Urgent Care My First Job

[daneka50, BSN, MSN, RN, APRN, NP]

I am 18 months in doing UC I’m handling it pretty well except for procedures. I work with 3 male providers who really don’t care about my practice or teaching me anything. I pretty much had my wits, my seven years of nursing experience and learning resources to get me through. They see I can handle the workload etc but I have been apprehensive about doing any procedures simply bc I have had no on the job training. I had one week of EPiC training which I was already familiar with and that was it. Again, brand new NP no advance practice experience. So now they want me to start doing lacs, i&ds yet they don’t want to train me. The only experience I have with procedures is in a classroom setting with dummies. Just today, I asked a provider to help me with a patient the staff roomed who had a splinter embedded in his fingernail. Rather than going in with me and showing or walking me through how to do it, he takes a pen and draws a diagram. WOW!. I’m like ok. Of course it did not go over well and he ended up doing it anyway. Unfortunately the poor boy was so petrified he turned pale when the md was with him. I don’t like this at all. I just don’t know what to do. I’ve spoken with management and they have informed the providers that they should be training on the job but it’s not happening. Am I expecting too much? How did u start out cutting and poking patients?

[Dembitz, APRN]

If you're unsure about a procedure, there should be someone there to back you up or you need to refer out. That being said, sometimes you just need to go for it. I learned digital blocks (admittedly more straightforward than some other procedures) by watching YouTube videos. You sort of have to do a few to learn how skin and tissue move and behave. Give good follow up instructions, ALWAYS. Remember, most people will actually get better regardless of what we do.

Look for procedural continuing ed -- it's still on a pig's foot, but it will give you more hands on experience and you'll get to talk to experts about the typical challenges they face.

[ICU2NP]

I agree about finding continuing education for procedures - they are obviously live in person but I found out about them by searching online in my area. I was initially interested in urgent care and looked into those since my school offers no training in that - but I'm adult/gero so there's no way I'll get hired so that dream went to the wayside real quick. Anyways, I found all sorts by googling. Good luck!

[soldierRN71]

I am considering Urgent Care when I finish my FNP program this year. I have 20 years of experience as a civilian and Army ER nurse. In your interviewing as a new nurse, did they take your experience into consideration to work in the Urgent Care?

Thanks!

[daneka50, BSN, MSN, RN, APRN, NP]

Yes, soldierRn. I mentioned that I did not hv any experience with procedures other than classroom setting. I even asked what kind of ojt would be provided but they really didn’t answer the question. Now they’re trying to figure out how to train me when quite frankly I should hv received an appropriate orientation process, especially as a brand new provider straight out of college. I can only do what’s comfortable for me. Unless they start using the method of—“see one, do one, teach one”—I will never ever be confident. Drawing a diagram and then telling me to go try it...i mean, who does that?! Would u put everything u worked so hard for on the line? I’ve done workshops. 1-2 hr cues on minor procedures but I’ve never had the opportunity to be guided in the real thing. I don’t need my hand held. I just need someone who has done it watching me making sure I’m doing it correctly before I start slicing and dicing. My background in nursing was med surg (3 years) and OR (circulating nurse only for 5 years).