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    A nurse is a nurse anywhere. You should not define nursing practice by tasks. Nursing is working in collaboration with health professions to promote optimum patient/people outcomes. Nursing can be practiced anywhere. I am a nurse who works in the ICU. I am not an ICU nurse. I have a license to practice where ever that may be and so do you! Don't let a doctor tell you that you will not be practicing nursing. The doctor is essentially saying that nursing is tasks when he says you will not be using your skills. There are leadership skills, assessment skills and, public health knowledge in your background, just to mention a few. In an office, it will just be practiced differently. Anyway, the doctor probably does not want to pay you with your experience and was steering you away. Be proud to be a nurse anywhere.! Cath
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    I have now been employed in a physicians office for 6 years as an RN. Previously I was
    employed in critical care units of the hospital (burn unit, IMCU, L&D) to name a few. The
    physician you interviewed with is accurate in saying your patient care hospital skills would
    not be all utilized. However the challenges are many. It depends on the type of practice
    your are employed in. Nursing is not just technical skills in action. Skill physically is
    learned. Nursing is cognitive . Office Nursing is a real test of a nurses foundation. Also it
    is a must to respect the philosophy of the MD's practice you work in. Ultimately your
    excellence in Nursing complements his Practice. You are employed by the MD not a
    hospital any longer. With managed care in constant motion more pts. are presented in the
    office setting sooner due to earlier discharge, chronic medical care, medication
    dependence and health maintenance. The full picture become much clearer. The business
    end reminds me I am happy I am the care giver and not the billing clerk. It is essential you
    are a independent learner and stay current.You must be aware of NQCS,OSHAand the
    Nurse practice acts. You will be the orchestrate of HMO site reviews. All national and
    state standards that must be meet in Hospitals also hold true in the MD office. Patient
    teaching is the stepping stone in pt. compliance thus you need to communicate appropriate
    information. Your pt load is no longer 10-30 pts. It is now 1,000. You need to be
    equipment literate. Stock keeper. Organizer. Triage skills and confidence in execution of
    appropriate judgment is in the fore front. I have 3 children .I enjoy holidays weekends and
    my husband. I especially love my work. I work in a OB/GYN office. Your work is what
    you make it. If Nursing means Ventilators, Monitors, IV pumps, CVP readings and BLD
    gases STAY IN THE HOSPITAL.
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    I left the hospital post op floor 16 years ago to work in an OB/GYN practice. I now am the teamleader of 14 nurses in this 7 man, 4 NP, 3 midwife practice. Best move I ever made. Here we have patient teaching, psch support, you really get close to some of these patients. You get out of nursing what you put into it--no matter where you practice! Good luck !
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    I spent four years working in Med/Surg, Telemetry, and O.B. while I also began my family. After my third child, I decided things might be smoother if I took an offered job at a pediatric clinic, and from there went on to work for a G.P. in solo practice. While both positions paid a lot less than I'd been used to, I learned so much! Office nursing allows one to develop skills that are untapped in a hospital setting - telephone triage, patient education, health program development. While hospital nursing keeps those clinical skills up to date, leadership and management skills can come forth here. Ambulatory care adds another dimension to a resume, too, emphasizing people-skills. I spent a total of 8 years in out-patient care and came to the conclusion that I was better suited to nursing outside of the hospital. Because of that experience, I decided to get into an RN to BSN program and then continue on to become an FNP. So today, I'm working part-time, attending classes and raising a family. I commend you on your consideration of a job change; I think that you'll never know until you get in there; and if it turns out to be something you don't like, there are always re-entry programs to brush up on clinical skills. Good luck to you and I'm interested in knowing what you decided! Meegan
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    I have been an RN for 20 years. I am in my last class at GMU for RN to BSN. I have worked in office nursing since 1981. The last 5 years have been spent as a Nursing Supervisor in two large Primary Care Practices. Office nursing is actually one of the most autonomous fields in nursing there can be. The practice I work for encourages all of my nurses to act as independently and autonomous as possible--during assessment, doing treatments, having the patients fully prepared for the provider to see. While some of the more technical skills are not utilized, the skills of assessment, critical thinking, patient education are utilized to the fullest possible extent. One of the best parts of office nursing is the continuity you share with the patient base, and really knowing the patients, and them knowing you. Office nursing is very rewarding, and very challenging. No two days are ever alike. We even have a nursing ladder system so that nurses can advance as they show leadership skills and act as role models and preceptors for new nurses coming on board. We do case management, nurse education in diabetes and asthma, and carry a full nurse schedule for quick streps, UTI's in females, pregnancy tests, and other procedures that can be carried out by nursing under physician standing orders. The schedules are great--the one drawback is that the pay is not as high as working in acute care settings. But there are a lot of rewards and satisfaction that go into working in this setting. I would encourage you to try it.
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    Hi Snoopy!! You really love your job, don't you!?!?! I commend your field of choice! I have a few questions...your nursing schedule for rapid streps nad UTI's etc...does your area HMO's have a pay scale so the the practice gets reimbursed?? I feel very limited in my practice because my schedule only includes injections...I cannot even do a BP check and have the office get reimbursed!(at least that is what our billing girls say...) Also..when you do pt teaching...again, how is the practice reimbursed? How far do you go in the initial assessment phase....I am the only nurse in this small practice of one MD and one NP and the other girl in the back with me is a med assisstant---our roles are extemely similar and I am looking for ways to convince the MD to utilize my nursing more effectively-----That usually includes making sure that he is reimbursed for the time I spend with people!! Because of the lack of reimbursement, I cannot even do a suture removal anymore!!! He has the NP do it, so that we get reimbursed! If you have any ideas, please let me know!!
    Thanks..Mary in Rochester, NY
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    I am an LPN and have been an office nurse since 1985, and have loved every minute of it! For the last 3 years I have been an office manager in our Rural Health clinic in Kansas. It's true nurses in a physician office don't always get to use their nursing skills they learned in school, like you would if you worked in a hospital, but nurses are nurturing people, and people skills are very important also today in the continuous change in the medical field. The office where I work has 3 physicians, 1 nurse practitioner, and 2 physician assistants. We have our main office and 3 satellite offices, which can be a scheduling nightmare, but we are available to our patients when care is needed. It's important to have a good patient/nurse relationship, because patients rely greatly on the nursing care they receive in the office. It's a joy to see a patient return to the office for a re-check for a condition that required changes in medication, and seeing that the treatment really made a difference in the health of that patient. The paperwork demand is growing, and Managed Care is putting more demands on us every day, but patient care will always be the most important aspect in the office setting, because if it weren't for our patients, there wouldn't be a need for an office. And it's surprising how much the medical providers rely on the nursing staff to hold their day together for them!

    [This message has been edited by Richelle (edited 10-16-98).]
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    WOW some smart nurses out there finally.
    But come to Massachusetts and you will find there is no such thing as an office RN--except maybe for a large HMO. The last HMO I applied to said they had not hired a nurse in almost three years!!
    I am so glad to see that someone out there does not put us office nurses down.


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