Pros and cons of RN clinic nursing?

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 Quality Management.

in my clinic MAs reports to RNs and documents it as so we do oversee them and write them up if a verbal warning doesn't work.   I tell you the MA to report to me if vitals are out of range once and 2nd time you don't do it I tell you again 3rd time I catch you you're written up and if its a serious out of range vital such that I need to write and occurrence report you the MA is getting written up on first violation.

OK BACK TO TOPIC

I work in a primary care clinic,  what I do is triage, in person and by phone, and by secure email messages, conduct nurse visits to educate manage DM and HTN issues, give vaccinations, educate on chronic diseases, using motivational interviewing techqniques to empower patients to manage their own disease processes, respond to clinic emergencies, discharge patients, occasionally transfer patients to ER, or floor admission which is a hassle, I do the occasional EKG and venipuncture just to maintain my skillsets and get street credits as this way my MA and PCAs know that this nurse knows her job and their jobs too and if need be can do theirs and know if they are cutting corners, I administer meds PO or injectables meds as ordered, I double triple check the orders as residents are doctors in training so I'm afraid they'll make a mistake and I'll be the one losing my license.  I do not involve myself with office politics or kissing up because I believe that my skills speak for itself and make it very clear I am not interested in such games by ignoring all gossips and doing my job to the best of my ability and smile and say good morning to people from janitor up to the Admins Execs.  Anyone insisting on dragging me into politics gets to meet my alter ego that few have seen and lived to talk about it. LOL

Specializes in Hospice.

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.  Primadonna Specialists abound, and you've got to have a Very Strong back and stomach to put up with it.  You've Got to know where your RN authority ends; do not Ever expect an MD to cover your behind if it comes to it.  It can be "implied" all the way uptown and downtown, but that will not hold up in court.  Never feel embarrassed or intimidated into Not asking and/or calling the MD to verify orders. His or her angry and/or intimidating speech will of course cause your heart to race and thoughts to be scrambled.  Don't fall for it; repeat your initial concerns and what you would like to do; their dinner or sleep is of no concern to your license.  They are getting well paid to be on call; the only people to suffer from a bad choice is your patient and you, if you don't advocate for the patient in distress.  

Specializes in Nurse Leader specializing in Labor & Delivery.
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.  

Did somebody hurt you?

Specializes in Hospice.

Nope, but it sounds like you're trying to be aggressive, passively.  It didn't work it's obvious.  Got to get to work.  Have a lovely day, primary care RN 

Specializes in ER.

This is an internal medicine clinic. My interview is this afternoon.

Basically,  my strengths are that I'm gifted at patient interaction and totally love that aspect of nursing. I've also never had any problems interacting with doctors and mid-levels. I have no problem communicating with those people, and I can practically cast spells on the patients.

My weakness is navigating the intricacies of the mundane social interactions required in the workplace. This would be a new specialty to me. Sometimes people underestimate my intelligence if I'm not getting something right away. Usually there is an undercurrent of drama. I know that people don't like to stereotype, but I worked in a cabinet shop before nursing that was mostly men and I never saw the ridiculous High School drama that occurs in the female-dominated profession of Nursing.

7 minutes ago, gemswanson90 said:

Nope, but it sounds like you're trying to be aggressive, passively.  It didn't work it's obvious.  Got to get to work.  Have a lovely day, primary care RN 

Wow that is very unnecessary. I appreciate your input but I really don't want this thread to turn a slugfest.

Long time clinic nurse here. Every clinic runs its workflow differently. Your concern about workplace culture is paramount. There are definitely politics to consider. Will they let you shadow for a day? If so, take note of the provider-MA-office assistant relationship. Does the clinic have the tools you need to do your job (I.e. a Dynamap)?

Most clinics have RNs triage only and their work involves managing the Epic in-basket. They leave their desks to insert IVs, etc (every state has different laws around MAs and scope of practice). MAs seem to come and go through a revolving door. Do you have to fill in for the MA when she/he leaves or calls in sick? Train new MAs? This means an extra long day for you. Who will be filling in for you when needed? Are you expected to float to other areas/specialties (without float pay)? Will you be expected to take on projects? If you commit to 2 days/week, will you be expected to work extra? I've never had a part-time job where I wasn't expected to add on days. 

Even though MAs work under the provider's license, unless you are in a room of your own you will be overseeing them. Will you be sitting in the nurses' station or in a triage room?

Having to babysit grown adult patients who won’t take their medications properly yet you're still responsible for their outcomes is huge. Internal medicine is "graded" on BP, A1C, patient experience, etc., etc. Your company will expect you to be every patient's best friend. Get ready to have nasty EMR messages sent when your patients don't get what they want. 

The office assistant's capability is a big one too. Most of them have no health care training. Are they allowed to constantly interrupt you with questions, or are they expected to message you when a patient calls? 

 

"Wow. Sounds like you need better management".

THIS! In my experience, the managers swoop into the units, smile, pass out treats and want to be everybody's best friend. They don't take care of business when needed. Remember, they themselves are "graded" by those working under them as we are by our patients. 

Specializes in ER.

The interview was fun

Specializes in Hospice.
1 hour ago, Emergent said:

The interview was fun

That was a Great Comment.  I encourage all nurses to go on "Okay What is This About" interviews.  No harm, no foul.  I recently went to an interview for a hair removal place; YES for an RN.  It was weird, but I liked it.  I definitely knew that was NOT for me...but hey there is a niche for all RN's, right? Who is to say..My job is more important than your job...right?  I also learned a lot from asking questions about the hair removal business in the process.  I consider it an educational experience.  

Specializes in Nurse Leader specializing in Labor & Delivery.
2BS Nurse said:

MAs seem to come and go through a revolving door. Do you have to fill in for the MA when she/he leaves or calls in sick? Train new MAs? This means an extra long day for you. Who will be filling in for you when needed? Are you expected to float to other areas/specialties (without float pay)? Will you be expected to take on projects? If you commit to 2 days/week, will you be expected to work extra? I've never had a part-time job where I wasn't expected to add on days. 

Even though MAs work under the provider's license, unless you are in a room of your own you will be overseeing them. Will you be sitting in the nurses' station or in a triage room?

Clearly every clinic is different. What you said about the MAs is not at all what it's like at our organization. The RNs would have NO IDEA what the MAs do or how to train them. They sit in a completely separate area of the clinic. The RNs at our clinics (my clinic is one of dozens in our organization) have NO oversight of the MAs/rooming staff (the. rooming staff are either MAs. or LPNs).

Also, our MAs have quite a bit of longevity at. our clinic, so no revolving door. The MA with the least seniority has been with us a year. The ones with the most have been with us for 20+ years (two of them).

Emergent said:

The interview was fun

Tell. us more...

Specializes in ER.

They had a list of questions, and I have a list of questions. There's lots of personal stuff discussed, My Philosophy on patient and interactions and love for patients, how I've overcome some of my difficulties with overly assertive coworkers, lots of discussions of different duties, and making fun of how restaurant servers interrupt people's conversations and my idea to solve that problem.

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4 hours ago, Emergent said:

They had a list of questions, and I have a list of questions. There's lots of personal stuff discussed, My Philosophy on patient and interactions and love for patients, how I've overcome some of my difficulties with overly assertive coworkers, lots of discussions of different duties, and making fun of how restaurant servers interrupt people's conversations and my idea to solve that problem.

I transitioned, decades ago from intensive care to a community health center. I worked with an internal med/peds surgeon and an OB/GYN/PEDS surgeon. There were 6 other physicians and 3 NPs also practicing in the facility although some of the providers were part time.   It was busy with walk-in as well as visits by appointments.  As an RN I performed all tasks and teaching that was above the skill set of the MAs. The docs and the clinic manager supervised the MAs, not the clinic nurses.  I  maintained an ambitious patient program for follow up because our patients were on the low end of the economic spectrum and their ability to follow pocs was often limited by their employment, cash flow or transportation challenges. 

It was a fulfilling and enjoyable job.  The interpersonal conflicts with staff can be a real problem if the clinic is poorly managed. 

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