In my new job now....question about Doc/nurse ratio

  1. Okay, maybe I should have known this was coming.

    I just finished my first week in my new job. I went from a pediatrician's office, seeing one patient every 15 to 30 minutes, the pace was slow and steady and the work was great. I'm now in a family practice with 5 (and as of Tuesday 6) doctors...4 are on duty all the time, 3 family practice, 1 walk in and me. I'm responsible for the family practice and to help with the walk in when I can. I run like a fool from the moment I walk in at 8:30 until I collapse for lunch and then start all over again until quitting time at 5. I'm expected to take care of all the physicals, well baby visits, needles and some procedures.

    I like the work. It's interesting and I'm doing things I've never done before.

    But I'm wondering, is a nurse/doc ratio of 1:3 or 1:4 common in family practice?

    If so, tell me, how on earth do you prioritize? How in heaven's name do you keep from feeling bad because you can't do two physicals at the same time?

    And do you ever get used to the pace?

    Either I'm not suited for this kind of work or I was terribly spoiled in my last job.

    I hope it's the latter!

    Laura
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  2. 9 Comments

  3. by   Nurse Ratched
    I am responsible for 1 doc and 2 NP's daily. There are also 3 more part-time NP's and 1 part-time doc, one of whom is there all the time, so I guess I average four providers. This is the only job I've had in an office, so I don't know any better. It seems like a lot more humane load than the hospital lol.

    I suspect you'll develop your own style and do just fine. I try to do a first in/first out thing and take care of folks that way unless there's an acuity issue. I apologize when people have to wait a little bit, and if the nurse on the other team isn't totally swamped I'll ask her if I get to drowning (altho it sounds like you are it as far as nursing staff - are there aides there - is there anything you can delegate so you are freed up to do some things?)
  4. by   laurasc
    Well, you are right, it IS more humane than the hospital. Man, I wouldn't go back.

    I'm just finishing up my second week and I think I'm beginning to get used to the pace. I don't come home completely exhausted anymore. The receptionists are really good there. They've worked without a nurse for so long that they know what to do and really help me out. If I'm busy with someone then they call in the next patient.

    Now all I need is to beg them for a little tiny space where I can sit and do my paper work. As is I have no place to sit unless I use one of the doctor's desks.

    Laura
  5. by   Nurse Ratched
    Glad to here things are looking up!

    Starting a new job is ALWAYS rough, no matter how great it is.
  6. by   laurasc
    I've been there for 8 weeks now and am officially looking for work...ANY work and FAST. I still like the work, it's interesting and challenging. I'm building nice relationships with the patients. I like the doctors as well. But the whole working environment there stinks! I don't sit down at all during the day except for my short lunches. I asked the docs for a little desk with a phone so I could sit down and do my phone work and they said no, there's no room. So I have NO place to sit during the day. Because of that I have severe plantar fasciitis in both feet and half the time I have a hard time working.

    Add to that there's one receptionist there who decided she absolutely hates me and is causing me a lot of problems. Of course, she's the one who rules the roost there and is seen as the cat's meow by all the staff but me. I'm responsible for keeping between 6 to 8 exam rooms filled and moving in a clinic that sees anywhere from 15 to 25 patients per doctor per morning!! I rely on the receptionists to bring in the patients when I'm busy elsewhere. Unfortunatly lately that's all stopped. I've complained but was told that they are "too busy" with their own work. (what's too busy, they do that anyway when I'm not there on Fridays!) They've also taken to not pulling all the charts so I waste a lot of time pulling the charts (which is always faster than waiting for them). The whole atmosphere in that place is very oppressive.

    My hubby says I've been miserable lately, and I guess I have. I need to find something else but right now office jobs are rare. I'm going to go back to my old boss and talk to him, he hasn't replaced me yet, so he may want me back. If not, I'm not sure what I'm going to do.

    It's too bad really, that job had a lot of potential.
  7. by   Nurse Ratched
    I'm so sorry it's not working out. I presume you have made the docs aware of the degree of your concerns about the job. If you've talked to them and aren't getting anywhere, then you've done all you can. Toxic co-workers just dig their own grave - now they'll be without a nurse and have to do it all all the time again.

    You mention going back to your old boss. Make sure you review whatever the reasons were for leaving there in the first place to make sure you aren't going into another crummy situation.

    (((laurasc)))
  8. by   susanmary
    I'd talk with the physicians before I leave -- you are being set up to fail. If they won't accommodate you, I'd give your notice ... even if you don't have a position to go to. You've been given good advice -- think hard about why you left your first job before you go back. Can you take some time off -- look around -- job shadow a bit? Can you work for an agency -- they fill nursing office positions -- you have experience -- advocate for yourself. It's not all about the money -- although you are NOT a volunteer at work. You are an employee and deserve to get paid appropriately. It IS ABOUT safe working conditions -- it is your license and your well-being -- both mental and physical.
    This is your life. You have choices. I wish you the best of luck -- I'm also at a crossroad in my career.
  9. by   laurasc
    Thank you for your support and advice ladies.

    Regarding talking to my doctors, I already have talke to them and nothing has changed.

    Ladies, this has gotten so bad that I'm starting to get anxiety attacks....something I've NEVER had in the past. The worst part is that there aren't many nursing jobs in the area and I have to work because I'm the one supporting the family right now. Hubby is in school until end of October.

    As for why I left my old job....I wanted to try something new and exciting. What a big mistake that was!

    I'm sorry if I sound like I'm whining. I'm not a whiner normally, but this whole situation has really gotten for and I am literally hanging on by my fingernails and lots of prayer.

    Laura
  10. by   Nurse Ratched
    You're not whining, Laura. It's an awful position to be the breadwinner in the family when you hate your job.

    Have you had a chance to talk with your old boss yet?
  11. by   NURSEFLA
    I am definitely not one to give advice on THIS subject but if
    you feel a need to vent, please email me and we can compare
    horror stories.

    you can email me at inozip@hotmail.com

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