If you've been working a traditional hospital-based nursing job, then you might be in for a surprise when you first start working as a nurse in a clinic.
What you’ll realize is there are somethings that clinic nurses do that’s unheard of in the inpatient setting.
Fear not, because in this article I’m going to give you some quick tips for new clinic nurses to help your transition that much easier.
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What Are Clinic Nurses or Ambulatory Care Clinic Nurses
Clinic nurses are nurses who work in an outpatient setting. As a clinic nurse, you’re usually taking care of patients who are not in critical status.
Your clients will range from patients who are struggling with chronic illnesses like diabetes to patients who are dealing with minor ailments like a sore thumb.
What Makes Working in Ambulatory Care Clinics Hard for Nurses?
What makes working in ambulatory care clinics hard for nurses is that most nurses are trained to act and respond based on inpatient nursing circumstances.
When I was going through nursing school. I was aware of clinics but my nursing school clinical hours were primarily focused on the inpatient setting.
Tips for New Clinic Nurses
1. Get Used to Working with Doctors Regularly
You're probably wondering, “wait, I've always worked with doctors.” To which I would say sure, but you've never really worked with doctors side by side.
Here's what I mean. In inpatient settings, a nurse's interactions with doctors (and providers) are actually minimal. The providers will come and do their rounds, and you might call them if you need orders, but for the most part, that's usually the extent of your interactions.
In a clinic setting, you're working with and interacting with the providers (MDs, Do's, PAs, and NPs) pretty much the whole day.
It's not just providers that you have to think about. The entire work environment for a clinic is very different.
The inpatient settings I've worked in were pretty much run by nurses and nurse aides.
In clinics, you're going to be interacting with doctors, nurse practitioners, physician assistants, fellows, medical assistants, and administrative staff.
Depending on the clinic, don’t be surprised if you're the ONLY nurse in the clinic.
2. Make Sure You Have a Good Preceptor
I cannot stress enough how much a preceptor (good or bad) can make or break your tenure in any new nursing specialty, let alone clinic or ambulatory care nursing.
A good preceptor is not just somebody who's orienting you but ideally, will become a mentor to you. They'll show you the written policies of what you should do, and the unwritten or unspoken things you should or shouldn't do.
If you do end up getting a bad preceptor to make sure to talk to your nurse manager about it.
If you do go down the route of talking to your manager, make sure you write down precisely what's going wrong and how expectations are not being met.
The conversation should be more than “my preceptor is not very good.” It also shouldn't be focused on saying bad things about the character of your preceptor.
3. Make Sure You Come to Work with a Teachable Mentality
It doesn't matter how good of a preceptor you have. If you're attitude sucks and you're not teachable, it's not going to be a very good experience for you.
4. Get Comfortable with Having More Autonomy
In a hospital, there are rules, standing orders, and protocols for just about everything. You pretty much can't do anything in a hospital without a provider’s order or hospital protocol to justify what you're doing.
In a clinic setting, it's a little different. While there are protocols and standing orders for things there's a lot of things you're going to deal with that there won’t be clear protocols for and will require nursing judgment.
5. Get Comfortable Calling Patients and Making Phone Calls
When you’re working inpatient nursing very seldom will you be on the phone. The exception might be if you’re dealing with pediatrics, but besides that, it’s not a very common thing.
That's not the case for clinic nursing. You’re going to be calling patients:
- To remind them of their upcoming appointment.
- To follow-up with patients after the appointment.
- To follow-up with patients if they miss the appointment.
- For scheduling appointments.
- For rescheduling appointments.
The list goes on and on. After a while, I was shocked at the amount of talking on the phone I was doing.
My advice to you, if you’re going to be doing clinic nursing you need to get comfortable talking on the phone because you’re going to be doing it a lot…A LOT!
6 Get Comfortable Dealing with High Patient Volume
Inpatient nursing relative to clinic nursing doesn’t deal with as many patients in a given shift. High acuity inpatient specialties like ICU nursing might deal with 1 to 2 patients on any given shift. Step down units and med-surg units will be dealing with 4-8 patients or so.
Clinic nursing you’re going to be dealing with patients in the double digits. It’s not necessarily a bad thing but it’s just different.
7. You're Going to Lose Certain Skills
This very fact was why I thought the notion of new nurses must start in medical surgical nursing as a bit overblown. The thing is after a while you're going to lose certain skills that were commonplace in inpatient nursing that's just not really needed in clinic nursing.
Something to keep in mind (and this goes for any new area you go into) is as nurses lose “skills” when entering into a new nursing specialty they also gain other skills that they need to be successful in their new job.
If the thought of losing any inpatient specialty worries you than consider getting a PRN job to “keep your skills up.”
More Tips for New Ambulatory Care Nurses
8. You'll Plan Your Life Around Your Work Some Days
Many clinic positions will have a rotating call schedule for nurses. Depending on your life and family circumstances it's effect can range from not that big of a deal to a life hassle.
Make sure you find out the details of the call schedule (if any) before accepting any clinic position.
9. Get Comfortable Working 5 Days A Week
One of the nice things about inpatient nursing (at least in my opinion) is the 12 or 16-hour shifts.
With those longer shifts, it means you have at least one day off during the week to take care of things that need to be done during the working week. It also means you're driving to work less.
Related Article: Do Nurse Get Paid Extra for Working Over 8-Hours?
10. You Might Need to Take On a Second Job
There's a reason I included this. The first is that clinic and ambulatory care nursing positions tend to be lower-paying unless it's a specialty position (sources).
The other thing about these positions is that there tends to be few opportunities for overtime. Because of that if you want to earn more money you usually will have to pick up per diem or PRN nursing shifts elsewhere.
11. You’re NOT Dumb, But Don’t Be Surprised if You Feel Like it
Like any new job, it takes a while before you get acclimated to the pace of that specialty and that department. You could come from a high acuity field like ICU or ER and walk into a clinic where you hear less monitor beeping and everything “feels” calmer and suddenly feel lost and confused.
If that’s you rest assured that the feeling will eventually go away.
Being a new nurse in a clinic can be overwhelming. Rest assured that the feeling of overwhelm will pass as your time in the ambulatory care clinic passes.
What's a good tip for new clinic nurses that we didn't include but should have?