leaving clinic with Patients still in exam rooms?

[bethburlson]

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.

Can I have fellow Nurse feedback?

Thanks, Beth

[bethburlson]

Why do other clinics s have closers?maybe becUe they actually are good clinics? It sounds.to me like people on here are clinic nurses ans are afraid to have to stay over . Let's get rid of the overtime save the hospital millions. All other clinics have to stay because safety is the key factor. I was just wanting advice, and good advice. Bye everyone

[bethburlson]

When I worked in pre op clinic we had to stay. When I was in urology we had to stay. When I was in general pediatrics we had to stay. Where these just better clinics?

[dishes, BSN, RN]

We don't have enough information to determine if they were better clinics.

[bethburlson]

Also. This is a specialty learning hospital. When other doctors mess up patients come here to get it right. These patents can be very very bad off

[bethburlson]

This particular eye surgeon gets all pts from other institutions that have messed up

[macawake, MSN]

as you have read-- "I HAVE NOT TALKED TO ANY MEDICAL PEOPLE!!!

This is becoming slightly silly. You make it sound like you and the physicians move in completely different orbits in different solar systems. If I were you I'd simply approach the physician at the end of the day and say "Dr. Cornea, I'm done for the day. I plan on leaving in five unless you need me to stay? Patient X is in exam room A and patient Y in exam room B. Their status is ..." (if there is pertinent information that the physician needs to be aware of). It doesn't have to be more complicated than that.

Why do other clinics s have closers?maybe becUe they actually are good clinics?

You keep asking questions but you don't really answer the questions that we ask of you in order to clarify certain things. It's really hard to have any kind of meaningful conversation/exchange of ideas this way. I don't know if you work in a good or bad clinic, but you do have "closers"; the physicians.

I was just wanting advice, and good advice.

You have recieved advice. It may not have been to your liking, but we've shared our thoughts on the matter. What you do with the advice given is of course entirely up to you.

It sounds.to me like people on here are clinic nurses ans are afraid to have to stay over .

Let's get rid of the overtime save the hospital millions.

I don't think that most nurses in this thread are clinic nurses but some might be or have been at some point. Don't make the mistake of thinking that we are protecting the hospital's bottom line simply because we don't agree with you on this issue.

I'm a nurse anesthetist so of course I don't leave for the day until I'm either done with my cases and have handed them over to PACU, or am relieved by a suitably qualified coworker.

[bethburlson]

When pts are in our grounds, we are responsible,atter how they got there and yes, even the parking garage. We have had codes in cars before

[NurseGirl525, ASN, RN]

Is this really about you not getting some OT you think you are due? Because I think you are misinterpreting your license if this is not about hours, pay, or something.

Also, I thought this was a new job at an outpatient clinic? Since you have started you have had "people" code in cars? People? As in more than one?

It's the prerogative of the physician and legal dept as to how this clinic is run. You don't own the clinic. If you are this worried, either quit or call your malpractice carrier. That's all anyone can advise at this point that may have a chance of satisfying you.

But I think this is about more than what's on the surface.

[dishes, BSN, RN]

This particular eye surgeon gets all pts from other institutions that have messed up

It is common for surgeons who are renowned for their expertise to have more patients than they can see in an eight hour clinic day. You haven't given any evidence as to why the after hours patients need a nurse to escort them to and from the clinic rooms, as they can be escorted by the physician. If you're worried about patients falling on the premises, speak to the physicians and manager about implementing a falls screening checklist, it can be used to flag high risk patients.

[JustBeachyNurse, LPN]

Why do other clinics s have closers?maybe becUe they actually are good clinics? It sounds.to me like people on here are clinic nurses ans are afraid to have to stay over . Let's get rid of the overtime save the hospital millions. All other clinics have to stay because safety is the key factor. I was just wanting advice, and good advice. Bye everyone

This is not true not all clinics have nurses as "closers" some have medical assistants (and no nurses on staff whatsoever) as "closers". Some have receptionists as closers. Some physicians close the clinic and apparently some demand nurses close the clinic.

Your insistence is misguided. There is absolutely nothing that a nurse can do with the exception of nursing diagnosis and care planning that is out of the scope of a physician. You are creating a problem where none exists

[JustBeachyNurse, LPN]

When I worked in pre op clinic we had to stay. When I was in urology we had to stay. When I was in general pediatrics we had to stay. Where these just better clinics?

Nope. These clinics had different SoPs. Were they aligned with a teaching hospital? Again there is nothing other than nurse care planning that a nurse can do that is out of the scope of a licensed physician in the US.

[Altra, BSN, RN]

I hesitated before replying, thinking that my reply was coming from my own assumptions. But truth be told, many other responders have also interjected a whole host of assumptions here as well.

Don't most of us see patients, in any setting, who are frail, with multiple comorbidities, often accompanied by a spouse who doesn't seem to be in much better shape? Who make us wonder, how in the heck are these people managing at home? Who raise our BP every time they attempt to transfer or ambulate? Who, although they do ambulate independently in their smaller home setting, are overwhelmed by navigating a larger environment like a giant parking lot/garage -- hospital layout -- clinic location?

I doubt I'm the only one who works on a hospital campus that can take 15 solid minutes to navigate, even walking at a good clip that qualifies as a cardio workout warmup.

OP's references to diabetic patients and surgical patients leave me picturing an older, higher-acuity patient population. Not the family visiting for their annual eye exam and picking out cool new frames.

Having said all that ...

OP, I am aware of clinic providers who see patients without support staff. They check patients in, obtain vitals, update histories, etc. Some nurses with clinic experience have responded here that their workplaces operate like this, at least for the later part of some workdays. Hopefully this gives you some reassurance.

I am aware that the chain of command in clinic settings can be a bit muddy, with nonclinical administrative management mixed in with clinical leadership. But I'm confident you can ask your question of a charge nurse/provider/etc. ... and get some clarification on expectations. I would suggest making your question as specific as possible: "Provider X has appointments through 7pm on Wednesdays. Are you looking for me to stay until those appointments are completed on Wednesdays? If so, I can plan on that for scheduling purposes." If you get clarification that the clinic providers are fine operating without nursing or support staff for the later part of their day and that is the way the clinic operates ... I would not worry that that there is any risk to you as a nurse.