Job Title: Registered Nurse
Type of Company: I work as a registered nurse in the urgent care department of a major New Hampshire medical center, but I also work as a home health nursing supervisor for a local home health agency with a caseload of both adult and pediatric patients.
Education: BA, Art, University of Lowell AD, Nursing; RN, New Hampshire Technical Institute (Concord, NH)
Previous Experience: I worked in pediatric home health for thirteen years, specializing in medically fragile and severely disabled patients. I also worked for a couple of years as a nurse in an inner city school.
Job Tasks: In Urgent Care, the department is set up based on an emergency department model, but with the idea of serving patients with urgent, rather than life-threatening health needs. Patients see a patient service representative upon arrival for demographics, general concerns and insurance information. After that, the patient is assigned to a room and triaged by a nurse on a first-come, first-served basis. During triage, or information gathering, the nurse assigns each patient an acuity level from 1 to 5 based on a standardized emergency severity index, with 1 being an immediate life threatening need. The patient is then examined by a physician or physician's assistant who orders whatever meds or treatments are needed and performs any necessary procedures. Nurses administer any ordered meds or treatments, draw blood, insert IV's etc. Nurses also process most labs for blood, flu, mono, pregnancy, strep throat, urine etc. on site.
Just as in an emergency department, the focus is on the specific problem or urgent need of the patient at the time of the visit. For example: "Why are you here today? What is happening now?"
The environment is busy and fast-paced. Nurses and providers need to be able to continuously multi-task and re-prioritize. People who do not like to sit at a desk all day and enjoy being on the go every minute do well in Urgent Care.
Best and Worst Parts of the Job: There are many best parts of the job. Meeting and helping patients is extremely rewarding. The environment is challenging with the opportunity to continuously learn something new. Starting IV's is my personal favorite. There is nothing like finding a good vein on the first stick and guiding that catheter in.
The worst part of the job is having to put away stock and supplies, including breaking down cardboard boxes and disposing of them in the dumpster. Since we are in an off-site medical center and not in the actual hospital itself, the nurses are responsible for many tasks that are not traditionally thought of as nursing. It can be very stressful when we have a waiting room full of patients and boxes of medical supplies piled up blocking the computer we need to use.
Job Tips: Prior to choosing a nursing school, make sure that the school you are considering is NLN: National League of Nursing accredited. This will be imported if you ever want to transfer any credits to further your nursing education after you graduate. As a new student, you will need to choose between LPN or RN. For RN, you will need to decide on an associates degree RN (2 year degree) or BSN RN (4 year degree). If this is a change of career and you already have a Bachelor's degree, there are now bridge programs that allow you to go from non-nursing bachelor's to MSN RN. Some bridge programs even allow you to get your nurse practitioner's certificate.
As a new graduate, you'll want to get hospital experience, preferably medical-surgical. This gives a new nurse a good foundation and is required for most specialties, including urgent care.
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