One nurse for three busy providers. This can't be safe, right?

Specialties Ambulatory

Published

  • Specializes in Clinical Documentation Specialist, LTC.

You are reading page 4 of One nurse for three busy providers. This can't be safe, right?

klone, MSN, RN

14,790 Posts

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

Dear, for the love of your sanity, you need to find a different job. I LOVE my clinic job, and it saddens me to see another nurse at a poorly run clinic burning out so soon. You've been given an impossible task, and you've been set up to fail. You deserve better than this.

LTCNS, LPN

623 Posts

Specializes in Clinical Documentation Specialist, LTC.
Dear, for the love of your sanity, you need to find a different job. I LOVE my clinic job, and it saddens me to see another nurse at a poorly run clinic burning out so soon. You've been given an impossible task, and you've been set up to fail. You deserve better than this.

I've been sending out my resume' and applying for jobs on my lunch break. I never thought I would hate working in a clinic so much. I know they're not all like the one I work in, and there are some really good ones out there. I just need to find the right one. There is a new clinic that just opened up right down the road from where I work. I plan to walk in there on my break tomorrow and apply.

I'm done. I will go to work and do my job and take care of the patients, but I have nothing for the supervisor or my co-worker. As soon as another opportunity comes along I will be out of there so fast they won't know what hit them. I hate to say it and I know it's unprofessional, but I probably will not even give them the courtesy of a two weeks notice. Why should I? I am not given the courtesy of having help, and obviously my license doesn't mean squat to them.

klone, MSN, RN

14,790 Posts

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

I don't blame you in the slightest. My thoughts are with you. I look forward to your post, telling us about your fabulous new job. :)

LTCNS, LPN

623 Posts

Specializes in Clinical Documentation Specialist, LTC.
I don't blame you in the slightest. My thoughts are with you. I look forward to your post, telling us about your fabulous new job. :)

Thank you. I look forward to it too! :D

pfchang

370 Posts

I know you need to leave but you don't have another job yet, and like most if us, probably can't quit until you have another job. I would makeN appt with that supervisor and SHOW him/her what you have told us. Show him the stack of referrals, call backs, lists of patients waiting for triage. Ask him to triage your work, while telling him you can not or will not work overtime to get it all done. This sounds unsafe. Do you have patients with chest pain waiting for a callback? Are any of the referrals for urgent issues? Everything thing else stops for a walkin with SOB and chest pain. What the hell does everyone else do your clinic?

I am ****** for you and worry about your license.

Oedgar

248 Posts

Specializes in peds, allergy-asthma, ob/gyn office.

70 referrals? That is overwhelming. I hope your situation eases soon. Please keep us updated.

LTCNS, LPN

623 Posts

Specializes in Clinical Documentation Specialist, LTC.

Unfortunately, I do have to wait until I get another job before I can leave the clinic. There is no way in heck I would've returned today if I had a choice. I am completely and fully fed up. The NP I work with really wants me to stay, but she knows it's just a matter of time and has told others she wouldn't blame me if I just walked out.

None of the call backs are urgent. They're mostly for lab values and med. refills, and any c/o chest pains are sent to the ER. If a patient walks in with chest pains, they are sent to the ER. Most of the referrals are not urgent, but the NP marks almost every single one with a red exclamation mark, meaning do them ASAP, as in within 24 hours.

klone, yes, I have, as of today, more than 70 referrals. On the rare occasion it's a slow day I can knock a few out, but on the average day, I'm only able to do 3-4 per day. Everyday the NP makes referrals, sometimes up to 6-7 per day so I can't catch up. If they would hire a nurse to do referrals and return phone calls and call pts. with labs, that would be great, but they don't care.

Most of the referrals are made for patients who have no insurance, so they have to go through a process which can take 4-6 weeks, but who do you think gets the abuse from the pts.? And who do you think gets questioned about referrals I haven't been able to get to? I have referrals that go back a month because everytime I start to make some progress, more referrals are piled on. I Just cannot catch up. Oh and the pet nurse? She is down to 19 referrals because the CM lets her take the time to do them. I have literally begged to have just one day to get the numbers down but it just is not happening.

On a good note, I have an interview next Monday with a Home Health agency doing skilled home visits. Now I need to think of an excuse to extend my lunch break. Any ideas?

pfchang

370 Posts

Where is the supervisor? Why is the CM letting the other nurse get referrals done and you can't? Is the case manager a supervisor?

None of this makes sense to me.

Tell them you have a doctors appt for Valium for anxiety caused by working there. Lol. Seriously, say you have a doctor's appt or better yet, call in on Monday and take a walk before your interview.

LTCNS, LPN

623 Posts

Specializes in Clinical Documentation Specialist, LTC.

Oh, and what do you all think about this? We have quite a few pts. who come in for STD testing. Quite often they come back positive and the nurse has to tell the pt. Then the pt. gets upset and starts asking all kinds of questions that I personally believe the provider should inform them about, but the provider does not get involved. Am I wrong in my thinking? I know we can report lab values to the pt. and educate, but shouldn't the deeper, more technical stuff come from the provider? Like treatment options for example?

LTCNS, LPN

623 Posts

Specializes in Clinical Documentation Specialist, LTC.
Where is the supervisor? Why is the CM letting the other nurse get referrals done and you can't? Is the case manager a supervisor?

None of this makes sense to me.

Sorry for the confusion. The clinic manager (aka the supervisor) does not have a medical degree of any sort so he has no clue, and the other nurse gets to work on her referrals because she is, to be honest, his eyes and ears and keeps him informed. In other words, she tattles and kisses up. He lets her do whatever she wants. The whole clinic sees it.

Honestly it doesn't make any sense to me either. The chaos and disorganization is legendary.

missnurse89

107 Posts

This is almost exactly the same situation I was in 2 years ago. I tried to stick it out. Made it one yar and just couldnt anymore. I was so fatigued by the end of it all. I voiced my concerns for patient safety more than once and was told it would be fixed. It never was. An office or clinic is a very busy place and not everyone realizes this! I was busier in the office than I ever was in the hospital. And being thr only nurse for 3 drs? I can't even imagine!

We worked from 8 and saw last patient around 8. In between I had to check and return calls, find time to discuss some calls with dr, do prior auths (yuck), perform skills, triage every patient every 30 minuted plus work ins, walk im for b12 *****, testosterone, vaccines, and have everything my Dr needed for the visit or he would get upset. And prep for procedures and assist. Take calls from the hospital or other physicians, pharmacies, working in patients, calling to admit OB patients or other patients, clean up after work. Cleaning, packaging and autoclaving our tools so we would have them the next day. And did I forget to mention sorting through labs and reporting critical s, taking critical from lab over phone, I hardly ever ate lunch due to no time from trying to catch up and ended up losing weight unintentially. It was madness! I so feel your pain. There is no way one nurse can or should be expected to handle that SAFELY. I had no training for the job. Thrown out on day one.

I finally realized that I was just a tool to them and not appreciated. I know every situation is different. My best advice to you is to start searching for a different position. I know how much you would rather try to make it work. But if you are feeling like they are not working with you or being attentive to your concerns, than that is no place to work. You so not deserve to be miserable. You are a nurse and deserve to be valued. I am so sorry you ate going through this. I hope you find a better position where you are more appreciated because you certainly deserve it.

missnurse89

107 Posts

And the providers usually will try to get by on minimal nurses because that's less money they have to pay out. Thays why yoi see mostly MAs in clinics and not RNs. Drs have bills to pay too plus the clinic expenses and minimizing expenses is a must. It's sad by true.

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