who does the lab and x-rays in your office?

Specialties Ambulatory

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I may be starting an office job soon...my duties will include doing lab and x-ray. Other than accu-checks, I have never done these as I have worked in a hospital 25yrs. Does anyone out there do these in an office? Is it difficult? Makes me nervous. I like to learn new skills but still get nervous. Thanks

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I have worked in several different physician offices. In some offices I did as many as 15 venipunctures a day. ( Internal Medicine and a Lab happy doc) Currently I do not draw blood.

You mentioned that you like to do new things so you will do fine.

Just view it as a skill.. practice practice and more practice

Before you know it, you will have mastered the skill

You will start sizing up each patients arms or even checking out the veins on your waitress.

Like most nurses, I find myself looking at arms and thinking ahh..easy target I could hit that one blind or darn I bet those veins roll etc. etc.

(I have no input on the Xray as I never had to do those.)

The office I worked in while doing venipunctures sent us to the hospital lab for a day..We were able to stay with a lab tech and learn some tricks from the lab phlebotomist. It was worthwhile

What specialty area are you going to work in?

I wish you good Luck... Office nursing is GREAT!!!!!

Joy and Smiles *DARLA**

Remember** Life is a gift, value your self and respect others!;) ;)

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Darla..thanks for your reply. I appreciate the information. The office is general practice. The particular doctor I will be working with likes doing lots of procedures. The office manager realizes I have not been doing these particular procedures but doc is willing to show me how. I am familiar with venipuncture as I am IV certified but have no idea what to do with blood once obtained ha ha ha. Hopefully will get adequate training before let loose on the unsuspecting public. Sounds like my days will go fast. Have not had any of the thanksgiving holiday off in 6 yrs! Looking forward to no holidays. Thanks again for your reply.;)

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Greetings!

To be on the safe side, I would check with either your state BON

or with someone in the state department that regulates your xray

equipment about who may perform this function. You may be surprised to learn that you may be exceeding your scope of practice. Not a nice thing to find out when a lawsuit happens.

Good luck--office practice is a lot of fun!

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So you are comfy with the venipunctures.. that should make it easy for you.

It won't take long and the terms tiger top, lavender top and blue top won't mean the color of your favorite sweater.

Willl you have to do ICD 9 codes for the lab?

For me, coding is time consuming but I have a great cheat sheet.. "Rapid coder" so now when the doc tells me order a magnesium for the CHF patient I know 428.0 is the code or PT/INR I know 427.31 is Afib and V58.61 is monitor long term drug therapy and those # need to go on the lab requisition.

At first.... I really disliked all the number managemant but it is easier as time passes. I get a little testy when he gives me more obscure diagnosis that requires some sleuthing.

But my doc is always willing to help me find a code. We also have a great computer program callled Encoder..much better than the old ICD 9book. I like to click the mouse and get my answers.

I am sometimes surprised at the role insurance plays in the office....all that coding is just so the insurance will pay and occasionally patients get ticked off when labs are not coded to their satisfaction.

Tonight I had a phone call from a woman asking me to "change the codes" on her husbands lab work so her insurance would pay. I gently told her the doctor determines the diagnoisis for the blood work and I cannot control the insurance. I just have to shake my head.

Enough of that....

What hours willl you work?

We have wed afternoon off.. and then run late clinic on Thursday..I love the afternoon off in the middle of the week.

And Yes Canna ..no more holidays spent running up and down the hall starting IV's, turning off alarms, passing meds, emptying bedpans, flipping patients etc etc etc!!

The relationships you develop with your pateint population in the office will become special!!

I better close .

Again I wish you Good Luck!!!

Joy and Smiles *DARLA**

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Thanks again Darla! When I saw the term ICD9 codes..I went huh? ha ha I have a lot to learn! Have not started just yet but our days are Tuesday-Friday...every other week we work 1/2 day on Mondays. The clinic is owned by local hospital so we get same benefits that they have there..sick time , vacation time , insurance with their group rates..we can pick up overtime if we want it by working our days off at the hospital. The dr is really nice..he is heavy into procedures...I like that...and the other nurse is one that i have worked with b4 at our hospital. I just hope nothing happens to job slot at last minute. If someone from the hospital that owns them wants this job..they have to give it to them. So far the administrator and dr want me..said they were real impressed with my credits and references. I have to wait one more week to make sure no one at hospital wants it. very few ppl want to lower their salary this much except for reasons like me. My salary will decrease by 4$ /hr. I don't care anymore and neither does my husband. He wants me home.:D

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Let me know when you start

I also took a pay reduction when entering the office world.. but the hours and homelife make up for the paycut!!

It is great that a seasoned office nurse will be at your side.

Procedures are one way physicians can make money in the office

These facts may surpirse you as they did me..... I did not realize procedures done in the office garner more money from insurance then the office visit itself.

EG: Dr orders an ECG which he spends two minutes interpreting and the insurance pays about 75.00..on the other hand the Dr. spends fifteen minutes doing an exam, making med adjustments and the insurance pays only $36.00. It is a messed up system.

Procedures can be fun... and I bet you will love the one to one interacatoin with your patients in the office.

keep in touch

Joy and Smiles *DARLA**

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Originally posted by canna42

Thanks again Darla! When I saw the term ICD9 codes..I went huh? ha ha I have a lot to learn! Have not started just yet but our days are Tuesday-Friday...every other week we work 1/2 day on Mondays. The clinic is owned by local hospital so we get same benefits that they have there..sick time , vacation time , insurance with their group rates..we can pick up overtime if we want it by working our days off at the hospital. The dr is really nice..he is heavy into procedures...I like that...and the other nurse is one that i have worked with b4 at our hospital. I just hope nothing happens to job slot at last minute. If someone from the hospital that owns them wants this job..they have to give it to them. So far the administrator and dr want me..said they were real impressed with my credits and references. I have to wait one more week to make sure no one at hospital wants it. very few ppl want to lower their salary this much except for reasons like me. My salary will decrease by 4$ /hr. I don't care anymore and neither does my husband. He wants me home.:D

Hi Canna,

I, too, will be starting an office job and losing about $4 an hour. And my husband and I have had lengthy discussions about this. In the long run, everyone wants me home at night and on weekends/holidays. I hope it is worth it and I hope I love my job. I'm going to be in a pediatrician's office, somewhere I never imagined myself! But I plan to make the most of it. It will be just me and another LPN, so I think I will get lots of learning experience. Plus, I get to eat dinner every night with my family! :D

Good Luck,

Laura

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I had worked in pediatrics for the first 15yrs of nursing. You will love it! Children are so honest and tell it all ha ha ha. Grandma's can be scarey at times though (for real ! ). So far I have not heard final word. The office was closed Monday. I am hoping yesterday they interviewed the other two. One way or the other I wish they would call today and let me know. The suspense is killing me. I am like you...would love the hours to be with my family. I will be so depressed if I don't get this one. Best of luck to you..let me know what happens. Darla has been a great source of information to me. Good luck!!!

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Canna, make sure you let us know what happens, okay? Put me on your buddy list if you want. Good luck!!!!

Laura

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Laura thanks..I added you to buddy list..not sure if I know how to use it though ha ha not very computer literate. Just got home from work..was a long 12 hr nightshift. Hope they call this morning but I am not going to hold my breath.Let me know how to use this buddy thing please! Canna:eek:

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Laura just wanted to say I start my office job Nov 12th. I turned in my 2 weeks notice Friday. Have done the drug screen and signed the tax papers already. Looking forward to first week even though I will probably be all thumbs!! Lots to learn but I am excited about that part. Have done 25yrs of hospital...time for something new. Have worked nightshift for those yrs so I also have to get use to day hours..whew...lots of adjusting but worth it. Thanks canna42:D

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