New NP.

[nitasarn]

Im a newer FNP and I just have to say family and friend have ask me how my new job is going. Do I like it better? Oh it must be easier than working bedside and in the hospital. But Im just gonna say...It is mentally exhausting. I question everything. I look up doses twice. I work in an urgent care and some patients I dont know if I need to work them up or send them to the ER. Then if I sent them to the ER, once I think about it some more and I dont want the ER to think Im stupid, Im like may be I couldve done more here, but when you suspect an appendicitis vs pyelo vs kidney stone and we dont have advanced imaging, what elses can I do but get a UA! Then I feel bad cause they pay a co pay just for me to say "Go to the ER" I know theres no easy answer. I know it takes time. I just wanted to vent.

Thanks

[JUSTanLPN]

Sounds like your really digging in, and the questioning your every decision thing is safe practice IMO. Congrats on your accomplishment!

[bayouchick02]

I feel the same way!! I think it's better to send them to the ER and it turn out to be nothing than for you not to send them and the patient deteriorates.....I question everything too. People tell me it will get better with time. I sure hope so because I sure hate feeling like I don't know anything!

[danielle2000, MSN, RN]

I want to say major congrats! That tells me you are conscientious about your practice and your are grooming yourself to be on of the best! Hang in there, as time goes you will feel more confident in your decisions!!!

[Tinabeanrn]

It is always hard to work up a belly, whether it be in the ER or in the Office. But when in doubt, send them to the ER. Sometimes ppl are just in the wrong place. They come into the office with a gangrene toe just about ready to fall off asking for oral antibiotics. They are just in the wrong place. Its is great that you know when to say when, and you do refer them to the ER. Im sure you are not sending everyone to the ER and your doing the best you can. Its important to look up the doses when you are not sure. To me its much better than nursing. Although I am not in an urgent care, I am in the office and I have more history and more time to think than you probably do. I think ppl are right when they say it takes time. Even the ER send ppl home and the person may go to another ER and find that they have a life threatening illness. So dont feel bad at all. Just be excited and diligent like you have been being and ask when you are not sure and look things up when you are half way sure. Dont be so hard on yourself! That is one thing I have learned. I am pretty new too and it is going to take time to develop into an awesome practitioner that knows things like the back of my hand. It takes a special person to do what we do , congrats to you and keep up the good work!

[NervousNP]

I thought I was the only one that felt this way! I work in family practice but I also still question somethings even almost 2years out. I do worry about when I have to send someone out to the ED I'm going to feel like they think I'm stupid but you are correct if you have the proper advanced diagnostic equipment in house & they deteriorate it's on the provider. So good for you for being extra cautious!

[chillnurse, BSN, RN, NP]

it just takes time and you will gain confidence. better safe than sorry. when i doubt just say "this symptom can be something serious, I would feel much safer if you go the the ER just to be on the safe side and get a better workup"