transitioning from acute setting to ambulatory

Posted

I have worked in a hospital environment for over 15 years. I recently got an offer to work at a family medicine center nearby. I am nervous and excited at the same time. Its 5 days a week, with no holidays and weekends as opposed to 12 hour shifts in the hospital. Iam wondering those who have made this transition are you happy with this change? And what's a typical day at this type of outpatient center? thanks for all your input.

TriciaJ, RN

Specializes in Psych, Corrections, Med-Surg, Ambulatory. Has 41 years experience. 4,295 Posts

It's still very busy and hectic, but most patients arrive on their own two feet and leave the same way. There'll be a lot of variety and don't mothball your critical thinking skills just yet.

The schedule will put you back in sync with the rest of the world. You won't have to wonder if it's your turn to have Christmas off this year.

advicenurse1

advicenurse1, ADN, BSN, RN

Has 20 years experience. 9 Posts

As a nurse who worked bedside nursing for about 10 years, ambulatory nursing is definitely my niche. No call lights going off, no bedpans, no incontinence care, I don't have to worry if I'll get the pt who is on the call light all day and best of all...no weekends, nights or holidays! I don't have to worry if I'll get xmas or thanksgiving off this year because" we are closed"! Never thought I would ever say those words in nursing. It gets busy but not hospital busy. You'll love it and wonder why you didn't make the move sooner.

ChitownRN17

ChitownRN17

6 Posts

I agree with the above posters for the most part. I left the ER because I was 26, had been dating my now-husband for a year and was working nights, weekends and holidays. I was missing too much in life and had missed holidays with him family for years so it was time. I love the flexibility of a salaried clinic position that you can leave early for an appointment or flight if needed, and you don’t have to swipe in and out at my clinic. That being said, we are always short staffed and constantly hiring new doctors (which means more patients) but hiring nurses at a much slower rate. The burnout rate is high, the turnover rate is high, and unlike the hospital, you know what you are coming back to the next day (and then add new stuff to that). Worst part of my job is insurance- I HATE having to spend so much time on hold and answer questions that were already part of the office notes sent in. Also, the work distribution is not equal at all but because the less busy nurses say they are “busy” when management asks, instead of being honest or trying to help someone else who is on the verge of tears from stress, nurses who work hard and fast are punished with more work because they get it done.

There are definitely pros to this job, don’t get me wrong. But I miss the hands on part as most of the job is phone triaging or insurance stuff, and people are sometimes disappointed that the nurse is calling back instead of the doctor when they are seeing patients in clinic. Lastly, my family lives in a different state, so it’s great to have the actual holidays off, yes, for sure. But nursing does still stink in the sense that you can’t just take your PTO when you want to, it has to be approved by teammates and then requested from management. Would be amazing to travel home for several days with my whole family since they can all do it with their non-medicine jobs but I always am the last to get home and the first to leave.

I dont mean to turn anyone away! Some people say they could never do any other kind of nursing, and it seems to be a great option for people with kids, I just don’t have them yet. Just being honest so you can compare and weigh all options. Good luck!

jrt4

jrt4

244 Posts

I transitioned from inpatient management to outpatient management about 6 months ago. I had never worked outpatient a day in my career but it was a good opportunity. I think the most important thing to consider for a bedside nurse is its not always an "easy" job. Offices are more fast paced than you would expect when you are seeing 3-4 patients across every 15-30 minutes depending on the level of visit. However, if you get behind its not like inpatient. The worst that happens is the wait time increases and you get out late or miss lunch. Getting behind in the inpatient world could have bigger consequences. Its just a different way of thinking and different types of "busy". I enjoy both worlds but it is nice that I don't typically have to wake up to 3AM phone calls about staffing and bed crunches. Definitely some perks.

Nerdy RN

Nerdy RN

24 Posts

ChitownRN17 hit the mark on a few of the pros and cons. It is nice to have weekends and holidays off, but patients get mad when you call (they only want to speak to a doctor!). I often get chewed out by patients when I answer the phone; they only want their Providers. I feel like I am wasting my skills and knowledge working in ambulatory care, but at least I know I will have off x-mas, turkey day, etc., etc.

Meagan

Meagan, BSN, RN

Specializes in CHF. Has 11 years experience. 3 Articles; 21 Posts

The hardest thing for me to adjust to was working 5 days per week. It's still hard to find the time to schedule appointments or get errands done. You will find your balance and what works for you though. The nice thing is not having to worry about holidays, nights or call. That is a huge relief!

NicoleRN707

NicoleRN707

10 Posts

I have never worked in a hospital setting, so I can only say from one side. I love having weekends, holidays off, and salaried position if I did need to leave early then I don't have to use sick/vacation time. Cons would be working 5 days a week in a major city can be difficult and I am still trying to get use to it. Volume of patient needs can be vast especially during a pandemic. I could see up to 100 patient in a day all having different issues and needs. Can get exhausting. But the some day can be more light. I would say it's more of an office/triage job at my place of work so it depends if you like that type of work. I do have to say I miss more hands on action at times.