kkit

Hello all! I'm in a difficult situation at work at the moment and need an outside perspective. I work for a small clinic and recently the other provider left and now I am still relatively new at the specialty (I am purposely being vague but it is a kind of niche specialty) and basically by myself. The supervising physician is in a different state and comes in one day per month. My boss is working from home and suddenly very concerned about finances so has decided I need to see twice the number of patients I was seeing before. I am being triple booked all day and being basically forced to provide poor care and ignore my patients when they message me and when I complain I am basically told to suck it up. I am months behind on paperwork and weeks behind on messages and orders and documentation and every day I show up I get more behind and it is panic inducing but they just keep overloading me anyways. We are billing for 15 hours worth of visits in a 9 hour day. (Which means I rush through the visits and then have a mountain of work and stay till 9pm every night and come in at 530am every morning). I have finally accepted I just have to give my notice even if it means shutting down the clinic but I still have to give a 2 month notice per my contract and it feels like it keeps getting worse and they keep adding more time slots for double and triple booking and who knows how much worse it could be in 2 months? Is there a way to at least get them to limit it somewhat in the interim? Every day I feel like I am going to end up having a panic attack just by going into work at this point and I am so embarrassed about the poor care that I am giving/ worried about getting a bad reputation as a provider. They do not seem to even care about my opinion on the topic. And apparently they don't care about staying open either. I feel powerless. Thanks for any feedback you can give!

When I meet someone who says they are going to school to become a nurse practitioner and then admits that they are still taking their prereqs for the bsn program I genuinely don't understand their decision making. Why not just become a PA? Why do these people not want to be nurses?

most medical schools require your prerequisites to be within the past 5 years, I believe. So it is unlikely many FNPs would qualify. I mean, how long ago did you take biochemistry? or physics? But, also, why would anyone want to do this? We became nurses instead of doctors for a reason.

FYI. I live near Asheville, NC and every time I get curious and look to see what types of opportunities are out there (Just being nosy because I love my job) it looks like they are DESPERATE for psych NPs here. If anyone is having a hard time finding a job in this area consider the hills of WNC!

Well it says part-time so I guess it would depend how many hours a week we are talking.

wow! Thanks guys! I will look into these!

well they require me to have some sort of a contractual relationship with a doctor in order to even be licensed.

Hi all! I just passed my FNP boards and am moving to NC from FL in December. I will be living in Fletcher,NC. I heard that you need a doctor to vouch for you in order to get your license? How do people accomplish this if they are from out of state? Also, how difficult is it to get a job as a new grad in that area? Thanks, Kat

I agree that it is always safest to ask the physician in situations were the patient is NPO for surgery and has a high BS. HOWEVER, 185 is not worth waking the doctor up. You did the right thing. If the BS was > 200 I would have called, though.

This seems like a no brainer to me. Go to the new job. You will save on gas and have significantly more time for your family! I have worked both days and nights and agree that nights are not easy. However, they are a little less hectic and your co-workers/charge nurse will have more time to help if you get behind. That being said, I will say that I prefer dayshift. The doctors are awake and available to answer your questions and discuss the patients and they don't yell at you or ignore you when you page them. I feel much more "in the loop" about what is going on with the patient. I sleep MUCH better and am not tired all of the time. Your first couple years as a nurse will be difficult whether you are on days or nights. However, I think nights are a good place to start. You can switch back to days once you get the hang of things. Hang in there. It really does get better!!!

Down here in Florida, 5-6 patients per nurse on days is the norm. 7 only happens at night. They might TRY to cut your orientation short but you really need to stick up for yourself and demand a full orientation. I'm having a really hard time with 6 patients. But I am told, and am trying to believe, that it WILL get easier with time...After 3 months off orientation, I feel comfortable on a day where I am dealing with typical problems that I know how to solve. The problem occurs when I suddenly have 3 discharges and an admission all at the same time and (since we are short staffed at the moment) there is no charge nurse to help me out. Then I sink miserably. Also, when I have multiple issues that I have to deal with that are not everyday problems I am so green that I just dont know how to solve them. Those instances put me way behind but I am hopeful that as I am exposed to more and more unique situations the "unique" situations will get farther and farther between and I will be able to rely on past experience in determining my actions and this will help me to resolve them faster. And I am also hopeful that we will be better staffed soon :)

yeah. i guess i DO ask those questions as I go but I hardly even USED my stethoscope that day =0(

I'm embarrased to say that I've been off orientation for 3 months now! I usually can handle that many patients (6) but yesterday was just hell and it was with the same group of patients i had the day before when it was ok! All of these issues just came up and I got so caught up in trying to sort them out and play phone relay between doctors etc that I began to feel like I was neglecting my other patients. What do you do when it gets to be too much and there's not enough available help?

I was drowning today. And, while nurses were willing to help, they were busy too and could only do so much. I don't feel like a safe nurse when I hardly even have time to regularly check on some of my patients. =0(