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

Specialties Ambulatory

Published

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?

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

And in most clinics, the providers run the show. They are the bosses. I don't think "You need some training" is really going to fly.

Up Vote Up Vote ×
Specializes in Clinical Documentation Specialist, LTC.
I know this conversation happened in June. It just caught my attention is all..."three providers to one nurse...can this be safe?"

I have fifty-two providers. And they're grown ups. And I'm very busy, but sounds like your providers need some training.

Wow...

Anyway, doesn't seem like I've been at the new job over two months already. I'm really enjoying it so far, esp. working only 1/2 day on Fridays lol! I've caught on well and have even filled in for another nurse with another provider when the nurse was out sick. Makes me feel good that they have enough confidence in me to float me when needed.

Up Vote Up Vote ×

I am happy for you, LTCNS. Sometimes you have to kiss a lot of frogs........

Up Vote Up Vote ×
Specializes in Clinical Documentation Specialist, LTC.

I was blindsided this past Friday and given two weeks to "improve" or I will be terminated. Long story short, the provider I work with told management she has to "repeatedly" remind me that patients are ready to be brought back to the exam room. In my defense, every single time I walk up to the waiting area to get a patient, said patient is still in the lab, although the schedule has the patient's status as "nurse ready." I have told the provider this numerous times but she still complained.

I did tell management about this being an ongoing issue but it didn't help. From now on I am going to document every time I go to get a patient and they are not ready like the status on the schedule says. Even if I'm terminated at least I will have the problem in writing.

I honestly thought I was doing a good job. I don't call in even if I'm sick and I'm never late. I have gotten many compliments from patients about how courteous, helpful, prompt and friendly I am. I don't understand what I've done wrong. I honestly thought I was doing a good job :(

Up Vote Up Vote ×
Specializes in peds, allergy-asthma, ob/gyn office.

OH... wow. I have been thinking about you and appreciate you updating us. This just... burns me up!!! I am in almost the same predicament. My doc and I have ONE exam room, a partially shared 2nd exam room (other doc still often gets priority over it).. and ONE shared patient bathroom/lab/vitals area. The footwork and shenanigans otherNurse and I go to the keep traffic flowing.. and it can still go really bad really fast with something as simple as an extra visitor needing to use the ONE bathroom... or a slow-moving elderly patient. My doc told me awhile back that I "wasn't on the same page" as she was as far as keeping on time... and then proceeded to chat with OtherDoc's wife in the break room for ten minutes while I had patients ready and waiting... or the fact that EVERY morning and after lunch she is at least 15 minutes late.... Another favorite thing I love when she says is, as I bring her a patient "I was wondering what was taking so long." And my answer is always, " OtherDoc's patient was in bathroom/lab (all of our visits pretty much start with getting urine, since we are OBygyn). Anyways, Other Nurse and I have taken to documenting what time we are given the patient chart (which signifies when the front office has them ready for us)... and what time they are roomed... and I document why they are roomed that time (no room available, Other Doc patient in lab/restroom, patient arrived late, etc) I think you are on the right track as far as documenting each time you go to get the patient and they are not nurse ready. Start tracking the positive patient comments you get. If it comes up again, tell management " I received 5 patient compliments this week." .. and the nurse ready issues you have written down. I wish you luck. It might not help you if they have already formed a negative opinion, but it gives you some fuel to go out with dignity..... or fuel to save your job. They sound like jerks. I can't wait to get out of the toxic environment I am in.

Up Vote Up Vote ×
Specializes in Clinical Documentation Specialist, LTC.

Thank you Oedgar. I really hate that you're struggling as well, esp. when it's not your fault at all.

It's ridiculous really. The provider failed to inform management that I very often have her rooms filled with patients waiting for her to come into the room, or that she takes extra long lunch breaks and I've had to text her to tell her she has patients waiting to be seen. No...She only told them I'm not fast enough in bringing patients back.

I really do like the job overall as it is less stressful than the last job, but this complaint is not fair at all. I would own it if there was any truth to it.

I hope you're able to get away from your current situation soon Oedgar. I haven't even been looking at job ads, but it's looking like I might need to dust off my resume'.

Up Vote Up Vote ×
Specializes in peds, allergy-asthma, ob/gyn office.

Yup.. same crap I am dealing with. My Doc is on leave right now. I am very focused on getting out asap.

Up Vote Up Vote ×
Specializes in Clinical Documentation Specialist, LTC.

Well, apparently I have "improved", but to make double sure, I was given another 4 weeks to make sure I don't "slack off." :sarcastic:

Really?? Slacking off is not an option even if I wanted to. This past Friday was super busy. So much so that the Dr. who complained about me couldn't even keep up with me!

I really, really want to make this job work and stay put, but looks like I'll be dusting off the ol' resume' just in case. *Sigh*

Up Vote Up Vote ×
Specializes in peds, allergy-asthma, ob/gyn office.

Definitely, get out of there! My doc is finally returning from her leave. I have set a goal to be out by June 1st... sooner if I can.

Up Vote Up Vote ×
Specializes in Clinical Documentation Specialist, LTC.
Definitely, get out of there! My doc is finally returning from her leave. I have set a goal to be out by June 1st... sooner if I can.

I'm definitely looking into it. Next week my provider is off with her youngest for Spring break which means I will be floated to other providers who's nurses will be off as well. I have not worked for most of the other providers so I will be flying blind. Feels like I'm being set up for failure :(

Up Vote Up Vote ×
Specializes in peds, allergy-asthma, ob/gyn office.

I definitely understand the flying blind feeling. When I have to do stuff with other doc I feel a bit out of sorts. Is there a chance this other provider will treat you better? I hope so.

Up Vote Up Vote ×
Specializes in peds, allergy-asthma, ob/gyn office.

Yes!!!! The door for me has opened! I will definitely be out by end of June. I plan to give notice April 1... lol.

Up Vote Up Vote ×
+ Add a Comment