After several months of applying to various positions at different facilities, I was offered a per diem RN position in an ambulatory care setting! Yeah I know I've only been a RN for like 5.2 seconds but remember I am only employed part-time, leaving room for me to work elsewhere to supplement both my income and experience. It wasn't easy since I lack ambulatory care experience and I am still a relatively new nurse still developing my practice but I was honest about my experience and knowledge, and apparently sold myself at the interview. Interestingly enough my very first interview for an RN job was at a large outpatient clinic but I was hesitant to begin my nursing career there since I felt it was imperative to have at least some acute care experience before going the outpatient/ambulatory route. Now, roughly a year later (I interviewed for the job right before taking NCLEX last year) I find myself trying to transition to ambulatory care, perhaps a little sooner than I initially anticipated. Since the position is per diem, I will be maintaining my current med/surg position while I work in outpatient practice which is cool since I will have a mix of experience (not to mention I keep my current position for at least a year) which I feel looks better to potential employers. I was told the position could potentially lead to full-time in the future but even if it doesn't, this opportunity will at the very least allow me to explore working in an ambulatory care setting with less commitment and more flexibility (the employer could say the same!). I start orientation next month.
Is Ambulatory Care for Me?
Quite frankly, I don't know. In my pediatric clinical in school, I worked in a peds clinic and although some areas appealed to me (like triage/walk-in, patient education), some aspects of working in the clinic seemed a little boring to me (I also have experience volunteering at a health fair which I loved but don't know if that counts for ambulatory experience). Ambulatory care however is so varied and it's hard to use my one time experience to determine whether or not I would enjoy working in a clinic setting for adults. What I do know is that the days and hours I will potentially work would be less than the 13+ hour days I work at the hospital, will never work Sundays there (since the clinic is not open on Sundays), and the clinic is part of a large hospital system that could potentially expose me to other acute or ambulatory care opportunities in the future if that's where my spirit leads me. I am also realizing that management of chronic conditions seem more appealing to me now than the unpredictability of acute conditions in the hospital (I guess working in critical care is no longer an ideal option for me?). I am cautiously optimistic about my new position but optimistic nonetheless.
Wednesday, September 25, 2019
On my Own
I have been on my own now for over 5 months now it's going OK, I guess. Overall things are a little better but progress is slower than I'd like it to be. I still leave late most shifts (I usually leave about 45 minutes to an hour after my shift) and there are times when I feel overwhelmed (my meticulous nature has a hard time adjusting to being pulled in multiple directions constantly). I still feel dumb now and then and make mistakes (nothing life threatening thank God) but there are also moments where I feel like I am helpful and actually know something. My critically thinking still needs tweaking but there is evidence of improvement. I still don't love or even like med/surg nursing and I am sure I will not be doing it in my 40s (which starts next year by the way) but I would be lying if I said I wasn't learning a lot. All and all this is how I would break down my nearly 9 months of experience as a registered nurse:
The Good:
Most of my coworkers seem to be cool and decent people, especially those that work day shift which makes going to work more bearable. This is not to say that "nurses eating their young" doesn't exist, it's just that my interactions with coworkers, both fellow RNs and support staff has been more positive than negative.
Med/surg nursing, despite it's very fast-paced and varied nature (think 1:7 most shifts, excluding admissions/transfers), is still a good place to start a nursing career even if just for a short time
My schedule is the $%#*! Having 5 days off (or 4 days when I pick up an extra shift) allows me to do a lot at home and be more involved with my kids which was much harder when I worked 5 days and when I was in school. I can easily schedule appointments, run errands during business hours, etc. during my off days.
I am getting my initial experience working in a hospital, which is what I wanted and probably needed.
Even though I work part-time, it's still a day position which is not easy to get as a new RN.
As long as I get to work on time (which is all the time, to date) I get free, easy parking. If I worked in the city, this would probably be a luxury.
The Bad:
I work part-time, which not only means less money but also less experience than full-timers.
I am still anxious and overwhelmed before and during my shifts. I even notice an increase in my anxiety level the day before my shift. I often wonder will it ever get better.
My hourly pay is less than most hospitals in the the city/Long Island, I am not in a unionized hospital, and I am not sure if I see myself setting "roots" where I am now.
I almost never leave on time because I am doing the documentation I had no time to do during my shift. Giving hand off report also can take forever since you usually are giving hand off to multiple nurses.
When I work I am literally out of the house for like 15 hours/day since I leave the house around 6 am and don't get home until close to 9 pm.
I need close to a day to "recover" from my long shift since it is taxing on my body. I can also forget about doing anything else on my work day other than eating (barely), sleeping, and showering.
Some providers can be @#$holes. Most are not but the ones that are usually let their superiority complexes get in the way of what is best for the patient. Humility goes a long way!
The Ugly:
The nurse seems to get blamed for and is expected to do everything, even things beyond their control (like the time a patient goes to a procedure or if a patient refuses treatment or when a provider fails to update patient/family member on patient's health status and you have to track them down like a detective). Nurses have to deal with the brunt of frustration from patients, family members, providers and even other staff members.
Running a hospital like it's a hotel or restaurant makes an already difficult job even harder (I still don't get the whole "VIP" thing since I was under the impression that all patients should be given the same level of quality care but I digress)
Family members can be a lot. Seriously. I get their concern and the need for involvement (as it should be) but when they start telling you how to do your job or they get so much in the way that you can't, well, do your job, it actually can impede patient progress and takes away precious time from all the other #$&* you have to do for your 6 (or possible more) patients.
Recently, I have been offered a per diem RN job to supplement my income and to hopefully expose me to a new environment as well a different set of skills. Will this new job lead to my nursing niche? Only time will tell.
The Good:
Most of my coworkers seem to be cool and decent people, especially those that work day shift which makes going to work more bearable. This is not to say that "nurses eating their young" doesn't exist, it's just that my interactions with coworkers, both fellow RNs and support staff has been more positive than negative.
Med/surg nursing, despite it's very fast-paced and varied nature (think 1:7 most shifts, excluding admissions/transfers), is still a good place to start a nursing career even if just for a short time
My schedule is the $%#*! Having 5 days off (or 4 days when I pick up an extra shift) allows me to do a lot at home and be more involved with my kids which was much harder when I worked 5 days and when I was in school. I can easily schedule appointments, run errands during business hours, etc. during my off days.
I am getting my initial experience working in a hospital, which is what I wanted and probably needed.
Even though I work part-time, it's still a day position which is not easy to get as a new RN.
As long as I get to work on time (which is all the time, to date) I get free, easy parking. If I worked in the city, this would probably be a luxury.
The Bad:
I work part-time, which not only means less money but also less experience than full-timers.
I am still anxious and overwhelmed before and during my shifts. I even notice an increase in my anxiety level the day before my shift. I often wonder will it ever get better.
My hourly pay is less than most hospitals in the the city/Long Island, I am not in a unionized hospital, and I am not sure if I see myself setting "roots" where I am now.
I almost never leave on time because I am doing the documentation I had no time to do during my shift. Giving hand off report also can take forever since you usually are giving hand off to multiple nurses.
When I work I am literally out of the house for like 15 hours/day since I leave the house around 6 am and don't get home until close to 9 pm.
I need close to a day to "recover" from my long shift since it is taxing on my body. I can also forget about doing anything else on my work day other than eating (barely), sleeping, and showering.
Some providers can be @#$holes. Most are not but the ones that are usually let their superiority complexes get in the way of what is best for the patient. Humility goes a long way!
The Ugly:
The nurse seems to get blamed for and is expected to do everything, even things beyond their control (like the time a patient goes to a procedure or if a patient refuses treatment or when a provider fails to update patient/family member on patient's health status and you have to track them down like a detective). Nurses have to deal with the brunt of frustration from patients, family members, providers and even other staff members.
Running a hospital like it's a hotel or restaurant makes an already difficult job even harder (I still don't get the whole "VIP" thing since I was under the impression that all patients should be given the same level of quality care but I digress)
Family members can be a lot. Seriously. I get their concern and the need for involvement (as it should be) but when they start telling you how to do your job or they get so much in the way that you can't, well, do your job, it actually can impede patient progress and takes away precious time from all the other #$&* you have to do for your 6 (or possible more) patients.
Recently, I have been offered a per diem RN job to supplement my income and to hopefully expose me to a new environment as well a different set of skills. Will this new job lead to my nursing niche? Only time will tell.
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