What do you do?

MzMouse · Sep 27, 2007

I have worked for two different general surgeons and occasionally for a plastic surgeon in my seven years as an office nurse. As I worked with them and they became comfortable with me and my abilities I started trying to do little things that make their job easier. The surgeons I work for are all very willing to pull their own drains, remove staples and sutures and even do dressings. But why should they when I am very capable and can free them up for other things?

I also do a lot of patient teaching, both pre-op and post-op. Don't me wrong; a lot of information needs to and does come from the surgeon. But there is tons we can teach patients that the docs simply don't have time to do.

I just try to be in tune with what is causing them stress and dragging on their time and see what I can do to help.

Hope that helps.

Daye · Sep 27, 2007

Anticipate what additional forms the doctor might need ie; lab reqs or other diag. tests and have the forms handy for him if you can tell by the pt c/c.

I have become familiar w/the other doctors (back linephone #'s) that he likes to refer pt's to set up appt, for instance we have a lot of referrals to GI, OB/GYN, Endocrinologist, it is repetitive enough to know who he likes.

I take a lot of pt questions, requests for Rx refills, test result questions and so forth via e-mail and phone this creates a log for documentation, w/which I can pass along info to my doctor of developments.

Call facilities ahead of time to request results if we don't already have them so during pt appt w/the doctor they can go over the results.

I do a lot of pt education. Pt that are having a lot of issues and difficulities often I get e-mail's daily or weekly or whatever so I am available and supportive and it help's to get some accountability if the pt ha been given an assignments.

If there is some kind of procedure ie; drain tubes dc'd or wound packing or dressing changes I do that or have everything ready to do in the event it might be dc'd.

I do a lot of paperwork for FMLA and RN level physicals,

Draw labs if they are having them in the office instead of at a lab.

Of course there is always a lot of documenting to do, ordering supplies, and a bucket full of tasks.

We are always so busy I always have a hugh pile on my desk to take care of, the time just flys by!

I love it.

I hope you are enjoying yourself working there.

santhony44, MSN, RN, NP · Sep 27, 2007

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.