NEW Grad FNP starting in immediate care clinic.

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I wanted to get some opinions from others NPs who work in an urgent care/retail type clinic. I am a new grad FNP that is considering starting with an immediate care clinic. I am not sure what the patient population will look like since this will be a brand new clinic that will open in the next two months. According to the physician I will be working completely alone aside from the front office staff. I did mention to him that I would like a shadowing experience before hand since i am a new grad however, he reassured me that I would be fine and that he or his partner would only be a phone call away. This would be a great opportunity for me, but to be completely honest I am terrified. I don't want to feel like I bit off more than I can chew.” Any advice would be greatly appreciated. Thanks.

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...I did mention to him that I would like a shadowing experience before hand since i am a new grad however, he reassured me that I would be fine..

This is what some people might call 'false reassurance'. He can't know that everything will be fine. Because you are a brand new NP they should have given you an orientation---even if its a short one. You're supposed to come into your position feeling supported, not terrified. This doctor sounds like a couple of them that I have worked with in the past...only concern is about the money that you will be bringing in.

What is your RN background and experience? If you have good ER experience then you will likely do ok in urgent care because you will be used to seeing all different kinds of things walking in through the door. Most people who come to an urgent care probably won't be all that critical. It will be up to you to use your judgment and assessment skills to determine which of them actually need to go to the hospital and send them there as appropriate. You are usually able to determine this with the same old SOAP formula: objective observation and by listening to what they tell you when they walk in. Usually, people come in complaining of just one thing: a flesh wound after an accident, animal bite, a headache that won't go away, pain after a fall... etc. So you are able to quickly narrow your assessment focus and determine the appropriate diagnostics/treatment. Its not like a Medicare patient with 20 different comorbidities who walks in to primary care for a follow-up. Whenever you are in doubt, call up Dr. Dollar$ and ask for his input. And, anybody who looks unstable, send them to the hospital.

Congratulations on your new position!

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Thank you so much for your advise I greatly appreciate it. You hit the nail on the head about the doctor, he spent about 30 minutes talking to me about how much money is in retail clinics which prompted him to open one.

As far as my experience I have only worked in long term care facilities and in mental health as an RN so I don't have any urgent care/ER experience aside from my NP clinical rotation. If most of the cases coming through are simple complaints as you mentioned I should be okay with that. There are just certain patient populations such as peds where I would not feel as comfortable treating without another provider on site.

Thank you again!

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Specializes in NP, ICU, ED, Pre-op.

IMHO this is a really bad idea if you have no ER experience. However, it is my understanding that these clinics usually run off of protocols and you are only going to "see" certain types of problems. Most certainly there will be children though so you need to be ok with this. Also, if you have never worked in the ER, make sure you start reading up on some common urgent care stuff. Asthma attacks in children can go really bad, really quick. Don't be afraid to send them to the ER....

Good Luck!

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Yikes. The new and the completely alone are a scary combination. If there was another provider in the clinic with you it would help with any questions/concerns that come up. Those clinics (from my understanding) are like a sick clinic with many of the same types of patients you would see in the ED most ESI 4,5 and maybe a 3 in the mix. Definitely ED experience would be huge going to the role as an NP as it would help you quickly decide what you can treat and what you should send to the ED plus solid suture skills would come in handy as the Urgent clinics around my community get minor lacs all the time.

Good luck with whatever you decide..

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Specializes in ER, PCU, UCC, Observation medicine.

You may find yourself very lost in urgent care with no ED experience at first. I had a colleague who only had cardiology background switch over to ER/ urgent care. She lasted about a month, mainly because she wasn't use to the pace, and poorly grasped new things. If I were you I'd start preparing for things you will encounter and how you will treat things. I have a huge amount of experience in urgent care. So you can PM for any help/resource.

Make sure you know how to do basic procedures like I&D and suturing. If you aren't aware look me up on YouTube I demonstrate how to do all these things, just type in TheNP on YouTube and you'll see my channel (same logo as allnurses).

I think it's easy to learn urgent care and it's very fun. This will all be new to you and likely overwhelming especially being by yourself. Just give it time if you take the role.

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Hi FNP23, it's been over 1.5 years since you posted this question. I was wondering if you ended up taking this job and if so, how did it/is it going?

If not, I'm curious where you ended up as a new grad FNP.

- Aspiring FNP

Thanks!

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