Sitting down - New nurse looking for advice

GlitterPrincess · Mar 9, 2019

I am sorry you're going through this struggle at the moment, and really hope you can find a solution that not only meets your needs but is fulfilling also.

My initial thought when I read your post was 'telehealth'! I am not sure if you're familiar with telehealth services, or if they're available in your region, but I thought I would throw this suggestion out just in case you've never heard of, or considered, it. Where I live my provincial health region has a number that you can phone to receive health advice and information from a registered nurse. The specific type of telehealth where I live is called 'Healthlink". I am going to go out on a limb and say that I *assume* they're sitting as they're answering phone calls and using the computer (I feel this is a very safe assumption to make). This is NOT the same as community/public health nursing wherein you take on a patient load and have to triage/return their calls. This service is one wherein any member of the community can utilize at any point (24hrs/7 days a week). An example of advice you may give is- advising them on whether to call another agency, see their health care provider, go into the emergency department, call 9-11, call poison control etc etc. Basically people will call with their problem and signs/symptoms and you give them health advice for same. Within reason, obviously someone describing their new onset rash to you is completely different than you assessing it in person, but you might (depending on other S&S) advise them to take an anti-histamine and monitor for other systemic changes, and then to go to emerge if symptoms persist or get worse. I hope that explanation made sense ?

I am not really sure if this will be helpful to you or not, or if a similar service is provided by your health region. If it is then I hope it gave you another option to add to your list.

Best of luck!

FolksBtrippin, BSN, RN · Mar 9, 2019

7 hours ago, twinsmom788 said:
Needing an update...what is an ACT team? Like Rapid Response?

ACT is an intensive psychiatric community treatment model. My ACT team consists of 2 RNs, 2 vocational specialists, 2 drug and alcohol specialists, 2 therapists, 2 advocates, a psych NP and a part time psychiatrist. We serve people who have been hospitalized frequently, and for whom other treatment models like group homes, day programs, case management, etc have failed.

We can stay with people for their whole lives if necessary. Almost all of our work is done in the community. Mostly in people's homes, or wherever they are. We also transport our people to medical appointments, food shopping, etc. When our people go to the hospital, we see them there and coordinate with the inpatient staff. We go to court with our people and see them in jail if they wind up there. We do whatever people need to function in the community.

Each of us on the team needs to be able to do general ACT work, but we focus on our specilaties. The nurses are responsible for our medication room which is like a psych pharmacy. We deliver people their medications if they need that, and many of our people are on long acting injectable psych meds, so we administer those. We also educate and monitor our diabetic and hypertensive folks and any other illnesses. We are the team's "medical" resource. So for example, if a therapist goes out to see someone and notices a burn on the finger, she might ask me to check it out and decide whether it requires ED, urgent care, etc.

The wikipedia page has some good info on the model https://en.m.wikipedia.org/wiki/Assertive_community_treatment

Feel free to ask me anything about it. I'm an ACT geek.

AutumnDraidean · Mar 9, 2019

It sounds like you love the ED, just not the pace. I don't know how location locked you are, but you might love a small critical access rural hospital. You will see many of the things you'll see in a level 3, you will go on transports and get certifications galore (if you don't already have them) but you will do it at a slower pace.

It won't advance as many skills but you would gain assessment skills working in an urgent care.

School nursing is really dependent on crack assessment skills and differentiating big trouble from work avoidant otherwise healthy children...and everything in between.

Trauma Columnist · Mar 9, 2019

Just a gentle staff reminder that we can't provide medical advice per the terms of service.

To the OP: I sure hope you can work something out. Outpt dialysis might work too as the nurses do both standing and sitting. Best wishes

OyWithThePoodles, RN · Mar 9, 2019

I haven’t read through the comments but I’m a school nurse and I sit the majority of the day. Of course there are other nurses in my district who rarely sit. It just depends on the needs of your school.

That said, you should try to get in a year of experience before trying to do school nursing. We go it alone. We do more than most people think and there are no other medical professionals to call upon. So you need to know your stuff.

Best of luck. The great think about nursing is there are a lot of different options, but it is best to have some experience to give you leverage.

kbrn2002, ADN, RN · Mar 9, 2019

This may sound crazy but don't rule out LTC. The med passes are undoubtedly huge and time consuming but if you can find the right facility there's ample opportunity to sit for brief periods of time. There's also a ton of charting which again is usually sitting down. I work with a couple of nurses with chronic conditions that do well in this setting. The key is finding a facility with enough CNA's that do the more physical aspects of the job. Sure, you'd help occasionally but it's not a full shift of heavy labor.

If you are not averse to management a unit manager or MDS position in LTC could also be a good fit. While some facilities definitely prefer LTC experience as a nurse you'd be surprised at how many do not. Good leadership skills will trump floor experience in many cases.

DaniannaRN, ASN, BSN · Mar 9, 2019

I did not read all the replies so I'm not sure if anyone else covered this already.

IMO, the best positions for those who can't stand too long are in the insurance industry. I am always telling anyone who will listen about working in insurance. I was going to leave nursing altogether until I found insurance work

You can do utilization management, case management (they have complex critical patients they work with too), QA. Or you can be a field nurse and visit the members who need home care attendants to determine medical necessity for them. None are standing and all let you work from home, either all week or most of the week. You can do HEDIS chart reviews and go to doctor offices. There is so much work in this industry, you just have to go to all the websites and apply.

If you really want to stay in the clinical setting, then I would suggest residential psych. I did that before getting into insurance and it wasn't too bad. You would supervise nursing care at group homes/supported living apartments. Very minimal physical activity for this type of setting.

I'm sure you must really like your job, but your health comes first. Maybe look into something else and keep this job as per diem?

klone, MSN, RN · Mar 9, 2019

16 hours ago, Ruby Vee said:
The OP asked a question. She got some answers she liked and some that she didn't. When you ask a question on a public forum, you get the answers you get. They don't all have to be positive feedback. Sometimes negative feedback is necessary and helpful.

He

Aliens05, ASN · Mar 9, 2019

21 minutes ago, DaniannaRN said:
I did not read all the replies so I'm not sure if anyone else covered this already.
IMO, the best positions for those who can't stand too long are in the insurance industry. I am always telling anyone who will listen about working in insurance. I was going to leave nursing altogether until I found insurance work
You can do utilization management, case management (they have complex critical patients they work with too), QA. Or you can be a field nurse and visit the members who need home care attendants to determine medical necessity for them. None are standing and all let you work from home, either all week or most of the week. You can do HEDIS chart reviews and go to doctor offices. There is so much work in this industry, you just have to go to all the websites and apply.
If you really want to stay in the clinical setting, then I would suggest residential psych. I did that before getting into insurance and it wasn't too bad. You would supervise nursing care at group homes/supported living apartments. Very minimal physical activity for this type of setting.
I'm sure you must really like your job, but your health comes first. Maybe look into something else and keep this job as per diem?

This is something I would be interested in after I gain some acute care experience. I haven't seen anything on indeed.com or similar websites for any of this type of work and I live in a city of about 800k people. What specific websites can you find this work on? Thanks danianna

DaniannaRN, ASN, BSN · Mar 9, 2019

Just now, Aliens05 said:
This is something I would be interested in after I gain some acute care experience. I haven't seen anything on indeed.com or similar websites for any of this type of work and I live in a city of about 800k people. What specific websites can you find this work on? Thanks danianna

A nurse doesn't even really needs tons of acute care experience to work in the HMO field. Just gotta be a nurse!

There is a Blue Cross/Blue Shield in most states, start with them. Try Aetna, United Healthcare and small local insurance in your area. I'm near NY so we have a few smaller companies too, like VillageCare or Oscar. Just go on their sites directly. Even if the main office isn't close to you still apply. Most let you work from home after training so you would only be commuting until your probation period is over.

It's the best career out there in my opinion. No nights, no weekends, no holidays, no waiting for your relief, no worrying about what you're gonna do when it snows.

Aliens05, ASN · Mar 9, 2019

15 minutes ago, DaniannaRN said:
A nurse doesn't even really needs tons of acute care experience to work in the HMO field. Just gotta be a nurse!
There is a Blue Cross/Blue Shield in most states, start with them. Try Aetna, United Healthcare and small local insurance in your area. I'm near NY so we have a few smaller companies too, like VillageCare or Oscar. Just go on their sites directly. Even if the main office isn't close to you still apply. Most let you work from home after training so you would only be commuting until your probation period is over.
It's the best career out there in my opinion. No nights, no weekends, no holidays, no waiting for your relief, no worrying about what you're gonna do when it snows.

Awesome! thanks so much

DowntheRiver · Mar 9, 2019

53 minutes ago, DaniannaRN said:
A nurse doesn't even really needs tons of acute care experience to work in the HMO field. Just gotta be a nurse!
There is a Blue Cross/Blue Shield in most states, start with them. Try Aetna, United Healthcare and small local insurance in your area. I'm near NY so we have a few smaller companies too, like VillageCare or Oscar. Just go on their sites directly. Even if the main office isn't close to you still apply. Most let you work from home after training so you would only be commuting until your probation period is over.
It's the best career out there in my opinion. No nights, no weekends, no holidays, no waiting for your relief, no worrying about what you're gonna do when it snows.

This is not true. Please provide example of someone successful with less than 6 months or 1 year of experience. I have 5 years experience and these companies don't even bother to look at my resume. They are looking for experience. Typical job posting says 2-3 years but they really want more. Even my facility says 2-3 years experience for case management or utilization review but there isn't a single nurse there with less than 12-ish years experience.

I admit, my experience may be anecdotal and specific to my area of the US but if you research here on AN you'll see many people citing the same problem.