Registered Nurse's role in physician's office

[Shortcake_BSn]

What exactly should a registered nurse's role be in a physicians office? Sometimes I feel like an overpaid medical assistant. The RNs, LPNs, and MAs are used and viewed interchangeably at the physician's office that I work at. I honestly feel like the RN's are not being utilized properly but I could be wrong because I'm not sure. What should be the RN or LPN's role and what should be the medical assistant's?

[SaltySarcasticSally, LPN, RN]

I have worked in doctor's offices for most of my LPN experience, the RN's role is going to depend on what kind of practice your in. Right now, I am in a family practice and myself and the RN functions like an MA. There is nothing (besides testosterone injections) we can do that they can't since we do not do IV's or administer meds other than breathing treatments. When I worked in an occupational health, the RN had a vastly different role since she was assessing injuries and administering treatments, meds, and emergency care.

The family practice I work in currently also uses the word "nurse" very widely. We don't do much triage, if the person is sick the front desk gets them in or tells them to go to the ER/Urgent care. But our MA's do answer the phone as "This is the nurse's line" when none of the nurses are actually answering the phone. Obviously it's misleading but the majority of doctor's offices I have been have always allowed the MAs to refer to themselves as nurses, unsure of why since we all wear big flash tags with our titles clearly visible.

It is pretty redundant in family practice. I am only doing it because I needed a PRN job to finish out my RN degree in April. It's great hours but oh so boring. If you need more of a mentally stimulating job try occupational health or same day surgery, you will get to utilize your skills more in that area.

[Julius Seizure]

This is so true. I've had to correct several docs, usually first year interns but a couple residents and even an attending, regarding my scope. Usually they were asking me to pull a drain or central line, unaware that I am legally unable to do so!

Some of that is dependent on where you work. I've worked in a few different states (and obviously, different hospitals), and the rules are different.

In one place, I could push ketamine but not pull central lines.

In another place, no ketamine, no pulling femoral CVLs, but I could pull them jugular CVLs.

In ANOTHER place, I could pull any CVL.

Mostly, I meet doctors that underestimate nurses, rather than overestimate them.

[Julius Seizure]

I recently was shadowing an NP in a pediatric clinic. Oh my, I was surprised and concerned on multiple occasions there! Hand hygiene was definitely not up to par! No nurses there, only very nice but very young MAs. They gave breathing treatments, vaccinations, tylenol and motrin. I didn't know this was allowed, especially the breathing treatments. They sometimes did discharge instructions for the physicians and NPs. Sometimes they would give the families instructions on care before the physician or NP even went to see the patient.

They were helpful, but didn't really have any medical understanding at all and I'm not sure what their training is on giving shots or other meds, or anything like that. I have no idea what the official rules are, but my understanding is that since they are not licensed, they can pretty much do whatever the practice lets them do. I definitely felt like there should at least be a nurse over seeing the MA staff.

[chiromed0]

Wow...first you are a rarity. Most doc's offices are too cheap to hire RN's! I wouldn't feel "bad" about it, after all if you want meaningful work I am not sure a medical office vs hospital (acute care) is where you will find it. Most offices are mundane, repetitive work even if seeing sick patients. The way the doc probably looks at it is "everybody" works for him and nobody is "special" unless you can bill for their service. Even then it's questionable although I do think they can bill for some stuff you "should" be doing and it might be worth investigating and bringing that up to them. They listen to money, not complaining.

I agree with everybody that being called "nurse" even if they got hired the day before out of high school to just answer the phone IS ANNOYING. But on the same subject everybody gets called "doc" by patients even if they are mid-levels and most mids aren't doctorally prepared. I notice when people would call me doc even when I was working as an RN-I am a doc so I figured well at least it's accurate. In the clinic, the staff jumps from calling me by my first name, sometimes doc (even though I work as an NP here--MSN not DNP) so that is confusing too. I personally don't refer to myself as "Dr" anything anymore unless I think it helps with the patients confidence in their care. Otherwise, it's just a title that gets in the way..it's not about me it's about them so that is where the focus should be. On a sad note most DNP's will never be called "Dr" in a hospital or clinic b/c it confuses the patients if they work under a physician. As Rodney Dangerfield said, "I get no respect, no respect". Even in my clinic my "peers" call me by my first name but will refer to people with my same credentials as "Dr. so & so"...sometimes the closest people to you respect you the LEAST!