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Student Health Services- Your Thoughts & Pros vs. Cons


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Hey guys,

I recently accepted a job at a private large university institution as a nurse practitioner. I was wondering if anyone works in student health or has in the past? Did you like/not like it? What were the pros and cons? This is my first job as an NP out of school; however, I have previous experience as an orthopedic physical therapist and as an emergency room nurse. While I would have enjoyed more medically complex patients, the compensation and commute were hard to beat. I'm probably underestimating the specialty to some degree, as I'm sure there are students who are medically complex. As of now, I consider it family-med lite (you see the students and their family members as well). There will probably be some employee health mixed in as well. Needless to say, I'd love to hear your thoughts on it. I'll probably pick up registry hours at a family medicine clinic elsewhere in order to keep my skills intact. 

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39 minutes ago, sas5814 said:

My RHC covered the local campus for about 18 months after their provider retired. It was not difficult work but I found them to be the most whiney neurotic delicate little flowers on the planet. Every emotion needed a pill.

And that was just the campus staff!  I couldn't resist the dig.

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I provided student health services at Michigan Tech U for 1 year.  Pros: I liked being back around a university setting and most students were really nice. Cons: The social dynamics were more complex than I had anticipated. For example, I had several girls come in for, basically post rape, check out for sexually transmitted diseases, yet, they did not want to go to authorities for the typical reasons (afraid of being scorned by other students, or "it was my fault because I went to the party and drank too much, not knowing that five boys would have sex with me while I was unconscious"). These stories kept me awake at night as I tried to end this abuse.  Others included, suicide prevention, addiction issues and these issues also kept me awake at night. But, the most frustrating problem, which happened over and over, was a student coming in with a URI, wanting antibiotics. When you don't provide antibiotics, then mommy or sometimes daddy calls from out of state, mad as hell and demands to speak to you. They tell you how important and rich they are and how their private doctor in Chicago or wherever, always gave them what they wanted. Then, when you don't cave in to them, your (nonsupporting boss, SP) comes in to scream at you after their parent calls them.  

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4 hours ago, jmj11 said:

I provided student health services at Michigan Tech U for 1 year.  Pros: I liked being back around a university setting and most students were really nice. Cons: The social dynamics were more complex than I had anticipated. For example, I had several girls come in for, basically post rape, check out for sexually transmitted diseases, yet, they did not want to go to authorities for the typical reasons (afraid of being scorned by other students, or "it was my fault because I went to the party and drank too much, not knowing that five boys would have sex with me while I was unconscious"). These stories kept me awake at night as I tried to end this abuse.  Others included, suicide prevention, addiction issues and these issues also kept me awake at night. But, the most frustrating problem, which happened over and over, was a student coming in with a URI, wanting antibiotics. When you don't provide antibiotics, then mommy or sometimes daddy calls from out of state, mad as hell and demands to speak to you. They tell you how important and rich they are and how their private doctor in Chicago or wherever, always gave them what they wanted. Then, when you don't cave in to them, your (nonsupporting boss, SP) comes in to scream at you after their parent calls them.  

Wow thank you for sharing that. Those are definitely complex cases with a lot of variables at play. I imagine I’ll encounter similar scenarios, so thank you for the heads up. 

The URI/ABx thing will be interesting. It’s an ivy-league level school, and you’d think that smarter students would have a better understanding of this issue (which unfortunately is usually not the case). I’m curious how much entitlement there will be when they enter the clinic. I definitely have some preconceived notions, but maybe they’ll prove me wrong. 

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8 hours ago, sas5814 said:

My RHC covered the local campus for about 18 months after their provider retired. It was not difficult work but I found them to be the most whiney neurotic delicate little flowers on the planet. Every emotion needed a pill.

Haha I can only imagine. I’ll be on the lookout for all the delicate little flowers. Hopefully it won’t be a glass case of emotion!

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I enjoy it quite a lot (and work at a large, state institution). I worked for several years in a community health setting with low rates of health literacy and high rates of morbidity and, compared to that, student health has been really refreshing. I almost never get bothered about not giving antibiotics. I almost never get whiny students. I have never had a parent call and complain. If you treat them like the adults they are and don't assume a snowflake complex, they are really some of the best patients I've ever treated. While the stressful stuff is sometimes complex, it occurs with enough frequently that there are systems in place to limit the confusion (though they are still exceptionally rare). You will still see medically complex things also (e.g. acute abdomen, neurological disorders, unique infectious disease from international populations, travel medicine, psychiatric illnesses, etc...). I imagine your mileage may vary, but don't go in with a bad attitude. 

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1 hour ago, printer2100 said:

I enjoy it quite a lot (and work at a large, state institution). I worked for several years in a community health setting with low rates of health literacy and high rates of morbidity and, compared to that, student health has been really refreshing. I almost never get bothered about not giving antibiotics. I almost never get whiny students. I have never had a parent call and complain. If you treat them like the adults they are and don't assume a snowflake complex, they are really some of the best patients I've ever treated. While the stressful stuff is sometimes complex, it occurs with enough frequently that there are systems in place to limit the confusion (though they are still exceptionally rare). You will still see medically complex things also (e.g. acute abdomen, neurological disorders, unique infectious disease from international populations, travel medicine, psychiatric illnesses, etc...). I imagine your mileage may vary, but don't go in with a bad attitude. 

It has been over 25 years ago when I had my short stent in student health and that may have been a different time. My memory may have been skewed as well. I had a terrible SP during that job and why I only stayed a year. It seems like there were several parents that called, but I do remember one couple from Chicago, both lawyers, who bugged the hell out of me when I would not give their daughter antibiotics for her cold. They were very angry and ended up calling my worthless SP, who completely folded and came down and screamed at me for not giving the students what they wanted. Otherwise, I would have loved the work.

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17 hours ago, ventana said:

Just curious. 

 

How long have have you been an NP? And PT?

Been practicing as an orthopedic physical therapist for six years and as an emergency department nurse for 2 years. This will be my first job as an NP. What’s up?

Lots of schooling would be an understatement. 

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22 hours ago, printer2100 said:

I enjoy it quite a lot (and work at a large, state institution). I worked for several years in a community health setting with low rates of health literacy and high rates of morbidity and, compared to that, student health has been really refreshing. I almost never get bothered about not giving antibiotics. I almost never get whiny students. I have never had a parent call and complain. If you treat them like the adults they are and don't assume a snowflake complex, they are really some of the best patients I've ever treated. While the stressful stuff is sometimes complex, it occurs with enough frequently that there are systems in place to limit the confusion (though they are still exceptionally rare). You will still see medically complex things also (e.g. acute abdomen, neurological disorders, unique infectious disease from international populations, travel medicine, psychiatric illnesses, etc...). I imagine your mileage may vary, but don't go in with a bad attitude. 

Thank you for sharing that. Your description is what I’d imagine going into the university that I’ll be working at. I’m sure every college institution is unique in its own way, but I am looking forward to the challenge. With my background in orthopedics and sports medicine, they’re giving me a lot of the “reigns and autonomy” to manage those cases. I’m excited but the credentialing process really sucks. 

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Twelve years at a huge public university (all told 37 years as a PA)   We had every resource at student health (pharmacy, lab, PT, radiology, women's health, allergy, dental, sports med and optometry) in house.  The international students kept it a little spicy.  However, I got really bored.  Took advantage of tuition reimbursement, got a doctorate and now I'm teaching and not counting the hours.  Student health works well life-wise.  

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15 minutes ago, Jofriend said:

Twelve years at a huge public university (all told 37 years as a PA)   We had every resource at student health (pharmacy, lab, PT, radiology, women's health, allergy, dental, sports med and optometry) in house.  The international students kept it a little spicy.  However, I got really bored.  Took advantage of tuition reimbursement, got a doctorate and now I'm teaching and not counting the hours.  Student health works well life-wise.  

I’m in a similar boat as you. We get a lot of Asian and middle eastern international students who come to our school. I don’t know if we have optometry but we have everything else on board. 

Working in the ER as an RN the last two years has been a great experience, but it’s tiring coming home to a 2 year old daughter (with another on the way soon). That made this job slightly appealing tbh, at this stage in my life. What did you end up getting your doctorate in? One reason I’m interested in this position is the reimbursement. I figured I mind as well get the DNP with psych specialization for free and call it a day on school for good. 

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My doctorate is from the college of education in "Workforce Development and Education".  The emphasis was on adult learning and my cognates included use of technology for learning.  My researcher was on older health professionals adopting technology for their continuing education.  Bottom line re. topic - those who are willing to change are more willing to adopt technology. (that only took five years :)) And, for an incredible read of my abstract:

https://etd.ohiolink.edu/pg_10?0::NO:10:P10_ACCESSION_NUM:osu1542630929115933

My research cohort were my PA classmates which was a lot of fun.  

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On 9/20/2019 at 3:48 PM, 2234leej said:

Been practicing as an orthopedic physical therapist for six years and as an emergency department nurse for 2 years. This will be my first job as an NP. What’s up?

Lots of schooling would be an understatement. 

just trying to frame the question and what the background was as it is different (not bad) to have an NP asking job questions (whos is a DPT) on a PA board....

 

On the topic of schooling - yup many PA's have a LOT of schooling in the medical fields - it all helps in some ways but the hard medical knowledge of bug, drug and pathology is where the rubber meets the road....  atleast in my IM world.  Ortho might be very different.

 

As a first job out I would be hesitant to do anything except primary care, or surgical - you really really really need to burn in the knowledge, and learn new knowledge in the first few years out.  A front line job where you are inundated with pathology will really help with this process.   I went through the whole interview and negotiation for a college health job.  ended up turning it down as it seemed dominated by nursing  and the level of pathology was exceeding low.  There was a vibe that they were saving the world when in reality they we catering to a small sect of society which a pretty defined narrow field of practice.   I also started to get the sense it was far more political than I care to be.  I follow guidelines and don't really care if patients don't  agree (and most patients really like me so it is not confrontational), colds don't get ABX blah blah blah.   I just got the sense that due to a lack of pathology they seemed uncomfortable with even silly little things.  Just my sense of one college health center (it was one of the better state university systems and was undergrad and grad).

 

There is certainly some benefits to state employment that are huge (bennies and retirement) but it just seemed like a limited job..

 

I would say look into physiatry, or even ortho or rheum as those would really build on your PT and medical knowledge. 

 

 

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3 hours ago, ventana said:

just trying to frame the question and what the background was as it is different (not bad) to have an NP asking job questions (whos is a DPT) on a PA board....

 

On the topic of schooling - yup many PA's have a LOT of schooling in the medical fields - it all helps in some ways but the hard medical knowledge of bug, drug and pathology is where the rubber meets the road....  atleast in my IM world.  Ortho might be very different.

 

As a first job out I would be hesitant to do anything except primary care, or surgical - you really really really need to burn in the knowledge, and learn new knowledge in the first few years out.  A front line job where you are inundated with pathology will really help with this process.   I went through the whole interview and negotiation for a college health job.  ended up turning it down as it seemed dominated by nursing  and the level of pathology was exceeding low.  There was a vibe that they were saving the world when in reality they we catering to a small sect of society which a pretty defined narrow field of practice.   I also started to get the sense it was far more political than I care to be.  I follow guidelines and don't really care if patients don't  agree (and most patients really like me so it is not confrontational), colds don't get ABX blah blah blah.   I just got the sense that due to a lack of pathology they seemed uncomfortable with even silly little things.  Just my sense of one college health center (it was one of the better state university systems and was undergrad and grad).

 

There is certainly some benefits to state employment that are huge (bennies and retirement) but it just seemed like a limited job..

 

I would say look into physiatry, or even ortho or rheum as those would really build on your PT and medical knowledge. 

 

 

Thanks for sharing that Ventana. I originally wanted to get my PA license after working as a PT for a couple years (that's initially what brought me to this forum). After lots of conversations, discussions, research, etc., I ended up going the NP route. I enjoy the conversations that are on this forum, so I end up popping my head in every now and then. I appreciate the conversations here more than allnurses.com, which I am a part of as well. 

I'll probably end up doing a per diem/part-time family medicine job elsewhere. I do enjoy working with medically complex patients and I don't want to lose that skill (I'm sure there will be some patients like that as jofriend described, just not nearly as many). 

Honestly, my orthopedic/sports medicine knowledge has proven invaluable in primary care. 3.5 years of PT school + 1 year of orthopedic residency is far more training than PCPs get in MSK, and it has helped tremendously in my practice. To be honest, I didn't realize how many primary care complaints were MSK. While I can build on that knowledge, I became an NP so I could focus on other areas of medicine (i.e. family med). I thought about doing ortho and/or physiatry, but it's "more of the same," so to speak. 

You are right though: it is limited, and somewhat family-lite, so to speak. Nonetheless, the compensation, commute and reimbursement was hard to turn down. 

 

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10 hours ago, 2234leej said:

Thanks for sharing that Ventana. I originally wanted to get my PA license after working as a PT for a couple years (that's initially what brought me to this forum). After lots of conversations, discussions, research, etc., I ended up going the NP route. I enjoy the conversations that are on this forum, so I end up popping my head in every now and then. I appreciate the conversations here more than allnurses.com, which I am a part of as well. 

I'll probably end up doing a per diem/part-time family medicine job elsewhere. I do enjoy working with medically complex patients and I don't want to lose that skill (I'm sure there will be some patients like that as jofriend described, just not nearly as many). 

Honestly, my orthopedic/sports medicine knowledge has proven invaluable in primary care. 3.5 years of PT school + 1 year of orthopedic residency is far more training than PCPs get in MSK, and it has helped tremendously in my practice. To be honest, I didn't realize how many primary care complaints were MSK. While I can build on that knowledge, I became an NP so I could focus on other areas of medicine (i.e. family med). I thought about doing ortho and/or physiatry, but it's "more of the same," so to speak. 

You are right though: it is limited, and somewhat family-lite, so to speak. Nonetheless, the compensation, commute and reimbursement was hard to turn down. 

 

You and any NP's are welcome here on these boards anytime.  I enjoy the insight I get from them.

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9 hours ago, Cideous said:

You and any NP's are welcome here on these boards anytime.  I enjoy the insight I get from them.

I'd far rather chat with real NPs giving actual differing perspectives, rather than trolls who are fake PAs trying to stir up outrage against NPs.

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I work at a big-10 university health service. 

Overall I like it. It can suck during the school year I wont lie. But I'll most likely stay until my loans are paid or I leave the state. 

Pros:

  • Amazing summer flexibility and low volume. Summer here is May though September. We still see patients, but only 8-12 a day (easy), and we can take as much time off as we want. Some providers leave for 6 weeks.

  • Benefits. 6 weeks paid vacation (includes a week of CME), 2 weeks paid sick, paid paternity/maternity, 6 months ext sick and 6 months ext sick @ 50%. Excellent health insurance, dental/vision/legal, etc.

  • Good patient population. College students are for the most part healthy and easy to work with compared to the adult public.

  • Good autonomy and variety. It's primary care + urgent care with a college focus. So lots of sexual health, minor injuries, mental health (if that's your thing), URIs, derm, and some infectious disease.

Cons:

  • Endless colds from September to May.

  • Lots of hypochondriasis (whiny, cant deal with simple sx, every little tingle needs a diagnosis, etc. )

  • High volumes (20-30 ppd) in the school year

  • Overt political initiatives ( LGBTQ everything)

  • Parents sometimes get involved

Edited by BruceBanner
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On 9/23/2019 at 11:45 AM, BruceBanner said:

I work at a big-10 university health service. 

Overall I like it. It can suck during the school year I wont lie. But I'll most likely stay until my loans are paid or I leave the state. 

Pros:

  • Amazing summer flexibility and low volume. Summer here is May though September. We still see patients, but only 8-12 a day (easy), and we can take as much time off as we want. Some providers leave for 6 weeks.

  • Benefits. 6 weeks paid vacation (includes a week of CME), 2 weeks paid sick, paid paternity/maternity, 6 months ext sick and 6 months ext sick @ 50%. Excellent health insurance, dental/vision/legal, etc.

  • Good patient population. College students are for the most part healthy and easy to work with compared to the adult public.

  • Good autonomy and variety. It's primary care + urgent care with a college focus. So lots of sexual health, minor injuries, mental health (if that's your thing), URIs, derm, and some infectious disease.

Cons:

  • Endless colds from September to May.

  • Lots of hypochondriasis (whiny, cant deal with simple sx, every little tingle needs a diagnosis, etc. )

  • High volumes (20-30 ppd) in the school year

  • Overt political initiatives ( LGBTQ everything)

  • Parents sometimes get involved

Thanks for sharing your experience in student health. You definitely have really nice benefits. We have comparable benefits but I think yours are slightly better. We do get 2k/year for CME/CEU courses and education time off which is pretty nice (most offer $1500/year around here). I didn't even think about the variation in volume for the Summer, but that'll definitely be a nice surprise. 

How many students were on your campus? Our campus is ~20,000-25,000 and their high volume is usually 20s. 30 is quite a bit. 

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