Stressed as a nurse practitioner resident

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I graduated from an Adult/Gerontology primary care nurse practitioner program 1.5 years ago with a 3.73 GPA. I've been in an adult primary care residency for the past several months and while people say I've done well, I've feel like I've really been struggling. I was selected by my residency to train for a permanent position in urgent care, which I've been training in for the past 5 months. The urgent care is located within the ER of a hospital. However, I find myself really struggling to keep up with the pace of the urgent care/ER work and get all my work done. I feel as though urgent care is too fast-paced for me. So, I'm looking for another work setting that might be more manageable. I know that no nurse practitioner job is going to be very slow-paced or easy, but are there specialties that might be somewhat slower or more manageable? I've researched dermatology and cosmetics, and people have thought that I would be great in that setting. Does anyone have any suggestions?

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LTC. It isn't glamorous, but you work at your own pace.

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Urgent Care is not for everyone. I could not believe the case loads, 40 - 60 patients a shift. The liability there is enormous. It is so easy to miss a critical diagnosis when rushed at that pace. I agree with the comment about LTC.

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I think derm is pretty fast-paced also. An NP I am working with now did derm for awhile, and she said it was patients every 10-15 minutes. So she took a 50K pay cut to leave because it was too much.

I am in the TCU, LTC, and AL setting. It is pretty go-at-your-own pace. I love that I can prep the patients when I want (at 5am with coffee on my couch), then go in and round on my patients at leisure, then sit with my lunch and chart. Then go see a few more, and either chart there or head out & chart elsewhere. Done by 3pm. Love it.

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Derm will be just as hectic. It's very procedure intensive, but they expect you to be expedient and a perfectionist - at the same time. You will have multiple patients each hour that you have to see, examine, possible do a procedure on, and chart. LTC might be the best fit for you.

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Specializes in Psychiatric and Mental Health NP (PMHNP).

Sleep medicine.

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18 minutes ago, FullGlass said:

Sleep medicine.

From the comfort of my living room, miles away, with my crystal ball, I already know that 100% of the patients will have sleep apnea.

OK, maybe I am cynical and jaded.

Personally, I think it is mostly a huge, expensive crock. Feel free to disagree. I would love to hear from you.

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Specializes in Psychiatric and Mental Health NP (PMHNP).
51 minutes ago, Oldmahubbard said:

From the comfort of my living room, miles away, with my crystal ball, I already know that 100% of the patients will have sleep apnea.

OK, maybe I am cynical and jaded.

Personally, I think it is mostly a huge, expensive crock. Feel free to disagree. I would love to hear from you.

LOL. Well, I interviewed at a sleep medicine clinic. There is a physical exam to check for airway passage size. But, basically, everyone gets a sleep study. I have sent patients to this clinic and not everyone has apnea, believe it or not. However, most patients who suspect they have sleep apnea have partner/family that tells them they snore.

There is expertise needed to determine the best solution to sleep apnea - oral appliance, cpap, which kind of cpap, fitting it, etc.

Some people don't have apnea, but have insomnia or other sleep issues, in which case behavioral therapy can help. There are also some medications, of course.

This is a very low-stress job. It is very routine, there is nothing life-threatening, so it is low risk. People are very happy if their sleep improves. The H&P and PE are very routine, for the most part.

The doctor offered me the job, but told me I would probably get bored, and he was right. He said this was a good job for someone who wanted low stress and low risk.

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I work in occupational medicine and love it. I am at an onsite clinic and am only responsible for workers who get hurt in the plant during work hours. Some days I see 10 patients some days I see 2 patients. My company has urgent cares around the US and mostly see workmen comp injuries in those urgent cares.

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I agree with LTC/skilled nursing facilities. I'm an LVN and work at a skilled nursing facility and the NPs come in usually in the morning three days a week. It's mostly geriatrics but the skilled patients there for rehab are more acute so you wont feel like you are just treating them and waiting for them to die as most will discharge home. Some of the NPs are contracted and others work for specific MDs that round in the local hospitals MH, Methodist.

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On 7/26/2019 at 5:44 PM, ICU2NP said:

I think derm is pretty fast-paced also. An NP I am working with now did derm for awhile, and she said it was patients every 10-15 minutes. So she took a 50K pay cut to leave because it was too much.

I am in the TCU, LTC, and AL setting. It is pretty go-at-your-own pace. I love that I can prep the patients when I want (at 5am with coffee on my couch), then go in and round on my patients at leisure, then sit with my lunch and chart. Then go see a few more, and either chart there or head out & chart elsewhere. Done by 3pm. Love it.

Hi ICU2NP, do you work for a specific company? I was always interested in LTC as an NP, I'm in physical medicine and rehab right now but I wanted to find out how I go about finding a job rounding on patients in LTC/AL? Thanks!

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On 2/3/2020 at 9:49 PM, Natalie Marie Presley said:

Hi ICU2NP, do you work for a specific company? I was always interested in LTC as an NP, I'm in physical medicine and rehab right now but I wanted to find out how I go about finding a job rounding on patients in LTC/AL? Thanks!

Yes I work for a private company that is local to where I live, they contract with the facilities (I do not work for the facilities). Many of the larger hospitals also have contracts with them. I believe if you just search LinkedIn, Glassdoor, etc. you could find some companies. There are multiple companies hiring in this setting where I live right now. Good luck!

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