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What would you recommend?

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First of all I want to thank you all for the numerous times you guys have offered insight and advice to my questions; thank you for that.

I am asking the following question for a friend whom is feeling pretty “shi**y” to say it in an honest way.

He completed a Nurse Practitioner program back in 2016 and started working right after as a hospice NP with no other forms of experience.  Because of all these pandemic he has been dealing with a lot of end of life issues and it’s gotten to a point where he says it’s affecting him emotionally.  

He wants to start looking for new opportunities doing “real medicine/management” like he said but feels that because his only experience has been in hospice he will have a difficult time being considered for family practice, internal medicine, ER/UC, or hospital medicine.  His second concern is that he feels “everything” that he learned he forgot because he has just been focusing on hospice care.  This situation has him all bummed out and feeling hopeless and asked me for advice.  I honestly felt that I had no good advice/guidance and asked him if he was ok exposing his situation here and go from here.


what do you guys he should do to regain some Confidence in his knowledge given his background? Should he study any specific books, online review?  What would be the best approach from your experience and perspective?

Thanks in advance and wishing you all a good new year! 

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I think this could happen to any of us who work in a unique space. You concentrate on deeper learning about what you do every day and lose your skills in other areas. The burn out I get too. Hospice isn't for everyone. I did end of life care for years and it didn't wear me down because I had a strong feeling that tending to someone's death was just as important as tending to their life. OK...enough of that.

A residency as Cid said is a great idea if your friend has the time and inclination. There are some pretty amazing ones. One of my ortho PA colleagues wife is an NP who did a 2 year neonatology intensivist residency at Baylor and she was pretty impressive.

Your friend could start with some seminars and certifications just to get the brain going. ACLS, ATLS, short courses on procedures like rapid sequence intubation or a basic and advanced suturing class or EKG class. This gets his/her brain going again, new learning builds confidence, and it gets some fresh certifications on the resume. It shows initiative and the ability and drive to continue to learn new things.

Then work on negotiations. Be willing to take less for a short, finite amount of time to demonstrate willingness to compromise while continuing to learn. Consider jobs that often have trouble filling slots like community health centers or remote locations.

Lastly, and I say this frequently, open your mind to any possibility. That is not to say take anything anyone will give you. Settling almost always ends in regret and resentment. Consider new fields, new locations, and be willing to relocate if possible. Opening your mind to anything interesting that comes along no matter where it is located will greatly improve his/her chances of finding meaningful work.

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  • Moderator



he didn't learn much in NP school (sorry but it is inferior to PA school) and now has forgotten what he has learned



take a job in a small clinic for a reduced wage (PCP) and realize it will take a year to get back up to speed, hitting the books and working hard.



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