Need advice RE: Job change and starting NP program

[HealthyRN]

I really need some advice. I have been a nurse for about a year. I started off in med-surg and worked there for a month or so before getting a position in the ER where I have been working for 9 months. My job in the ER is much better than working on the med-surg unit, but I still don't love it. In fact, 90% of the time, I hate my job and I absolutely dread going to work. I have considered getting out of nursing altogether many times during the past year, but I've decided to stick it out since I recently was accepted to an FNP program that will begin in the fall. I originally went into nursing because I wanted to be a family nurse practitioner.

My dilemma is that I dislike my ER nursing job, so I started looking for another position and I just got an offer. I think that I would enjoy this position, MUCH better. It involves working for a home health company and there would be no direct patient care involved. It is an 8-5 job, no holidays or weekends. It pays less than my current job, but the money is not a factor for me.

Now that I have the job offer though, I don't know what to do. Since the job is 8-5, I don't think that I could work full-time and attend the NP program full-time. I hate to work for the company for just 3 months only to quit because I am going back to school. I'm also worried that accepting a position outside of acute care will affect me in the future when I am looking for an NP job. On the other hand, I really don't like my current job and I am miserable.

What do you think? Should I accept the job and then ask to reduce my hours or work part-time when I return to school?

[aquaj1]

Hi, I think you have more of a dilema than you think. I have been a N.P. for over 7 yrs. Prior to becoming an N.P. I was a LPN and RN in the ER for many years. You said that you are miserable with your current job, but really didn't state why. I currently work in a rural ER staffed by NP/PA's. I love my current job due to that autonomy. It's not for everyone. I previously worked in very busy ER's as a N.P. and got burned out. I need more info before I can give you advise.... Joe...

[aquaj1]

Hi, I think you have more of a dilema than you think. I have been a N.P. for over 7 yrs. Prior to becoming an N.P. I was a LPN and RN in the ER for many years. You said that you are miserable with your current job, but really didn't state why. I currently work in a rural ER staffed by NP/PA's. I love my current job due to that autonomy, and other reasons. It's not for everyone. I previously worked in very busy ER's as a N.P., and nurse, and got burned out. It sounds like you have less than 1 yr of experience as a nurse. I don't think that this is enough time to decide whether or not you want to continue in this field. My initial response would be to advise you to get more nursing experience before you make a decision.....Joe...

[HealthyRN]

Thanks for your input, Joe. I don't like my current job for many reasons. I don't enjoy shift work and having to work nights, weekends, and holidays. I don't like not being able to take a break because we are so short-staffed. I don't like the way that management treats the nursing staff. To be completely honest, I don't really enjoy doing many of the nursing tasks that we do in the ER. I just don't like working at the bedside in acute care.

You said that you would advise me to get more nursing experience before going on to become an NP. Do you mean more nursing experience in acute care? I would say that I already know that I don't enjoy that. Do you really think that you need to enjoy working at the bedside in order to be a good NP? Are the jobs really that similar and if so how? After researching the NP field and talking to other NPs, I have the impression that working as an NP is much different from working as a staff RN. By the way, I want to work in primary care as an NP, not in a hospital setting.

[traumaRUs, MSN, APRN]

Hi there...I'm a CNS employed in an NP-role in outpatient dialysis. It is like an office environment. However, I still do care - I have to examine patients, deal with other nurses, management of the dialysis units and then deal with the docs and fellow mid-levels.

I had 12 years as an RN prior to becoming an APN. Your assessment skills that you learn on the job in an acute care setting is the most important thing to learn. You can't get that experience from a lab or clinicals.

And even as an APN, I don't always get lunch because I have lots of patients or I have an emergency. It is true that I schedule a lot of my own time. However, I have to see x-amount of patients per day in order to be productive for my practice. That sometimes means that I work 12-13 hours too.

Have you shadowed an NP, investigated what jobs are available?

[ukstudent]

How about doing case management if you don't like patient care. Please reconsider becoming a NP.

[christvs, DNP, RN, NP]

If you want to be a primary care/family NP, then why not now get an RN position in an office, perhaps even working where they have family NPs? I think it is really helpful to have nursing experience before you become an NP, but I agree with you that the two positions are very different-RNs administer meds & monitor and assess patients' responses to treatments, whereas NPs order lab exams, diagnose conditions, prescribe treatments, etc.... But I personally think if primary care is what you really are interested in, and you want to be a family NP, then why not attend the FNP program and in the meantime look for an RN position in outpatient care...that way you will get more experience doing primary care for when you are an NP. Good luck in whatever you decide to do. :)

[carachel2]

Well, I'm still in FNP school, but some of your words rang true and I just wanted to offer some support and some encouragement.

I have been an RN for about 12-13 years now. I worked CCU for two years and have spent the rest of my career in cardiac rehabilitation..which I totally love. I started investigating an FNP program because I LOVE working with and managing patients with hypertension, diabetes, CAD and CHF. Since I was starting school and I knew I would need the skills (plus, the shiftwork would come in very handy with school !) I MADE myself switch to the ER.

I stayed about 1.5 years. Some days I loved it, most of the days I hated it. I realized it isn't the job or the patients, but more of my personality. I thrive on a predictable routine and the ER does not really provide that environment.

It DID, however, tremendously boost my assessment skills and introduce me to a wide variety of patient care scenarious I would have never encountered.

I am about halfway through an FNP program and almost done with my first clinical class. Can I say how much I LOVE working in primary care at a family practice clinic ? I get to sit down with the patients, take my time to do a thorough assessment and work on lifestyle and disease management INSTEAD of cleaning up poop, fighting combative hypoxic patients to put in lines and tubes and all that wonderful stuff. :uhoh21:

From the sound of your post, the lack of predictability and the focus on skills that you do not really like doing is what is making you abhor the ER and making you question your ability to be an effective FNP.

I switched back to working in cardiac rehab and am taking just one or two classes at a time. I am glad I am in a school that allows that. You may find that is an option for you that would allow a predictable job scenario (that you don't despise) and allow you to work through school.

There are also LOTS of work at home opportunities to help you earn some extra cash. Internet based web coaching is new and emerging. Some long term care insurance companies pay RN's to go and do intial assessments for people who have applied for a policy.

I hope I haven't rambled, just wanted you to know that even though you hate the ER you CAN still thrive as an FNP student and find your niche.