Any RNs w/ urgent care experience?

Roseyposey · Jan 13, 2007

Maybe you don't want my input, as I'm just an LPN - but, I've worked at an urgent care clinic for about 7 months now and love it. The doctors I work with are great. The days can get a little monotonous - lots of stuffy noses and sore throats, but we get alot of sutures and we do get emergencies. I give a lot of injections - Td, Rocephin, Toradol, etc. It can get a little hectic, but I like a fast pace.

NurseCherlove · Jan 13, 2007

Maybe you don't want my input, as I'm just an LPN - but, I've worked at an urgent care clinic for about 7 months now and love it. The doctors I work with are great. The days can get a little monotonous - lots of stuffy noses and sore throats, but we get alot of sutures and we do get emergencies. I give a lot of injections - Td, Rocephin, Toradol, etc. It can get a little hectic, but I like a fast pace.

I am sooo sorry! I did not mean to exclude input from LPNs at all! I'm sure the job descriptions in this type of setting are pretty much the same for RNs and LPNs alike. I should have asked for input from 'nurses' - just wasn't thinking.

Well, let me ask you this...have you ever worked in a hospital on the floor? The reason I ask is just wanting some kind of comparison a far as the stress level. Fast-paced is ok..to me, faster pace does not necessarily translate into higher stress (although it might). It's just that where I work now, on a med-surg unit, the days that are really stressful can be so physically/mentally taxing. I actually like my job now, but I could see where too many of those very high stress days close together could interfere with school.

What kinds of emergencies do you see? Any CPs, seizures, etc.? Do you think this is because people don't know that they should instead be going to the ED?

Thanx for your replies.

tkhayman · Jan 13, 2007

I don;t work at urgent cares, but do work in clinics, as an RN. i love it compared to the hospital( where you are waiting for the doctor to call you back, doing discharge and admissions and post-ops, and having family member and difficult patients on your case for 12 hours) . YOu do your assessment put the patient in to see the doctor and then if he orders something you carry out the order.

The down side is it can get hectic sometimes and you run out of rooms, and yes sometimes you are running a lot and sometimes not.

But i do love this type of nursing, because the doctor is always there. You take care of the patient and then they go home. You only have to deal with them for a short period of time. The paperwork is less than hospital nursing.

I do get tired at the end of the day, but i don;t have the mental worry that i forgot to do something.

NurseCherlove · Jan 13, 2007

i don;t work at urgent cares, but do work in clinics, as an rn. i love it compared to the hospital( where you are waiting for the doctor to call you back, doing discharge and admissions and post-ops, and having family member and difficult patients on your case for 12 hours) . you do your assessment put the patient in to see the doctor and then if he orders something you carry out the order.
the down side is it can get hectic sometimes and you run out of rooms, and yes sometimes you are running a lot and sometimes not.
but i do love this type of nursing, because the doctor is always there. you take care of the patient and then they go home. you only have to deal with them for a short period of time. the paperwork is less than hospital nursing.
i do get tired at the end of the day, but i don;t have the mental worry that i forgot to do something.

well alrighty then! if urgent care is like this...less paperwork and...yes!... not having to deal with the patients/family members who think they are the only patients you have and that you are their servant....i'm sold!!!!

Crocuta, RN · Jan 13, 2007

I've worked in Med/Surg before, and I'm currently in ER with occasional coverage of our urgent care area. It is definitely faster in pace and if you're really good and you've got good docs, you can turn patients through those rooms at a staggering pace. You have to swallow your tongue sometimes when people come in for primary care for things that really have no business there. Keep in mind that you'll need to utilize all your assessment skills though, and never run someone though because they're "just urgent care." I remember one patient who came in with a c/c of toothache that started a couple hours before. No sign of abcess or inflammation. We could have given her an Rx for a couple days of pain pills and sent her to a dentist, but something didn't seem right. Her color was slightly off and her pulse was kinda high. Turns out her tooth pain was more jaw pain, and yeah, now that we mentioned it, she did seem a little SOA today. She was actually infarcting and we got her into an ER bed and got her treated.

Lots of MRSA abcesses - too many lately that are hurtling toward necrotizing fasciitis, and what is it with people slicing those things open with dirty razors for a few days before coming in, anyhow?

Personally, I love the lacerations. Had a guy cutting wood with an axe and nearly took his thumb off. Last week it was a guy arguing with his brother and he took it out on a plate glass window (we had a discussion about finding better outlets for his anger.)

Most certainly less paperwork than med surg. Emergency care in general is less paperwork, but it's always growing, thanks to JHACO. I moved to ER because I got tired of spending the vast majority of my day charting. (And I'm not bashing Med/Surg here...It's definitely it's own specialty, and charting is my biggest weakness.) You can't let your paperwork slack though. Eventually, you'll have a patient try to claim something, or there will be an adverse outcome, and you still need your documentation to speak for itself.

So, it can be very rewarding, and you can brush off your psych skills and do some little social interventions in the ten minutes you spend with a patient. Hope you enjoy. :)

NurseCherlove · Jan 13, 2007

I've worked in Med/Surg before, and I'm currently in ER with occasional coverage of our urgent care area. It is definitely faster in pace and if you're really good and you've got good docs, you can turn patients through those rooms at a staggering pace. You have to swallow your tongue sometimes when people come in for primary care for things that really have no business there. Keep in mind that you'll need to utilize all your assessment skills though, and never run someone though because they're "just urgent care." I remember one patient who came in with a c/c of toothache that started a couple hours before. No sign of abcess or inflammation. We could have given her an Rx for a couple days of pain pills and sent her to a dentist, but something didn't seem right. Her color was slightly off and her pulse was kinda high. Turns out her tooth pain was more jaw pain, and yeah, now that we mentioned it, she did seem a little SOA today. She was actually infarcting and we got her into an ER bed and got her treated.
Lots of MRSA abcesses - too many lately that are hurtling toward necrotizing fasciitis, and what is it with people slicing those things open with dirty razors for a few days before coming in, anyhow?
Personally, I love the lacerations. Had a guy cutting wood with an axe and nearly took his thumb off. Last week it was a guy arguing with his brother and he took it out on a plate glass window (we had a discussion about finding better outlets for his anger.)
Most certainly less paperwork than med surg. Emergency care in general is less paperwork, but it's always growing, thanks to JHACO. I moved to ER because I got tired of spending the vast majority of my day charting. (And I'm not bashing Med/Surg here...It's definitely it's own specialty, and charting is my biggest weakness.) You can't let your paperwork slack though. Eventually, you'll have a patient try to claim something, or there will be an adverse outcome, and you still need your documentation to speak for itself.
So, it can be very rewarding, and you can brush off your psych skills and do some little social interventions in the ten minutes you spend with a patient. Hope you enjoy. :)

Thank you for your input, Crocuta. This really is sounding better by the minute. I feel ya about the paperwork - I really hate it sometimes.

One question though: Do you think that a setting like urgent care would be a good segue for ER (I only have about a year of med/surg experience - still a relatively new nurse). I have often thought that I would either make an awesome ER nurse or a horrible one. I know that sounds weird, but let me explain: Sometimes I feel like I do not handle stress well at all. But when I really think about it, the stress I feel doing med/surg is when several things happen all at once and you know you are getting behind on the scheduled things you need to do (or other items of importance that now get knocked down on the list of priorities). I don't think I would get too stressed out having to react quickly to emergencies. I just have a problem sometimes with the constant reprioritizing and subsequent feeling of getting behind because I want to have everything done. I'm a little ADD which I think adds to this stress of having to constantly reprioritize because I am constantly thinking about the other things I need to be doing. I have heard other ER nurses say that being kinda ADD can be advantageous in the ER. What do you think? Sorry to go on and on...I just recently had the thought about wanting to post a thread on here about nurses who have moved to ER after working med/surg.

Funny...seems like you never read a thread about "I can't imagine working anywhere but med/surg", like you do about ER or ICU.

lauralassie · Jan 13, 2007

Worked one. Liked it really well, but we had to have ER experience to work there. It came in handy many times. It's amazing how many people come their with chest pain or even labor.

clee1 · Jan 13, 2007

Urgent Care can be a GREAT place to work; IF the Docs don't have a God complex.

I found the paperwork less onerous than a floor, but still plenty. If the Medical Director likes to play PCP to a select minority of pts, you'll have lots of insurance crud to deal with.

Decent pace, variety of c/o's, and occasionally you can make a difference for someone in the initial stages of a crisis.

Crocuta, RN · Jan 13, 2007

One question though: Do you think that a setting like urgent care would be a good segue for ER (I only have about a year of med/surg experience - still a relatively new nurse).

There's alot of mixed thought on entry level ER. Search the boards and you're sure to find it. Personally, I think the right new grad can (and frequently do) fit right into an ER with the right orientation. A year of med/surg is the traditional entry point to ER, anyhow. We have several people who spend time in urgent care and then move to the main ER. There are so many routes, and so many options in nursing. Just do what seems rewarding to you at this point in your career.

I just have a problem sometimes with the constant reprioritizing and subsequent feeling of getting behind because I want to have everything done. I'm a little ADD which I think adds to this stress of having to constantly reprioritize because I am constantly thinking about the other things I need to be doing.

ER is even more constant reevaluation of current priorities than other areas, in my opinion. When I was on Med/Surg, my patients were generally stable and with the occasional change in condition, I could map out my priorities at the beginning of shift. In ER, you see people in the acute phase of the illness when they may be unstable and in a heartbeat that patient with the BP of 70/30 and septic is no longer your priority because the guy next door just started desatting and is c/o SOA. About the time you reprioritize, someone rolls in the door who isn't breathing at all. (Oh and by the way, we're out of beds, so which of your patients can be moved to a wheelchair???) It can be maddening trying to keep all of your patients in the back of your mind, but having a good team, and remembering ABC's are your salvation. Of course, the most important patient (according to her and her very loud family members) is the one that has been waiting for 5 hours to get that hangnail excised. ("And no, I don't care that you were trying to save her life! This hurts!" :trout: )

Funny...seems like you never read a thread about "I can't imagine working anywhere but med/surg", like you do about ER or ICU.

I have many friends on the floors that can't imagine coming to work in the ER. They enjoy the stability of having the same patients for an entire shift (and sometimes the same patients for several days.) They have an amazing skill to look at a patient who has been in the hospital for two weeks and just instinctively know that something has changed since they left the day before and can implement interventions. I've tried to get them to come down and float once in a while, but they have no desire to do anything but Med/Surg because they find it so fulfilling, and God bless them for being there and doing what they do best.