I'm in an RN program and I could use a little advice. Before starting the RN program, I worked in a hospital as a nurse aide in med-surg and hated it. I also work in a primary care clinic (mostly in pediatrics, some in family practice) as a medical scribe and I really enjoy it. It's early at this point and I just finished my rotation at a SNF, but I still dislike everything about bedside care.
I really like the patient flow and the vibe of the community clinic I work at. Patients come in, they get help, then they leave instead of needing to be tended to and monitored all day and all night. Obviously there are patients who need to be in hospital, and those hospital nurses are great, but I don't feel like that's a good fit for me personally. My clinic job is not easy and most days everyone hustles pretty much all day. We see about three patients per hour depending on complexity, but generally we see them one at a time. My previous job at the hospital was just crazy busy, especially for aides like me with 10 to 12 patients each. I'm never doing that again if I can help it.
Should I try for a new grad job in public health or primary care without doing time in a hospital first? I could probably do a couple years in hospital if absolutely necessary to gain experience, but I'd rather not. In the hospital setting I felt stretched too thin with too many patients to care for at once, and the nurses were not impressed with my performance (mainly my speed) even after a year. In the community clinic, it took only a few months before everyone respected me and wanted me to be their scribe. I'm very concerned that if my first job is in a hospital, I'll do poorly and get a reputation for mediocrity that might have a lasting negative effect on my nursing career.
I'm a bit torn by what I hear about the ICU. It's bedside care but only one or two patients at a time, and I've heard you get great experience doing detailed assessments which increases your medical knowledge. However the ICU patients are fragile and very ill, so they have multiple problems to manage and as a new grad maybe i would not have the necessary knowledge to care for them.
At the clinic where I work they just hired a new grad RN to train as a pediatric triage nurse, so I know at least a few of those jobs are out there. However, they tried this several months ago with another new grad RN and she quit for a hospital job saying she felt like she needed the experience. The veteran pediatric triage nurse does have misgivings about new grads in triage without hospital experience. The RNs in the clinic do mostly triage and case management but also help with catheterization, etc. I actually love talking to patients. My dream job would probably involve wellness checkups, triage and patient education.
Helpful advice is much appreciated. Telling me I'm lazy for wanting a day shift clinic job or that I simply won't be a real nurse if I don't do bedside care is probably less helpful, but if that's the way you feel go ahead and share. I'm so sorry for this long post I can't stop writing! Thank you for any help!
I guess I don't understand what a scribe is. Your description of tasks sounds like the role of a medical assistant. Are these the same job?
Medical scribe is a newer type of job that has materialized mostly because of computerized health records and increased documentation requirements. The job varies somewhat depending on where you work. Generally, scribes take notes and send the clinician's orders through the computer (like ordering immunizations, X-rays, etc.). Where I work I cannot send a medication order, the clinician has to tell the nurse directly.
Often, scribes to not touch the patients. However, where I work a number of medical assistants have been cross trained as scribes, and some scribes have been cross trained as "processors." As a processor I can room patients, take vital signs, and start the documentation process. I work in an outpatient clinic, mostly in Pediatrics. As a scribe and processor, I can order immunizations but I cannot give the injections (an MA, LVN or RN does that part). The pediatrician describes the immunizations to the parent, then the parent agrees to the immunizations, then I send the order through the computer immediately to the LVN, who prepares the shots outside the room while the doctor and I are still in the room finishing up the visit. This saves the patient and parent from waiting, as the shots are usually ready shortly after the doctor finishes the physical exam, etc.
Although scribing is not generally considered "patient care" I sure have learned a lot watching the doctors, NPs and PAs do hundreds of exams and documenting the visit. Anyway, that's what a medical scribe does, at least where I work.
Although scribing is not generally considered "patient care" I sure have learned a lot watching the doctors, NPs and PAs do hundreds of exams and documenting the visit. Anyway, that's what a medical scribe does, at least where I work.
Scribing seems like a GREAT way to get your feet wet in medicine. I would have jumped on that when I was starting out in the health care field.
OP, you're limited to Acute Dialysis, Psych, Corrections, and Pre-Ops; they're all highly paid, so that's the good news.
As a new grad, you're unlikely to qual for pre-ops (from *my* clinical rotation experience, it's a very cushy gig).
I got hired into Pre-Op in a hospital setting as a new grad with 3 months experience. Yes, I realize it was more than likely luck but nevertheless...it happens. Now that I am here though (it's been a little over a year), there is no way I would go back to floor nursing. For one thing, it would be like starting all over again experience wise. I feel like I accidentally specialized in a certain area of nursing but I do really like it.
Just like floor nursing, every day is different. I play patient transporter a lot. It's a lot of hurry up and wait. Our hours are super unpredictable. The other day I had to call a cardiologist from my personal cell phone bc the family was refusing to let the patient go to surgery without talking to him first and the entire OR team was tapping their foot waiting. It's always something crazy like that.
My point is that it definitely can be stressful but it's a different kind of stress than traditional floor nursing. We deal directly with surgeons and anesthesia all day. Some days I feel more like a personal assistant and cruise director than a nurse. Our direct patient care is usually about an hour if the patient comes from home. Less if they are inpatient. We answer a lot of family & patient questions.
I would look into it if that sounds like anything that would interest you.
ETA: Forgot the best part- hours. We are M-F 0500-1700. No nights, weekends or call. Major holidays (Christmas day, thanksgiving, July 4th, New Year's Day) we are closed. Day before or after these we usually only have one person go in. A lot of the times the surgeons will take off around the holidays too.
Your "between the lines" reading is not providing you with an accurate portrait of me. For $35 an hour, I'll change diapers or insert catheters all day. However, I do not like the idea that while I'm doing that I've got four other patients sitting in poop, lying in pain waiting on me to give a pain med or having increased difficulty breathing while I run around like crazy with only one or two aides on the floor. Time management is an important skill, but how about hospital management providing better staffing so I don't have to skip breaks and drink two Monster drinks per shift just to keep up!
Not to be rude or anything. But based on the way many people here lament about bedside nursing and the current state of hospitals, is it any wonder that some new grads are trying to avoid that environment??? Coupled with negative experiences during clinicals/externships I am not shocked many people are seeking non-bedside careers off the bat.
I agree. I work as a forenic nurse. Screw bedside. I spent years waking up to a job I hated. Seems some people on this board think that there is only one way to be a legit nurse: bedside, bedside, bedside, you're not a legit nurse/knowledgeable nurse unless you've started at bedside. Pfffff. What if I start out in L&D? Is my knowledge base going to be the same as an ICU nurse? What about psych nurses? All experiences are worthwhile.
Goes back to that old nurse mentality I come across a lot: "my way or the highway--all young nurses have to go through the grind like I did."
Reading between the lines, she doesn't want to get her hands dirty, literally. How is she handling clinicals???
This is how you have a student say "I never gave an injection" the week before pinning! I think nursing schools are doing a disservice to the students and the profession. Orientation for a new grad should involve planning and time management, not teaching basic nursing skills.
Hey, I went my whole program without having put a foley in! It happens
So you became a nurse but you don't want to take care of patients. Weird. At least in the beginning of your career. Once you get to be my age, four years from retirement, it's normal to want to slow down. I guess different strokes
Bedside nursing is a foundation that we as nurses learn to do through the whole nursing school and early career process. I totally agree that it can be very hard at first. It was hard for me to do bedside nursing at first because I was trying so hard to do like the textbook said. Finally, I told myself that it is OK if I am a little off of what the textbook says as long as I cover the major steps. Once you have mastered the basic skills, then you can look into medical record jobs or triage nursing via telephone. That will require you to remember your bedside care and then make assessments based on that. I wish you the best.
I agree. I work as a forenic nurse. Screw bedside. I spent years waking up to a job I hated. Seems some people on this board think that there is only one way to be a legit nurse: bedside, bedside, bedside, you're not a legit nurse/knowledgeable nurse unless you've started at bedside. Pfffff. What if I start out in L&D? Is my knowledge base going to be the same as an ICU nurse? What about psych nurses? All experiences are worthwhile.
Goes back to that old nurse mentality I come across a lot: "my way or the highway--all young nurses have to go through the grind like I did."
Off topic, but I'm really interested in forensic nursing - do you love it?
Avoiding bedside care can be done, but it is hard when a nurse is just in the learning phases. They have to do the bedbaths, dressings changes, change linens, and other things. Then, the nurse can do other administrative things once all of the bedside nursing is mastered. You can do internet searches based on nursing that does not involve bedside care. You can go to the library and get a book on nursing areas that are more clerical. I personally really like medical records. It gives me a chance to look at the patient's medical file and then take note on what course of treatment that they need to follow on so that I could make the care plan.
Lemon Bars
144 Posts
Medical scribe is a newer type of job that has materialized mostly because of computerized health records and increased documentation requirements. The job varies somewhat depending on where you work. Generally, scribes take notes and send the clinician's orders through the computer (like ordering immunizations, X-rays, etc.). Where I work I cannot send a medication order, the clinician has to tell the nurse directly.
Often, scribes to not touch the patients. However, where I work a number of medical assistants have been cross trained as scribes, and some scribes have been cross trained as "processors." As a processor I can room patients, take vital signs, and start the documentation process. I work in an outpatient clinic, mostly in Pediatrics. As a scribe and processor, I can order immunizations but I cannot give the injections (an MA, LVN or RN does that part). The pediatrician describes the immunizations to the parent, then the parent agrees to the immunizations, then I send the order through the computer immediately to the LVN, who prepares the shots outside the room while the doctor and I are still in the room finishing up the visit. This saves the patient and parent from waiting, as the shots are usually ready shortly after the doctor finishes the physical exam, etc.
Although scribing is not generally considered "patient care" I sure have learned a lot watching the doctors, NPs and PAs do hundreds of exams and documenting the visit. Anyway, that's what a medical scribe does, at least where I work.