It’s a New Dawn, New Day, New Job
- Mike
- May 3, 2022
- 5 min read
In December 2021, I accepted a new position as an RN at an outpatient acute care facility. I’ve gone back to visit my original inpatient coworkers and I have visited my own family members in the hospital. While I thoroughly enjoyed the challenge and adrenaline of my inpatient experience, I was becoming burned out physically and emotionally. I needed a change of pace to reset and enjoy life again.
To be honest, I applied to every single outpatient position that was advertised within my health network. I had no clue where I would end up or even where I wanted to end up, but I knew that I needed to make a temporary change for the betterment of my health and my life as a whole. Due to my residency locking me into a 1 year contract, I was unable to laterally transfer to any of the job positions for which I initially interviewed. Luckily there was one position that took a chance on me, and that was Urology.
There is a lot of skepticism and criticism surrounding the outpatient world; this is only perpetuated by those who work in the inpatient world.
I have to admit that I was one of those individuals. We go from the grind of nursing school having our rotations in the hospital setting and then get thrown into the complete chaos of the hospital - there certainly is a sense of glamor and excitement to it all. The travel-nurse influencer culture has bolstered the idea that being a nurse in the hospital is the epitome of the nursing profession and anything less is subpar. To be honest, I still long for working in a hospital again, this is due to my apparent ‘savior complex’ which I freely admit to having.
There is not a day that goes by where I don’t have flashbacks and PTSD to the nights back on my night shift cardiac unit. There are pros and cons to both the inpatient and the outpatient nursing realm. That being said, I am working to make the most out of my new position.
When someone thinks of being a nurse in an outpatient facility, they often imagine a nurse taking vitals and preparing the patient for the Provider. In some offices, that is exactly what happens. In other outpatient settings, a nurse might also draw blood for the lab, perform EKGs, assess the patient, etc.
To put it bluntly: I work with peens and vageens. The day to day flow of work includes: patient assessment, catheter evaluation, urethra and suprapubic catheter exchanges, discontinuing nephrostomy tubes, removing staples/sutures, removing ureteral string stents, injecting testosterone and Androgen Deprivation Therapy for Prostate Cancer, mixing and instilling BCG in the bladders of patient with bladder cancer, assisting surgeons with cystoscopy fulgurations and botox injections, and other miscellaneous tasks.
I am doing so much more than I ever imagined an outpatient nurse would do, and I am growing as a nurse.
One of the facets of the outpatient workflow which I was not entirely prepared for was the administrative work. The amount of time I have to spend on the phone facilitating prior authorizations for imaging or medications still blows my mind and I have been doing this for 4 months. Another concept is the odd sense of “entitlement” that the patients have; just like those on the inpatient side of medicine, patients sometimes act as if they are the only patient in the world and that their priorities take precedence over everything else. I am unsure if the global pandemic has caused people to be hyper aware of their medical state, if people have a lot more time on their hands now, or going from one medical appointment to another is just how one’s life turns out to be after a certain age, but this is a new experience for me. I have newfound respect for those who have to work with patients in the outpatient realm.
This switch from in to outpatient has caused massive positive changes in my life. I work a very traditional schedule Monday through Friday with no shifts scheduled at night, on weekends, or on holidays. My sleep schedule is healthier and I am finally eating an appropriate amount of food, both of which have improved my overall well being. I am able to fully enjoy family gathering and nights out with friends as I am no longer falling asleep or filled with anxiety. My relationship with my fiance has also been positively impacted by the transition, where we get to eat meals together and have a daily routine we both look forward to.
While the pay as an outpatient nurse is lower than that of an inpatient nurse, I look at it this way: the lives of my patients are not necessarily hanging in the balance of my hands anymore, I am not treating the patient as a whole, and I got my life back.
Putting aside my savior complex and longing to ‘save the day’, I actually enjoy existing now.
Not everything about outpatient nursing is positive. It is a little sad to see what happens when private practices are bought out by larger healthcare networks. These practices are turned into money-making machines, cramming in as many patients into a daily schedule as possible. Taking my place of work as an example: there are 3 MDs and 1 APRN. Each MD has two surgical days in the hospital setting and 3 days in the office; the APRN is in the office seeing patients 5 days a week. When in the office, the MDs typically see 35-40+ patients a day (15 minutes each). Looking at this from the patient’s perspective, it does not seem like adequate care can be provided in such a short amount of time. That being said, this is nowhere near the Providers’ fault - healthcare is a business.
It is also not the employee’s fault that all the Providers are booking appointments all the way out in June/July; those scheduling appointments are often yelled at and belittled when there is nothing they can do, all because the system of healthcare is broken. The proper way to get the help you need as a patient is to treat those who provide that help with respect and patience. It does not help anyone to be rude/entitled and for lack of a better term, a “Karen”.
From my experience as a whole thus far, I have learned that a Nurse is a Nurse, no matter the setting.
Despite me having a BSN, I see the LPNs I work with as my equal. I treat the outpatient work environment as if it were inpatient, with each member of the Nursing team acting as a partner. We all work together and step in when our teammate is starting to drown with the workload. Healthcare is an interdisciplinary service. Whether it is all the moving parts of the hospital or all the moving parts of the office, healthcare is healthcare. Each component of this career has its pros and cons; it boils down to the silver linings you can find in each day you go to work.
I might have been working on getting my life back on track and working out again, but nursing is certainly still my cardio.
Thanks for sharing such a nice blog keep it up.
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