Trying to get a physician office, outpatient clinic or school nurse job-not hospital

[saccarah]

I loved nursing school. All of the wonderful things nurses do and the quality of care I was able to give in my clinicals. I couldn't wait to hit the floor. After one and a half years of school, I got a job as a patient care assistant in a local hospital. Loved it! A year later I graduated top of my class, passed NCLEX, got a RN job at that hospital and then.....REALITY hit very very hard. hmm. I don't like bedside nursing at all. The nurse to patient ratio sucks, the management staff sucks and don't back you up, I'm in fear of losing my license daily, I don't think I got enough training or orientation, the list goes on and on. I am thinking I am abnormal. Am I? I just want to be a good nurse. Give back to the community, advocate, counsel and educate like we learned in school. So I have decided I want a Dr's office, outpatient or school nursing job. Something a little more slower paced, where I can work with patients and give back. I look for months at all the sites-Monster, hotjobs, ohio means jobs, indeed, career board. Signed up with 3 staffing agencies. Nothing. How do I get this type of job???

[HouTx, BSN, MSN, EdD]

I don't know about your part of the world, but in my area, physicians are more likely to MAs or LVNs than RNs. Obviously, the salary is a huge issue.

In the US "health care" system, there is a huge disconnect between the ideal nursing role and what exists in reality... and this is driven by reimbursement. Frankly, there is no money to be made with the touchy-feely stuff. So, since the Wellness-oriented interventions are not reimbursed, they are not valued. However, you can do what nurses have been doing forever.... we integrate the 'advocacy, teaching, counseling, etc' into each patient interaction. There's nothing to stop you from discussing these issues when you're starting an IV or doing a bedbath -- unless you want to do it in total silence.

You could also look into a more focused area such as wound care or diabetes educator... these are some areas in which patient teaching is actually reimbursable - LOL.

[joyeRN]

Thanks for this post. This is exactly why I am on this site to network. I worked as an LPN for years in a Cardiovascular office and loved it. I had these BIG plans that after I obtained my RN I was hitting either the CCU or tele floor. Well, I sure had a wake up call. I landed a great tele job in a small Community hospital. Great co-workers, nurse manger, etc. The docs on the other hand were a different story. I was soooo discouraged I only was able to tolerate 5 mons there. I felt so disrespected by the doctors when I would be on the "front lines" for them allll night long. They would hang up on us, tell us not to call them back, or even be appalled we were phoning for a pt in critical situations.

So from there I have gone back to Ambulatory care nursing in a Peds ofc. Still not 100% happy. The hours are reasonable, but I miss Cardiac nursing. Being there now only 4 mons. I've tried those nursing personality tests, and they confuse me even more?

What I'd like to know is. In being new RN's how many jobs did it take to find that "happy medium?" I'd really like to start looking to move back into Cardiac nursing, but fear I will look unstable for switching jobs too often. Any advice on what I should/can do?

Thanks!

[westieluv]

You mentioned Ohio in your post, so I'm assuming that's where you live. I live in SE Michigan, so not too far away, and I can tell you the same thing that another PP told you, very few doctors hire RNs to work in their offices anymore, because they can pay MAs and LPNs a whole lot less and you don't really need the critical thinking skills of an RN to do that job anyway, since the doctor is pretty much always there to assess the patients first hand. I think it's about the same in most outpatient clinics, since the doctor is generally always there. As far as being a school nurse, from what I understand, most school districts are facing major budget crunches right now, and if anything are laying off the nurses that they have. That's probably why you don't see those jobs advertised. I work with a wonderful, experienced RN with her MSN who got laid off from her job as a school nurse after several years and was forced to find something else. A LOT of school nurses in our area have lost their jobs due to budget cuts.

Another thing to consider: if you are fortunate enough to find something like you're looking for, are you prepared to take a large pay cut? Those kinds of jobs don't pay near what a hospital job pays. There are days (thankfully, they're rare!) when I would love to give up bedside nursing too, but I make over $30/hour and I know I won't find an easier job that pays that much.

Good luck to you!

[saccarah]

Thank you everyone for your feedback. I am still looking and pondering every day what I am going to do.

[Purple_Scrubs, BSN, RN]

For school nursing, contact the local districts directly to see what they require. They really don't generally advertise on the big websites. I felt the exact same way as you and left tele after less than 6 months for school nursing, and while the learning curve is steep for a new grad, the right person with the right support can be successful at it. Good luck!