Not digging outpatient

[novemberpromise]

Hello all! I love this forum group. I just need to vent and ask for some advice. I recently, very recently, went into outpatient nursing from inpatient nursing. I was working in a hospital, had 4-6 pts on average, all acute diagnoses, med/surg/oncology/hospice. Then we became a covid unit. This burned me out quick. I loved the job when I first started. But later I found myself online looking for other positions. I got hired at a very prestigious organization (that's a huge reason I went) in an outpatient clinic and am now working with orthopedics. I am at a crossroad because I have been there for a very short amount of time, but something is not sitting right. I miss my inpatient setting. I feel like all my skills I was just utilizing are going down the drain. How long do I stay to see if I feel different one day, before trying to get back to inpatient? was thinking of even navigating thru the organization for it may be easier since I'm an established employee. Any thoughts? Advice? Anything is much appreciated ?

[Jedrnurse, BSN, RN]

The whole "losing my skills" things is not as bad as people say; you'd be surprised how fast you can jump back on the horse when you need to. Also, don't dismiss the skills you can use in outpatient, particularly if you strive to do the best job you can. (As opposed to "coasting", I mean.)

If you're in a big organization with room to grow, stay a decent amount of time in your current position (at least the amount in their transfer policy) then look for something else there. If I'm getting your timeline correctly, looking this soon would probably make you look like a job hopper. Believe me, time will pass sooner than you think.

[Nurse SMS, MSN, RN]

Since Covid has only been around about five months in a serious capacity, it sounds like you did a knee-jerk jump. Now it sounds like you want to do another knee-jerk jump.

Any time you change specialties its going to take you about a year to feel comfortable. Only you can decide if you are willing to give it a year. You can ask for your old job back - if you are in a surge area, they will be thrilled. Or, you can delve into finding an inpatient position elsewhere and hope it doesn't involve Covid. Or, you can stay where you are and give it six months to a year to begin to feel at home.

[novemberpromise]

Thank you!! Yeah I was in love with inpatient til covid...did med surg for about 6 mos then our unit turned covid and did that since March...was there a year but wish nursing school taught more about outpatient careers....

[llg, PhD, RN]

Most nursing schools few their primary mission as preparing you to pass NCLEX and getting you a license. Then, they try to prepare you for your first job -- which for most people, is in a hospital. Third, they try to recruit you into their graduate school (if they have one).

Preparing you for a long-term career comes below those other things on their priority list. I obviously disagree and fell that there should be more emphasis on long-term career success and satisfaction.

[Katie82, RN]

Not necessarily "losing your skills", but expanding your skills if you take advantage of it. When I took a position as a Care Manager for Chronic Disease patients, I found out how little I actually knew about chronic disease processes when I worked bedside. My on-hands skills were sharp, but my physiology skills had not expanded much since leaving school. Lucky for me, the company that hired me offered a 6-week crash course in chronic disease, and that job led me to work Case Management, my true love.

[FolksBtrippin, BSN, RN]

I find that people who talk about losing skills are usually not actually talking about real nursing skills, but technical stuff that anyone could learn in a day.

You are a nurse, not a technician.

Apply the nursing process with your patients. Doing that in any setting, is your nursing skill. Everything else is a Youtube video.

Not sure what your role is in outpatient, but I am certain that if it were just a bunch of technical stuff it would be done by an MA, under a physician.

Outpatient tends to be a lot of education and triage. You are teaching people how to care for themselves, and you are the gateway between that person and the hospital. To educate them well, you need to know a lot about their dx. You need to be up on the research. You are the expert. Start reading and read every day.

You need to have excellent assessment and the ability to triage. Don't be the nurse who sends every person to the hospital who calls with a problem. Learn to get info over the phone, what questions do you need to ask? Is this a doctor visit, urgent care, emergency room or do you need to educate the patient and keep her home?

These are skills you didn't need in the hospital and you should be working on them now. If you're not up for it, then go back to inpatient.

[CommunityRNBSN, BSN, RN]

Just my two cents because I know that not everyone will be happy in outpatient. But— if you want to use your brain, there are a million things to learn in outpatient. If you are lazy, you can definitely sit in a chair and just do what is absolutely required. At my job, we only have one lazy nurse, but yes, she’s losing whatever skills she may have had in the past. Because she just waits until someone says “go give a flu shot”, and then she does it. I and the other nurses really like to know what is going on with our patients. I am a valuable and trusted nurse because I take the initiative to say “Dr So and so, when this patient came in for his nursing visit, he mentioned to me that he had XYZ symptom. It made me wonder if he could have ABC. Do you want to go look at him?”

The doctors are so busy that they fly through the visits and miss a million things. I, OTOH, have quite a lot of time (some days at least) to talk to patients, examine them, and put pieces together. I definitely couldn’t run a ventilator, and you wouldn’t want me trying to start an IV on your grandmother, but I know a LOT about the million oral meds for T2DM, and about the local resources for outpatient addiction treatment.