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Any tips on how to protect your self in a clinic?

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Life22feb Life22feb (New) New

Hi, I'm a new LVN, I was offered a job at a clinic but I'm kinda nervous because I've never worked at a clinic before. Everything is electronic charting. How do you protect your license when working at a clinic? What tips can you give me for those who have worked at a clinic? Thank you for your help.

Everline

Specializes in public health, women's health, reproductive health.

I'm confused. What do you mean "protect yourself"? What kind of clinic is it?

Any tips on how to protect your nursing license?

Rose_Queen, BSN, MSN, RN

Specializes in OR, education. Has 15 years experience.

Practice within your scope and as a prudent nurse should. It is actually very difficult to have an action taken against a nursing license- if you read the updates as for why a license is disciplined, suspended, or revoked, you're likely to see reasons related to drugs, alcohol, or criminal acts as the most common reason. This fear of losing a license is so pervasive and I can't for the life of me understand why.

Practice within your scope and as a prudent nurse should.

^^ That, and be good at charting. I agree that it's a lot more difficult to lose your license than many people who post here seem to think. OP, what exactly are your concerns about your license in that setting? Why do you think it would be riskier than practicing in other kinds of settings?

I just sometimes fear that maybe I might misspell something in my charting or what it I forget to chart something. I think I might be overreacting.

Here.I.Stand, BSN, RN

Specializes in SICU, trauma, neuro. Has 16 years experience.

I just sometimes fear that maybe I might misspell something in my charting or what it I forget to chart something. I think I might be overreacting.

Yes, you are overreacting. ;) Don't practice outside of your scope, don't steal drugs or Rx pads (if they are used), don't batter your pts, don't commit ID theft with pts' info -- and your license will be fine.

KelRN215, BSN, RN

Specializes in Pedi. Has 10 years experience.

I just sometimes fear that maybe I might misspell something in my charting or what it I forget to chart something. I think I might be overreacting.

You are not going to lose your license over a misspelling.

Document at the point of care and you won't have to worry about forgetting to document something. But, again, unless it's something really egregious that causes serious patient harm, you're not going to have disciplinary action taken against your license for a simple omission.

I don't really understand what you're concerned about. Why would working in a clinic and having electronic charting mean there's anything in particular you need to do to "protect" your license?

By and large if you don't want to lose your nursing license, don't divert controlled substances from work and don't work under the influence of alcohol or drugs. I have only ever known one nurse who lost her license- she was stealing narcotics from the prison she worked at and then just didn't show up at any of her hearings at the BoN.

Ddestiny, BSN, RN

Specializes in ICU, Post-Surg, Oncology, Psych, Family. Has 7 years experience.

Nursing schools really do make new nurses come in walking on eggshells, afraid they're going to lose their license for the slightest social faux pas. A few years in the field seems to be all it takes to get them to calm down, but until then I take the opportunities I can with the students I help to let them know: you're going to make mistakes, you're going to drop pills or forget little details, and yeah it sucks, and you may even cause minor adverse things with your inexperience (i.e. when I first started on my Post-surg floor I didn't question the "remove foley" order on a patient with an epidural. 8 hours later he couldn't pee, which happened to fall on the night shift, and they couldn't insert the next foley because of his giant prostate -- previous one had been done during surgery -- and they had to call in the urologist to place a coude. Crappy night for my patient and the night nurse and I learned a big lesson. I've never repeated that mistake and I make sure to tell the new nurses and students about this whenever it comes up, but no, no legal action was taken against me, and my boss literally told me "you're new, how could we expect you to know this?") but as long as you are not being negligent and/or literally breaking the law....you're going to be fine.

I just sometimes fear that maybe I might misspell something in my charting or what it I forget to chart something. I think I might be overreacting.

What is going on in nursing schools nowadays that new grads have the impression that a misspelled word is going to cost them their license. REALLY?!!?!?!?

Any tips on how to protect your nursing license?

Don't steal your patients' drugs, don't show up to work high or drunk, don't falsify the medical record, don't abandon your patients, don't physically or sexually abuse your patients, don't kill your patient by gross negligence.

Did you notice that misspelled words are not among the previous offenses?

Carry on.

CelticGoddess, BSN, RN

Specializes in Palliative, Onc, Med-Surg, Home Hospice. Has 6 years experience.

Don't steal your patients' drugs, don't show up to work high or drunk, don't falsify the medical record, don't abandon your patients, don't physically or sexually abuse your patients, don't kill your patient by gross negligence.

Did you notice that misspelled words are not among the previous offenses?

Carry on.

I was going to say basically the same thing.

As far was what nursing schools are doing/teaching: I know my school (graduated 2011) the instructors were often saying "you need to protect your license". We had one instructor who actually did explain why people lost their licenses. She pulled up a few people she knew personally who were not just suspended but had their licenses yanked. All three had the same thing in common, they refused to comply with the board. One was suspended for diversion, one was suspended for false documentation and the third was suspended because she got 2 DUI's in one year and didn't report. But all three lost their licenses for failure to comply.

ivyleaf

Specializes in Ambulatory Case Management, Clinic, Psychiatry. Has 13 years experience.

document everything, esp in tele triage. if you are unsure about anything, as the doc or NP. use tele triage protocols, esp if you are not running things by the doc. also, never downgrade a pt a triage level (as in office visit vs ED) unless doc or NP OKs. I have worked in a clinic for the past 1.5 yrs.

Also, no scanning (if you are used to that) so make sure to double check your meds. With pedi vaccines, if you are not familiar, keep cheat sheets for timing and method (sq vs im)

Go online to your board of nursing website.

Check out how others have lost licenses.

Don't do what they did.

TriciaJ, RN

Specializes in Psych, Corrections, Med-Surg, Ambulatory. Has 39 years experience.

Go online to your board of nursing website.

Check out how others have lost licenses.

Don't do what they did.

You can't get advice more succinct than that.

Lane Therrell FNP, MSN, RN, MSN, RN, NP

Specializes in Family Nurse Practitioner. Has 7 years experience.

All the advice you've received so far is excellent, and I have a few additional thoughts to share which might help you decide whether to embrace this new opportunity or not. I'm a clinic-oriented nurse practitioner, myself, so this (long) comment comes straight from the heart.

When you are making a decision work in a clinic environment, there are a few key questions you need to ask: 1) What kind of clinic is it? (ie, urgent care, family practice, specialty, etc); 2)What are the other staff members' levels of licensure? 3) What kind of training will you receive and is there a probation period? Here are my thoughts on each:

1) The type of clinic will determine the pace of work and over-all work environment, and will drive the specific kinds of interventions and duties you'll be asked to perform. For example, urgent care clinics in urban areas can be super-fast-paced while a family practice clinic in a remote rural area can move at a slower pace that some people might find intolerably boring. In general, an LVN at a clinic is likely to end up rooming patients, facilitating in-office procedures, and performing office-like duties-- such as answering phones, confirming/rescheduling appointments, following up on transfers of medical records, physician orders, prescriptions, insurance paperwork, etc. These types of things should be made clear in a job written job description. In your job interview, you might want to ask what a typical day for you might be like.

2) The levels of licensure held by other clinic staff can help you anticipate whether you might run into trouble regarding your own scope practice as an LVN. Are there other LVNs at the clinic, or are you the first/only one? Does the clinic employ RNs? Do they employ Medical Assistants? Are the providers nurse practitioners, physicians assistants or physicians? If you are the first/only LVN the clinic has hired, or if there are no RNs or NPs on staff, you may need to be prepared to educate your co-workers about the LVN role and scope of practice. In my experience, non-nurses often do not understand that there is a difference between MA and LVN or LVN and RN. (By the way, when you frame it as "educating others" regarding the LVN role you remove yourself from a defensive or protective stance and can enter a more professional frame of mind that will work to your advantage in any environment).

3) You will definitely benefit from training, especially regarding the clinic's EMR platform (not all EMRs are created equal or are easy to use). Be prepared to ask about training in your job interview -- and remember that a probation period works both ways, so if you discover after a couple of weeks that that particular clinic environment is not a good fit for you, you should feel free to move on to greener pastures. Be sure to ask about this in the interview; if they don't have a training plan in place maybe you can negotiate for one, and if they're not willing to train you, that's a potential sign that you may not want to work there.

After all the great advice you received from this post, I hope you'll feel sufficiently confident to at least give it a try! Clinics can be incredibly rewarding environments. And of course, please keep us posted on how it works out for you.

meanmaryjean, DNP, RN

Specializes in NICU, ICU, PICU, Academia. Has 40 years experience.

Just reading the title of the thread, my answer was going to be 'open carry'.

Mavrick, BSN, RN

Specializes in 15 years in ICU, 22 years in PACU. Has 30 years experience.

Just reading the title of the thread, my answer was going to be 'open carry'.

What about that little bit of "protection" guys used to carry in their wallet?

Too far?