Pros and cons of RN clinic nursing?

Specialties CNS Nursing Q/A

Now that I am recovering from my PTSD I'm getting back into nursing. I already have a (very part-time) home infusion job, and I have an interview soon for a two-day a week Clinic RN position. In preparation for this interview I would like to know more about Clinic RN work. What questions should I ask in the question portion of the interview? 2 days a week is just the right amount for me.

Specializes in school nurse.
15 hours ago, 2BS Nurse said:

@klone: 

"Our MAs have quite a bit of longevity at our clinic, so no revolving door". Consider your clinic lucky. There are so many MA jobs for the taking in my area. They are very difficult to recruit and retain. If you're not expected to leave your triage room to do the MA's job (when he/she quits or calls in sick), consider yourself lucky too! In one clinic I was doing double-duty. MA and RN.

I would expect that almost anything that the MA does would fall under the scope of nursing practice as well. What was the differentiation of job duties?

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
22 hours ago, Jedrnurse said:

I would expect that almost anything that the MA does would fall under the scope of nursing practice as well. What was the differentiation of job duties?

See my first post in this thread regarding the RN job duties. MA job duties are to support the clinician during their clinic day. They are the "rooming staff" and room, take vitals, do med reconciliation, give immunizations, help with procedures, do ear washes, anything that the clinician they work with needs during the day as they see patients for appointments. 

At our organization, the MA and the RN have completely different/separate roles, and the RNs would never fill in for the MAs (they would have no idea what is expected or how to chart). If we are extremely short-staffed, we would have one MA double up with two clinicians, or the clinicians room their own patients (and then just shout out to whoever is available if the patient needs immunizations). 

It's not that the RNs CAN'T do the MA job, legally. It's that they don't know HOW to do the MA job. Because they are two different roles, the RNs are not trained to do what the MAs do. Also, at our organization, if we had an RN regularly doing the MA job, we would get in trouble with the union.

On 2/20/2022 at 7:07 PM, gemswanson90 said:

LOL; you won't need to oversee them much. In my experience, they're calling out sick or on break when most needed.  You will wind up rooming patients, taking vitals, and making appointments much of the time.  

I'm sorry this has been your experience. By and large, the MAs at my primary care practice are great. I am the only nurse in the clinic. I can't remember the last time I had to room. I do make lots of appointments because I am doing telephone triage, so naturally if they need to be seen same-day, next-day etc. I am going to schedule that while I am on the phone with them. 

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

The prior posts give you a great picture of the possible experencies you may have in clinic nursing.  For the most part, I really enjoyed my clinic jobs.  The only pitfall I can think of is that the staff is usually more insular than in large inpatient facilities, and thus a dysfunctional personality can have a magnified negative effect on the entire team.

Fortunately, I only worked at one place where this occurred, and I eventually had to move on.  Higher-ups in the food chain protected this person, and there isn't much to be done about that.

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the clinicians room their own patients

I think our jaws would fall to the floor in amazement if we EVER observed this happening! 

"The RNs CAN'T do the MA job, legally. It's that they don't know HOW to do the MA job. Because they are two different roles, the RNs are not trained to do what the MAs do".

Um, yes we are. Rooming, vitals, EKGs, ear lavages, injections, PO meds, glucometer use, assisting with wet preps, all EPIC charting, I could go on and on. We are expected to assist the MAs with these tasks (and fill in for them) when necessary. Our performance reviews and pay increases suffer if we don't.

"Also, at our organization, if we had an RN regularly doing the MA job, we would get in trouble with the union".

There you have it. There are very few unions in my state. I don't know of any outpatient unions.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I did clinic nursing for a busy OBGYN office a while back.

We assisted them to complete their EHR questionnaires that were to be done before the doctor would see them....

We did all intake assessments which take a lot of time and patience. There were pages of work to go through for each new patient.....

We did indeed room and take vitals on our own patients...

Did telephone triage and obtained and called in orders to doctors...

Cleaned up exam rooms after patients were done, sometimes, if everyone was busy---and that was often...

Processed specimens for the lab.....

Assisted the doctors with pelvic exams as needed, chaperoned many of these ourselves...

Did nonstress tests on moms as indicated/ordered by doctors and triaged them over to labor and delivery as patient condition warranted.....

paperwork paperwork paperwork!! And when that was done, MORE paperwork.

It was far from stress-free and there never seemed to be a day I could get it all done in the 830-530pm time I was assigned to be there. Sometimes stayed late especially if there were a lot of telephone calls/needs for followups and prescriptions to be requested from the doctor and called in.....

The MAs are invaluable and a really wonderful asset. But they get busy too. Everything that fell under their scope also fell under mine so I could often be found doing things they normally did just in the name of efficiency and moving things along.

Was it better than the hospital? Yes I think so. But not that much less stressful. You really are thinking on your feet and can't always bug the doctors to do the thinking for you. You will have to know each doctor well and what their preferences/idiosyncracies are and work with them in order to keep things smooth.

The pay is not comparable to the hospital. It's much less. MUCH less. But that may not matter to you.

It may be for you in your desire to seek change. It's a whole different animal than hospital nursing. You have to love talking on the phone every minute you are at your desk. There is little to no downtime.

One upside was the office was closed at noon-1pm daily and this allowed me to actually eat lunch and stay hydrated. I liked that I could have coffee at my desk and go to the bathroom more regularly. Those are definitely plusses.

OH and ditto those who said there is drama. There IS. A lot. I stayed out of everyone's business and minded my own. I got along fine.

 

Very well written SmilingBluEyes. I forgot to add in lab specimen processing and cleaning/stocking/ordering supplies and medications. And yes, provider preferences. They get annoyed when we get behind, even if it's out of our control.

I don't know of may clinics that take an  hour lunch break anymore.

Specializes in ER.

This is an internal medicine clinic. I'm still working at the farm store and also I just started the home infusion job which is basically starting an IV, and administering a very very expensive medicine to a patient with things like autoimmune diseases, genetic disorders. A lot of immunoglobulin medicines and other new-fangled therapies. The company is expanding into this area and hiring RNs with good IV skills.

I want to go into the interview with open eyes. I'm not certain this is the right path for me. My initial concerns are that this is an entirely different environment for me, and will I be allowed to learn it in a friendly manner. I have heard mixed reviews on how it is to work with medical assistants. I'm concerned about workplace culture. I have heard from a couple people that it's a decent Clinic. I would want to be given the support I need to be successful, especially if I'm only working 2 days a week, it takes longer to learn new skills.

 

Specializes in ER.

Thanks for all the good information. I'm going to carefully reread it all and make up a list of questions that I want to ask. This is a whole different specialty than I am used to.

I am very comfortable and have always had a very good relationships with the doctors that I've worked with. What really makes me nervous are the medical assistants. I really want no part in overseeing them because that can be a minefield. I'm worried about all the politics of working in an office setting, and that I will feel too closed in and claustrophobic. I don't want to get into something that would not be a good fit.

I see the positives as being a) the hours, b) interacting with members of the community,  c) being out of the hospital setting,  d) the fun of doing something totally new. 

 

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

Agree with JKL. The RNs typically do not oversee the MAs. 

Specializes in Hospice.

LOL; you won't need to oversee them much. In my experience, they're calling out sick or on break when most needed.  You will wind up rooming patients, taking vitals, and making appointments much of the time.  Please feel free to return in six months and challenge my assertion.  On the other hand, they will be there to cause drama, stir the pot, and complain about anyone to try to hoax your buy-in so that the rumour mill can Really get some wind.  Don't take the bait; remain neutral and pleasant.  Word to the wise

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
gemswanson90 said:

LOL; you won't need to oversee them much. In my experience, they're calling out sick or on break when most needed.  You will wind up rooming patients, taking vitals, and making appointments much of the time.  Please feel free to return in six months and challenge my assertion.  On the other hand, they will be there to cause drama, stir the pot, and complain about anyone to try to hoax your buy-in so that the rumour mill can Really get some wind.  Don't take the bait; remain neutral and pleasant.  Word to the wise

Wow. Sounds like you need better management.

gemswanson90 said:

Yay for you, primary care RN.  I worked in Specialty Clinics...not primary care. If you're in primary care, you get to funnel your "problem" elsewhere... that is where my specialty clinic takes over.  

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