New Grad Leaving Hospital for Office Job

[IcySageNurse]

Hello everyone,Just need some advice on leaving a hospital job for office work. I just graduated a few months ago, and took a job in a hospital. At first I absolutely loved it, but now I hate it and no longer want to work in a hospital. I find the work demeaning and labor intensive - boosting, cleaning excrement, etc. My ultimate goal is to be an FNP, so I don't plan to be a RN for long before I go back to school. My concerns whether office work in a primary care clinic is good enough training to be an FNP? I feel like skill wise, I'll be doing less, but I will get to see more and work closely with other FNPs. I have been offered a job in a primary care office, and I need advice if I should do this or not.

[mclennan, BSN, RN]

Wow. LOL

I've worked with NPs for years in many different settings and EVERY. SINGLE. ONE started out cleaning up POOP! AND put in at least 3 to 5 years (some longer) working shifts on hospital floors in Med Surg. They all lived to tell about it, too.

If you search the forum you'll find many a new grad getting schooled hardcore by experienced nurses after they complained about POOP. I have 4 sets of letters after my name and 6 years experience and working on my Masters.....and I would jump right in and clean up POOP if it needed to be done. That's what nursing MEANS. And EVERY NP I know would do the same. Their understanding of nursing is what makes them successful NPs. They'd never leave a patient laying in their own POOP.

Most FNP programs are fiercely competitive and will require some experience in Med Surg - and yes, cleaning up POOP. Because that happens on units that are short CNAs and that happens in nursing, period. If I were on an admissions committee of a FNP program and read this -knowing you'd applied - I'd LOL and tell ya to come back when you've had experience and some understanding about what nursing means.

Sorry princess. And good luck.

P.S. POOP

[IcySageNurse]

Here we go. I'm so sick of nurses that think every freakin nurse on the planet is required to clean up poop and other things that 99% of the population wouldn't even dream of doing. There are plenty of nurses that work OUTSIDE of med/surg - in clinics, radiology, etc. And I've even heard a nurse comment that she worked in radiology so she didn't have to deal with all the nasty stuff. Does that make her less of a nurse? No, nor does it make me less of one. I am allowed to not want to do something filthy and still further my education without the snide remarks of other nurses. Must this profession be so catty?

My point here is, PAs and NPs are both midlevels. They are educated in different models, but still function very similarly in a medical setting, hence why many jobs request a PA or NP for a particular position. In PA programs, all of the knowledge neccesary to be a PA is IN the program. They learn about medications, diseases, etc from their training in PA school. Is this NOT similar to NP school? Do NPs HAVE to work in a hospital to have the ability to be a good NP? Do NP programs themselves not teach the required information neccesary to diagnosis and treat without one having prior experience in a hospital?

I just want an honest answer here so I can plan accordingly. I know that in nursing, people seem to value someone willing to clean up poop over someone who is book smart - I think that's a little backwards once you get to the provider level. I am an extremely intelligent person, very booksmart, with a previous degree in Biology from Yale University. I entered an accelerted BSN program and graduated top of my class with a 4.0 and honors. I am very, very booksmart, and that's what we need in the NP world. As a patient, I would rather have a well-educated competent NP than one who tells me she happily cleaned up poop before becoming an NP. We are all different, and there is a place for all of us in the world of nursing. I have every right to be an NP, and while I may not be happy about cleaning up excrement, I think my intelligence will make up for that as a provider.

[CrunchRN, ADN, RN]

I wouldn't say you need to stick with acute care a long time. Just a couple of years so that:

1. you are competent handling emergencies & running a code as this happens in other settings also

2. you have a very good understanding of illness and how disease processes work from early to late stages

3. you have a good grasp on how to perform procedures because you will be expected to competently do this in the office as an NP

Office nursing mostly prepares you to do phone triage and manage a schedule of patients, but not the rest.

I see nothing wrong with you not wanting to clean poop forever, but I think the above 3 things are super important to learn before you leave acute care.

[IcySageNurse]

CrunchRN - thank you for your response. What if in the office I was working closely with the FNP and helping her with some procedures that I wouldn't get to do in a hospital setting?

[CrunchRN, ADN, RN]

That will give you some of what you need, but not all of it. I was an office nurse for over a decade and the nurse rarely gets to assist. They mostly stick you with phone triage and the MA's get to do all the fun stuff.

[Susie2310]

Gosh, I was shocked to read you use the word "demeaning" in regard to common nursing duties. Imagine a patient with severe diarrhea and sepsis for example. That very sick patient is relying on you to keep them clean and prevent skin breakdown along with administering fluid boluses and antibiotics and monitoring their BP etc. And you find giving that kind of care degrading and beneath you. If you don't want to provide basic nursing care and just want the prestige and status of a medical provider who generally doesn't clean up diarrhea, why did you go to nursing school? What kind of experience did you think you would bring to being a nurse practitioner? I don't mean to be harsh, as bedside nursing is not for everyone, but put yourself in a very sick patient's place, completely dependent on the care you give, and imagine how they would feel knowing you feel demeaned by helping clean up their diarrhea. If you don't care enough about your patients to be able to do this without feeling demeaned, will you care about your patients more as a NP? I personally don't want to receive care for myself or my family from a nurse or other provider who feels demeaned by providing basic care.

[mclennan, BSN, RN]

It's a running joke on this forum that many people come here asking for advice, and when they are told things they don't wanna hear, they predictably become defensive and angry. Way to keep the stereotype going. All the book smarts in the world can't teach character. Yano?

The best NPs I know have an equal balance of book smarts and background in POOP. What really matters is the ETHIC and VIRTUE that you need to demonstrate that you'd never, ever see any patient care, from cleaning POOP to using Euclidian Geometric Philosophy to project their ejection fraction or whatever - as "beneath" you or "icky." It's the CONCEPT, the IDEA that you'd apply such elitist thinking to someone lying there in their own diarrhea.....before you've even APPLIED to NP school that is going to get you in trouble. NPs are wonderful but they are NOT doctors and not PAs. Their training comes from a nursing perspective, that which you sorely lack. I also came into nursing with a bunch of academic trophies and medals and degrees and book smarts, blah blah who cares. That patient lying there in their own POOP doesn't give a flying fig about your Yale diploma. I can guarantee that.

[NightNerd, MSN, RN]

I just want an honest answer here so I can plan accordingly. I know that in nursing, people seem to value someone willing to clean up poop over someone who is book smart - I think that's a little backwards once you get to the provider level. I am an extremely intelligent person, very booksmart, with a previous degree in Biology from Yale University. I entered an accelerted BSN program and graduated top of my class with a 4.0 and honors. I am very, very booksmart, and that's what we need in the NP world. As a patient, I would rather have a well-educated competent NP than one who tells me she happily cleaned up poop before becoming an NP. We are all different, and there is a place for all of us in the world of nursing. I have every right to be an NP, and while I may not be happy about cleaning up excrement, I think my intelligence will make up for that as a provider.

Yeah, as a patient, I would like someone who did well in school and learned what they needed to help me. Good for you. As you pointed out, the program should prepare you with the knowledge you're going to need to competently perform the role of NP. You still need to be able to react to ALL of your patients with compassion and kindness. If they can tell you are disgusted or uncomfortable with some sight, smell, etc., all the intelligence in the world isn't going to make them feel safe or cared for with you.

Regardless of what you decide to do before entering the NP program, I hope you'll develop the ability to at least pretend gross things don't bother you, because they WILL NOT just go away in an office setting.

[Susie2310]

It's a running joke on this forum that many people come here asking for advice, and when they are told things they don't wanna hear, they predictably become defensive and angry. Way to keep the stereotype going. All the book smarts in the world can't teach character. Yano?

The best NPs I know have an equal balance of book smarts and background in POOP. What really matters is the ETHIC and VIRTUE that you need to demonstrate that you'd never, ever see any patient care, from cleaning POOP to using Euclidian Geometric Philosophy to project their ejection fraction or whatever - as "beneath" you or "icky." It's the CONCEPT, the IDEA that you'd apply such elitist thinking to someone lying there in their own diarrhea.....before you've even APPLIED to NP school that is going to get you in trouble. NPs are wonderful but they are NOT doctors and not PAs. Their training comes from a nursing perspective, that which you sorely lack. I also came into nursing with a bunch of academic trophies and medals and degrees and book smarts, blah blah who cares. That patient lying there in their own POOP doesn't give a flying fig about your Yale diploma. I can guarantee that.

Absolutely. Book smarts, board certifications, high GPA: I have them too along with plenty of other nurses. OP you are not unique in your academic achievement. Nursing care is patient centered, not provider centered. There is not a lot of prestige in providing basic nursing care, but that basic care is critically important to the patient. Instead of thinking about your own feelings and needs, please try to put yourself in the place of a very sick patient with diarrhea, and think of their needs and feelings.

[LTCnurse11]

In honesty, this post is borderline offensive. Someday you might be siting in your own excrement. Sorry if you think I'm catty and mean by having just said that but honestly---I provided care for total care patients for years. And I would not be where I am today without my experiences. It's basic nursing care. And don't forget you have to learn how to walk before you can run. Take that med surg experience and learn as much as you possibly can. It doesn't mean you'll be swimming in a sea of poop to get your experience.

[IcySageNurse]

Listen everyone, I do not mean to come across as elitist toward my patients or other nurses. Quite the contrary, I entered nursing to care for people. As a nurse, I have had my fair share of "nastiness" working on a med surg floor. While it did gross me out, each and every time, I did what I needed to do to help the patient. Did I enjoy it? Not one bit. But I would NEVER leave a patient to sit in anything - I kept my patients completely clean and did what I needed to do and made sure no one ever felt bad about it. Now, despite that, I am simply saying that I do not enjoy doing this, and I find in med surg I am doing this at least once per day. I want to leave that and go to an office position where I can help people and learn what I need to go into primary care without feeling nauseous all the time. I simply want to know if working in an office will still prepare me to be an FNP? As for the demeaning comment - I suppose I feel that as nurses have 4 year college degrees, we shouldn't be doing something so nasty. In our society, more education typically means doing less labor and using your brain more. I feel that nurses should do procedures, assess patients, etc, but I believe that techs and CNAs should clean patients when they make a mess, poop, etc. you guys can attack me for this all you want, but I think nurses work harder than any other person on a unit and some of the things we do that are mainly labor intensive (lifting patients, cleaning patients) should go to those that don't have the same level of education as nurses.

One last point - there are direct entry FNP programs for non nurses. They don't work on the floor at all. I would at least have some experience over them, right?

[Esme12, ASN, BSN, RN]

Here we go. I'm so sick of nurses that think every freakin nurse on the planet is required to clean up poop and other things that 99% of the population wouldn't even dream of doing. There are plenty of nurses that work OUTSIDE of med/surg - in clinics, radiology, etc. And I've even heard a nurse comment that she worked in radiology so she didn't have to deal with all the nasty stuff. Does that make her less of a nurse? No, nor does it make me less of one. I am allowed to not want to do something filthy and still further my education without the snide remarks of other nurses. Must this profession be so catty?

My point here is, PAs and NPs are both midlevels. They are educated in different models, but still function very similarly in a medical setting, hence why many jobs request a PA or NP for a particular position. In PA programs, all of the knowledge necessary to be a PA is IN the program. They learn about medications, diseases, etc from their training in PA school. Is this NOT similar to NP school? Do NPs HAVE to work in a hospital to have the ability to be a good NP? Do NP programs themselves not teach the required information necessary to diagnosis and treat without one having prior experience in a hospital?

I just want an honest answer here so I can plan accordingly. I know that in nursing, people seem to value someone willing to clean up poop over someone who is book smart - I think that's a little backwards once you get to the provider level. I am an extremely intelligent person, very book smart, with a previous degree in Biology from Yale University. I entered an accelerated BSN program and graduated top of my class with a 4.0 and honors. I am very, very book smart, and that's what we need in the NP world. As a patient, I would rather have a well-educated competent NP than one who tells me she happily cleaned up poop before becoming an NP. We are all different, and there is a place for all of us in the world of nursing. I have every right to be an NP, and while I may not be happy about cleaning up excrement, I think my intelligence will make up for that as a provider.

I think you have been given some great advice......it would be better to get your basic skills down and assessment skills down to be the best Nurse Practitioner....for even though you will seek an advanced degree...you are still a RN first. PA school and NP school are different animals. The NP program will begin on the basis that you are seeking an advanced nursing degree which means you have a firm grasp on the basics. PA school and NP school are different animal with different focuses.

Many credible NP schools will look at your practical experience to make you a competitive applicant. That you worked in a office will not give you that competitive edge. knowing where you came from will light your way to the future. By saying that the standard duty of being a nurse is demeaning is disrespectful of all those nurses who choose to care for those patients at the bedside .....where would those patients be without these people. It's not the "poop" cleaning that will make you a superior NP.....it is knowing the day to day grind of caring for these sick and frightened patients to give you the best insight/assessment skills on how to best care for them and gain the respect of your peers.

For although you want to pursue an advanced degree...you will always be, at the end of the day..." a Nurse"