Looking for advice/recommendations/solidarity. I have been an NP for almost 4 years. This is my second job (urgent care). Left my previous job after 3 years due to stress and lack of work/life balance. Started current job and work prn but stress level is the same. My patient load isn't heavy, but I feel chronically plagued with worry and stress regarding clinical decision making. I know I am competent and I do have a supportive team of attendings, however, this causes significant anxiety (especially after shifts and just before shifts) and difficulty sleeping at night for fear that I've made mistakes etc. I have never had this issue working as an RN. I am contemplating leaving my practice as an NP and perhaps nursing as a whole to pursue other options i'm passionate about. I'm not sure this is the right field for me but it is also hard to give it up. Can anyone relate or offer any sentiments on this?
Hindsight, what-if's, and rethinking can drive a person crazy. So many diseases and ailments have common denominator symptoms. Just do what you feel is right and prudent, make sure these patients take some accountability for their own health too. We can't force medication down them, or make them otherwise do what they should do. But, we can make sure we give them good directions and document it. I am sure there are some less stressful NP jobs out there. A rural clinic servicing a geriatric population might be one of them.
Rural would be worse. You're often the only provider in a several mile radius, and geriatric care usually involves various co-morbidities. Wouldn't recommend for OP.
Perhaps your underlying passion for something outside of nursing is affecting your peace of mind to the extent that you are not confident, happy, and satisfied in your present role. Sit down with yourself and explore your future. Change fields altogether, step back to the RN role, find another NP position that might be better, or employ other avenues of self help. There are many ways to approach this until you find a level of day to day functioning that you can live with. You can always come here to talk about what is going on with you; members will be only so glad to hear you out and offer you support.
Rural would be worse. You're often the only provider in a several mile radius, and geriatric care usually involves various co-morbidities. Wouldn't recommend for OP.
Actually in all the rural counties nearby there are multiple clinics and multiple providers. The population is also lower and geriatric care often involves the same chronic conditions repeatedly. That is how it is in my area.
I have been an NP for 15 years and love it, but I do feel the weight of the responsibility at times. Your post was actually reassuring to me, because I feel some NPs are overconfident and too casual in their approach.
I am in Psych, and I had someone die early in my career directly from the effects of a med I had prescribed. It was a fluke reaction and nothing ever came of it, but it convinced me all the more that this is very serious business.
There was a time earlier in my career when I took an SSRI for anxiety. It helped. Just a thought.
It sounds like the MDs you work with are decent. But in Urgent Care, a symptom that seems innocuous can actually be the sign of something serious. That should be worrisome. How do the MD's handle it? Or your NP co-workers?
I found it helpful to research psychiatric malpractice cases. Google, in other words. It was reassuring. There weren't that many, and the mistakes were things I could easily avoid.
It was probably helpful in the end that I was involved in a malpractice suit. Me and the other 75 people who were listed in the chart. Nothing ever came of it, and the only person who got into any trouble was an RN who documented something she didn't do on camera.
It might be helpful to know exactly what are the expectations when a pt comes in with something vague, maybe diffuse abd pain. I know when I have been to urgent care, I always get a paper that says to come back if things don't improve in 24-48 hours.
Those are my thoughts. I am now in LTC with a relaxed pace. That might be an option to consider as well.
Great advice! It takes more time, but I try to type out the specific signs and symptoms including any worsening symptoms and the time parameter for follow up on both the AVS and the chart. It is also very helpful for nursing staff if they call in.
ToFNPandBeyond
203 Posts
Rural would be worse. You're often the only provider in a several mile radius, and geriatric care usually involves various co-morbidities. Wouldn't recommend for OP.