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FNP Made to Work Alone?

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AnaLong has 5 years experience as a BSN, MSN, APRN, NP and specializes in FNP: Urgent Care & Primary Care; RN: Med-Surg.

6,018 Profile Views; 123 Posts

I work at a FQHC, which is stressful enough, but on occasion I have to work alone.  They do not send help when my nurse has to be out. Has anyone else had to go through this?  How many M.D.’s do you know of are expected to sometimes work alone?  Did you stay at that organization? 

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FullGlass has 1 years experience as a BSN, MSN, NP and specializes in Adult and Geriatric Primary Care.

5 Followers; 2 Articles; 920 Posts; 8,076 Profile Views

What do you mean by "alone?"  Do you mean you are the only provider or do you mean you are the only person present?

I don't understand why you say "I work at an FQHC, which is stressful enough."  I work at an FQHC and it's not any more stressful than any other type of general primary care.

Sometimes I am the only provider and that's fine.  I have the phone numbers of our MDs and my NP colleagues if I have a question and they are great.

I'm not sure how your clinic is staffed, but even at our remote locations where there is only one provider, there are 2 MAs, plus front and back office staff.  We never have a provider work alone, as in being the only person in the clinic, even at our most remote locations (and I mean areas that are officially classified as "frontier.")

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AnaLong has 5 years experience as a BSN, MSN, APRN, NP and specializes in FNP: Urgent Care & Primary Care; RN: Med-Surg.

123 Posts; 6,018 Profile Views

1 hour ago, FullGlass said:

What do you mean by "alone?"  Do you mean you are the only provider or do you mean you are the only person present?

I don't understand why you say "I work at an FQHC, which is stressful enough."  I work at an FQHC and it's not any more stressful than any other type of general primary care.

Sometimes I am the only provider and that's fine.  I have the phone numbers of our MDs and my NP colleagues if I have a question and they are great.

I'm not sure how your clinic is staffed, but even at our remote locations where there is only one provider, there are 2 MAs, plus front and back office staff.  We never have a provider work alone, as in being the only person in the clinic, even at our most remote locations (and I mean areas that are officially classified as "frontier.")

I mean that I am to function as the nurse and the NP.  I don’t know about your facility but mine wants us to see every patient that comes though the door.  So if it’s 20-30 they should all be seen by me.  I must call them back, get vitals, provide care, blood draws, PAP smears, EPSDTs, referrals, etc without a nurse.  Just me and a receptionist!  That’s what I mean by alone.  They would scoff at having 2 MAs. 

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474 Posts; 12,119 Profile Views

this is why some people prefer to become a PA instead of a NP.  Anything with the word Nurse in it's job title complicates things. 

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FullGlass has 1 years experience as a BSN, MSN, NP and specializes in Adult and Geriatric Primary Care.

5 Followers; 2 Articles; 920 Posts; 8,076 Profile Views

1 hour ago, AnaLong said:

I mean that I am to function as the nurse and the NP.  I don’t know about your facility but mine wants us to see every patient that comes though the door.  So if it’s 20-30 they should all be seen by me.  I must call them back, get vitals, provide care, blood draws, PAP smears, EPSDTs, referrals, etc without a nurse.  Just me and a receptionist!  That’s what I mean by alone.  They would scoff at having 2 MAs. 

Well, that sucks.  At any rate, if the nurse or MA is not there to do vitals and so forth, then you need to have more time per patient - 10-15 minutes more.  If your management doesn't understand that, start looking for another job.

I'm starting a new job soon in another FQHC and it is similar to my last job.  I had a dedicated MA.  My primary assignment was in a clinic with multiple providers, so each provider had their own MA, plus there were 1 or 2 "float" MAs every day that would perform other tasks, help out MAs, etc.  At the very remote clinics with only 1 provider, there were 2 MAs.  

I don't know where you are, but I am in California and have interviewed at multiple FQHCs and even private practices and the set up is basically the same at all of them.

 

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AnaLong has 5 years experience as a BSN, MSN, APRN, NP and specializes in FNP: Urgent Care & Primary Care; RN: Med-Surg.

123 Posts; 6,018 Profile Views

Mississippi. But other FQHCs here are more organized.  There is a lot of turnover.  My loans are being paid but the headache is not worth it. 

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I would leave.

Sounds like a recipe for burnout...

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AnaLong has 5 years experience as a BSN, MSN, APRN, NP and specializes in FNP: Urgent Care & Primary Care; RN: Med-Surg.

123 Posts; 6,018 Profile Views

10 hours ago, ToFNPandBeyond said:

I would leave.

Sounds like a recipe for burnout...

So I’m not crazy or “to big for my pants?”  This IS unreasonable, right? 

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FullGlass has 1 years experience as a BSN, MSN, NP and specializes in Adult and Geriatric Primary Care.

5 Followers; 2 Articles; 920 Posts; 8,076 Profile Views

6 hours ago, AnaLong said:

So I’m not crazy or “to big for my pants?”  This IS unreasonable, right? 

No, you are not crazy or asking for too much.  This clinic is being unreasonable.  The norm is to have a dedicated MA or nurse for each provider.  If the MA or nurse calls out sick, then arrangements must be made to get a replacement.  If that is not possible, then the provider will need more time per patient to allow for the extra work they are doing.  Start looking for another job.  Good luck!

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It's totally unreasonable and that would be a dealbreaker for me.  I honestly don't even know where the vaccines are and have never been in a role to administer them.  I sometimes see 20 patients a day, and I am going the entire day...not sure how that would even be feasible unless the requirements and charting is less than a traditional program.

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On 10/23/2019 at 8:02 PM, AnaLong said:

I mean that I am to function as the nurse and the NP.  I don’t know about your facility but mine wants us to see every patient that comes though the door.  So if it’s 20-30 they should all be seen by me.  I must call them back, get vitals, provide care, blood draws, PAP smears, EPSDTs, referrals, etc without a nurse.  Just me and a receptionist!  That’s what I mean by alone.  They would scoff at having 2 MAs. 

Geez, even the FNP can't catch a break. This is why I am not sure I want to become a NP

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Jory has 10 years experience as a MSN, APRN, CNM.

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I would refuse to work alone. That is a safety issue.  If your nurse is out, so are you and tell them, "Yes, I expect to be paid that day."

NO WAY would I do that. 

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