SoundofMusic 11,098 Views
Joined Apr 7, '07.
Posts: 1,028 (55% Liked)
Just started in a primary care office in Maryland. Often, patients under 18 are coming in without parents, and without any sort of parental consent form on the charts.
Coming from the Minute Clinic environment, I always thought kids had to be accompanied by the parent. I realize this is not true for teenagers seeking birth control, pregnancy testing, STD testing, etc .....but for routine medical visits, shouldn't they be accompanied by a parent? We get a lot of the school physicals also being done without the parents of the older teenagers. To me this can be fraught with issues when kids are unreliable historians, uncooperative, clueless about their family history, etc.
Looking at our state consent laws, it's very confusing.
I'm finding lots of trouble with parents not present during these visits ...
Right -- I think that over time, as an NP you will catch up simply due to experience in practice, but it's very tough at first.
I don't know -- everyday I wonder if I should just hang it up ...I'm just four years into it, spent 3 in retail, and now during my first year in true primary care, I get easily overwhelmed and am often in a state of panic and/or sheer terror. However, it is pretty cool to write those orders and do that follow up, especially if your treatment helped that patient. Really nice when patients like you, want to come back to see YOU personally, and to see how much they believe in you.
Also nice to have nurses to help you, especially if they know what they're doing. Nice to not have to do the grunt work anymore .... nice to get a smidgeon more respect from patients than you did back in the days of nursing. Nice to work with a great doctor, which I do work for, and to collaborate and/or discuss cases with him. Nice to have weekends off finally. I'm still balking at having to wear street clothes, however -- just wish they'd let me wear scrubs and a lab coat ....which they won't.
And I guess the money is better ....but you sure work hard for it. I feel NP's should get paid far more, and I also think doctors, should also get paid far more than what THEY do. We're all so pitifully underpaid considering the work we do, and the responsibility we hold.
Oh gosh -- I'm relatively new in the field, but still have not really seen one who seemed to have the ability to effectively really manage, and who just did not seem untrustworthy and smarmy. The one I have now does a lot to make my job easy, but also CONSTANTLY cracks the whip on us in terms of patient volume and a host of other things. She just seems to always be lurking . .... right around the corner, ready to pounce if she sees something out of line. And it is tough at times taking orders from someone you KNOW has likely half or a third the education you do and truly has no understanding of how hard your job is. That said, yes, it's their job to keep the office running at a profit so we can all get paid ...
The one I have now is already driving me crazy. She seems to draw you into her conflicts with others, which is ridiculous, because she doesn't seem to have the balls to stand up to the people whose behavior she wants to correct. She wants everyone to just keep their mouths shut, keep their heads down and do their job .... but it's just so unrealistic. There will always be a little bit of gossip in any office ...will always be a few moments here and there where people who are constantly hustling will sit back and slack a little. There will always be patients who take up a huge amount of time, and there will always be times where you just fail to perform perfectly. This one seems to look at us providers as if we are cattle ....she ALWAYS comes to talk to me during my lunch hour about SOMETHING ....which makes me mad ...I NEED A BREAK ...even just 15 mins to clear my head before the next session ... but she will never leave me alone during this time .... just wish they could view us providers as people/humans who need a little leeway ....but there is none. She's always digging and always saying things like, you need to remember who you work for .....ugh. (not necessarily to me, but says that about others ....actually, I think she's just a little off.) Also tough to see her relaxing, sitting at her desk with her manicured nails and cute outfits, all the while I'm sweaty, running from room to room, with my hands in various patient orifices, and me just trying to keep myself looking like an entirely disheveled mess.
My dream would be to have my own practice where I as the provider ran things .... and eliminate the NEED for this type of person. But not sure that's entirely feasible ....lol.
I will honestly say, I strongly feel not all that much. I did 700 clinic hours, whereas my doc went to med school for 3 years, then did 3 years of solid residency ....that's what you NEED. I wish that's what I could have done. Now I'm out and expected to know and do what he does ...(well, not really), but sort of ...it puts you in a perpetual state of intellectual disarray and discomfort/risk ... even the PA's I work with were far better prepared. Now that I'm here, I wish I'd gone to PA school. A nurse turned PA is a nice combo -- you've got the nursing background, but get the medical training to prepare you more thoroughly. Just my .02.
Oh I know .... I absolutely cannot and will not say much if anything at this point ... just trying to formulate a coping strategy for now.
Yep -- grates on me even more as I have to stand in a tiny room right right next to me While I chart .... ν ½νΉ
Been working in primary care office for a while now and enjoying it -- for the most part. What's tough for me at times is working in close proximity with nurses with very foul mouths, loud voices, and just having to listen to the nasty talk, gossip and just non stop chattering while trying to work, chart, learn and THINK!! I'm also new amongst folks who have been working together for years. I'm no prude, but the non stop F-word all day also just grates on me after a while. How can I deal with this -- don't want to alienate anyone but almost not sure I can work in this office at times with it ... the doc here just seems to rise above it and doesn't seem bothered by it. They're all good nurses, but I don't understand how they can do this and not realize how disruptive it is... and here I used to be a nurse who also used to goof off big time in the nursing station!! ππ
It is 100 percent true -- follow the guidelines to the letter and you're fine -- problem is, patients sometimes want the same type of care they receive at their PCP -- I would explain to them that you are NOT their PCP, and you have to follow the guidelines of your employer -- 100 percent at all times.
Well, yes -- and I may add -- the board doesn't exist to protect nurses .... it exists to protect the general public! (From nurses and other healthcare professionals, and while some errors are more administrative, some are absolutely endangering and/or highly unethical) So, no -- they are definitely NOT there to do you any favors .... they are a disciplinary body.
I'm sorry -- can't share beyond what I already have.
Having worked now, however, in a more traditional primary care office, I can say that the same situation definitely would not have likely even occurred. I do believe the risks in retail are very specific -- but there are also risks elsewhere. Again, just make sure your insurance is updated, anywhere you practice.
Thanks so much- it got me out of a bad job, that is for sure. I did get hired by a new employer and am doing fine!
Very kind of you to say! I would never make the same mistake again, that I can tell you!
Very rough, isn't it? I can't even explain it .... it's just a total threat and assault on your personal self image, your professional and personal identity ..... a threat to your overall livelihood. If you have actually harmed a patient intentionally that's one thing, but unintentional errors due to poor judgement which result in no harm .... I really do feel the punishment is a bit extreme in the sense that it is public and stays in data banks, etc.
And as far as I know -- record of these errors stay with us forever, unless we pay more fines to have them expunged. In my opinion, this should change if a nurse or provider can prove they've taken steps to remediate and/or have passed a certain period of time without any similar violation ..... but it sticks with you.
Well, without sharing any personal details, I was notified of the report a full two months after the incident. This was shocking to me as Inthought perhaps they had just tossed it, but the wheels of the boards turn slowly. Once you are contacted by the board they give you a couple of weeks to respond. Hopefully at this point you have a lawyer giving you guidance and sending the documents and communicating to the board for you. The board investigator then takes a look at the response and determines if a violation occurred. In my state, I would have to sign something that basically says I will accept the board's discipline whatever that may be. I personally am hoping for a lesser outcome such as a counseling letter. Every state may be somewhat different. It's my understanding that once I sign the consent order, it could take months to hear from the board as to their final decision. It's truly a nerve wracking process, but in my case, I did find another job with an employer who heard my story and hired me anyway. I'm very grateful for that, but it was pretty mortifying to have to explain myself.
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