This is getting to be a mantra of sorts in my house. I work in a very small clinic, and the staff is equally small. We have one gal that does our referrals, a medical assistant, a receptionist, an office manager, and me, the Nurse Prac.
The OM's brother works a few hours a day, doing scheduling. We have a lady that does our drug screens, but she is employed by the screening lab, not our clinic.
The medical assistant is training. She hasn't quite gotten to the point of drawing blood, but she's learning and she's a gem.
The office manager has a young child and sometimes can not work a whole day.
Therefore, I wind up wearing many hats. I answer the phone, I draw the blood, I triage, I post labs, I make patient phone calls, I call in meds, I sort charts, I file charts, and today, when the referral gal had to leave, I did referrals. Oh, and I saw 40-some odd patients.
My DH is of the opinion that I should go in, see my patients, and walk out. No blood, no phone, don't help out extra at all. His argument is the fact that my maternity leave replacement didn't do any of that, and she got away with it. Yep, she did, and she's also not there anymore.
I am of the opinion that whatever I can do to help, I'm gonna do it. If I don't draw the blood, it won't get drawn. If the referral gal has an emergency, the referrals won't get done. Doc gets ill, my patients don't get good care, etc.
I say it's a team effort...it's ALL a part of my job.
Feb 2, '13
by nursel56 Guide
I worked in a small clinic (as a nurse) for several years after working in a much larger one for several years. I loved our small clinic and we had very little "it's your job, it's my job" stuff going on. There were times when a doc would pitch in and see a walk-in the nurse was just about to make them an appointment for. Once the doctor I was with insisted on disimpacting a screaming 2-yr old himself (a few minutes after closing time) as the receptionist was in the process of telling the mother that "constipation isn't an emergency", most likely because she didn't want to cause our doc to get out late.
Next bit for people who agree with Angelfire's DH and refers to normal ebb and flow in clinic life and not chronic understaffing - I can't imagine what it would've been like if all of us refused to do anything other than strictly MD things or strictly nurse things etc. In small places conflicts loom large. Two people in a snit might be 1/3 of your staff!
Suppose the place is jammed to the gills with people in the waiting room and empty rooms sitting there because there aren't enough people to call them in and take vitals. I'm quite sure that someone sitting in their office reading a journal won't last very long. Our doctors regularly called people in themselves when it was busy. Nobody became complacent, but perhaps that was the luck of the draw.
It really served as a model for a healthy culture, which helped me cope in subsequent jobs with absolute hell as a culture because now I don't take hell as a given in the healthcare world.
Anyway, I'd say let your emotional barometer be your guide. Most of us know when we are frazzled and being walked on, and that isn't what going above and beyond is all about in my opinion. Part of feeling OK about it is knowing your team will have your back too should they be in a position to be the decider about how that will go for you, and knowing your situation is during a transitional time (like when a new person is being trained). It is really so rare to feel positive about your team, especially the way you describe the other place -- if it were me there is no way I would leave unless the next job was near perfect.
(sorry for jumping into the NP domain - it's just I felt my experience in a similar environment might be helpful)
Last edit by nursel56 on Feb 2, '13
: Reason: put a space between "strictly" and "MD"