Normal for clinic nursing?

[AJ1980]

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.

[ivyleaf]

In our group (we have 20-something offices) there are a few different nurse roles, although they vary by office and some offices have more than one

resource nurse- phone triage, nursing visits (meds; MAs do immunizations), help w some case management duties, some pt/disease education

case manager- hospital follow up calls, BP checks, diabetes/nutrition/htn/etc education, help w in office meds (b12, testo, depo, etc), more focus on quality/outcomes

offices that don't have a CM have resource nurses that also do hospital follow up calls.

although mas technically aren't allowed to do "triage" they do "screen" low acuity patient calls (cough or rash without other symptoms, nasal congestion, sore throat). MAs also do rooming (vital signs), Rx refills, immunizations, ppd testing/reads, some bp checks/urines/simple nursing visits, and respond to a lot of pt calls/questions that are not high acuity and do not require a nursing degree. coumadin management is either done by the MD, nurse, or an experienced or certified MA (md always 'confirms'/signs off on dosing changes).

we also have some specialty offices with specialty nurses-- in derm, helping with procedures; in rheumatology, doing biologic injections and helping with some of the more complicated results calls

in general, unless you are the person responsible for pt/inrs, the doctors are responsible for their own labwork and imaging results. results letters are generated by the computer (very little work required). we have psr's/secretaries who make the majority of pt appts (unless you are triaging someone and then need to schedule them- then you do it yourself). insurance auths are mostly done by ma's, although sometimes an experienced secretary or nurse will do them as well.

sounds like OP is understaffed- i dont know anyone in our group who fields 60-70 calls a day! i guess i am also lucky in that our group is run pretty well overall and we are afilliated with a major hospital group with arguably the best hospital in the state. we have a robust group of float MAs and secretaries/front desk folks. i am the only full time float nurse at the moment, although hopefully that will change eventually.