Hate my FNP job

Specialties NP

Published

Recently I took a position working in a retail clinic. Prior to the clinic opening I was placed in a doctors office (this Is a large company). So I am a brand new nurse practitioner. In the office I was not allowed to have my own nurse because "I would not have one in the clinic" I was told prior to starting that I would only be seeing same day sick patients. However, I was seeing everything and was not allowed to start my own patient panel but they kept making me see new patients and also patients who were not mine and managing their chronic illnesses. There was one time when the MD's nurse had gone on vacation and I was required to be his nurse, my own nurse, and a nurse practitioner.

Fast forward to now....I'm in the retail clinic. Where I was required to put together office chairs, vital signs machines etc. All the things I need are not in place yet. My height chart hasn't been mounted so I had to purchase a tape measure to perform a school physical. Then I was told when I'm not seeing patients I must log on to a Skype type platform and see patients via the Internet. I have told the administrator several times I'm not comfortable as a nurse practitioner seeing patients in the office (I have been seeing patients about 3-4 months which have been the bear minimum patients because the doctors in the office would double or triple book themselves so I wouldn't see their patients) so I know I'm not going to be comfortable seeing patients on this platform. So basically today after not responding to my email for about a week and a half, she told me well we keep your time at a minimum. But we need you to fill in occasionally.

I'm not sure what to do, what rights I have, I can't perform safe patient care if I'm not comfortable. When I took this position I was told things like I would only work every third weekend. I have worked every weekend since I have been in the clinic. Typically 5 days in a row. (8-12 hour shifts). I'm not sure how to approach this... Anyone have any advice?

You are a provider, you are not there to organize furniture and put equipment together. When you say that you are not comfortable seeing patients are you saying that you need some type of orientation or are you referring specifically to the Skype thing? Also, you're the gofer nurse for the doctors, and you're also working every weekend...

It seems to me that you already know that these people are taking advantage of you. This is the future of the NP profession on the whole as long as we continue to allow them to get away with things like these. And they do get away with it in many situations because it isn't easy for brand new NPs to get jobs, and the relatively few places that will take them often offer them low pay and abuse them horribly.

My advice is that you revisit your long term and short term goals and pull on whatever resources you have. This plan should include searching for a new 'first' job. Since you don't have a binding contract then once you get another job, give them a 2-week notice and just leave. You won't have to tell them why you're leaving because they will already know.

Listen to Golden! : )

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I really don't know why anyone would want to be an NP.

Maybe you should consider it extra credentials under your belt... And go back to being "just a nurse."

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I really don't know why anyone would want to be an NP.

Maybe you should consider it extra credentials under your belt... And go back to being "just a nurse."

trolling?

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Specializes in Assistant Professor, Nephrology, Internal Medicine.
I really don't know why anyone would want to be an NP.

Maybe you should consider it extra credentials under your belt... And go back to being "just a nurse."

There are plenty who would ask, "why would you not want to be an NP?" Different strokes for different folks. There is also no such thing as "just a nurse".

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Specializes in Family.

I wish my professors had told me that I would hate my first year. I started January 2016 & suffered a nervous breakdown in August. I am now struggling to figure out how I am going to go back. I am hoping they will move me from family practice to urgent care. I previously worked in the ER as an RN. I am hoping it will be a better fit. I found I could not handle the complex comorbidities patients & it threw me into severe anxiety.The situation with my collaborator was not good, she was not available to mentor me as I had expected. One thing I learned from this- make sure your collaborator doesn't work part time while you are working full time. Make sure they want to mentor you.

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go back to being "just a nurse."

Come on. That was weak. You should be ashamed of yourself for saying it.

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This is why NP independent practice is scary to me. These programs do not prepare students to function independently. Why do you think doctors have such a lengthy residency program? Because real world application is very different from textbook/didactic learning. It takes a transition period to become a successful practitioner. NP's keep pushing for independent practice. Yet their is no formal method of training them. It greatly varies and it really comes down to if one gets lucky and gets a job with mentors willing to train. Nurses really need to understand what they are getting themselves into. We want independent practice yet can't handle the demands required as a new grad NP. Very scary. There's another thread asking why do we even need MD's in Primary Care. Well who is going to train new grad NP's?

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Specializes in Nephrology, Cardiology, ER, ICU.

I do believe in independent practice - it doesn't mean you don't ask questions. I've been an APRN for 10+ years in the same specialty - I still ask questions. However, it would be nice to be able to order home care, DME, etc., for my pts without waiting for MD signature.

Independent practice doesn't mean I'm going to run wild with orders, care and that I will be careless - it simply allows me to do my job!

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Q: "Well who is going to train new grad NP's?"

A: experienced NP's

I don't advocate for the removal of physicians from primary care. NP's do need either real supervision or a residency period for 1-2 years, but the opportunity for experienced NP's to supervise new grads is reasonable. Beyond 1-2 years supervision becomes entirely about MDs profiting off NPs and the red tape that experienced NPs in supervised states deal with is a detriment to patient care.

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Specializes in Adult Internal Medicine.
Why do you think doctors have such a lengthy residency program?

Why is it exactly that they do? DO you think it's all about the experience? Or do you think that it has some to do with cheap labor and delaying entry to practice to keep salaries up?

Because real world application is very different from textbook/didactic learning. It takes a transition period to become a successful practitioner.

How long have you been in practice? What do you think was the most difficult part of the transition? How would address it?

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Congratulations on the new job. As a student NP I am reminded by my professors that we will hate being a NP for the first year and not like it the second year. They encourage us to hang in there untill year three when you feel confident, and love what you do. Best to you on the new job. Keep posting as a student it is great to learn from a new grad as well as from those who are great, experienced NPs.

Im half way on my year 3 as an NP. I can't say I hate my job. I can't say I love it either. I hope things look better per your prediction!

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Q: "Well who is going to train new grad NP's?"

A: experienced NP's

I don't advocate for the removal of physicians from primary care. NP's do need either real supervision or a residency period for 1-2 years, but the opportunity for experienced NP's to supervise new grads is reasonable. Beyond 1-2 years supervision becomes entirely about MDs profiting off NPs and the red tape that experienced NPs in supervised states deal with is a detriment to patient care.

Honestly, a 1-2 year residency is a very reasonable compromise. After that they can have independent practice. It's crazy to me this push for independent practice from day one. Because if you think about it very few medical professions offer full independent practice day one. Most either require or highly recommend a residency program. Nurses need to understand the political forces behind this push for independent practice before automatically jumping on the bandwagon.

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