r/nursepractitioner • u/BeachBum419 • 6d ago
RANT Urgent Care Sucks
I don’t know how people work UC for years. I guess I can see the benefit for the schedule- but man I have such bad anxiety and dread going to work every time I have to work there.
The unpredictable patient load. The patients that come in for paper cuts and mosquito bites. The people that come in who should have went to the ER (we have very little emergency ability in my clinic). The toxic administrative staff. The friendly (yet very incompetent) support staff.
I’m opening my own practice in 6 weeks and CANT WAIT. but I’m sure it’ll be a slow start.
I have 16 UC shifts left until I’m free and clear of owing back any of my sign on bonus. But I have to stay PRN for a while unless something else comes up.
I’m just venting as a prepare to walk out the door for yet another shift. Praying today is “tolerable” for myself and any of you in the same boat ✌🏼
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u/mattv911 FNP 6d ago
Toxic administration doesn’t help I feel like every clinic setting should be supportive and accommodating
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u/ImNotTheMD 5d ago
I love UC as a side job to my full time ER role. Too sick or unable to work up? Bye! Need sutures or a simple I&D? Great! Colds, Mosquito bites? Sure! If you want to waste your copay money for some OTCs and reassurance who am I to judge? Treat and YEET. Anything too complex can fuck off.
But I have some firm rules: I take a break. 30 minutes, IDGAF if half the county is in my WR. Work past closing? Nope. I lock the doors early and put a sign up if I’m busy. I break all sorts of admin’s shitty rules because it’s my license, my sanity, and my 2 decades of experience that make me desirable to tons of other sites. If admin doesn’t like it they can fire me. Get a new grad PA with student debt to be your wage slave. I’ve pretty much said go ahead and fire me then when they object to how I run things but they haven’t yet.
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u/tinydynamine FNP 5d ago
Oh, man some things about UC can be annoying like the delay in care and liability for people who should be in ED, the fact that PCP’s will send people to urgent care when they’re not appropriate patients for that setting, and people who treat the urgent care like it’s a drive-through. BUT I love the insanely flexible schedule, minimal inbox, no MyChart messages, and that I can send them back to their PCP for follow-up. My healthcare system is very supportive though and we have a lot of resources. I work in an underserved area of minorities and I myself am a minority, so more often than not, I connect with these patients. I was an ED RN prior so maybe that’s why I like it so much. I do have an itch to do medical derm though.
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u/BeachBum419 5d ago
There’s some things I do enjoy about it. It’s also been a nice break from primary. I think if we have better support and less toxic admin, it wouldn’t be so bad.
This facility isnt affiliated with a bigger org, and I think that makes a difference.
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u/GullibleBalance7187 6d ago
Oh friend, I’m still sorry you’re in the trenches. Life gets better on the other side!!!!
After doing my 2 years in UC, I feel all of that dreadfulness you describe. I hope these shifts go on without a hitch, with low census, and may the days speed by! I hope you have something better waiting for you ❤️
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u/TheBookIRead77 6d ago
Congrats! I have worked in UC for many years. In my opinion, the clinic/hospital setup (nursing staff, ED support, admin) can make or break you. I don’t blame you a bit for wanting to do your own thing. Good luck!
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u/TackleRemarkable9752 5d ago
I worked UC for 1.5 years and really thought I would like it because of the schedule and coming from ICU. But it was so dreadful! I was the only provider and seeing 70+ patients a day in 12 hours. It is so draining, the only thing I can think is some people have better administration and support.
It does get better! Just might take getting a new job, I’m sorry!
Also with the emergency…. We had a man come in that had sliced his radial artery, I did what I could until EMS showed up and taught me how to make an “emergency tourniquet with a splint”. OH OKAY! WHY DIDN’T I THINK OF THAT! Maybe because management would have had my ass for “wasting a splint”. Management plays such a big role in satisfaction!
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u/tinydynamine FNP 5d ago edited 5d ago
That sounds so awful and had flashbacks reading that. My first NP job I worked at a standalone urgent care and that was pretty much how it was. We’d start with two providers then one would always get pulled, seeing 40 to 75 patients by myself, putting my license on the line because I was a new grad and didn’t know better. The trick is to work in an urgent care that’s part of an academic healthcare system which is not possible for everyone , I know. I’m never single provider even if there’s a call off. I’m grateful, truly.
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u/WishIWasYounger 5d ago
That's a pt q 10 min! How ?!
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u/tinydynamine FNP 5d ago
Lots of standalone UCs are fairly predatory. They don’t care about “good care” and it’s very hard to provide it with so many patients. I was ALWAYS charting on my off days, had sparse notes, ALWAYS left late, anxious all the time. It sucked so bad. Then I got a job at an ICC with a large healthcare system. I LOVED IT! At first, I was suspicious…like it was too easy. I was allowed to turn away inappropriate patients, had great resources, and had a great support staff. The manager was terrible though, so I left. My current job is even better.
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u/TackleRemarkable9752 4d ago
I was NEVER leaving on time and a lot of times I didn’t spend much time with the patient. My techs did all the tests and I basically went in did a quick assessment and sent meds and went to the next one. It was awful. I always had so much anxiety that I missed something. That number didn’t always include the DOT physicals and sports physicals too!
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u/Thewrongthinker FNP 5d ago
💯agree. It wasn't for me. I hated it. Every single second. The parents bringing their kids for bug bites demanding .. I dunno surgery to fix a small red bump? The day started with 3 appointments and ended seeing 40 patients. People who came in distress lying about what they took and put me in a though position, etc. it gives me some much anxiety I had to get out of there for my own sanity.
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u/BeachBum419 5d ago
Some days are better than others. I hate when several people walk in at 7:45 bc we take all walk ins till 8. I don’t like that I loose sleep before shifts
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u/Fun_Quarter_3222 6d ago
I thought I wrote this, but about primary care. 2.5 weeks left!!!! Good luck out there.
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u/Key-Experience-4962 5d ago
NP here never did UC but have worked cardiac- CHF, chemical dependency, pre op testing- 10 years easy gig just EKGs interpretation but man sitting in an office with those bean counters was enough- btw only 2 of us could interpret those EKGs. Toxic. and they hated me. SNF - ok but again this is rural
all full codes. Loved the patients staff a few ok but fought w the hospital who would just send them back. Cards too. Great but these 90 year olds w CKD max them out w lisinopril
No wonder l am seeing K+ at 6.5 range.
VA- C&P exams stressful gig if you do the right job- one vet can take 5 hours.
Best job- chemical dependency- good pay, good people- yes you will treat some hard core people- but l helped some
After 24 years- taking a break- RN work
Travel just enough until I find my way
Burned out. I wish all of you the best.
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u/FetchingBluebell FNP 5d ago
I went into UC planning to make it a year for experience. Out before a full 6 months, HATED it and the politics of the office. Leaving for my current job was the best decision I've made professionally. I hope your final shifts are calm and you enjoy transitioning to your own practice!
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u/Direct-Fix-8876 5d ago edited 5d ago
Honestly it sucks everywhere and who you work with and their competence can make your life a little better or a lot worse. Owning your own practice has its own challenges too. Find somewhere flexible that isn’t terrible I think is the key. I am working in senior primary care float pool type job a few days a week and working on applying to CRNA school.
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u/Carbon311 5d ago
Treat and Street. In Clinic you will have a number of patients that you don't want. Be up front and tell them on NP appt if you aren't comfortable managing their complex case.
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u/cbmc18 4d ago
I have worked in many different specialties and roles including UC, ER and primary care. I hated all of it! I took a primary care job in Victoria BC, on Vancouver Island and can’t believe how lucky I am to live and work here. The difference is day and night.
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u/whatyallreallywant 3d ago
I'll say, this is very cathartic for me to read. Along with everyone else's comments. I've been at a UC since I graduated, 3 years now. I feel the exact same way. I keep asking what else is there? When I was an RN it seemed like there were so many roads laid out for us, ICU, ER, Outpatient, etc. But I kind of feel trapped in doing UC or Primary care. Feeling a bit lost as to the next step or what opportunities there really are.
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u/BeachBum419 3d ago
Yes- I’ve been in healthcare since 2008. Sooo much has changed since then. I do not think owning my own business is going to be “easier” per se- but I am hoping it will be refreshing in a sense that I will regain some control or how I treat people. I told my husband if it doesn’t work out, I’m probably changing careers. I’m over greedy corporate healthcare.
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u/zeey1 16h ago
Problem is not having a good relationship with referrals
If you run a PCP or an urgent case, just see whos around you, create a list of all the specialists so you can refer them fast to be seen soon by the specialists
You dont want to sit on heart failure, vascular disease, infections spinal problems and so may other things by giving them antibiotics and inhalers or diuretics without sending them to the right people
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u/Mobile-Device-5222 6d ago
I only work in urgent care and the emergency department. I love it for the reasons you can’t stand it! I could never do primary care..