wanna_be

I am an experienced FNP and I am considering locum tenens but can't find much information online from other providers about their experiences. Would love to hear the pros, cons, important questions to consider when looking at staffing agencies and contracts, and any other helpful information. Also curious if doing locum tenens will negatively impact my ability to find permanent positions in the future. Thank you very much!

Ugh, I'm sorry this happened to you. I've been nurse for 1.5 years now and still fear getting fired pretty much all the time (my supervisor was recently cut along with a lot of other staff, so it hits close to home). I wasn't there, so who knows what happened, but I will say that you come across as fairly level-headed considering the circumstances. You will bounce back. Getting fired after two weeks as a new nurse has the silver lining of still being able to say you're a new nurse. Being let go, as I've learned, often has a lot to do with the politics of the organization--sometimes moreso than your individual work ethic. That said, one thing to learn (and perhaps you have) is to remain humble and admit your mistakes is one of the best traits you can have as a nurse, because we ALL make mistakes, all the time...but the difference is how you handle it :) I don't know if that applies to your situation or not, but take what you will. As you look for a new job, consider deeply what mistakes you may have made at your last job and learn from them. Best of luck!

I graduated from a BSN program about 1.5 years ago, but have approximately eight years' experience in various outpatient settings (case management, medical assistant, etc.). My passion is ambulatory care, and for the most part, I would be alright if I never worked in acute care. But sometimes I am curious what I am missing. Recently, a Paramedic friend claimed that what I do in the outpatient setting is "just as challenging" as any hospital floor nurse. So, I'm hoping to hear from those of you who have experience in BOTH areas. What do you think? Is one more difficult to than the other, or is it comparing apples to oranges? As an example, as an ambulatory nurse, I do primary care throughout the lifespan, including OB and pediatric patients. I triage by phone and in the clinic, do assessments and work with PCPs on acute visits, administer oral, SQ and IM meds (and the occasional suppository), wound care, I.V. fluids, and urinary catheter insertion among other things. But I still feel quite intimidated by acute care nurses!

I did not realize until after the procedure was completed. You are correct, at a facility where I previously worked it was the clinician's responsibility to obtain both written and verbal consent, which is why it slipped my mind. Discussed with my manger today; will use this to initiate better policies around consent for procedure. Thanks for you input, everyone.

It's the weekend and I haven't been able to sleep since this happened. Looking for some advice, insight, and possibly self-forgiveness? Last week I was asked by one of the UAP to set up for an outpatient procedure that I had not been trained to set up for and had not done previously. It was a standard, low-risk procedure, and I was training another RN. I informed the UAP that I had not done this previously but would be happy to help set out the instruments with assistance. The UAP told me where the instruments were, where to place them, and as I was walking away she said, "don't forget the consent!". We brought the patient back and while rooming the patient discovered the patient had an acute complaint. I stopped the intake for the procedure and took a brief history from the patient regarding their acute issue. The patient was in obvious pain. I advised the patient that addressing their acute complaint took precedence over performing the procedure, and I would inform the provider. Myself and the RN trainee went to the provider and completed an SBAR handoff informing the provider that although the patient was scheduled for a procedure, they were in acute pain and I had informed the patient we would address this issue first. The provider verbalized understanding and stated he would evaluate the patient. I also informed the provider that I was unfamiliar with setting up for the planned procedure and would wait outside the room in case the provider needed further assistance. While waiting outside the room, I received a triage call and advised the RN trainee to continue to wait for the provider and alert me if assistance was needed. A few minutes later, the RN trainee sent me a message and asked for my help getting some supplies. We walked into the room as the provider was initiating the procedure. Soon after the patient left, the provider realized we had not gotten a signed consent from the patient. The provider stated he had reviewed the risks of the procedure with the patient verbally and the patient gave verbal consent. We agreed to call the patient to follow up that afternoon, but prior to doing so the patient called stating their pain had worsened and I triaged the patient and sent them to the ED. Fortunately it was determine their pain was unrelated to the procedure, but we completed an incident report d/t the circumstances and because a consent form was not signed. I have been a nurse for almost a year and I just feel horrible about this. I know mistakes happen, but I feel there were many points in this event where I could have done the right thing and failed to do so--I should have gotten the consent initially, or spoken up and stopped the clinician when I saw the procedure was being initiated without written consent. I informed my manager of the event in great detail along with the incident report. I'm really scared I'm going to lose my job and I feel awful for not following procedure and ensuring this patient received the best quality care.

Hello, thank you for the offer to help! I was just accepted to a DNP/FNP program and although this has been a career goal for many years, I am already getting nervous about job prospects after graduation as a new APRN. Background: I have about eight years' experience working in FQCHCs and look-alike clinics, first as case manager and later a medical assistant. I hold an undergraduate degree in public health and graduated in July 2016 with a BSN. My current (and first) job as a nurse is in a FQCHC; I work as a floor nurse, take triage calls, and participate in leadership activities at the clinic. I am a HRSA NURSE Corps scholar. The DNP is approximately three years and does not confer a MSN as part of the program. I will continue to work at my current position and the clinic is very supportive of furthering my education while working. My question is, what are the job prospects for a DNP/FNP upon graduation? Would my previous experience appeal to employers in primary care, or would being a relatively new nurse prior to starting my APRN degree negate that? Since many of the clinics where I've worked have employed APRNs I assumed the job market was good, but in doing more research I see that there are few openings for mid-level providers and many requires 3-5 years experience. Thank you so much for your insight!

I agree with the above post. My husband is a paramedic; I wish I'd fully understood the paramedic role before going to nursing school. I love being a nurse, but my ultimate goal, like yours, is to become a midlevel provider. I went through a lot of heartache trying to find a nursing school I could afford, then spent two years in school, and am now getting the experience I need (or feel is appropriate) before jumping into a graduate program. That's a lot of hoops if your ultimate goal is a midlevel provider, and you can get there with less time and money as a paramedic, plus still get a great education and great patient experience.

Thanks for the helpful advice, friends! Yes, I knew my original post would ruffle some feathers but I hope everyone can agree we're in the business of helping all people live full, dignified, and healthy lives, and the current administration seems to be fundamentally opposed to that goal. Anyway, fortunately my current employer (outpatient, not hospital) is VERY politically active and encourages us to participate in activism via legislative involvement. Attended a peaceful rally yesterday, it was great. I think my line is drawn when there's a risk of arrest; as much as I can appreciate certain acts of civil disobedience in the face of injustice, I also know my license is a valuable way of fighting the good fight and I don't want to lose it :) Appreciate the conversation!

Community health nursing. You get a very broad base of experience and also work closely with midlevel providers as part of a team. There are also a lot of FNP programs that require community health nursing experience, or favor it. Programs also look favorably upon applicants who have worked with vulnerable populations.

I will have one year of nursing experience come June. I currently working in community health, which is also what I did prior to obtaining my nursing license. My role in the clinic includes triaging patients and assisting in procedures (including EKGs, catheterizations, neb treatments, wound care, etc.) and managing the care of the occasional emergent patient who walks in the door (e.g. respiratory distress, severe burns, HELLP syndrome) until EMS arrives. I know that the emergency department is very competitive, and typically requires experience in the ICU or at least a Med/Surg unit. I'm curious if there's any crossover between community health nursing and the ED. From what I've seen (in clinicals), the ED is 90% what I do in the clinic (cough/cold/minor injuries) and 10% fast-paced, highly skilled critical care. I have my ACLS/PALS cert and am looking into TNCC. I enjoy my job but am just curious if I do someday want a change of pace if it would be feasible to apply straight to the ED or if I would need to pay my dues in Med/Surg first. Thanks!

If you're interested in activism, National Nurses United is very involved politically.

I will have one year of nursing experience come June. I currently working in community health, which is also what I did prior to obtaining my nursing license. My role in the clinic includes triaging patients and assisting in procedures (including EKGs, catheterizations, neb treatments, wound care, etc.) and managing the care of the occasional emergent patient who walks in the door (e.g. respiratory distress, severe burns, HELLP syndrome) until EMS arrives. I know that the emergency department is very competitive, and typically requires experience in the ICU or at least a Med/Surg unit. I'm curious if there's any crossover between community health nursing and the ED. From what I've seen (in clinicals), the ED is 90% what I do in the clinic (cough/cold/minor injuries) and 10% fast-paced, highly skilled critical care. I have my ACLS/PALS cert and am looking into TNCC. I enjoy my job but am just curious if I do someday want a change of pace if it would be feasible to apply straight to the ED or if I would need to pay my dues in Med/Surg first. Thanks!

Colorado as a new nurse in community health--->$60,000/year. It's expensive to live here but the job market is great and so is the quality of life.

I am a nurse and therefore believe in human rights, which naturally means that I do not support the actions of the current administration to dehumanize women, poor people, minorities, the LGBTQ community, and basically everyone who is not wealthy and white. I have always been an activist, but now that I have a professional license I also understand the added responsibility of maintaining my professionalism in my person life. I want to participate in demonstrations, marches, and protests, but also know that my most valuable contribution is as a nurse caring for the aforementioned groups without bias. My question is: is there any information on how to participate in demonstrations legally and to make sure I am not crossing any professional boundaries? Thanks for understanding--I know you all are a good group of folks :)

All I can say is be honest. There are situations in which the past is the past, but applying to school, your license, and ultimately employment are not the place for that. I had a few very minor brushes with the legal system as a youth (no actual charges) but having to put all that out on the table, frankly and not sugar-coated, when applying to my state BON was heartbreaking. Be truthful and upfront, and demonstrate what you have learned and how you have changed. It's a scary process, but there are many, many RNs who don't have a perfect record--hopefully all have learned and grown from it.