I am a new FNP and have been working since May in a rural primary care/urgent care clinic. I don't want to sound like a winer, but I am exhausted. Most days I see 20-25 patients back to back no breaks. Sometimes I'm really scared because I have pts who walk in to urgent care who really belong in the ER - not our clinic.The patients are mostly medicaid and medicare, welfare and unemployed or disability patients with chronic pain issues. It is all paper charting which takes up a lot of time. I have call one night a week and every other weekend for 4 days straight. I feel like I'm always working.
The clinic is owned by an FNP and his wife, the office manager. All they seem to care about is making money. They schedule us full and tight.
They have a high turnover rate, lost 6 FNPs in the last year. I thought I could handle it but I'm burning out fast. Sometimes i want to chuck it all - just get on a plane leave it all behind and go where no one knows me.
Is it like this everywhere? This is much harder than being an RN, sometimes I really miss my job in labor and delivery.
I feel like I have to stick it out for at least a year so I don't look like a job hopper and so I can get experience as an FNP on my resume. I would really appreciate some advice on how to handle this. I know talking to my employer won't help...they told the others who quit - "this is how it is, if you don't like it then leave."
I am a new FNP and have been working since May in a rural primary care/urgent care clinic. I don't want to sound like a winer, but I am exhausted. Most days I see 20-25 patients back to back no breaks. Sometimes I'm really scared because I have pts who walk in to urgent care who really belong in the ER - not our clinic.The patients are mostly medicaid and medicare, welfare and unemployed or disability patients with chronic pain issues. It is all paper charting which takes up a lot of time. I have call one night a week and every other weekend for 4 days straight. I feel like I'm always working.
The clinic is owned by an FNP and his wife, the office manager. All they seem to care about is making money. They schedule us full and tight.
They have a high turnover rate, lost 6 FNPs in the last year. I thought I could handle it but I'm burning out fast. Sometimes i want to chuck it all - just get on a plane leave it all behind and go where no one knows me.
Is it like this everywhere? This is much harder than being an RN, sometimes I really miss my job in labor and delivery.
I feel like I have to stick it out for at least a year so I don't look like a job hopper and so I can get experience as an FNP on my resume. I would really appreciate some advice on how to handle this. I know talking to my employer won't help...they told the others who quit - "this is how it is, if you don't like it then leave."
This is scary. That FNP owner has no business seeing complicated patients in an urgent care setting. I see very complicated patients like that, but there are doctors around! When I work in urgent care, I send people to the ER who don't have "minor" illnesses/injuries.
I wouldn't think twice about reporting this FNP to the Board of Nursing. It's malpractice for him to treat patients who are clearly over his head...let's face it, a lot of people need to see THE DOCTOR! BTW, have you talked to the supervising physician about any of this? I'm sure he/she would be furious if they knew the midlevels they supervised were seeing patients clearly beyond their level of education, b/c they'll get sued!
I think you know what you need to do.... Leave! Be polite, be professional work out your notice and head for safer waters.
My first job I was hired by a junior partner in the practice. As nice as he was the senior partner was his exact opposite. Unfortunately situations like this can occur since we don't know details about a job until we take the job....
Oh my gosh, that is sad... i am in the south making same as you, it is an inpatient position, i only do H and short P, and i'm lucky if i see 10 pts/day some days its like 5pts.. and some days we just call the patients I get 34 days pd vaca, no call, no nights, no weekends, i work 4-10hr/shifts, and if a holiday week, that is day off, free lunch, health ins. is okay.. anyways, i'm not sure why this place pays so high and so little work, we NPs stand around for several hrs/day. AND they just hired 2 more.... The boss actually told us at a recent meeting to "look busy" and also said they were like 6 million over budget... i really don't get it..
But if it makes you feel better i have only been there 2 months and even with all the great pay and benefits I am leaving. Reasons i don't want to post right now since i am still in notice period.
I graduated in Dec. and took cert in april and finally got licensed in this state in july i think. had license from other state in Feb.
I don't know where i am going or what i am going to do.
I don't miss being a RN really, but may do a travel job till i figure out what i am going to do.
It sounds like it is not a good fit for you. I too do not want to work my guts out, but on the other hand do not like being bored EVERY day either.... We just need to find a happy medium!
There are so many NP jobs out there, that even if you took a break and did a travel RN job, you will still be able to get a NP job, esp. if you are flexible with where you live.
You can PM me if you want, i feel like i can relate since i am in a simliar situation, but i am thankful i am not in your situation!!
YOu should not have to work your guts out for that kind of pay with NO benefits???!
For whatever reason you're leaving, it's for the best. There is no way they are going to continue to keep all those NP's around if they're not busy. Somebody has to "pay the piper" somewhere down the road and those NP's are going to get laid off.
Specializes in primary care, pediatrics, OB/GYN, NICU.
This is scary. That FNP owner has no business seeing complicated patients in an urgent care setting. I see very complicated patients like that, but there are doctors around! When I work in urgent care, I send people to the ER who don't have "minor" illnesses/injuries.
I wouldn't think twice about reporting this FNP to the Board of Nursing. It's malpractice for him to treat patients who are clearly over his head...let's face it, a lot of people need to see THE DOCTOR! BTW, have you talked to the supervising physician about any of this? I'm sure he/she would be furious if they knew the midlevels they supervised were seeing patients clearly beyond their level of education, b/c they'll get sued!
In my state (Oregon) FNP's are not required to work under a physician - so there IS no supervising physician. The clinic is run and staffed completely by NP's! Stupid me, I thought that would make it a safer and more supportive place to work!
Having worked in a toxic environment before, I'd leave. It's just not worth the stress. I would also use the experience to inform your next job choice - ask how long the other staff have been there, how many have left. It's a good indicator of a crappy work environment if staff are running for the hills. Of course, they may not tell you, but it's worth asking.
I would not risk my license in a setting which felt unsafe. You have to keep in mind what you'd say in court, when asked if you realized the number and acuity of patients was unsafe - "Yes". Then they would ask what you did about it. "Nothing" would not be a good response.
Having worked in a toxic environment before, I'd leave. It's just not worth the stress. I would also use the experience to inform your next job choice - ask how long the other staff have been there, how many have left. It's a good indicator of a crappy work environment if staff are running for the hills. Of course, they may not tell you, but it's worth asking.
I would not risk my license in a setting which felt unsafe. You have to keep in mind what you'd say in court, when asked if you realized the number and acuity of patients was unsafe - "Yes". Then they would ask what you did about it. "Nothing" would not be a good response.
I agree. My first job was working for a pain management doctor whom I absolutely adored. I was treated just like a colleague and I was paid as much as a physician. Then I began hearing about how he had gone through 3 midlevels in a year. I just couldn't understand that b/c I was treated extremely well and paid more than I could have ever imagined! After several months, I started noticing some really weird things. For instance, people were getting scripts for narcotics (usually Oxycontin with massive quantities of Lortab for breakthrough pain) and it was evident they didn't need it. People were failing drug tests left and right yet the doctor wouldn't discharge them because "they were good customers." The final straw came when I found out he was having his office manager call elderly patients at home and informing them that the doctor needed to see them ASAP. Then the patients would be scheduled for pre-op's for procedures they neither needed nor wanted. I left after I had been there a year and I'm glad I did. That doctor is now in trouble with the Board of Medicine plus he has already been kicked off at least 1 major insurance plan for performing unnecessary procedures! What's really wild is that his fulltime NP has STAYED with him for 2 years now! She is too stupid to realize that she WILL go down with him b/c she is fully aware of what has happened in the past and she did NOTHING about it. There is no amount of money that is worth being involved in anything like this...it's just WRONG!
Specializes in primary care, pediatrics, OB/GYN, NICU.
I know firsthand that money isn't everything. I have a low thresh hold for burnout and I left a job paying a high salary for a low wage nothing job.
If I could find a job somewhere else I'd do it and I wouldn't worry about looking like a job hopper.
I know money isn't everything, but right now I am nervous about the economy. That being said I have applied for 2 positions...once I have somewhere to leap, I am outta here!
I feel your pain. I am a new NP too, and am so stressed after just 6 weeks at my job. Not sure what to do. I think the main problems are: I work nights (which I cannot get used to), and cover way too many patients at night!!! It is overwhelming.
my motto: you only live one life, so don't eat stuff that doesn't taste good, and no job is worth being unhappy.
Plus if you are in unsafe environment it makes it worse.
I gave my notice at my first NP job, ~2mo after i started, my last day is coming up here soon. I do not have any employment lined up, but plan on doing a travel RN job til i figure out another NP job.
There's enough jobs out there, healthcare is not an unstable area of the economy.
Specializes in primary care, pediatrics, OB/GYN, NICU.
I agree. My first job was working for a pain management doctor whom I absolutely adored. I was treated just like a colleague and I was paid as much as a physician. Then I began hearing about how he had gone through 3 midlevels in a year. I just couldn't understand that b/c I was treated extremely well and paid more than I could have ever imagined! After several months, I started noticing some really weird things. For instance, people were getting scripts for narcotics (usually Oxycontin with massive quantities of Lortab for breakthrough pain) and it was evident they didn't need it. People were failing drug tests left and right yet the doctor wouldn't discharge them because "they were good customers." The final straw came when I found out he was having his office manager call elderly patients at home and informing them that the doctor needed to see them ASAP. Then the patients would be scheduled for pre-op's for procedures they neither needed nor wanted. I left after I had been there a year and I'm glad I did. That doctor is now in trouble with the Board of Medicine plus he has already been kicked off at least 1 major insurance plan for performing unnecessary procedures! What's really wild is that his fulltime NP has STAYED with him for 2 years now! She is too stupid to realize that she WILL go down with him b/c she is fully aware of what has happened in the past and she did NOTHING about it. There is no amount of money that is worth being involved in anything like this...it's just WRONG!
Did you report him after you left the job? I'm wondering what my responsibility is after finally getting out of a bad work situation (yesterday was my last day.) It wasn't just bad business practices or being horrible to employees...there are other ethical/legal issues that came up such as huge quantities of narcotics being given - amounts that are not humanly possible to ingest without being dead or in a coma, i wonder if they are being sold on the street!Do I need to make a report to the Board of Nursing? the Board of medicine? The DEA?
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ANPFNPGNP
685 Posts
This is scary. That FNP owner has no business seeing complicated patients in an urgent care setting. I see very complicated patients like that, but there are doctors around! When I work in urgent care, I send people to the ER who don't have "minor" illnesses/injuries.
I wouldn't think twice about reporting this FNP to the Board of Nursing. It's malpractice for him to treat patients who are clearly over his head...let's face it, a lot of people need to see THE DOCTOR! BTW, have you talked to the supervising physician about any of this? I'm sure he/she would be furious if they knew the midlevels they supervised were seeing patients clearly beyond their level of education, b/c they'll get sued!