New grad- Is working at a Dr.'s office a good way to start?

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I'm a new grad RN and I just got interviewed at a small allergy and asthma clinic. It will be a part-time position (approx. 30/wk). The main responsibilities will be giving allergy shots and doing allergy testing. It doesn't sound too difficult to handle, but my primary concern is I will be the ONLY nurse there if I get hired. The nurse that's working there right now will go on maternity leave, so I'll get about 1 month of training with her...and after that I'll be on my own with no other nurse to turn to if I have a problem. The MD seems nice...but I'm not sure if I could go to him for nursing problems. I'm a fast learner, but I'm so scared when thinking about being on my own with only 1 or 1.5month of training. Am I putting my license at risk if I accept this job? Should I accept this job? Does Dr.'s office provide for their nurses or is that something I need to get on my own? If a new grad can't get jobs at hospitals, are Dr's offices a good way to start out nursing career?

If there's any allergy nurses out there, please give me some advice/share your experiences (typical day at work, things to be cautious about, etc), anything would help! Thank you.

Is the doc's office part of a multispecialty clinic, where there are other people/departments around, or is it a freestanding clinic?

The day that you will be by yourself, is there a covering doctor that will be in the building in case there are problems? That part does not sit well with me either. You should also have another staff member around (even if you can pull one from a nearby department) so that they can check the vitals, administer Benadryl and possibly steroids and keep the other patients calm and monitored while you get the doctor.

If it is just you, what happens if your patients starts having a reaction during that day? Do you leave with that patient to get the doctor? If so, then what about your other allergy patients who are waiting there after receiving their shots? They should not be left alone, as a lot of them do not recognize the signs of problems (coughing, "itchy throat", increased difficulty swallowing or feeling as though there is a lump in the throat, increased sneezing/blowing nose, etc), and problems can come about fast. You at least need a second person there to collaborate with in the area otherwise I would not consider it safe. Questionable patients should be also checked out by a doc before leaving the office after their shot.

A big part of allergy shot monitoring is catching reactions early and treating early with liquid Benadryl, prednisone, possibly inhaler, possibly epi, and possibly transfer to the hospital. The earlier you treat the more likely you can stave off big problems. This is why you need to have a nurse in the room with the patients at all times to listen for problems, and triage quickly. Leaving your patients to room someone for 10 minutes, or to test someone for 15 minutes, or to go get a doc leaves your patients unmonitored and problems can occur during this time.

If you are by yourself in a freestanding clinic giving shots that day with no covering MD, I would make it a condition that they have to give you at least another nurse that day, or, change shot hours, before accepting the job. You are giving a substance that you know the patient is allergic to, and they can be fine one shot and the next week's shot go into anaphylaxis. Be cautious about how you proceed after getting the answers to these questions.

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Specializes in GI/ Peds?OB.

TAKE THE job. Its been more then several months and I am still not working...... just take the job and thank the guy up above that u got a nrs job then continue to look.

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I'm sure you'll be fine if you take the job.

Bad reactions to allergy shots are very rare. As an adult who has had shots for years, and who currently goes to an ENT, I can tell you that "monitoring for reactions" happens by having the patient sit in the waiting room for all of 15 minutes, reading old magazines, under the watchful eye of the receptionist. Yes, the receptionist.

The nurse does not sit there and look at the patient; it's kind of a self-reporting thing, even for the kids. I have never, ever seen a nurse involved. If someone does have a twinge, you just send them to the ER. It's extremely rare for someone to have more than a minor reaction -- nobody is going to keel over dead. The worst you will have to do is stick them with an EpiPen and send them to the ER.

I think you have a perception of the allergy shot process that is making you nervous. Try to find some friends with allergies and ask them about it -- it will make you feel better.

Take the job! I think you will be great.

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take the job, some nurses seem to think nursing is limited to what they do (hospital job).

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Specializes in Adolescent Psych, PICU.

I would definitely take the job!

Do you know how crappy most hospital nursing jobs are and how many nurses would kill for a job like the one your being offered? Most nurses are looking to get OUT of the hospital.

I think your over thinking the reaction/ emergency issues. Its not likely to happen and if it does find out what your procedures/policies are for something like that (standing orders for benadryl? etc?) and take it from there. I really dont think its an issue you need to worry about as much as you think. I think you will have peace of mind knowing what the policies and procedures are.

And you will learn with this job. Every nursing job requires a certain skill set and knowledge base. I think you will learn more than you realize. I worked ICU for 2 year and am now in psych for 1 yr....believe me, I have learned a lot at both jobs, both jobs I have gained nursing knowledge, various skills, seen a lot of stuff at both jobs.

You will be fine. At the very least later on you can always work med-surg and start there. I see RN refresher courses offered all the time for new nurses and nurses returning to the work force after awhile.

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Having been both a patient and worked as a nurse in an allergy clinic I can tell you, that if it is an aggressive allergy program(run by an allergist; ENT usually run entirely different programs), you will get patients with bad reactions to shots. I gave prednisone and yes epi multiple times, and yes, we had a nurse stationed in the waiting room for good reason, as most of those patients did not come up to us, we questioned them when we noticed subtle increases in symptoms.

Sure there are programs where the doc gives akin to water and you will have next to no reactions (I've seen as dilute as 1:2,000,000), but when you are going up to as high as 1:50, you are going to get reactions.

Yes, I know that some docs are irresponsible and defy AAAAI/other guidelines and let people leave before 30 minutes, and have a self-reporting system, but after the types of reactions I've seen, and speaking with a nurse on this board in the same situation as the OP who had a bad outcome with only herself staffing the clinic, I'm going to stand by my recommendation of caution.

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How's the new GIG?

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I want to start out in a doctor's office because I am on a med/surg floor and find it so hard physically. I am a new grad as well and am older---wish I was a youngster, maybe it would be easier to adjust to the 12 hour shifts. I am looking to switch to a clinic or doc's office just because I rather work at a slower pace than the hospital floor which is very stressful and chaotic at times.

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