New grad NP in pain management, bad idea?

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Specializes in ICU.

OK so to make a long story short... 

I’m a new grad, sort of, I graduated 2 years ago and I am finally starting my first NP job. (I was sick for a year and couldn’t work, postpartum depression is real people ?). 
So I have a dual degree FNP/AGACNP, but of course with covid nonsense I have not been able to land any inpatient jobs. There have been 50-100+ applicants for every job I applied for. Granted half the hospital in the area have been on hiring freezes for over a year...
After months of no success I moved on to the outpatient world and landed a job in pain management. Seems like pain management jobs are a dime a dozen right now and I’m beginning to think there’s a good reason for that. 
I’ve had 7 days of training and will start seeing patients on my own tomorrow. I am beyond stressed!! I was promised a 6 week orientation and that didn’t happen because the provider I was to replace up and just left (who does this?? Isn’t that patient abandonment??). So now I received 2 weeks of orientation and that’s all they can do. Beyond stressed about this. It just seems crazy to me. I have NO idea what I am doing, my back ground as a bedside RN is ICU and basically all my NP training was ICU and family medicine (which family med I completed 3 years ago.. soooo I can’t remember a damn thing from that). 

 I want to work inpatient. I want to work in the acute care world. But I need a job! I plan on continuing to apply to inpatient positions, but is this pain management job even going to be worth it? I will get no training, be stressed AF, to do a job in an area of medicine I do not like. (Who actually likes pain management??)

I am worried I am going to get stuck in the outpatient setting. 
I need experience, I need a job, but is working in pain management going to hurt my chances of ever getting into the hospital setting?  

All these hospitals want NP experience but is pain management even going to count? 

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Specializes in Psychiatry.

Just breathe, it will be okay!

You have landed a job!

Any experience is good experience. Pain management is tough but you can still learn. Make sure you're doing good assessments and thorough histories on every patient. Look up every medication they take and understand the interactions and pharmacology. Become an expert on pain control, and titration of pain medication!

Don't ever do anything you're uncomfortable with. Take it one day at a time, and get back into the groove of being a provider after 2 years.

 

After 6 months, start applying again for what you really want. Having experience and a current job makes a world of difference when applying.

 

Good luck! 

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Specializes in ICU.
22 minutes ago, MentalKlarity said:

Just breathe, it will be okay!

You have landed a job!

Any experience is good experience. Pain management is tough but you can still learn. Make sure you're doing good assessments and thorough histories on every patient. Look up every medication they take and understand the interactions and pharmacology. Become an expert on pain control, and titration of pain medication!

Don't ever do anything you're uncomfortable with. Take it one day at a time, and get back into the groove of being a provider after 2 years.

 

After 6 months, start applying again for what you really want. Having experience and a current job makes a world of difference when applying.

 

Good luck! 

How did you know exactly what to say!! 
thank you ?? 

I’ve been so stressed about working in pain management and then when I lost the rest of my orientation weeks I just panicked. It’s hard to be new... and even harder when it’s been 2 years... and even harder when I don’t think I’ll fit well in pain management! 
 

but my husband said the same thing. Just learn what you can and use it to your advantage and in 6 months apply to your dream jobs. I guess he sometimes has good ideas ??‍♀️
 

thank you for easing some stress!  Now if I can just survive my first day on my own tomorrow. 

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Specializes in Psychiatry.
7 hours ago, J&B-RN said:

How did you know exactly what to say!! 
thank you ?? 

I’ve been so stressed about working in pain management and then when I lost the rest of my orientation weeks I just panicked. It’s hard to be new... and even harder when it’s been 2 years... and even harder when I don’t think I’ll fit well in pain management! 
 

but my husband said the same thing. Just learn what you can and use it to your advantage and in 6 months apply to your dream jobs. I guess he sometimes has good ideas ??‍♀️
 

thank you for easing some stress!  Now if I can just survive my first day on my own tomorrow. 

You're welcome! Your husband was right! ?

When I was an RN, I went through a period of not being able to find a job. I had just moved and had quit my job a few months earlier to prepare for the move. In my new state jobs were scarce and I didn't even get interviews because I was "out of practice." I took a job at an office mostly checking people in, and I felt like I was going to lose all of my skills. After about 6 months I began applying to what I wanted to do again (ICU) and got calls for interviews immediately! Having a nursing job to show I was actually doing "something" is all they wanted to see. It helped my resume float to the top. So speaking from experience, this will be a big help!

As for pain management, just immerse yourself in it! Think of it has an extended specialized residency. One day, when you're doing what you want, you'll have all of these skills regarding pain management that will come in handy. Anything can be a learning experience and help you develop into the type of provider you want to be!

I know it's hard but I had colleagues who went into pain management out of school from their AGNP and FNP programs. One piece of advice I can give you is to look at your schedule and read ALL of the charts for your followup patients in advance. You can see how previous providers have managed different aspects of pain, how they assess, and what dosing schedules or medications they have started with. That can be really helpful until you get comfortable.

 

Good luck and check back in at times!

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Also don’t hesitate to make changes where necessary. Drug screen everyone. Do thorough assessments and ensure you are actually treating pain. Many pain management facilities turn out to be glorified pill mills or money grabs to bill for needless procedures. It’s concerning when a previous clinician unexpectedly leaves. When these places go down, current and all former providers are under a microscope. 

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Specializes in psych/medical-surgical.

My concern is that I can't imagine your school or NP training prepared you for this at all... I guess it is not "outside your scope" but that is something where the lines can be a bit blurred. Pain is the 5th vital sign and treating it seems like base nursing LOL...

I had an ADHD pt last night, and so I am taking at least 2-3 days of time and gobbling up everything I can about this problem. Embarrassingly & admittedly we just do not get enough training to prepare us for this work...

I wish I could share some podcasts or information on pain management. I have 3 podcasts I listen too as well as a ton of books but they are all therapy/mental health. 

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Congratulations! Try the job , you may like it , if you still don’t like it after 6 months, start applying for something else. Nothing loss, experience gained?

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Specializes in ICU.
On 4/22/2021 at 3:51 PM, djmatte said:

Also don’t hesitate to make changes where necessary. Drug screen everyone. Do thorough assessments and ensure you are actually treating pain. Many pain management facilities turn out to be glorified pill mills or money grabs to bill for needless procedures. It’s concerning when a previous clinician unexpectedly leaves. When these places go down, current and all former providers are under a microscope. 

Thank you for the words of advice! So far I’ve survive nearly 2 weeks on my own. It’s been stressful and hard. I see 13 patients a day for now and it’s busy. I feel like I’m learning from the ground up. But the support is there. I’ve been reading all the previous visit Notes and find that is really helpful. And the other providers are always on hand for questions. For the most part I am only seeing patients who are established and on a current plan. So that keeps it a bit simpler to figure things out. It’s scary... but I guess any new job is. 
I know I haven’t really given pain management a chance, but I am fairly certain this is not the role for me. That being said, I plan to just dive into this and learn all I can. Hopefully something that is more my passion will pop up soon and maybe this experience will get me where I want to go. 
Now if my dream job could just magically fall into my lap that would be awesome!

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OMG. I am in my third year and wanted out of the job I was in due to my boss being a total dirtbag. I found a QuickStart easy onboarding pain job. The pay was bad and the benefits were absent. They wanted me carry 28-32 plus patients a day… It was supposed to be easy… Then once I started things… changed for the worse. This is s very politically correct heavily monitored forum so I won’t go into specifics. My supervisors had histories, the patients were “grumpy” my coworkers were “low information” people. The hours sucked, the pay sucked, no benefits… These are new grad traps. I got all kinds of stories… There are a lot of new grad traps out there. Hope my new job goes better.

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Specializes in Nurse Practitioner.

I agree about pain management being a new grad trap, I am a new grad working in pain management and I hate it so much I've only been there 4 months and seeing 25-32 patients per day, I have had patients swear at me if I won't increase their meds, which I won't, grab me etc. It's a complete nightmare and I hate it. I have alot of cardiology background as an RN and was hoping to find a cardiology NP job but that didn't happen. So a job was posted that wanted 2 years cardiac NP experience to round 2 local hospitals, I applied anyway and they are currently writing me up a contract for my review and said they would be happy to have me. I was honest and told them why I hate what I am currently doing in pain management and how much I love cardiology and am comfortable in the inpatient setting as I worked in cath labs and ICU for most of my 15 year nursing career so just keep applying to other jobs and you'll find one and can bounce from pain management. I can't wait to write my resignation and never have to go to that clinic again the patients are complete nightmares, some are OK but majority is not and owner is all about the numbers to make money off me the pay sucks and I get no benefits at all so its no loss for me to leave. Half of the patients asked me when I started there if I was going to stay because they have had several mid-levels there I found out most all of them left without notice and I can see why after being threatened and grabbed by patients. They had 5 providers leave in 3 years so now add me to the list as soon as my contract comes through I am out the door, however I will be giving notice as I am a professional but I can see how the others left in a hurry.

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Specializes in Former NP now Internal medicine PGY-3.
On 11/23/2022 at 7:17 PM, Marpaia said:

I agree about pain management being a new grad trap, I am a new grad working in pain management and I hate it so much I've only been there 4 months and seeing 25-32 patients per day, I have had patients swear at me if I won't increase their meds, which I won't, grab me etc. It's a complete nightmare and I hate it. I have alot of cardiology background as an RN and was hoping to find a cardiology NP job but that didn't happen. So a job was posted that wanted 2 years cardiac NP experience to round 2 local hospitals, I applied anyway and they are currently writing me up a contract for my review and said they would be happy to have me. I was honest and told them why I hate what I am currently doing in pain management and how much I love cardiology and am comfortable in the inpatient setting as I worked in cath labs and ICU for most of my 15 year nursing career so just keep applying to other jobs and you'll find one and can bounce from pain management. I can't wait to write my resignation and never have to go to that clinic again the patients are complete nightmares, some are OK but majority is not and owner is all about the numbers to make money off me the pay sucks and I get no benefits at all so its no loss for me to leave. Half of the patients asked me when I started there if I was going to stay because they have had several mid-levels there I found out most all of them left without notice and I can see why after being threatened and grabbed by patients. They had 5 providers leave in 3 years so now add me to the list as soon as my contract comes through I am out the door, however I will be giving notice as I am a professional but I can see how the others left in a hurry.

Patients being unprofessional sounds like a good reason to Titrate them off the narcotics they probably do not need anyway. 

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On 5/11/2021 at 9:43 PM, J&B-RN said:

Thank you for the words of advice! So far I’ve survive nearly 2 weeks on my own. It’s been stressful and hard. I see 13 patients a day for now and it’s busy. I feel like I’m learning from the ground up. But the support is there. I’ve been reading all the previous visit Notes and find that is really helpful. And the other providers are always on hand for questions. For the most part I am only seeing patients who are established and on a current plan. So that keeps it a bit simpler to figure things out. It’s scary... but I guess any new job is. 
I know I haven’t really given pain management a chance, but I am fairly certain this is not the role for me. That being said, I plan to just dive into this and learn all I can. Hopefully something that is more my passion will pop up soon and maybe this experience will get me where I want to go. 
Now if my dream job could just magically fall into my lap that would be awesome!

I know this post has been laying low for a while, but just wondering if you're still out there and how this job is going, or went?  I see pain management positions pop up quite a bit.

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