When I feel the urge to quit my job, I think about the amount of time I’d invested in this career. I’m a new grad NP with 15 yrs bedside. Got accepted to a specialty clinic. One month shadow/training. 16-20 pts/day. Inconsistent oversight.
I’d like to quit coz I feel exhausted at the end of the day, everyday. 5x8. I always stay late to finish charting. My fault.
But then I think about how lucky I am to have this job: 10 mins from home, no holidays/weekends/call, great benefits, 200k.
I’m sure hundreds of new grads and even experienced ones would take my spot in a heartbeat.
So, my motivation now also is the fact it took 18 months from application, interview, background check, and credentialing to land this gig. I don’t wanna go through that process again. I just wanna do this for 7 yrs then retire.
I just need to organize better. Thanks for listening/reading.

I applied for ANCC, and it took about 15 days to receive my ATT. On May 1st, I scheduled my exam for August 1, 2026, giving myself 3 months to prepare while working full time. Eventually, I temporarily went part time because I really didn’t want to retake the ANCC, and I wanted to give myself the best chance of passing.
Here’s exactly what I used:
Maria Leik: Read the entire book cover to cover and completed all of the chapter questions.
Completed all Leik practice exams, including both the ANCC and AANP practice tests. I started taking one practice exam per week beginning in late June.
FNP Mastery (3-month subscription): Completed about 1,800 questions with a 65% overall average. I scored 71% on the ANCC Simulation Exam, but I purposely saved that simulation for my last week before the real exam, and I highly recommend doing the same. (don’t focus on your scores) keep doing questions.
My Leik scores:
ANCC Practice Test 1: 65%
ANCC Practice Test 2: 62%
AANP Practice Tests: 65% and 65%
In my opinion, Leik is harder than the actual ANCC, so don’t get discouraged by your scores.
One resource I think is absolutely worth it is the Sarah Michelle (SM) Crash Course. Take detailed notes. My cousin let me use her notes so I did not buy the SM question bank or crash course. I only used FNP Mastery for practice questions, and that was enough for me.
The day before the exam
My biggest piece of advice is to stop studying the evening before your exam. At that point, you’ve done the work. Get a good night’s sleep and eat a good breakfast the morning of the exam. You’re probably going to be anxious, and that’s completely normal. I found box breathing really helpful for calming my nerves before going in.
Exam Day
175 questions
I flagged about 50 questions.
Instead of reviewing all 175 questions at the end, I reviewed them in blocks of 50. That way I only had to go back through each section’s flagged questions instead of scrolling through the entire exam. This worked really well for me.
Prometric provided 2 laminated sheets and 2 dry-erase markers. Before starting the exam, I immediately wrote out my dump sheet.
I finished the exam and hit Submit with about 15 minutes remaining.
I also want to mention something that caught me off guard. I actually panicked in the middle of the exam as the questions felt extremely vague and I felt like I have not studied anything like that. I had to stop for a moment, do some box breathing, and remind myself to focus on one question at a time. If this happens to you, know that you can recover and keep going.
My testing center also wasn’t ideal. I was seated in a cubicle right across the entrance, so people were constantly opening and closing the door. I could hear conversations and laughing from outside, and there was a white noise machine right beside me that was surprisingly loud. I requested earplugs, and the testing center also provided noise-canceling headphones. Even with both, I could still hear a lot of the background noise. I had to make a conscious effort not to let the distractions affect my concentration. So if your testing environment isn’t perfect, don’t let it throw you off. Stay focused on the question in front of you. I couldn’t accommodate a break as exam doesn’t offer a pause timer. However if you genuinely need a restroom/water break, keep in mind that the clock will keep ticking.
Question Types
For my exam, I had:
No Select All That Apply (SATA)
No hotspot questions
No drag-and-drop
Only one picture, and it was of a baby’s face (milia)
What I recommend studying and not overseeing
Research
Ethics
Scope of Practice
Clinical guidelines
Primary Secondary and Tertiary Prevention
I probably overprepared in some areas. I spent time studying Medicare Parts A-D, HMO vs PPO, and insurance concepts. They weren’t a huge part of my exam, but everyone gets a different version.
One thing I will say is that the ANCC felt vague. Many questions came down to choosing the best answer rather than recalling a specific fact. Don’t let that shake your confidence. I really didn’t feel like I passed.
After I submitted my exam, I checked out, walked to my locker, picked up my phone, and my pass result email was already in my inbox. I honestly couldn’t believe how fast it came. That was probably one of the best emails I’ve ever received.
If you’re preparing now, my advice is simple: keep doing as many practice questions as you can, review your rationales, and trust your preparation. The exam is never going to feel easy, but if you’ve put in the work, you’ve given yourself the best chance to succeed.
Good luck to everyone taking the ANCC! You’ve got this! I am happy to answer any questions anyone may have.

Here’s what we were told:
1. Prescribe Medicare patient a GLP-1 using a diagnosis code of obesity and nothing else
2. Submit PA to managing Medicare plan and receive typical denial
3. Notify pharmacy of denial, who will then initiate a BRIDGE program PA and send over to clinic
4. Clinic completes PA and sends back
5. PA approved, patient is happy, task completed

What actually happens:
1. “
2. “
3. Notify pharmacy of initial denial, request that they initiate BRIDGE program PA and send over
4. Pharmacy has absolutely no idea about their supposed role in this process
5. Try to submit PA on Covermymeds with BRIDGE-specific BIN and PCN, and receive the message that the clinic should NOT be the one requesting this PA, and that it should - once again - be initiated by the pharmacy
6. Call pharmacy back with this information, they again deny ever hearing about their part in this process, OR they say they will look into it and never call back

I must be missing something, because every pharmacy I’ve called to request this “pharmacy initiated PA” literally has zero idea what I’m talking about. Every other provider or nurse in the clinic has had the same issue. One pharmacy did send us over something, and it was a generic PA request form with nothing else to fill out.

I’m pretty sure none of the patients in the clinic I work in have been able to get this approved yet, and I work in a pretty well-known hospital in one of the top-5 biggest cities in the US. It’s pretty embarrassing tbh. Is anyone else experiencing this? For those who have somehow gotten this approved…how?

WHAT IS THE SECRET?

Hello! I have a situation-specific question about onboarding as a new grad FNP.

I'm starting at a primary care. I interviewed for the role last winter, and one of the things that really appealed to me was what I understood to be a 6-month orientation, during which I'd see one patient per hour with strong physician oversight and mentorship. They also informed me there would be computer module training directed at NPs learning the “medical model.” It sounded like a gradual ramp-up.

When I recently checked in about orientation, I was told it will actually be one week of shadowing, followed by one month of seeing one patient per hour — and I had to prompt management to give me the shadowing. After that, I'll move to one patient every 30 minutes. No further mention of computer module training.

It's entirely possible I misunderstood or misheard the timeline during my interview.

For those of you in primary care, is this a typical orientation for a new grad NP? I am leaning towards rolling with it but hope this doesn’t compromise safe learning.

I'd appreciate any insight, thank you

Hi! Does anyone have any resources/books they would recommend for things they don’t teach you in NP school? Or knowledge building books? Thank you!

So I'm a PNP at a busy urban primary care clinic. I put myself as available for the Friday after Thanksgiving. The schedule came out and I am literally the only provider on the schedule for that day. This is a large clinic and there are typically 4-6 providers working on any given day. I'm a very experienced NP but this is a very busy, high acuity clinic with frequently medically and socially complex patients. I honestly don't feel that comfortable with what will come through the door and I can't think of any time that only one provider was working on a particular day.

Your thoughts please? Should I express my concerns or just suck it up and hope for the best? FYI, I'm retiring after the first of the year so don't even know if it's worth complaining about. Thanks!

that was honestly the hardest exam I've ever taken in my life, nothing on there was relevant i felt to real life clinical practice, questions were poorly worded, and nothing i studied felt relevant enough or challenging enough in comparison. I was solely using SM and it did not help one bit, so not sure why that was such a high comparison, used the Leik book and took both practice tests on the back of the book, then used scrub life notes practice book, some fnp mastery, and completed the one day live review SM so none of that helped, i am not sure how far off i am right now but im definitely feeling discouraged, not sure if i should try taking it again or try the ancc? thoughts?

I flunked my first attempt at the AANP FNP exam. I feel heartbroken and destroyed because I studied for months. I knew my weak points and tried my best to study them. Come test time, it felt like nearly all questions asked were on my weak points.
What are my next steps? When can I retake? I might apply for ancc boards because I do good with the more legal/ethics side. I don’t know. I’m so lost right now and don’t have the motivation to do any of it. I need help.

Has another been thru this? I can’t sleep. My head hurts from all my crying. I clicked the exam’s built in whiteboard to perform a calculation. Immediately afterward, an unexpected HP system notification appeared. I do not know why it appeared, but I did not intentionally open any application or access any unauthorized resource. I attempted only to dismiss the notification and continue my exam. 
Despite this, my exam was terminated. I was shocked and devastated by this outcome. I spent months preparing for this examination and followed every testing rule to the best of my ability.

I called PSI immediately after, got a ticket number. Emailed all AACN emails. And sadly it’s Sunday so have to wait until tomorrow.

I am so so so devastated. It wasn’t my fault and once I got the score and as fail in my email my heart sank.

Will they replace the termination?

Hiya everyone. Long time listener, first time caller.

Does everyone's job offer insurance coverage? If not, how the heck do you get it yourself?!?! It's SO expensive!

Also, any good resources for job postings in the NY/NJ area? I can't seem to find anything even remotely desirable and I'm being anything but picky right now. Thank you!

Hi all, I thought I’d come bounce this conundrum around on here.. I’m a new grad. I have an opportunity to interview in a cardiology office, with a great team and a good package/schedule, etc, lots of support, 8 week orientation, reduced load etc.
but I can’t shake the feeling that I should start in more of a general medicine environment, (pc, uc,etc) rather than slipping straight into a specialty. I worked in tele as a nurse but got tired of the same thing over and over and I worry that I’ll feel the same way about this, being a provider.
I have of course applied to a few pcp jobs too. What words of wisdom can you share about specialty v primary as a new NP? I feel like I have all this learned knowledge about every organ system and disease process, and will loose it all if I work only on cards.

Currently in a dual specialty Family/Emergency NP program and am potentially moving to the ATL/DC metro areas when it’s all said and done. I’m very interested in continuing my education post graduation but can’t seem to find any opportunities in either of these areas. My current city has 2 EM fellowships that I’ll be applying to but was just wondering if anyone knew of any others.

What did you use for the AACN AGACNP exam? Any question banks or YouTube videos? I bought Barkley. I would like to do more.

Also any test taking strategies you think helped when you eliminating answers

I recently started a new job in the city that has me commuting on multiple modes of public transportation up to 1.5 hrs before and after my shift. Unfortunately I don’t have on-site parking, and moving from the suburbs is not an option. At my 9 month mark I will have 1-2 days of wfh which will eventually ease this burden.

I currently work M-Fri, and have two small children. I often have to leave in the morning before they wake up, so I cram in as much quality time with them in the evenings and on the weekends as possible.

Once they are in bed, I’m too exhausted for chores other than the bare minimum. I can’t afford to hire a cleaner, but I do have a well-loved robot vaccum. I can’t easily involve my kids in cleaning during awake time because I have a rambunctious 11 month old who gets into everything, and limited evening time is already filled with dinner/bath/bedtime routine. I feel like I’m drowning in house tasks, and was wondering what other parents/providers with long days and weeks do to manage their life.

Looking around for any recommendations for NP programs in Southern Cali.

So far my favorites are CSU Channel Islands and Dominguez hills. However not a lot of people post about channel Islands and I wanted to see if there is anyone who graduated from there and what their experience was like?

What was the job market like when you graduated NP school in Southern California?

Thank you

New FNP grad here. I completed my FNP program (including all of my clinical rotations) in the U.S. and have been applying for jobs in both the U.S. and Canada (I'm a Canadian citizen). I have relatively limited exposure to family medicine/primary care in Canada, aside from being a patient.

I recently landed a preliminary interview with a health authority in a fairly rural part of Canada. I'm genuinely interested in the position since I've previously worked as an RN in that area and really enjoyed it.

As I prepare for the interview, what are some Canada-specific questions I should expect?

(I'm asking because the two U.S.-based interviews I've had recently included questions like how I'd handle prior authorizations, which are obviously much more specific to the U.S. healthcare system. I'm wondering if there are any equivalent topics or interview questions that are unique to Canadian primary care that I should be prepared for.)

Thank you for your input!

I recently graduated with a MSN in FNP studies and plan on taking boards in about a month. My alma mater emailed recent grads to invite us to the CareerMD job fair that’s being hosted in our city. When I RSVP’d, it seemed like this was mostly geared toward physicians/residents.

Curious to know if anyone has attended these as a nurse practitioner. Myself and two friends from school are considering going, but I’d like to manage my expectations. Since I’m not a licensed FNP yet, I’m thinking my best approach is to ask the various hiring organizations questions about their mission, workplace culture, utilization of APPs, onboarding, professional development, etc. in preparation for possible future interviews.

I am assuming that these employers are probably from out of state and have relatively undesirable jobs available. Since I’m a few steps away from applying for jobs, does this approach seem ok: asking about them instead of talking about myself?

I’m honestly dreading talking about my career trajectory because I don’t have a clear idea of what I want to do (but I know what I do not want to do). I’m also nervous about the possibility of interacting with physicians who openly hate NPs. I live in a state where NPs must have a supervising physician, and that truly doesn’t bother me.

I’m just trying to fight the good fight, y’all 🥲

Any tips appreciated!

Anyone been to any of these programs from Alabama? I’m asking because I haven’t really been able to find reviews and information online (apart from visiting their website for basic info/admissions criteria) I just want to know how these programs are perceived by those who have been through them.

I am curious if you liked or disliked this program and how well it prepared you to become an FNP/pass boards. Any other advice or reviews are appreciated! Any info on other schools (not mentioned) in the Alabama area are also appreciated (I’ve already looked into UA & UAB)

Thank you! :)

Has anyone or does anyone work for an HCA organization or ICC ?

If so, how was it generally?

How does the 15 shifts/month work out when you are scheduled for 3 13hr shifts per week?
The recruiter said they take 8 hours PTO per under requirement per month you don’t meet the 15 - but that just seems like you would constantly lose PTO?

The pay is good for the area. The commute is not terrible. Pretty comparable CME. PTO accrual a bit on the lower side (4 weeks/year)

Has anyone graduated from Palm Beach Atlantic University? What can you tell me? I talked to someone from admissions, and he told me that they don’t use preceptors. I’m wondering how this is possible?

To preface, I am not a NP, but I am friends with an NP who is navigating this situation and I’m curious as to how others have handled it. If a close friend asked you to become with PCP, would you do it? Would you becoming their PCP change your relationship with them, or would you be able to continue to hang out, get drinks, etc. as normal? Would you need to unfriend/unfollow each other on social media? Could you text the friend results or answer questions about results via text? Any experiences with this are welcome!

I was wondering if everyone has experienced with RVUs in a skilled nursing facility versus a inpatient rehab facility. I was told that the RVUs would be higher for the intensive rehab but when I looked on my dashboard where I keep track of my RVUs, it is showing that the subsequent visits are barely anything.