Normal for clinic nursing?

Specialties Ambulatory

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I have been at this GI office/clinics for a little over a week and I'm contemplating leaving. I have 7 years experience in the hospital in surgery and IR experience and this is first time in clinic but has been VERY stressful. I have been running a clinic within a clinic and feel like there isn't enough hours and know there are not enough hours in the day to get everything done. Between answering 60-70 patient phone calls, helping the doctor with clinic, checking all the labs/reports, making appointments, insurance authorizations, med refills, and traveling to and from satellite clinic there aren't enough hours in the day. I have had NO orientation at all the girl I replaced left before I got orientation. So basically been on own. Other nurses in clinic help when they can but that's not that much. Is this normal clinic nursing? Because I find it much more stressful than the hospital. Oh I also took a $6/hr pay cut for the job.

Oh yeah, that's normal! I have been in ambulatory care as an LPN for about 5 years now. I'm now at ab urgent care, we see 100 patients/day between 2 docs. Its insanity but less complicated issues than specialty practices since we do not manage chronic illnesses. You will get used to everything, see if one of the other nurses mind staying with you after work one day so you can write down some tips from them to make your day easier. GL!

And can you delegate insurance authorizations to the MA's? The authorizations can take up so much time and it doesn't have to be an RN who does it (at least it my state).

" I have had NO orientation at all the girl I replaced left before I got orientation."

Do not refer to your colleagues as girls, part of the problem here is, you are not getting the respect you deserve.

Now.. ask yourself why the previous clinic nurse cut and ran.. and why you did not get an orientation.

The job is unmanageable. Doctor is making you do the work of 2 people.. to increase his revenue. Bet his wife has a lot of nice jewelry.

Apparently we aren't allowed any overtime or will be written up. So apparently I'm suppose to have everything done at end of day. So can't stay late to learn.

Its been a challenge and I have been constantly compared to the nurse I replaced. How great she was and how she did it all. It's frustrating.

Specializes in Nephrology, Cardiology, ER, ICU.

Moved to ambulatory care forum

Don't be too concerned with the comparison to your predecessor. If she was so great, she would've trained you, no? Anyway, you are not her. You bring your own set of skills and gifts. Besides, I have noticed workers who tend to do everything lightening fast tend to make more errors, even without realizing it.

Some of what you mention can be delegated to MAs--notably the insurance authorizations and appointments (once triaged). If staff is resistant to making these changes, there really isn't much you can do except keep trying. You will get faster with practice but I have a hunch that anyone would have difficulty with the pace. Good luck.

Specializes in Psych, Corrections, Med-Surg, Ambulatory.
Its been a challenge and I have been constantly compared to the nurse I replaced. How great she was and how she did it all. It's frustrating.

Yeah, she was so great she ran away screaming. What did it take out of her to be that great? Obviously wasn't sustainable.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

You'll pick up speed, and get to know people and routines, but it's difficult for me to imagine how all of your responsibilities could be reconciled without more help, or the ability to have some uninterrupted time to catch up on your referrals, callbacks, lab reports, etc.

The doc might not mind the whirlwind pace, but when patients get irate over their expectations not being met, you'll get the brunt of it.

Some nurses thrive on the feeling of things being just about to spin out of control, so could fit in after the normal new person awkwardness resolves.

There are also providers who see dollar signs, and as others mentioned, may view staff as a disposable commodity you replace when the current one wears out or has a nervous breakdown.

If you're neither of the above types, it may become too frustrating to be worth it, but like anywhere else, there's a culture. I've been fortunate to have mostly good ones.

Hope it gets better!

Specializes in Ambulatory Case Management, Clinic, Psychiatry.

Ditto what nurse l56 said

I have worked as an ambulatory float for a year and a half now, and your responsibilities sound unsustainable. What do the other nurses and MAs do?

I'd like to know what the other nurses do as well. We have 8 (soon to be 11) providers in our Family Medicine clinic; 1 MA for each and 2 RNs. Our titles are 'Triage RN' and 'Staff RN' and we do a lot of everything you describe but our main focus is our what our title is (Triage does phone Triage; staff RN does nurse visits).

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