Time management-Clinic

[Oedgar]

Removing post

[TriciaJ, RN]

Sounds like a classic case of too much work and too few people. We as nurses always think there must be a better way to do things. Sometimes, there's just too much work to do in too little time and not enough people to get it done.

[klone, MSN, RN]

I have a few thoughts. I also work in an OB/Gyn clinic as the only RN, but we also have two MAs (one for each provider) - I have my own patient load, as well as taking care of triage, paperwork, staffing, and basically being the manager in charge when our clinic manager is out of the clinic (which is 90% of the time).

First thought - it's not evidence based to do a UA at every prenatal appointment. The only times we do a UA is a baseline at first OB visit, if she has BP issues or other sx of pre-e, a hx of UTI. I would work on trying to change that procedure. Secondly, if you have two providers, it's almost impossible to have good time management without two bathrooms. I know that's not easily changed.

Third, they really need to devote more time for intake appointments. 15-20 minutes is just NOT long enough to do a complete history and all the teaching that is necessary. That is where my role as RN comes in - I do ALL OB intakes, and that slot is given 60 minutes (I do 4 per day). I do the complete hx, fill out lab slips, do all the first trimester patient teaching, explain how the care will go over the next several months, figure out if the patient needs any Rxs, and then at the very end, the provider comes in to do a "meet and greet" (so that we can bill it as a level 4 visit). Generally they're in there for about 2 minutes at these visits. When I first started, I needed the entire hour to do an intake, now I can do one in 30 minutes. Bu 15-20 minutes is just NOT long enough.

The RN also does routine Depo revisits, BC consults, pregnancy tests, things that the provider doesn't need to be there for. That frees up the provider to see patients that are billable.

I agree with Tricia that the way you describe the set-up, it's just an impossible situation. Something needs to change in order for that to run smoothly.

[klone, MSN, RN]

Any way your doc would be willing to go to 3 slots an hour instead of 4? I think increasing it from 15-20 minutes, that alone would help tremendously.