The large Hospital I work at, I transferred to an eye/plastics clinic-in interview I was told I would work clinic hours-stay over a little once in a while/in reality a Dr stays over 3 times a week and sometimes till 9pm-I questioned this and the (non medical) manager told me just to leave when I'm ready (with Pts still in exam rooms)-the only one left in this clinic is the Dr and a resident (not even a front desk person). when I asked to talk to the head nurse-they would not let me (she works at a different site). These eye patients are not optical Pts and some are in bad shape. I feel this is unethical leaving Pts.
Is this a physician owned practice? If so, they apparently are okay with working like this and I would not feel guilty in the least for leaving when my work was done.
However, to me it sounds like a terrible place to work. I remember doing some of my CNM training in a practice where providers were booked solid for the entire day- if you were scheduled 8-5, your first patient was ready at 8 and your last was scheduled for 5 (in ten minute slots alll day long), which means you may not see them till 5:30-6. By the time the OBs and midwives were done, the support staff had left, and we would stay for another hour or so to finish charts etc. It was disheartening, to work so hard and devote so much of yourself to your patients, and to have your organization show such disregard for your work/life balance and your job satisfaction. You were only as valuable as your RVUs.
Now, I work in a clinic full time, 8 hours a day, also with 10 minute appointment slots. I can count on one hand the number of times I have had to stay late to finish with visits and charting. We frequently finish 10-15 minutes (sometime more!) early. Our patients are seen relatively promptly almost all the time. The only time the staff leaves before me is if I decide to work late for my own reasons, which I do choose to do every once in a while, because I love my job. Our last patient is scheduled an hour before closing, I have scheduled down time for follow up etc, and my lunch break is protected from everything but the most urgent, unforseeable issues. Even though we all have our assigned jobs, everybody pitches in until the work is done- if I finish first, I start turning over rooms, emptying trash etc. If the CAs ("clinic assistants,: our term for MAs) finish first, they go in and enter as many orders for me as they can, review our bills etc, and start scrubbing the next day' schedule.
The company could squeeze a ton more revenue out of me if they so wished. Instead, I feel like a valued and respected member of the organization, and I imagine the lost revenue is made up in the shockingly high rate of employee retention and the impressive amount of personal investment employees show towards the organization and it's stated mission.
And the elderly do live at home, but when are at the hospital they are our responsibility
Why do we push them from the entrance to the clinics in a wheelchair? They walk at home
I don't know why your hospital requires outpatients to sit in wheelchairs and be pushed, I have never seen this practice in any of the hospitals I have worked at. Does your facility require all outpatients who have clinic visits with physicians to be pushed in wheelchairs?
You're having a hard time adjusting from the hospital setting to the outpatient setting.
Remember that patients perceptions aren't actually reality most of the time, so the pt. who said she was "all alone" probably just didn't realize there was a doc in with another patient.
These patients aren't the same as inpatients, they came to the office on their own and will leave on their own. AKA, independent.
I know when I worked med surg for the first time after working in patient rehab I was horrified that I was wheeling patients to their cars when they were discharged, but I just recognized that it was a different level of care.
Same here, it's a different level of care. Don't make a fuss, just step back and take it in. It'll take awhile to adjust.
I am still not understanding... The physicians are the CLOSERS and and it seems like they are fine with that. But if you want to stay over everyday to make sure the place is safely empty. Just talk to them and see if they will let you do that. Me on the other hand, if they are cool I'm out!! Lol
I also don't understand why them having diabetes has anything to do with it. Are they sedated and unable to notice low glucose symptoms? If they live alone, they are probably capable to manage on their own.
If you are not comfortable with this, do you have to work there?
Is this policy in writing anywhere?
Has it always been like this?
Can you at least leave the exam room doors open?
Great questions!!! That they have not answered
I cannot find any other clinics that allow this (remember this is giant place).
In any other area, Pts are closely watched, and not left alone in any circumstances. It the eye clinic seems to think this is acceptable- HR thinks it's like people getting glasses when I'm fact these Pts are not eyeware fashion shoppers (that's why I brought up diabetes) the eye clinic is not physically connected to the building, but is on the campus and it there is a code, fast response would go there
I cannot find any other clinics that allow this (remember this is giant place).
In any other area, Pts are closely watched, and not left alone in any circumstances. It the eye clinic seems to think this is acceptable-
OP, forgive me if I'm being a bit dense here, but I still don't understand. Do you consider your patients so unstable that you expect a code situation to develop at any moment? Are your patients recovering from general anesthesia? Patients are often left alone in hospital and clinic settings. I'm sure that you know this. Most patients don't have a 1:1 nurse all the time, only some units/medical specialties are staffed that way. I'm confused.
I'm confused as well, your outpatients live independently in their own homes, manage their ADLs and their healthcare needs without need of caregivers, but the minute they cross the threshold of the clinic for their outpatient appointment, they are frail and vulnerable to falling or coding if they're left unattended?
Specializes in Complex pedi to LTC/SA & now a manager.
Is this an outpatient surgicenter where your patients received sedatives and need monitoring and supervision? If this is a retinal/macular degeneration/glaucoma/low vision center you are grossly overreacting. Even in the local eye surgery center patients aren't watched as if they are sitting in PACU recovering from anesthesia.
Diabetes does not create dependence. If they can get themselves in and out of the outpatient physician practice you need to either accept policy or find another job
And the elderly do live at home, but when are at the hospital they are our responsibility
Why do we push them from the entrance to the clinics in a wheelchair? They walk at home
As someone else said, are they 1:1 in the room with you? The only way to prevent a fall is to be within arm's reach of someone--even sometimes that doesn't work. Just being in the clinic will not prevent a fall. Despite popular belief, someone is allowed to ambulate out of the hospital/clinic--they don't need to use a WC. At my facility, they are encouraged to walk if they can. Either way, the doctors who are still there are quite capable of pushing the patients out in the WCs.
On a different point, if this is a "giant" hospital (even if it is not so giant)--the hospital code team/RRT team must respond to all codes/emergencies in your clinic. While the MD on duty will know where the crash cart is, he/she must start emergency response, but help is on the way.
bethburlson
31 Posts
And the elderly do live at home, but when are at the hospital they are our responsibility
Why do we push them from the entrance to the clinics in a wheelchair? They walk at home