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.

Quote

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 Specializes in L/D, newborn, GYN, LTC, Dialysis.
Just now, 2BS Nurse said:

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.

Well I was very lucky ours did. But often that was for the doctors not us. In their lunch hour they would often run next door to the hospital and round on their patients there, checking labor progress or discharging new moms. Or doing noontime csections. (at times). It was to allow them time to do all that and eat as well, except for the case of csections. They just usually took their break after the procedure was done. Anyhow I digress.

  For me it was a whole hour that I could often eat lunch anywhere I chose. But I was the ding-a-ling who sat at her desk going through voicemails and trying to catch up, more often than not, so I could get out on time, eating as I went Whew we were busy.

8 hours ago, 2BS Nurse said:

lunch break

What is this term you use? I'm not familiar with the concept.

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

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.

Sorry I was unclear - I was speaking for my experience at my facility; it wasn't meant to be a broad generalization of all inpatient clinics. Yes, the RNs know how to do the tasks, but they don't know the MA charting, they don't know collaborative documentation (starting the appointment notes for the clinician), they don't know the Medicare annual wellness visit workflow, or who needs ASQs or ACTs or PHQs, etc. Again, AT MY ORGANIZATION.

Specializes in school nurse.
2BS Nurse said:

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.

You dropped VERY important words in your unofficial quote. The OP said it's not that the RN can't do the MA job. That's very different from "the RNs CAN'T do the MA job, legally."

16 hours ago, 2BS Nurse said:

Very well written SmilingBluEyes. I forgot to add in lab specimen processing and cleaning/stocking/ordering supplies and medications.

Yeah, on top of everything else you will also find me ordering and stocking everything from toilet paper to vaccines and everything in between. 

6 hours ago, klone said:

Sorry I was unclear - I was speaking for my experience at my facility; it wasn't meant to be a broad generalization of all inpatient clinics. Yes, the RNs know how to do the tasks, but they don't know the MA charting, they don't know collaborative documentation (starting the appointment notes for the clinician), they don't know the Medicare annual wellness visit workflow, or who needs ASQs or ACTs or PHQs, etc. Again, AT MY ORGANIZATION.

It's pretty funny when I do have to room. I technically "know" all of that, I just do it so rarely I'm super slow and rusty. Figuring out which note the doctor wants (they are all different), then the wellness visits and all those questions and hearing the patient's life story when I ask if they had a fall in the past year or whatever. It's generally easier for everyone if I help the MAs with everything else when they are short instead of having me room.

The day would never come when our clinicians would room though, they wouldn't know how to start their own note, document vitals or who needs PHQs etc. either. I honestly believe we'd close the clinic first. 

    Guest
    Guests

    Guest

    0 Posts

25 minutes ago, NotFlo said:

Yeah, on top of everything else you will also find me ordering and stocking everything from toilet paper to vaccines and everything in between. 

Isn't therethere a clinic manager who is responsible for those duties?

Specializes in ER.

I think I'm going to get this job, they sent me a text wanting me to get references today. I have very good references including the CNO from my previous job.

"Isn't there a clinic manager who is responsible for those duties?"

The managers tend to "delegate" everything they can. 

Klone: It sounds like you work for a great organization. Sadly, where I worked the RNs had to know all of the above so they could conveniently slip into the MA role at a moment's notice. Again, it helps to have a union behind you.

 

+ Join the Discussion