What can I do with my MSN-FNP that doesn't require much patient contact

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by FNPStudentLife FNPStudentLife, BSN, RN Member Nurse

Specializes in ER nurse, FNP student. Has 5 years experience.

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Tegridy

Tegridy

Specializes in Former NP now Internal medicine PGY-3. 488 Posts

On 2/1/2020 at 2:07 PM, LadyT618 said:

I say if you have the time and the stamina, go to med school and become a radiologist. You don't have to deal with the bedside that comes with hospital nursing, you definitely get the respect and independence (more than you'd get as an FNP) and as a radiologist, you don't have to really deal with people. It's a win, win, win all around!

Great job but I thought it was boring lol. I like talking to (most) people

after a month of looking at imaging I was done. Even though the procedures are a nice break up in the day

LadyT618, MSN, APRN, NP

Specializes in Home Health, Primary Care. Has 17 years experience. 659 Posts

6 hours ago, Tegridy said:

Great job but I thought it was boring lol. I like talking to (most) people

after a month of looking at imaging I was done. Even though the procedures are a nice break up in the day

As much as I'm not a people person, I'd find radiology boring too LOL. I truly am loving primary care, even with the stubborn, hard-headed patients ?

PollywogNP, ADN, BSN, MSN, LPN, NP

Specializes in Med-Surg/Tele/ER/Urgent Care. Has 45 years experience. 237 Posts

The same patients that you see in primary care show up in urgent care often for chronic conditions that they have failed to keep/make apts or fup with PCP. Abdominal pain x 1 year, incontinence, med refills, ingrown toenails, knee/back pain, rashes for 7 years (and he was mad I didn’t know what was causing his rash), kidney stones etc etc etc.

It’s not all sore throats, pink eye & uti’s. Most urgent cares expect you to interpret X-rays, splint/cast, suture & minor procedures such as removing ingrown toenails.

And it is fast paced 3-4 patients per hour is typical, many its 12 hour shifts. And it’s complicated as they don’t know the name of their doctor/s or the meds they take or allergies.

Edited by PollywogNP

FullGlass

FullGlass, BSN, MSN, NP

Specializes in Adult and Geriatric Primary Care. Has 4 years experience. 2 Articles; 1,403 Posts

Another option to consider is Planned Parenthood. They hire FNPs and AGPCNPs and train them. A lot of contraceptive counseling, insertions. STDs. Also prenatal care. Generally not a lot of the frustrating chronic conditions. Known to pay well and have great benefits.

Also, consider a community college or university health system. The patients will be younger and healthier and are generally coming in for acute issues, birth control, STDs, stress, depression. A more well-educated group that is likely more motivated to follow treatment plans.

umbdude, MSN, NP

Specializes in Psych/Mental Health. Has 5 years experience. 1,218 Posts

I've met a couple of PMHNPs who went into hospital administration (they didn't like prescribing and the liabilities). Couple other options would be education and pharmaceutical sales.

I would get at least couple years of FNP experience first though. You might end up liking it and, if not, you'd have some advanced-level clinical experience.

CaliGrlOncNP

CaliGrlOncNP

Specializes in Hem/Onc. Has 9 years experience. 6 Posts

I'm a little late on this conversation, but I can relate to your predicament a lot, as it's basically how I felt most of the way through school and still now, 6 years after graduating.

I worked 2 years in family practice and had the same gripes - non-compliant patients, understaffed units, "worried well" visits) . Now, as an Oncology NP, the things that initially bothered me about primary care are not present. Patients show up to their appointments, are generally compliant, and are grateful for any help you provide them. I do not see that many patients (the MD I work with prefers to use me as an over-paid MA), which could be good or bad, depending on what you want. In primary care, however, you will likely be practicing full-scope. For me, this felt beyond my comfort zone as my "direct entry" NP program was really not adequate for the job. I was one of the shmucks who fell for the "direct entry NP" route, thinking it was no different then going to medical school without prior experience. As for respect, I personally haven't felt respected anywhere I've worked since becoming an NP, which is one of my main issues with the field in general, so if respect is important to you, I personally don't think being an NP is the way to go.

I too am now considering what other fields I can go into. Sadly, with $150K in student loans, my options are limited. I've considered moving into a pharmaceutical company and working on clinical trials.

Listen to your gut, but keep an open mind. Since you already have nursing experience and at one point liked working with patients, you may in fact just be burned out and/or need a change in focus.

FNPStudentLife, BSN, RN

Specializes in ER nurse, FNP student. Has 5 years experience. 1 Article; 36 Posts

25 minutes ago, CaliGrlOncNP said:

I'm a little late on this conversation, but I can relate to your predicament a lot, as it's basically how I felt most of the way through school and still now, 6 years after graduating.

I worked 2 years in family practice and had the same gripes - non-compliant patients, understaffed units, "worried well" visits) . Now, as an Oncology NP, the things that initially bothered me about primary care are not present. Patients show up to their appointments, are generally compliant, and are grateful for any help you provide them. I do not see that many patients (the MD I work with prefers to use me as an over-paid MA), which could be good or bad, depending on what you want. In primary care, however, you will likely be practicing full-scope. For me, this felt beyond my comfort zone as my "direct entry" NP program was really not adequate for the job. I was one of the shmucks who fell for the "direct entry NP" route, thinking it was no different then going to medical school without prior experience. As for respect, I personally haven't felt respected anywhere I've worked since becoming an NP, which is one of my main issues with the field in general, so if respect is important to you, I personally don't think being an NP is the way to go.

I too am now considering what other fields I can go into. Sadly, with $150K in student loans, my options are limited. I've considered moving into a pharmaceutical company and working on clinical trials.

Listen to your gut, but keep an open mind. Since you already have nursing experience and at one point liked working with patients, you may in fact just be burned out and/or need a change in focus.

Thank you for your response. I’m thinking about giving a try to urgent care. I know that I won’t be able to work as urgent care NP right after graduation because I’ll be a new grad, but it will be my goal. I like the idea of “treat them and street them”. If it doesn’t work out, I like the idea of oncology. I’m glad there are a lot of options out there. I am a little burnt out right now , but you’re right, at one point I liked working with the patients, so not everything Is lost ?

FullGlass

FullGlass, BSN, MSN, NP

Specializes in Adult and Geriatric Primary Care. Has 4 years experience. 2 Articles; 1,403 Posts

On 2/5/2020 at 10:59 PM, PollywogNP said:

The same patients that you see in primary care show up in urgent care often for chronic conditions that they have failed to keep/make apts or fup with PCP. Abdominal pain x 1 year, incontinence, med refills, ingrown toenails, knee/back pain, rashes for 7 years (and he was mad I didn’t know what was causing his rash), kidney stones etc etc etc.

It’s not all sore throats, pink eye & uti’s. Most urgent cares expect you to interpret X-rays, splint/cast, suture & minor procedures such as removing ingrown toenails.

And it is fast paced 3-4 patients per hour is typical, many its 12 hour shifts. And it’s complicated as they don’t know the name of their doctor/s or the meds they take or allergies.

True, but in Urgent Care you are not responsible for the primary care drudgery of ordering labs, referrals, blah, blah, blah.

There is nothing wrong with a fast pace. At least it is not boring.

FullGlass

FullGlass, BSN, MSN, NP

Specializes in Adult and Geriatric Primary Care. Has 4 years experience. 2 Articles; 1,403 Posts

Another comment: as providers, we need to create boundaries and not get so emotionally wrapped up in our work. I've heard similar complaints from other new grad NPs. Be in the moment. Honestly, if you provide good care to a noncompliant patient and they refuse to comply and keep coming back, it is on THEM. Every job has tedium and drudgery. Learn to just focus on the task at hand. If they paid you $150K per year to dig a hole, fill it up, dig another hole, fill that up, then go back to the first hole, etc., like in those movies about Boot Camp, who cares? You do your work and you get paid. (I think of digging holes when I feel this way to calm down)

If you were working as a retail clerk, would you agonize over every customer and if they are going to be happy with their purchase and use the item correctly? Of course not!

If you were a car mechanic, and someone keeps bringing their car in for service because they don't take care of it, would it get you so upset? As long as they pay you for your work, their car is their problem. Their carelessness is generating revenue for you.

I do care for my patients, and I also feel these frustrations, but don't let them overwhelm me. At the end of the day, it is a job and people must take responsibility for themselves.

Primary care is not for everyone. There are many other options for NPs to work in a specialty without the grind of primary care. Many specialty practices will hire new grad NPs and train them. And worst case, get 1 to 2 years of primary care experience, then go into a specialty or Urgent Care. It is also possible to find a primary care job serving a more motivated population that is not so depressing.

Just focus on what you can do and small successes. While there are noncompliant patients, there are also patients that will heed your advice. Even a noncompliant patient may improve and change over time. Remember this parable:

One day, an old man was walking along a beach that was littered with thousands of starfish that had been washed ashore by the high tide. As he walked he came upon a young boy who was eagerly throwing the starfish back into the ocean, one by one.

Puzzled, the man looked at the boy and asked what he was doing. Without looking up from his task, the boy simply replied, “I’m saving these starfish, Sir”.

The old man chuckled aloud, “Son, there are thousands of starfish and only one of you. What difference can you make?”

The boy picked up a starfish, gently tossed it into the water and turning to the man, said, “I made a difference to that one!”

https://starfishproject.com/the-parable/

PollywogNP, ADN, BSN, MSN, LPN, NP

Specializes in Med-Surg/Tele/ER/Urgent Care. Has 45 years experience. 237 Posts

Full glass sorry quote feature not working, but in the 3 urgent cares I worked at, we did order labs/xrays/ ct scans/US/ & often referred out. Many people don’t have a pcp to send them back to for follow up or the pcp doesn’t have any available apts for months. So depending on the test results it might bet necessary to send to specialists. In one year I found 2 cases of stage 4 tonsil cancer both with metastasis & one horseshoe kidney in a 19 year old that had been seeing a urologist since age 5! Urgent care can have different capabilities depending on the equipment available & the skills each provider brings. Some are the minute clinics that May only see very basic acute issues such as sore throats & uti’s, to those with X-ray and providers that perform procedures such as trigger point injections or knee injections with instructions to return in a few days for eval

CaliGrlOncNP

CaliGrlOncNP

Specializes in Hem/Onc. Has 9 years experience. 6 Posts

On 2/22/2020 at 2:00 PM, FullGlass said:

Another comment: as providers, we need to create boundaries and not get so emotionally wrapped up in our work. I've heard similar complaints from other new grad NPs. Be in the moment. Honestly, if you provide good care to a noncompliant patient and they refuse to comply and keep coming back, it is on THEM. Every job has tedium and drudgery. Learn to just focus on the task at hand. If they paid you $150K per year to dig a hole, fill it up, dig another hole, fill that up, then go back to the first hole, etc., like in those movies about Boot Camp, who cares? You do your work and you get paid. (I think of digging holes when I feel this way to calm down)

If you were working as a retail clerk, would you agonize over every customer and if they are going to be happy with their purchase and use the item correctly? Of course not!

If you were a car mechanic, and someone keeps bringing their car in for service because they don't take care of it, would it get you so upset? As long as they pay you for your work, their car is their problem. Their carelessness is generating revenue for you.

I do care for my patients, and I also feel these frustrations, but don't let them overwhelm me. At the end of the day, it is a job and people must take responsibility for themselves.

Primary care is not for everyone. There are many other options for NPs to work in a specialty without the grind of primary care. Many specialty practices will hire new grad NPs and train them. And worst case, get 1 to 2 years of primary care experience, then go into a specialty or Urgent Care. It is also possible to find a primary care job serving a more motivated population that is not so depressing.

Just focus on what you can do and small successes. While there are noncompliant patients, there are also patients that will heed your advice. Even a noncompliant patient may improve and change over time. Remember this parable:

One day, an old man was walking along a beach that was littered with thousands of starfish that had been washed ashore by the high tide. As he walked he came upon a young boy who was eagerly throwing the starfish back into the ocean, one by one.

Puzzled, the man looked at the boy and asked what he was doing. Without looking up from his task, the boy simply replied, “I’m saving these starfish, Sir”.

The old man chuckled aloud, “Son, there are thousands of starfish and only one of you. What difference can you make?”

The boy picked up a starfish, gently tossed it into the water and turning to the man, said, “I made a difference to that one!”

https://starfishproject.com/the-parable/

Great point. Being overly emotionally invested is likely contributing to such high rates of burn out, and is a skill that they should really teach in nursing school. We want to fix every problem, but that's an impossible goal to live up to, especially if patients aren't themselves motivated to make a change, or if they have an unfixable problem. It took me years to learn to the balance of empathy vs. being overly invested, and I'm much happier and a better NP now that I have. We also need to be better about teaching new nurses about managing emotions in this line of work.

Tegridy

Tegridy

Specializes in Former NP now Internal medicine PGY-3. 488 Posts

On 2/24/2020 at 8:39 PM, CaliGrlOncNP said:

Great point. Being overly emotionally invested is likely contributing to such high rates of burn out, and is a skill that they should really teach in nursing school. We want to fix every problem, but that's an impossible goal to live up to, especially if patients aren't themselves motivated to make a change, or if they have an unfixable problem. It took me years to learn to the balance of empathy vs. being overly invested, and I'm much happier and a better NP now that I have. We also need to be better about teaching new nurses about managing emotions in this line of work.

a good book on stoicism usually fixes the issue