight delay because my school did not process commencement until weeks after graduation). I booked my exam for seven weeks after graduation and gave myself six weeks to prep.

Resources:

1. my primary resource was the Leik book and questions. I spent about five weeks going through the entire book cover to cover, completing all of the questions and completing the four practice exams. I averaged 75% on the practice exams and about 85% on practice questions at the end of the chapter.

2. Sarah Michelle one day prep. I did the live one day review class and practice exam. It was a good general overview, but not particularly specific (which I expected, how in-depth can you get in one day?). The memory tricks were very helpful and their additional resources were beneficial. I got an 80% on the practice exam (which in their portal said a 99% chance of passing).

3. UWorld FNP question bank. In the last week I started doing between 100 to 200 questions per day. I started out averaging in the high 60s and ended up with an average in the high 70s. I felt that these questions were slightly more difficult than the exam but very worthwhile. Some of the questions were almost identical to what I saw on the exam too. The question bank is approximately 1200 questions, I did about 900 of them.

Exam takeaway:
- read each question at least twice to make sure you know exactly what they’re asking of you.
- know going into it that there will be questions you don’t know the answer to. It’s okay to simply make your best guess and move on. You aren’t aiming for an A.
- the questions are not designed to trick you. People kept saying the exam was very straightforward and it was. The information you need to answer. The question is either a) in the body of the question or b) not available because it is strictly memorization.
- do not change your answer unless you have a compelling clinical reasoning for changing it.

Like I said, I spent a long time scrolling on Reddit reading y’alls posts like this one so hopefully at least one person finds this helpful.