What It’s Like As an RN in Primary Care

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I started my job as an RN in primary care a little over one year ago and as I’m sure everyone is aware of, a year ago is also when the coronavirus started to circulate around the world. I will touch further on what it was like for me during the pandemic in a different blog but I know that it gave me such a sour taste in the start of my new job as a primary care nurse. I will discuss how things have been more recently now that we have been seeing patients in the office.

Here in Connecticut, only licensed medical professionals can give injections. What does this mean for me? I do a lot of injections which I truly do adore doing but this seems to be the most clinical thing I do. It’s not a bad thing but it definitely required an adjustment of my definition of “clinical duties” since I came from skilled nursing facilities that required hands on skills that were far more complex than just a simple injection. This adjustment has been and still is hard for me to grasp. But I do have to say that the experience that I received at the skilled nursing facilities gave a very good foundation to be able to do other tasks that are required of me such as, triaging patients.

So we do triaging of calls…. I mean, A LOT of triaging. But I actually don’t mind the triage calls because it requires a lot of critical thinking skills to make sure you are asking the correct questions and deciphering if this patient is in need of an emergency room visit or is it something that can safely be taken care of in the office. Sometimes the triages are easier than others for example, an injury requiring stitches – we don’t do that at our office so they need to seek urgent care or an ER visit. Others may not be so easy such as people who are complaining of chest pain and shortness of breath but refuse to go to the ER and are demanding to be seen by one of our providers. So dealing with the patients and being able to get them to the correct care but that also appeases their needs, is also part of my duty as a primary care nurse.

There is also a lot of administrative things that’s required of me. This is the part I have had the most difficult time with adjusting to. This is because I am considered the “clinical lead” yet hold an RN license so there are more responsibilities involved in the title than just having clinical skills or RN license. I need to take inventory, order supplies, try to be a liaison between clinical staff and management and take responsibility for our health and safety measures. All of those things fall on the shoulders of the clinical lead so my hang up had been, “why am I being paid to be an RN but yet I am required to complete these administrative tasks that anyone could do?” And that’s when I realized that I was not just an RN here… I was much more than that. My role is important and I do feel like I make a difference in the workflow of the office.

But one of my favorite things I do is the education part of it. We educate patients on their illnesses or do diabetic teachings (the diabetic teachings are my absolute fave!). We also ensure that the medical assistants have been trained and are competent at performing their point of care testings. So the nurses are responsible for being 100% knowledgable at these things because we are ultimately the go-to person for all things in the clinical setting and responsible for making sure the staff is correctly doing things. If someone is doing something wrong, it can be a reflection of the nurse that taught them.

Nurses are also expected to have an answer to the majority of the questions or concerns on the clinical side of things and if we don’t know the answer then we need to know where to find the answer. The providers and the medical assistants rely on us to handle things that they don’t have time for and that may be out of the scope for the medical assistants to complete such as reviewing more medically complex issues or test results to the patients. We are there to be of assistance for the clinical staff and patients and to make things run more smoothly.

So yes, it has been an adjustment going from a skilled nursing facility to a place that requires a very minimal experience level clinically yet has other important duties associated with it and I have also come to the understanding that my role is just as important. Of course I have my days where I’m annoyed with the patients or the people I work with…. every nurse feels this way at some time in their nursing career! But I appreciate the normal business hours and limited stress that this job has. I feel like I am also learning leadership skills that I didn’t have before. And with the skills I already had and the ability to learn a different side of nursing, it is causing me to be a more well rounded nurse, which I am grateful for. So if you are interested in trying a different speed of nursing, I would highly recommend primary care nursing!

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