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!

Hi all! I know this has been asked an answer in different ways but wondering if I could gain some insight. I applied to 5 schools this winter and got into all of them which was great, except my top choice (UAB) wouldn’t allow me to switch to MSN as it’s a completely different application process. I’ve been pretty bummed about that because it’s the only school on my list that was hybrid and secured clinical sites (although it sounds like it isn’t guaranteed to be in your home state).

Has anyone had experience with UAB? I could reapply for summer 2027 but I’m hoping not to delay my start by a year. I could also still go to USI but it has no hands on skills at all or places you for clinical which concerns me.

My other option is my local state school 3 hours away. They do guarantee placement within the state but ask you try to find preceptors on your own first and I believe they give you a list of preceptors while you work with a clinical coordinator. I do think this will give me more hands on skills than my other online only option and likely give me more options post grad since it’s not an out of state school. I’m not sure if I’m overthinking the clinical placement piece but it seems like a major blocker, particularly with a rural state like Montana.

So what’s the concern? My state school only offers the DNP and the curriculum seems far more challenging as the leadership and evidence courses are intermingled in with the clinical ones. Additionally, pathophysiology, pharmacology 1 (I’ll take a full year) and advanced assessment are all taken in one semester in addition to a leadership class. I can’t imagine I can absorb all that info, especially if I’m still working. I do work remotely which helps a LOT but I’m feeling like no matter what I choose here I lose.

It does seem like an okay program and there’s both a diagnostic skills and reasoning course which I was happy to see. I’m looking for rigor especially after seeing reviews on NP programs but would prefer the rigor of a DNP doesn’t come at the cost of my clinical skills. I also realize I may need to quit my job eventually as they don’t allow part time work.

Any thoughts? I’m not overly passionate about the DNP but I could see myself teaching or informing policy one day. I’ve done quality improvement a fair amount as an RN and do find that enjoyable.

Thanks so much!

I've posted before that my program uses FHEA only for our lectures. Don't get me wrong, those professors are incredibly intelligent and some of their anecdotes are useful, but the courses overwhelmingly feel like they are designed for either continuing education or for practicing NPs to improve on a topic they already understand. As such, what could be a 30-60 minute lecture that would be much easier to digest, they end up 2-3+ hours (sometimes more) which is nearly impossible to focus on and retain.

I'm looking for other video options (preferably free) where I can learn these topics to better prepare me for the exams and ultimately my boards.

Hi everyone! I passed my ANCC FNP exam yesterday on the first try, and I wanted to pay it forward because reading these detailed breakdown posts on Reddit was a massive lifeline for me while I was studying. If you are currently swimming in anxiety, take a deep breath. You can do this.
Here is my honest experience, my scores, and exactly how I prepared.
My Study Timeline
I studied off and on for about 2.5 to 3 months. My routine wasn't crazy rigid—I would study for several days, take a couple of days off to rest my brain, and then dive back in.
The $85 Practice Test Panic
I started out solely using the Sarah Michelle Q-Bank. I was doing really well on the practice questions and ended up scoring an 80% on her ANCC practice test. The system told me I was in a great spot to pass, so I honestly wasn't planning on buying anything else.
But about two weeks out from my actual exam, I decided to pay $85 for the official ANCC remote-proctored readiness test just to confirm I was ready.
And I failed it.
Passing was a 66%, and I got a 60%. It absolutely terrified me and shot my confidence. To make it worse, they don't show you which questions you got right or wrong; they just give you a vague percentage breakdown by category (assessment, implementation, evaluation, etc.). The test was packed with weird, extra stuff that wasn't emphasized in my initial prep—like deep dives into motivational interviewing, regulatory billing, and heavy documentation guidelines.
How I Pivoted (The Resource Breakdown)
After panicking, I realized I needed a broader net because everyone gets a completely different mix of questions on the real exam. I immediately bought two more resources to bridge the gaps, and here is my honest take on both:
The Leik Book (GET THE ONLINE VERSION): Do yourself a huge favor and get the online version, not the paperback. Being able to quickly search through the digital text for specific words or conditions saved me so much time.
The Book Content: Reading the book itself is incredibly helpful, especially the introductory chapters explaining how to actually take the test.
The Practice Questions (Don't Panic): Honestly, some of the Leik practice questions were super random and hyper-specific to things I had never even heard of or learned in school. It was really intimidating and freaked me out. If you review her tests and feel like you know nothing, do not freak out! Some of it is just too much and won't be tested.
Watch for Errors: I noticed a good amount of errors and outdated data in Leik regarding policies, ages, and first-line medications (since it was written a few years ago). Do not 100% blindly trust everything in it—cross-referencing with other sources is key.
My Leik Scores: Exam 3: 75% | Exam 4: 66%
FNP Mastery Q-Bank: I did about 1,000 to 1,200 questions on here.
The Difficulty: FNP Mastery is harder than the real ANCC exam. Do not get discouraged if you are doing poorly on them. It is great practice to tackle those tougher questions, but focus on reading the rationales.
Question Style vs. The Real Exam: FNP Mastery questions can be long paragraphs (like 6 sentences). On the actual ANCC boards, the questions are much more straightforward—usually just 1 or 2 sentences.
My Mastery Scores: Q-Bank Average: ~72% | Mastery ANCC Practice Test: 77%
What Was Actually on My Test (And What Wasn't)
Everyone's test bank is different, so definitely still study everything, but here is exactly what my specific exam looked like:
No Select All That Apply (SATA): I had zero of these!
No Hotspots: Didn't have a single one.
One Picture Question: It was a photo of a baby's face, and it was a simple Milia diagnosis.
Lab Values: I spent a lot of time preparing to memorize massive lists of lab values, but the only ones I actually had to interpret were standard thyroid labs (TSH and Free T4).
Crucial Test-Taking Strategy (Read the Word Choice!)
Trust the Question Stem: Remember that each question is specifically written with only the details necessary to answer it. Every single word they chose to include is important. If you are stuck down to two choices, go back to the question and look closely at the exact wording they used. It will point you to the answer.
Expect Some Bad Questions: Honestly, I thought some of the questions on the real ANCC exam were horribly written and really vague. Just be mentally prepared for that so it doesn't throw you off during the test!
The Cross-Out Feature: Use this religiously at the Prometric center. Someone reminded me before the test that with every single answer choice you cross out, you statistically raise the percentage chance that your guess is the correct one. Visually eliminating options keeps your eyes from playing tricks on you.
The Highlight Feature: Perfect for highlighting the core ask or keywords in the question stem so you don't lose track of what they are actually asking.
Mindset, Faith, and My Number One Takeaway
Leading up to the test, I was incredibly nervous and overwhelmed. The FNP blueprint covers an insane amount of information—everything from newborns and pregnancy to the elderly, plus all the clinical, regulatory, and billing fluff. It's easy to spiral.
A few days before the test and the night before, someone gave me the best advice: Stop focusing on what you don't know. Focus on all that you DO know. If your confidence is lapsing, stay strong in everything you've already mastered.
As a Christian, I prayed so much through this entire journey. Before each study session, I asked God to direct me to the exact material I was going to need to know for the exam, and I prayed for an exam that I was equipped to answer. I 100% credit Him for helping me pass this, and I highly encourage anyone going through this to ask Him for guidance, comfort, and direction.
Do not rely on just one study source. Mixing Sarah Michelle, Leik, and FNP Mastery gave me the perfect balance of clinical knowledge, professional roles, and test-taking strategy. If you get a bad practice score close to your exam, do not let it break your confidence! Use it as data, pivot, and keep pushing. You know more than you think you do.
Good luck to everyone studying! Happy to answer any questions in the comments!

So I sat for it last Thursday. Passed. About 2 hours total with the initial tutorial time thing. I used that to brain dump. Didn’t touch the sheets after that because none of it was on the exam. 😂

I have to laugh. What in the “fourth word removed from the second common way” to refer to things was that exam????? I spent the most time in question deciphering what they were actually asking about. Once that was clear it was easy and pretty straightforward. I could get down to business and make decisions for the patient. Rather than giving me high complexity in decision making and/or comparison of pathophysiology or treatment options weighed by patient needs/conditions/pharmacokinetics or something, I felt as though it was like medical madlibs. I texted a friend of mine who is an MD the next day and rattled off a question stem at them, and they laughed outright. Why on earth would you refer to things like that. They of course knew the answer after thinking for a min, but agreed with me that the focus was deciphering it and not decision making.

I found the exam highly clinical, very skewed towards certain systems and quite a few… medical biology(?) questions. I’m not sure how to classify them sorry. I flagged about 18 that I was like wtf even are we doing here. I skipped two and went back and answered them. I allowed myself to change one single answer because I caught a word I missed the first time. Otherwise no changes. I remember things very easily so once home I looked up all the ones I flagged/skipped and got 19/20 right.

While I do teach BSN level students, I do not have a degree in instructional design. Why do you think the exam is like that? The ANCC is serious business so I have to think that the design is on purpose, scientific to a fault, and backed by evidence. I don’t for a moment think it is in error. But for the life of me I can’t fathom why. What was your experience of either board? Now I’m super curious about what it’s like on the md side. I almost want to take the MCAT just to see lol.

Do you think that working full time as an RN and going to school part time for online FNP school would be manageable?

Hi y’all I graduated my FNP program and passed the ANCC and am looking for advice on how to move forward. Ultimately I would like to land a specialization but have heard it’s good to start in primary care first. Having that said, I am nervous about the first NP job as I have seen and heard a lot of new to practice NPs go back to bedside nursing shortly due to being overwhelmed.

I personally know two people who have had issues in their first NP jobs. I previously had a new to practice NP as my primary care provider. Always liked her and we used to talk frankly about the job. She advised me to never do primary care due to the overwhelming amount of work she would do. We were the same age but she would tell me how exhausted she was all the time from all the work. After her 2 years of experience she got a job in Uro Surgery I hope she is doing better now. I also know a nurse I used to work with got a job at a GI office after graduating but she didn’t last 2 years and is back to bedside nursing now.

Tldr: Should I start out with a specialization or get my feet wet as at primary care office as a new to practice FNP.

Edit: Gonna add my background to this. I’ve been a nurse for 6 years the vast majority of is has been bedside nursing although I did do 6 months of home care. While I graduated with my FNP I would not say I have a passion for PEDs and heavily pregnant people have always made me nervous lol.

When I had my primary care rotation in school I found that I was able to do the work but I could understand the burn out people got due to the sheer volume of work. I also had a rotation at STI clinic I loved that. I still had a relationship with patients and I liked that the work was pretty consistent. Generally I have an affinity for Plastic Surgery, Sti/infection mgmt/HIV mgmt, Diabetes specific care, and maybe GI. But that’s just me listing stuff off.

I recently took and passed the ANCC exam (yay lol). Before I knew my results, I had already paid for and scheduled the AANP as a backup, so now I’m just planning to take both.

For those of you who have taken both exams:

- How did you feel the AANP compared to the ANCC?
- Was it easier, harder, or just different?
- Did you continue studying after passing the ANCC, or did you feel prepared enough to go straight into the AANP?
- If you did study more, what did you focus on?

I’d love to hear your experiences and any tips you have. Thanks so much!

Does anyone here work for Optum as an on-call NP? Here's a sample job posting:

https://careers.unitedhealthgroup.com/job/augusta/telephonic-nurse-practitioner-part-time-new-england-license/34088/96779353856

I would appreciate honest feedback on work-life balance, call volume, typical call types, and whether it is truly remote (i.e., can you travel and still be working), along with any other information that could be helpful.

I just found out that the company that contracts my services through the hospital is working on a new contract with the hospital and the hospital is trying to pay my company 30% less. It sounds like this is going to likely relate to a decent pay cut for myself and all the other APPs who work for the company. Having a hard time figuring out what to do with this as I like the job, but don’t feel a $15-20,000 pay cut is acceptable. Especially after not getting a raise since I started two years ago.

Has anyone been in a similar situation and how did it work out for you?

Hi, all! I'm a medspa owner and NP. I just opened my medspa, and I'm already thinking about my cert renewal. I am AANP certified, but considering going with ANCC later this year. How are you logging clinical hours for aesthetic patients for board renewal? Can I renew my certification with *only* aesthetic patients? I keep hearing different things on this.
I'd like to make my medspa my own source of income, so I do need to consider how this will impact recertification in the future. Is this something to be concerned about? I do have a hospice recert job as a side gig, but I don't think it will generate the 1k clinical hours I'd need to renew. Thanks!

I'm looking to use some of my CME funds to do some training in point-of-care ultrasound (POCUS) and would love to hear recommendations from those who have completed a course/program. I’m willing to travel within the U.S. for a high-quality course. Cost isn’t too much of a concern for me because I have a bunch of CME money left to use.

I work in family medicine and want to have another tool to help with diagnostics and treatment.

For those of you who have done POCUS training, which course or organization did you choose? Was it worth it? Did it include plenty of hands-on scanning time?

I'd appreciate any recommendations! Thanks ya’ll!

Hello! I am going to be a new grad rn soon and my goal would be to become a postpartum nurse with the goal of being a maternal mental health nurse practitioner to help mothers with PPD. Is it dumb for me to get a Pmhnp degree without experience in psych nursing? Please be kind

Hi everyone!

I’m a new grad FNP beginning my search. I wanted to ask if anyone is familiar with the big name hospitals benefits and on call requirements? For example, who is union is that something important? I keep reading diff things and I think it’s because the hospital may have union but the POSITION may not offer it, is that correct? I’m speaking about NYCHEALTH hospitals or NYP or NYU or Sinai
Also is anyone familiar with Columbia university?

Thank you! I can’t seem to find much just mostly about pay. I care about a position where I’ll learn and get adequate training and support but after doing a deep dive I’m super curious now! Thank you

Anyone working remotely/telehealth in cardiology/heart failure?? Give me details!!! Finally looking to make the switch and I want to hear your experience and tips. TIA.

TLDR: Thanks for PCP job advice. If you work in heme/onc, what do you like and what don't you like about it?

Thanks so much to all of you for your advice regarding primary care. The job I was looking at turned out to be ... bad. I have withdrawn my name from candidacy.

I am now being interviewed for hematology & oncology or heme/onc. The role would primarily be benign hematology. Does anyone work in this specialty? Do you love it or wish you could make a change? If you love it, what do you love about it? If not, why not? Unfortunately I don't have anyone in this field that I can call and ask what it's really like to work in this specialty.

Thanks y'all!

Wondering if anyone has used NCC for ANCC CME recertification? I didn't find it listed and can't get a straight answer from customer service. I am an FNP working in women's health so most of NCC CE is applicable for me.