9 months in, quitting to work private practice

[seconddegreebsn]

I've been doing nights in med surg with all of the usual complaints - extreme short staffing (we are often two nurses short), high ratios of acutely ill patients, bad management. When I had started the job I had determined to try and stick it out a year. I've had two consecutive shifts that were so bad I didn't pee in 14 hours and could barely walk afterwards. I just hate working nights and weekends, I hate what working nights is doing to my marriage and how much strain it's put on us. I hate how much stress I bring home with me and how it bleeds into the rest of my life. Day shifts are even busier and still short staffed so it's not really a fix, plus there's the added "bonus" of having everyone's family there. I hate the abuse from management and patient's families. I know this is part of what's in the package deal but it's really bleeding me of empathy and it seemed like a bad sign that I'm burned out this fast. Everything I'm struggling with about bedside nursing comes down to bureaucracy, which is the same everywhere. My manager has refused to allow me to transfer and honestly, it doesn't matter because it seems like other areas are dealing with the same issues. I strongly suspect bedside nursing is not right for me.

On a lark, I went through an agency that had gotten me a CNA job years ago and interviewed at several private practice jobs and ambulatory surgery centers and found myself with several job offers, much to my surprise. Money was similar to hospital (benefits unfortunately were not, they stunk, but I have insurance through my husband), 9-5, seemed like the nurses had a high degree of independence and self-sufficiency and were overall happy with their jobs.

I just worry I'm kneecapping myself professionally by leaving this job so early. The hospital has a horrible reputation and we're on the verge of a strike, but I'm not closed to ever working in a hospital again - just not in med surg. I'm glad I learned what I did at this job but part of me feels thrilled with the idea of being able to have some semblance of a normal schedule and be able to see my friends.

I'd love to hear from nurses who have spent most of their career outside the hospital setting. Is this a great opportunity or a terrible mistake? What are the challenges that come with working in a private practice setting and how does the stress compare to working in a hospital.

[Q_vick03]

The biggest difference between the RN and LVN in my clinic is the RN has to do the phone triage. In Texas LVNs can only do in person focused assessments and obviously phone triage falls outside of that. We both room patients, do basic teachings (insulin, vaccines, etc), injections, the occasional IV or cath, lab draws when our lab tech is out, complete phone messages which include relaying lab results, oversee the CMAs. Our one RN is charge also so she has all the manager duties that comes with that but nursing wise the difference is triage. When she's not there I am the go to person and our call center RNs (who cover us after hours normally but are staffed 24/7 to cover the whole system) will do the triage when needed. Our providers will also take a triage call if I need them to.

I know at some of the specialty clinics the RNs get to do more procedure type stuff and they do have some meds that LVNs can't give, just my small family practice clinic doesn't.

If you are looking for an exciting fast paced job like the ER clinic nursing is not it. The pay is typically lower than our hospital counterparts. However the hours are great. Typically min-fri, no holidays, weekends, or call. Low stress. Don't have to worry about getting called in on your day off. Vacation time is easier to use because coverage is not as big of an issue as hospital. But you won't get to use your hands on skills near as much. It's rally a trade off. Right now for me the hours are more important than the pay or skill set.

Thank you for answering my questions. Hopefully, i will be a public health nurse one day.