RNs doing wellness visits

[Karamarie84]

Does anyone have any information or advise regarding an RN doing a wellness visit for pediatric patients in the clinic setting ? I work at a Peds clinic and they want me to start seeing patients for wellness appts and not see the dr. I didn't know we could do that but sounds awesome. Just looking for RNs that have done it before

[SiwanRN]

I don't really have advice for how it is done for RNs, but I know historically at the health department where I work that public health nurses did do well child checks in the public health clinic. In talking with one of my senior colleagues who was there in those days, usually it just involved a physical assessment, asking parents about milestones (roll over by X months, sit up by X months, etc), providing anticipatory guidance on common things (feeding, sleep schedules, etc), and then the vaccinations that were due at the appropriate intervals. If the nurse identified something out of the ordinary, then he or she would help get a referral to one of the local safety net clinics that saw indigent folks and families without insurance. They definitely did not do sick child appointments though, and if kids were sick that day for the well-child visit then they would be referred out.

[OldDude]

I can see how the MD could set up a protocol for a "nurse visit." Immunizations, routine labwork, etc. At the Urgent Care I work at rabies series injections are "nurse visits" and the patients don't see the MD during the visit unless our assessments indicate otherwise. Regardless a MD would have to sign off on it as a standing order. I'm sure it would affect the billing acuity level.

[CoolKidsRN]

In my primary care experience, nurse visits were for procedural only interventions. Wellness visits were always conducted by an MD or APRN.