Re: What do you do?
I'm a FNP, so maybe I can speak from the provider's perspective.
The two previous posters both gave good advice and sound like good people to work with.
Stay ahead of the provider. If there are labs to be reviewed with the patient, then they need to be available. If the patient is in to follow up from the ER, then have the ER notes available if possible. If you know or are pretty sure that certain labs or studies will be ordered or that a referral will be done, then have that paperwork ready. If it's a diabetic patient and the feet will need to be checked, then have the patient remove shoes and socks. If you anticipate the patient will need immunizations, have your paperwork all ready.
Keep the exam rooms stocked with whatever may be needed. It's annoying and frustrating to have to run around looking for supplies, especially things like gloves, culturettes, ear speculums, and so forth.
If the practice is still using paper charts and lab work regularly shows up for the physician to review, it would be helpful to have non-routine ones on top to be taken care of first. That goes for x-ray reports, etc as well. Non-routine: the C&S came back and the patient needs a medication change. Routine: the pap smear is normal.
If you think a patient might need to be looked at sooner rather than later, then point that out to the provider. "Little Johnny is in room 3; he's wheezing and his sat is 90%." It doesn't matter that Mrs. Smith in 1 is technically "next" according to the schedule, Johnny may be more urgent. And, if you know that there's a high likelihood that he'll be getting a nebulizer treatment, have everything set out and ready.
Learn how and when to interrupt the doc; don't make it standard practice. It drives me nuts to be interrupted while I'm trying to write out scripts and make brief notes. I lose my train of thought and forget things. I also don't like to be interrupted while I'm in an exam room with a patient unless it's urgent or it has to do with that patient. If I finish with Mrs. Jones and she waits until she's out the door to come back with "by the way, I need a refill on my med" then she needs to just sit and wait until I'm free. Don't interrupt me in the middle of seeing the next patient, or of writing out that patient's scripts, to sign her script.
Try to get things like referrals done as soon as you can. Prioritize your work, and help the physician prioritize his.
Leave your cell phone off if possible. Limit your personal business. I understand family stuff, but be reasonable about it.
Where you distinguish yourself from the non-nurses? It's the thought process, the prioritization, the picking up on little things: knowing that the wheezing patient might need to be seen before the routine patient, no matter who got there first; knowing that the patient's C&S indicates that the med needs to be changed and being sure the doc sees that result ASAP; knowing that the lab with the low sodium or high potassium or low hemoglobin needs to be looked at before the semi-annual lipid panel; knowing that the potentially very sick patient probably needs to be seen earlier than 15 minutes before closing time; knowing what's likely going to be needed in a particular situation and having it ready.
Having a good office nurse is a wonderful thing.
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