Leave Floor Nursing for office nursing?

mykidzmom · Aug 13, 2009

different stress. still stressful. adding to the stress is that you have to do your chores, errands and fun on the weekends with everyone else when it is crowded. plus you will be tired 5 days a week instead of 3. forget doctor and dentist appointments. you better plan them way in advance and at the beginning or end of the day. if you are doing telephone triage you will deal with people who will call you 8 times because you didn't get back to them in 20 minutes (and they are all out of their nexium!) or the 4 different family members having a few questions about mom/aunt/sister (the same pt). and then diagnosing over the phone...tons of fun there! should you send them to the ED, have them come in to your office or see how if feels tomorrow? delivering bad news with test results? they have already looked on the internet to see every possible option for every possible result. they lost their narcs--can they have a new rx? next month the rx got soda spilled on it and smudged the ink--can i get another one written? then next month they are not going to be in town when the narc rx is due, so could you write one now then i will get it filled in st. elsewhere? prior authorizations, medicare, private insurance---case manager stuff is on you-- dilbert comics will become funny. if you are closed on the 4th of july, the 5th will SUCK.

that being said, the patients are usually continent, then come in, handle their needs and leave. you also get to know patients intimately--because you see them when they are just being monitored, when they are getting a little sick and when something major is going on. you are thrilled when they get better. (you might call them at home just to check on them) you get to know them and care about them (even the ones who lost their narc rx every month). you get to teach and explain, without IV pumps beeping. you get to be smart and not have to "let me see what the doctor says" with everything. if you are off at 5, you stay till 6 because you know the patients so well that you become personally invested in making sure they get their prior authorization and if that laxative regemin you suggested worked or do we need to get them in and get out the big guns. you cry when they die because you have known them for 6 years. even the pain in the tush ones. you work with doctors who learn your strengths and once in a while trust you in a way they never trust the floor nurses and maybe even see you as on their same team.

i loved working 3 days a week and office nursing (depending on the specialty) is very very stressful in a way floor nurses don't understand. pro and cons to each--but me, i am staying in my outpatient oncology clinic (preferably not doing triage, but we all need our turn in the dungeon). i like having every christmas off.

neatnurse30 · Aug 13, 2009

My friend who used to work on OB gyn floor took position in a ob gyn clinic. She had received calls all day long. Every call had to be documented and a lot of these patients ( pregnant females) were yelling at her, cursing from time to time and wanted to see the doctor NOW. She said she would never think that general public can be that nasty. She said to me after she quit: you know, I would never think that triage could be more stressful than floor nursing.

angel337, MSN, RN · Aug 13, 2009

i think it depends on what you are ready for and what is going on in your life. i have worked at doctors offices 5 days a week and i was NOT near about as tired as i was running back and forth during the 3 12's. i liked not having to worry about the holidays and to me the dr.s office just felt more normal. there are pros and cons to each. hospital work works well because of the flexibilty, especially if you have school aged kids. triage takes a lot of time to get used to, but its not so bad and i think it is a great skill to acquire. good luck in what you decide but i don't think you will be too disappointed if you do choose the office.

RuRnurse? · Aug 13, 2009

From what I've seen of "office nursing", I'd rather set my pubic hair on fire than switch...Ugghh!

3boysmom3 · Aug 13, 2009

I liked mykidzmom's answer and I totally agree. I work in a large clinic, and yes, I often want to pull my hair out- but at the same time I love my patients. Yes, some of them leave me a voicemail every 10 minutes until I call them back. Or if I didn't call back fast enough another family member will call to leave a voicemail about the person. Sometimes I check my voicemail and all I hear is "Oh I got that damn machine again!" But I do get attached to all of them. My doc and I always send a sympathy card to the family anytime someone dies; I've attended several funerals. Sometimes I call a patient before I go home because I know they've been having a hard time and I was just thinking about them. Sometimes they call me just because they're stressed and want to talk for a minute. You do develop a relationship with them, and you grieve with them when they lose a spouse, and rejoice with them when something good happens for them. It's unbelievable amazing how little many people know about their medications, illnesses, etc. We see those who have just been discharged from the hospital, and yes, I KNOW the discharge nurse went over all their instructions--- just for the person to say a week later "I don't know what those medicines on that paper are so I just kept taking the ones I used to take." But you meet so many really amazing people with such rich histories. It's a privilege to get to know them. And you become special to them, as well. One of our doc's nurses left to take another job- her patients were all so upset you'd think they'd lost a family member! Of course now they love the new one. We take pride in our office in being very caring, considerate and thoughtful with our patients. It makes you feel great.

The days seem very, very long...getting there at 8 and leaving at 6- (yes, we close at 5 but there are phone calls to be made once the phones roll over to the answering service)- but it is absolutely awesome to KNOW that you will be off on Christmas. And Easter. And New Year's Day. 4th of July. And so on. You know that if your child has a baseball game in the evening, or a school play, you can be there. You can take them trick or treating even if it falls in the middle of the week. After years and years of odd shifts, weekends, holidays, etc., that is PRICELESS to me. Plus, I really do like my work!!!

netglow, ASN, RN · Aug 13, 2009

Lots in common with "The Mom's" posters (LOL).

Though a student, I am an older one and though not a triage nurse, I functioned similarly for a doc while taking my prereqs. Very overwhelming at first especially at a small office. But when you get to know the patient families you become comfortable. You'd be surprised how you get to pretty much know who is on the phone with you, maybe a quick chart glance is needed but I could wrangle close to 500 repeaters. He of course, never did remember them unless they really gave him a hard time. It got to where he would ask my opinion, and respect me when I had a problem with something he did or didn't do. I had emergency surgery one year, and received flowers and cards, and a casserole delivered to my house from patients! :bluecry1: still makes me cry. I even had one or two physicians who were patients of mine round at the hospital to see me (knew them well) screw HIPPA. When I returned, one woman told me my boss was all wringing his hands (what a tough guy) when they asked where I was, had I quit?!

The point is, that you are in the position to do a lot for people if you make that your job. You might have to argue with your doc for one of your patients, but you'll win. Just do what I always did. After an arguement, as you are leaving his office, say, "Now, tell me, who is the boss of you?" and, he'll know he has to say... "I know, I know, you are..." :wink2:

Otessa, BSN, RN · Aug 13, 2009

I work in a clinical setting-although not as a triage nurse. I do enjoy weekends, holidays, and evenings off (work 2 evenings per year-only until 9 PM though)-that time with my children in the evenings, weekends, and holidays is PRICELESS!

wouldn't change a thing.....

LovingNurse, BSN, RN · Aug 14, 2009

Thank you all for your wonderful replies. I did office nursing several years ago for a small private practice which included all the phone stuff, hands-on nursing and office manager and absolutely LOVED it and the intimate relationships with my patients over the years. This one would be triage only.

I love the variety of my current Med/surg nursing and technically love what I do and being well-rounded skill wise...but....I am soooo exhausted that I physically ache to the bone at the end of my shift. We have PLENTY of staff but they cancel RN's right & left to keep the budget down and we are worked and stressed to exhaustion. I don't eat until my charting is done - which means that most of the time I don't eat. Some nights I'm 10hrs into my shift before I sit to chart. I dread the drive into work, not knowing what I'll be walking into or if I'll be pulled to a different floor ( there's one floor I absolutely HATE to work & I hold my breath and pray when I look at the assignment board to see where I'll be.)

If our ratios were kept low and I was able to give the quality care to each patient that they deserve, I would LoVe my jobs. I would love an out-patient clinic where I can still do hands on, but those jobs just don't seem to be out there.

I'm sure it is stressful to be a triage nurse, and I would dearly, dearly miss the flexibility of 3 days a week and being able to be off 4-5 days in a row without using PTO, etc. - but as another member said ... it would just seem more "normal."

Thank you all for your help.:heartbeat Crossing my fingers I get the job. Please wish me luck.