What can I expect?

[meco46]

Hello colleagues, I have spent all of my three years as a nurse in dialysis. Now I am moving to ambulatory care (primary care plus clinic). I would just like to know what to expect and what areas of medical information I should reintroduce myself to? In dialysis, patients have multiple medical issues, however, as a nurse if their problems are not HD related, we are instructed to have the pt see their pcp. well, after three years of that I have become stagnant in nursing growth and have forgotten a lot of med-surg knowledge. What do I need to restudy to be a knowledgable nurse in the ambulatory setting.

[Rathyen]

Everything. Know your labs, medications, education techniques, multi-tasking, people skills, patience, tolerance, phone triage, how to make a doctor think your idea was his, and how to explain everything you ever learned in non-medical speak. Oh, and how to refute Dr. Oz and WebMD.

[pfchang]

Very true, Rathyen. And I would add assessment skills for everything from a scraped knee to an MI for the constant walk-ins who don't call first. And anti-coagulation, immunizations, etc, etc, etc.

[Rathyen]

Exactly!! You just can't even list everything that we cover! I laugh every time a hospital nurse tells me how easy my job is. I work way more hours than I ever did at the hospital and I don't just see my patients for a couple days and then they are gone, I see them forever!

[SHGR, MSN, RN, CNS]

Common chronic conditions. DM, HTN, contraception, STI's, immunizations, skin things, infestations (lice, scabies, bedbugs). Psych- many of your frequent callers will have psych comorbidities. Also, my least favorite, what I call "don't you have an auntie?" calls- things like my baby is constipated, my baby is pooping too much, my baby has a fever (and what to tell the parent if "the fever" is 99 degrees or 104 degrees)...get to know your triage protocols well because it will help you CYA.

Also don't forget to get to know your patients and enjoy them.