RNs being phased out of urgent care?

[cowan19]

Has anyone else noticed a lack of RNs working at urgent cares in your area? I would love to work at an urgent care, but every clinic I've looked into is only using MAs or paramedics. Maybe it's not a new phenomenon, but I think it's kind of sad and disconcerting.

[Wisc.RN]

yes, we have been told there are too many RN's in our UC, will be replaced with LPN/paramedics as RN's leave or retire. now the ambulance services are running short on paramedics! really makes no sense.

[2BS Nurse, BSN]

We staff both MAs and RNs. The RNs are required to be ACLS certified. If you only have LPNs and paramedics, you must not be running IVs.

[JRT1, MSN, RN]

Depends on the organization. We hire RNs, LPNs, CMAs and CCMAs. They all have the same job function and for many RNs this isn't fulfilling enough. The pay is better for the hospital and you have more autonomy. The hours aren't that much better typically as we are open holidays and evenings so RN interest is usually low. The RNs don't typically perform "RN level work" so thats why its not required in our clinics.

[2BS Nurse, BSN]

14 minutes ago, JRT1 said:

Depends on the organization. We hire RNs, LPNs, CMAs and CCMAs. They all have the same job function and for many RNs this isn't fulfilling enough. The pay is better for the hospital and you have more autonomy. The hours aren't that much better typically as we are open holidays and evenings so RN interest is usually low. The RNs don't typically perform "RN level work" so thats why its not required in our clinics.

We do perform "RN level work" because we triage, take care of allergic reactions, cath patients and run many IV infusions. We are probably working at a higher level in our facility.

It would take some extreme training if we got rid of RNs. Our MAs are fearful of the high acuity patients.

[frozenmedic]

On 12/22/2019 at 9:07 AM, 2BS Nurse said:

We staff both MAs and RNs. The RNs are required to be ACLS certified. If you only have LPNs and paramedics, you must not be running IVs.

Paramedics come out of their initial education program qualified to start IVs. Unlike some nursing schools IVs are actually taught as an essential skill, not "something you'll learn in the hospital." Additionally, paramedics can push IV meds which is out of scope of LPNs I believe. I'm not sure there is anything out of scope for a paramedic likely to be done in a typical outpatient clinic.

A paramedic is cheaper than an RN for sure, while at the same time the clinic probably pays the paramedic more than working on an ambulance does. It's a win-win from the perspective of the employer and the paramedic.

[JRT1, MSN, RN]

2 hours ago, 2BS Nurse said:

We do perform "RN level work" because we triage, take care of allergic reactions, cath patients and run many IV infusions. We are probably working at a higher level in our facility.

It would take some extreme training if we got rid of RNs. Our MAs are fearful of the high acuity patients.

Reread my first sentence.

[2BS Nurse, BSN]

2 hours ago, frozenmedic said:

Paramedics come out of their initial education program qualified to start IVs. Unlike some nursing schools IVs are actually taught as an essential skill, not "something you'll learn in the hospital." Additionally, paramedics can push IV meds which is out of scope of LPNs I believe. I'm not sure there is anything out of scope for a paramedic likely to be done in a typical outpatient clinic.

A paramedic is cheaper than an RN for sure, while at the same time the clinic probably pays the paramedic more than working on an ambulance does. It's a win-win from the perspective of the employer and the paramedic.

This is scary indeed. I'm glad this isn't happening in my area.

IVs were an "essential skill" in my ADN training.

[techitalia, EMT-B]

In our UC, the CMA's do all of the work, including the start of IV's. The LVN does not, she just trains and check's off the CMA's on their competencies. There are no Paramedics in our clinic, mainly I think because they don't want to room patients or work Check in up front, which CMA's also do. We rotate from front to back office.

[caliotter3]

The UC I go to utilizes MA’s and student MA’s. Can’t ever recall, at least lately, where I’ve encountered a nurse.

[2BS Nurse, BSN]

This is especially scary during the current pandemic. I wonder if they aren't used to seeing acute patients? CMAs can't push IV meds or infuse IV antibiotics in my state. They also haven't been trained to insert urinary catheters, change a Foley or draw labs off a PICC or port.

[TheSquire, DNP, APRN, NP]

On 4/4/2020 at 10:23 AM, 2BS Nurse said:

This is especially scary during the current pandemic. I wonder if they aren't used to seeing acute patients? CMAs can't push IV meds or infuse IV antibiotics in my state. They also haven't been trained to insert urinary catheters, change a Foley or draw labs off a PICC or port.

Many urgent cares don't do IV access/infusion except while waiting on an ambulance to take an acute pt to the ED, so those skills are rarely needed, and often done by the provider.