Relatively New FNP in Urgent Care Setting

allnurses Guide · Apr 17, 2012

Hi,

Do you know exactly what procedures you'll be responsible for? I think it's really important that you are comfortable with these before doing them on your own. I know a lot of NP programs are light on procedural training, so make sure you actually get to do some with supervision, and not just observe the MD doing them. Also, make sure you have a written job description stating exactly what your responsibilities are, and ensure they jive with your state regulations for NP scope of practice, and what you feel comfortable doing and have been trained for. Does this Urgent Care handle things like rashes, URIs, and UTIs, or will you be expected to deal with minor traumas, chest pain, and severe abdominal pain? Will you have access to lab and imaging? What kind of support staff will you have?

I bring all these things up because I have an NP friend that got in over her head with an Urgent Care practice. She was not properly trained, the head MD expected her to work outside of her scope of practice (he took patients that should have been in the ER, not in Urgent Care), and then when something went wrong with a patient he blamed her. It was her first job out of school and she didn't ask the right questions-she was just thrilled to have a job. So, proceed cautiously. This job should be fine, if you get adequate training and know exactly what is expected from you. You may get to learn some great stuff. Just make sure you will be comfortable with the setting and your responsibilities.

allennp · Apr 17, 2012

I agree with BC caution. I would look into the type of patient population and procedures you are expected to do. I take a bit of curious caution though with her reference to working within your scope of practice. If in a independent state your scope would be that of a MD or DO in the setting, that is if you are trained and you are skilled and comfortable then ?????

I agree with BC that it is easy to get in deep under the umbrella of a UC. You know it is one but patients do not. It is my current primary practice. Patients show up with chest pain with stemi's or PE's, open complex lacerations, fractures of all sorts, if they can walk they will be there. Though we offer X-ray. reasonable labs, 12 leads, IV's, et et. one needs to be adept to quickly get a sense of what one can handle and when to call transport and manage them until transport. I work alone about a third of the time, another provider (ARNP, PA, DO or occ MD) about a third of the time, or three of us a bit of the time. See about 20-35 patients a day, depending on flow and acuity.

I know some "UC's" that have very limited resources and would bump quickly many pts on to a larger facility. What is your back ground any ED? How many pts a day? What procedures are done. Do you have RN staff or MA staff. What is your "adventure" tolerance. I came from a teaching center, where it was a see one, do one, teach one mentality. Not everyone is comfortable with that. A UC can be a great place to practice if you are comfortable.

A

TX RN · Apr 17, 2012

1. Splinting

2. Suturing simple wounds

3. Joint aspiration

4. Trigger point injections

5. + A few others I'm sure I'm forgetting........

Do what you're comfortable with. Funnel the rest to the other providers until you do get comfortable.

bcaliRN · May 13, 2014

Hi DuncanBella2012,

I am in a similar situation as you, so I wanted to know what your decision was…did you accept the job in the urgent care as a new grad FNP? Similarly, the urgent care clinic I am thinking of joining would want me to work alone with MA but no other provider (NP/PA/MD) on the shift. My concern is that without any support or sufficient training I am not setting myself for success and it would be too stressful as a new grad FNP not to have any official training or support.