Should I take a job at an urgent care clinic for experience?

MissBrittanyRN · Sep 19, 2009

Hey natsirt21,

I think we are in similar situations. Are you a new grad having difficulty getting into a hospital or residency program? I have been seriously considering an urgent care RN position, but will not even have my interview for another 10 days. First interview though!....out of almost 50 applications (mostly, but not all hospital.) Where are you in the process of getting a job in urgent care? Have you interviewed yet? How will your orientation be, if you already know? My concern was that they are not as familiar with a new grad's educational needs as a hospital may be, and ultimately my license will be at risk, and I want to have the best start, and training in my nursing career, so that I can provide the best care. I started another thread about my concerns in the emergency nursing forum, so please feel free to chime in! An RN there told me, and I completely agree, that I may miss subtle things that only come with experience. That was my concern from the beginning, which is why I prefer to start out in a hospital, but this urgent care center seems to be very nice, have a strong appreciation for their employees, and I hear that the pay is not bad, but that is the least of my concerns right now. I just want to have the best start...

natsirt21 · Sep 19, 2009

Hi there,

Yes, it looks like we are in similar situations. I do have some experience though, a 4 month New Grad program, but I've also been out for 10 months.

The urgent care clinic in my situation has already given me the job offer. I got the job in June but when I went to the US boarder to get my TN VISA (I'm Canadian), I was rejected because I didn't have important documents that noone told me about. Now I have them and the clinic still needs me. I actual spent a few observation periods there. This clinic didn't seem too acute...just a few fevers, sutures, referals to specialists because of severe long term injuries and 1 chest pain that ended up not being an MI.

My worry also is that the training period will be short and I'll miss subtle assessment details that will endanger patients. But, the MDs do see the patients quickly at the clinic and I won't be the only RN.

I'm worried about the crapy pay and hours. In these small clinics and new businesses everyone wheres multiple hats and does everything, so I feel like I may be over worked too.

How busy and acute is your potential clinic? Because if it is more like an ER setting, I'd be concerned and take the experienced nurses advise. To make ends meet you could take a CNA job somewhere or something like that.

Hang in there.

Cheers,

Triss

natsirt21 · Sep 19, 2009

Me again. I have a few tips for finding a hospital job and maybe it will be helpful. 1. Try hospitals furthar away and not the big down toen teaching hospitals....they may be more desperate but still have a quality program. 2. Call the HR departments and find out the names of the unit managers that are looking for people/new grads. Then go with a resume to the unit and introduce yourself - it seems pushy but in this market you need to stand out (advise to me from my ACLS instructor). 3. Take a few extra certifications that will make you stand out....ACLS, PALS, diabetes educator, online CE courses, practical review courses etc...4. Make sure your resume looks good and you have stellar references....even get a written reference to attach to applications. 5. Don't get discouraged (I know I am). 6. See if one of your school clinical instructors will call someone at one of the hospitals with New Grad programs and give you an inproptu reference.

As for signing a contract at the urgent care center....make sure your training is in writing.... at leat 1 month with a precepter and extra certifcations paid for etc... Don't sign on for a year or something....try to make a deal saying after the preceptorship if you aren't a good match then your contract can be broken or something. Then, you will have a preceptor, who's liable and a built in support until you know if you're in a good situation or not.

I don't know if you've ever been employed before but once they give you the job offer then make some reasonable demands, which you're allowed to do.

Good luck! And keep looking for hospital jobs if you're employed elsewhere. And get out if its not for you.

Cheers,

Tristan

MissBrittanyRN · Sep 19, 2009

Thanks for the reply. I do not know a lot about it yet, because my interview has not come around. However from speaking with a tech who works there who is also very new to the center this is what I have gathered. It is a busy chain in the mid atlantic, urgent care and primary care. People come for sports physicals, check-ups, colds, broken bones, they shouldnt come for MI's, but it apparently happens, and I believe that some location(s) have delivered babies. They shouldnt be handling this acuity, and they will call 911, but stuff happens. Births, I can handle lol. I have practically delivered a baby as a cna in a hallway, but long story...

I believe a standard orientation is 30 days, of course during my interview I will see if they have a different program for new grads, and the possibilty of an extension if I do not feel ready. But with the wide variety of presenting problems, 30 days is not much. Because this is a walk in with or without appt. you never know what you will get, and I do not yet know how many nurses will be staffed at once.

Even with assessments, which we already have a foundation of in nursing school. During orientation we may get a little bit of this and a little bit of that. I have spoken with new grads who have gone through residency programs and the new grad and the preceptor do assessments together so that the new grad has immediate feedback. I don't expect to completely master everything immediately as a new grad, but I feel like with such a variety as a new grad, I will not familiarize myself with so many different presenting problems in time to provide quality care.

MissBrittanyRN · Sep 19, 2009

Hey, just got your other message. That is great advice. I have every intention of getting additional certifications, but they are pretty expensive, so I need to work to pay for them lol. That is an excellent idea to ask that an instructor to make a call for me. I have also been planning a door-to-door day, and wondering what expressions I will encounter when I show up on the unit, but desperate times call for desperate measures! I am waiting on a few letters of recommendation that are being worked on, and will be picked up shortly. I have an excellent employment history with a previous manager, but hospital policy is that she cannot give me a reference. I guess they have had lawsuits before based on previous employees acusing managers of preventing them from getting jobs or something. They can only say that they would or would not rehire, but I have copies of my impressive performance reviews.

It is very difficult to get into a hospital in my region as a new grad. They start their programs at specified times during the year, they are full, even if they want to hire you, they are not allowed the budget from the higher-ups, seemingly regardless of how you stand out... Really it's my fault. I put my eggs in one basket assuming that I could stay where I worked as a patient care tech during nursing school, and missed the deadlines for the new grad programs here. Then my hospital had a hiring freeze. Did not lay off nurses, but cut hours, and definiately will not hire new grads. I could stay as a tech as long as I desired, and my unit manager wanted me to, but the hospital will not allow an RN to work as CNA.