calwen

Your employer’s main concern is their business and profit margins. It will never be you. Only you can take of yourself and protect your license. Nobody else. You will come up across employers and supervisors who will ask you to do things you shouldn’t do, like perform tasks you are not adequately trained in. Or in your case, work when you are sick and possibly expose vulnerable patients to a highly contagious virus. They don’t care, because they want you to make their lives easier. And guess what, you don’t have to. You are doing the right thing- start learning to take care of yourself now, because no one else will.

I have worked many areas in acute care, and then transitioned to community health and case management roles. It really depends on what you are interested in, and what your strengths are. For example I really liked teaching patients/families about their health conditions, medications, etc in plain English in the hospital. That interest brought me to the role I do today working for a nonprofit agency in a community health/nurse liaison role. Do you like flexibility or structure? Do you like researching and finding answers to questions? Do you like working with a team or more independently? What have you been praised on in your performance review or by peers? What successes have you had working at the bedside ( seeing a complex patient heal and go home, saving a patient in a crisis, heading off an error, etc) and how did it make you feel (proud, relieved, dread you would have to do again, etc) There is a lot out there besides bedside nursing, but none of it is perfect of course. There will always be some things you don’t really like about any job. And your boss and the team you work with our extremely important- it will make or break a position in any realm. But acute care nursing is one of the more stressful areas for sure, and our current health care system treats nurses as expendable (even when they are being hailed as heroes). Be patient, keep your mind open, hone in on what you really like about nursing, and keep searching.

There are some positions with insurance agencies, health plan utilization review, worker's compensation, legal offices, etc that are chart review only. You are using your medical expertise as a nurse to determine if clients are eligible for programs, services, etc, or offering medical opinions pertaining to a legal case (like malpractice). Of course it depends on if this is the type of work you would like to do. It is obviously analytical, a lot of reading, and for some people is too boring. However, depending on who you work for you can have a lot of autonomy and flexibility. I work in a job where my primary role is screening candidates who are eligible to transition from a SNF to a residential home or to the community setting with supports in place. Although I have made my role more interactive because that is my style, there are other nurses in similar roles who do it all through chart and document review. I also worked for a physiatry office specializing in worker's comp, that was all chart review and compiling medical summaries for the doctors. Good luck-hope you are able to find a good fit for you. Life is too short to work in a job that makes you miserable!

Good thing to leave before you are burnt out to a crisp, and maybe realize nursing is not for you. Otherwise you turn into a very angry person-I have worked with my share. You may be surprised after some time away by how you really feel though-I am assuming there is a reason you wanted to be a nurse in the first place. LTC nursing is horrid unless you are in a top-notch facility (very very rare), and hospital is not much better these days. My husband begged me to leave nursing because of nights/weekends/holidays plus the stress too, as well as ultra crappy management that treated us like children. Zero respect, recognition or support-just a body to fill a shift. So many nights I would lay there and worry, go over my shift again in my head. I finally ended up in Urgent Care after too many years in Med-Surg and though I still had to work some weekends it was sooo much better. If you work with a good group it is way less stressful and you get to deal with mostly normal people, and have a chance to pee, and *gasp* eat lunch! I too, fantasized about leaving nursing altogether A LOT, but there are other areas that are still interesting and challenging, but don't have as much as crap as LTC or hospital. I am now starting a new job in community health nursing after some time off, and I am actually looking forward to going to work. Never thought I would say that about nursing!

I worked in Med-Surg for several years before switching to an Urgent Care clinic. I also would help out in the Family Practice clinic as well at our facility. Clinic nursing is quite different than in the acute care setting, and even for an experienced RN there are some new skills to learn (like applying splints). I was the only RN in my clinic, and worked with 2 MAs and 2-3 doctors-this is fairly typical. Some offices don't even employ RNs, just MAs or LPNs. Sometimes you have a CPM (clinical practice manager who is also an RN) along with an office manager (usually not clinical but just administrative), but not always. Sounds like in this case there was no CPM at this office. In terms of training, you usually train with the nurse you are replacing, but if they didnt have an RN before or the person left before they hired for the position, then no, you would not necessarily have anyone other than the MAs to show you the ropes. The MAs did orient new staff and participate in peer reviews at my clinic. As the only RN for an office or clinic, you need to have a solid set of skills, be proficient in patient assessment (if the MA doesn't know what to do, they come to you) be able to prioritize and multi-task A LOT, and direct the flow of the clinic. The way you described the job is actually fairly accurate, and though it sounds overwhelming at first, once you get the rhythm it is manageable. Good MAs also make the job much better! Usually an office wants someone who they think can step in and do the job-I did not get much training when I started in Urgent Care. It is possible to do as a new grad, but usually better to start in a more acute care setting where you get more formal training and can build your skills. Good luck!