One nurse for three busy providers. This can't be safe, right?

[LTCNS]

As of today, I am temporarily the only nurse available in the clinic where I work for three providers, which altogether see over 100 pts. per day. The two Nurse Practitioners see on average about 24 each per day, and the MD sometimes sees over 50.

One nurse just lost her father yesterday and the other is out for the duration of her first trimester of pregnancy, so about another month.

I am still new and have not had to work the whole clinic by myself, but if the supervisor can't bring in a nurse from another clinic there is a possibility I will have to do so. I don't feel this is safe at all. I don't feel it is safe for the patients and definitely not for me or my license. I was thrown out on my own on day three and have been there for only five weeks.

So my question is, what would you fellow clinic nurses do? Especially being new to the clinic?

[LTCNS, LPN]

A lot of PCPs are referring patients to pain specialists for narcotics with the cracking down on controlled substances and prescribing those (at least in OK). Here, a LOT of documentation and follow up is being required as to why the patient needs controlled medications. So a lot of providers are being safe and referring to pain clinic. Your manager should know this. Some managerd have no idea how things work on our side of thr fence. It upsets me how those clinic managers have a duty to run the clinic but have absolutely NO idea how things are and need to be. I have had one of those before and she made my job impossible.

Exactly. Personally I believe clinic managers should be required to have a medical background. I was under the impression that a clinic manager was required to be a RN, but apparently I was wrong.

[Nurse acewa]

This is not good for the patients or nurses. All the pt meds are in the computer so you do not have to rewrite the list of meds on a paper chart right? We still use paper charts.

[missnurse89]

It does help when they are on the computer. I can only speak from the office I was in and even through we were computer charting we had so many patients a day and so many different types of visits that updating meds was even challenging just because something was always changed (all those telephone calls). I always tried to update the med when it was changed over the phone in the office but then you have the specialist who change the patient's meds then on call patients, then tje hospitalized patients coming in for follow up and EVERYTHING is different. There is just no way to keep up. It's just crazy. Office work is so different than what people realize. Pretty mich all duties fall on the ONLY nurse for that doctor. Did you find any other position you are interested in?

[Nurse acewa]

"Don't underestimate the impact of the continued stress."

Listen to this piece of advise before you end up physically and emotionally drained.

[LTCNS, LPN]

This is not good for the patients or nurses. All the pt meds are in the computer so you do not have to rewrite the list of meds on a paper chart right? We still use paper charts.

We are completely paperless which is great in most ways, but when the server is down it can get pretty hairy. Doesn't happen often though, thank God!

It does help when they are on the computer. I can only speak from the office I was in and even through we were computer charting we had so many patients a day and so many different types of visits that updating meds was even challenging just because something was always changed (all those telephone calls). I always tried to update the med when it was changed over the phone in the office but then you have the specialist who change the patient's meds then on call patients, then tje hospitalized patients coming in for follow up and EVERYTHING is different. There is just no way to keep up. It's just crazy. Office work is so different than what people realize. Pretty mich all duties fall on the ONLY nurse for that doctor. Did you find any other position you are interested in?

I had an interview today on my lunch break for a 3-11 position in a skilled rehab. home. Didn't get a good vibe at all so decided not to take the job. I really don't care for that shift anyway to be honest. I suppose I'm just desperate to get away from the clinic, but not if I'm going to be just as unhappy in a place I don't have a great feeling about.

"Don't underestimate the impact of the continued stress."

Listen to this piece of advise before you end up physically and emotionally drained.

This is excellent advice.

Today was horrid. Walk-in after walk-in. They did not stop from 8am-4:30pm. I am utterly exhausted.

[pfchang]

Hang in there. I'm glad you trusted your gut on the rehab facility. You will find something.

[LTCNS, LPN]

I have an interview for a clinic position at a major university health center on 9/11, and am going to talk to a clinic manager at another clinic today who is interested in meeting with me. Things are slowly but surely looking up.

[pfchang]

Good luck.

[LTCNS, LPN]

I had a phone interview with the clinic manager yesterday with another clinic and she was pretty rude. Kept cutting me off. I decided then and there I was not going to take the process any further.

Now for the interview on 9/11. I need to put in a leave request for the morning off. Will do that Tuesday when I go back to work.

Happy Labor Day all!! Enjoy your weekend!!

[LTCNS, LPN]

Ended up not being able to go to the interview on 9/11 due to a family emergency. Hubs didn't want me working there anyway as it is in a pretty bad area with high crime rates, drive by's and out in the open drug deals.

So it turns out three providers are leaving as well as support staff at another clinic. One of the providers is the one I have been working with, and so far they are not trying to find a replacement. In the meantime, I will be reassigned to pediatrics to work with a pediatrician who is notorious for running off nurses very quickly, or getting them fired by setting them up if the nurse does not agree with her.

I am going to do my best to hang in there for a year before I seriously start looking again, as I feel pediatric experience will look very good on my resume'. That is if I'm not shown the door before then or if working conditions do not become unbearable.

What's so sad is the provider I have been working with has been a loyal, dependable, hard working employee for more than a year. The patients and staff love her and she has been seeing over quota almost every single day, but not one person from administration has bothered to call her and ask her if there is anything they can do to make her stay or even at least find out why she is leaving. They don't care. We are just warm, replaceable bodies to them.

[LTCNS, LPN]

God is certainly good! I landed a job in a large, physician owned multiple specialty clinic! :) I had submitted my resume' more than two months ago online and after not hearing anything for over a month, I figured the position was filled. Turns out they held onto my resume' while they recruited a new physician, and I will be that physician's nurse! The position pays more and is just a much better deal all around. No more having to do my own referrals and prior authorizations, no more working Saturdays as the only nurse in the after hours clinic where patients pack the waiting room, and as an added bonus, the clinic closes at 12:30pm on Fridays. The whole environment is so much more relaxed and friendly.

My last day at my current job is October 31st, and my new job begins November 3rd. The clinic manager at my current job is disappointed to lose yet another nurse, but he is happy for me and said he doesn't blame me for wanting to leave. I am so very thankful and will hang onto the job with a vengeance. I can't wait to get started on this new chapter God has opened in my life!

[klone, MSN, RN]

Oh, that is so awesome! I'm so happy for you!