Quality

hey there!!! my respsonses are in red!!

i am an rn in an internal medicine office. i had been a lpn since 1999 and just made rn in december....very exciting!! right now i have two medical assistants that i work with, 2 receptionists, a md, a np, and our office manager.

i love my job....who would give up the weekends and holidays!!!

let me know if you have anymore questions!!

just dont get stressed out.....

new patient: 45 minutes for our md, 1 hour for our np

established patient:15 minutes if just a regular followup

well woman:30 min

well child: we are internal med...no peds ( yay!! i do not miss it!!!)

med refill: we call in refills if up to date on their regular appts

biopsy: 30 minutes for derm procedure and bx

walk-ins': all depends on what the problem is....alot of stuff we can triage without patient being seen by md, or we have them come back

lab draw: no time to do lab draws....we see patients from 0800 to 12 and 1 to 330....no time!!!

the rn's do all their own lab draws, we have to spin them down and then a courrier comes and gets them everyday. so when the provider orders labs we do it right after they are done in the room with them, then this seems to get us behind on the rest of the schedule. we are scheduled to see a patient every 20 minutes, thankfully there are some no shows because the charting and icd9 codes take a lot of time. you really need to discuss this problem with your office manager.....maybe there can be a phlebotomist hired??

also..

what quality controls do you have to do for the equipments (do you have to run control on the autoclave and how often?) we dont have an auto clave, we had manual sterlizing of equipment. the cleaning stuff has to be changed every 2 weeks...

inr machine: luckily are inr machine does not require liquid controls...the machine is made to check its own controls with each test done....so, for qc purposes, we write that the key in the machine is the same as the code on the strips we use.

accuccheck: controls done once weekly and days that the machine is used

ref/freezer temp log

in our procedure room the old nurse put needles in the cupboards for easy access, they are not locked up, so anyone could get to them if they just looked in the cupboard. we have not had problems with this, but it could be one if somene found out. do you have poicy about keeping needles locked up or out of patient rooms? i do not leave any sharps in the exam rooms, except for the scapels in the procedure room, and im in the room with the patient at all times when we're in there.

where do you order your medical supplies from and are you responsible for your ordering or does someone else take care of that? luckily, we are underneath a hospital system, so they have a template for ordering. i go in and punch what i need on the computer. before that, i had to fax in the order to the company we used....now we use mainly moore medical ( they have the prices listed in the book which helps!!) and we use to use cardinal health...

thanks for any input.

also any tips for a new office nurse would be great :)

Thanks for the input, very helpful.

Our office is going through a lot of changes right now. They are thinking about cutting one of the nurse positions due to lack of funds because it is a grant clinic, things need to get get better organized so we can keep up with patient flow and everythng else, because one nurse will not be able to handle all the things we do.