I've been an NP for 1.5 years, but I've only been seeing patients at my new job for about 5 months, I work mon-fri seeing Rheumatology and Arthritis patients, and on the weekends I work ER/Fast track, I'm seeing a good number of patients and charting w/o worry in the ER, however, I'm struggling in my clinic during the week, and week before last, I hit a wall, angry, exhausted, tired, sleepy, nauseated.
I was/am getting overwhelmed, I opened my own clinic (within our facility) seeing patients on my own in March of this year, after a few months training with some of the Rheumatologists for a few months prior to that, and initially I was doing ok, seeing mostly knee/shoulder pain w/lots of steroid injections, as our office had a contract Rheumatologist with over 40yr experience seeing all of the harder Rheumatology patients, she abruptly left the office and I have been seeing her patients now as well as seeing new Rheum consults all with very little Rheumatology training or back up and it's taking a toll on me, as I'm spending hours reading/charting and trying to figure out what the patients correct diagnosis is, and if you've worked Rheum, the difference between diagnosis is minute, I've been studying/charting until 10pm at night and I'm getting to be angry and grumpy, exhausted.
Luckily, this past week, I've been back to mostly injections, gout treatment, fibromyalgia, etc, easy stuff, so I"m out on time, but I'm still quick to anger now, kinda punchy, I dunno, it's a mixture of fatigue and self doubt coupled with a little resentment, I suppose, I've received a tiny fraction of the training that the Rheumatologists receive and I make less than most of the RN's that I work with (VHA system).
The Rheumatologist Fellows are MD's, graduated medical school, residency, etc, and they get 3 full years of Rheumatology Fellowship with an Attending that staffs with them on each patient and aren't out on their own until the 3 years are up, they train in the main hospital branch.
I'm down at the satellite branch and I got 3 months of how to do injections, with a little on the fly Rheum training and I'm seeing patients on my own, with very little help when I have questions, and it's just a little overwhelming, a great opportunity to sink or swim, but I spend hours reviewing everything, with the hopes that I'm not missing too much, but week before last week, I just couldn't go any further and honestly if last week had been like the previous 4 weeks of nothing but new consults to the Rheumatology service, I don't think I would have made it to the end of the week, I'm trying to get them to remember, that I'm not a Rheumatologist!
What do you do when you hit a wall? Literally I sleep a few hours, dream about diagnosis, dream about patient RVU's, and then I wake up and go back to work, now everyone looks like a joint, I don't see people, I see knee's, hands (dip, pip, mcp, cmc), ugh........If I had a life, a wife or girlfriend I wouldn't be able to keep up, as it is, it's just me, so I plug away.
Some days I think that I should just take an RN job in the clinic, it'd be
As I look at the clock, it's 1:30am, I have to stop rambling, I need to wake up in 5 hours and get ready for work! Sorry for the long rant and whining, I'm just so frustrated lately and I don't know how to make things better.
