[Downthetube]

I have been in nursing for 29 years, the last 15+ in an Internal Medicine practice.The practice has 2 providers. I worked for one Dr. for 15 years. Because of health reason's he has decided to cut back on his practice.

His partner hired me after his nurse moved 6 mo. ago. To make a long story short I went form a busy practice, to a very busy practice. I am enjoying the change.

My problem is the front deck staff. They think I can take every phone call that comes in. This doesn't allow me to do the unbelivable amount of paper work that piles up. I have asked them not to interupt me while I am with a pt or working on form, unless it is a TRUE emergency. I did this with office manager present and she is backing me but the front does what they want.

Any suggestions.

Thanks

[pagandeva2000]

Managers at the front desk are interested in bringing in the dollars while nursing is interested in safe patient care...the two do not mix. I work in a clinic in a hospital and we constantly fight with our clinical manager, who will slam things down nursing's throats because they are interested in numbers and don't have a license to protect. An example of this is that we do not have any physician with us on Wednesday mornings and we do not schedule PPDs for that reason. We also try not to schedule PPD readings after 3pm for the same reason. However, they still schedule patients to come in at times when we cannot obtain an order for a CXR and LFTs for these positive reads. It is easier to get the patient to go for the XRAYS and blood work at the moment they receive this news rather than tell them "Yes, you are positive, now wait 3 hours for the doctors to return or come back tomorrow so that we can have your CXR and bloods ordered". Our patients live in a poor community and it is not likely that they will return. But, they don't listen.

Other times, if the clinical manager sees me in the office alone typing in our computerized charts, she will just drop a patient in the seat before me without seeing if I am ready for them. I told her several times that charting is just as important as seeing patients; she does not know if I had a complicated experience that has to be charted accurately, or I was viewing a chart before calling in another patient before this one she so unceremoniously dropped before me. I HAVE to review a chart before calling a patient, and for some, there are things I need to get together before calling them. I may see that a doctor ordered a medication like Keflex when they are allergic to penicillin or see that a patient who has in the chart that they are allergic to chewable aspirin and need enteric coated-all of these mean that I have to go back to that doctor and have him change the prescriptions (preferably before I get the patient before me). This isn't good enough for her, but it is MY LICENSE we are speaking about, here, and patient safety.

I can't tell you what to do per say, because I don't know the personalities, however, I can say that in many cases, people do not realize the implications these things mean to the nurse. I let them know, and I have stopped them in their tracks on quite a few occasions when I see the possibility of a mistake or an error if I am bombarded upon.