RNs being employed in primary care clinic

[go-for-it]

Hello all, what do you think RNs being employed in primary care clinics instead of staff just being of nursing or medical assistants. I don't think every nursing graduate wants to practice on acute floors. I think RN's role as a health promoter will be so much useful to the community as a whole .

[Cathyma4]

I have been working as an outpatient clinic RN for about 10 years both in Primary care and in a psychiatrist office. It is a good fit for the skill set an RN has and a growing need. I do a lot of triage and education. I spend a lot of time on the phone. The system I work with uses our assessment skills to help make sure patients are being seen in the appropriate place. Our patients are not being hospitalized like they used to be so more is managed in the outpatient setting. Because of this their is more need for critical thinking skills. Si in answer, yes it is a needed and growing role for the nurse.

[Lemon Bars]

I work at a large primary care clinic which is primarily staffed with medical assistants and LVNs. There is one RN on duty daily in each of the main departments of the clinic that I work at, and one RN at each satellite clinic. They mostly do triage over the phone, and they go out to the lobby sometimes for triage, and perform certain "high-level" skills in the clinic occasionally. They probably do some other stuff too, I'm not sure what all of their responsibilities are. Generally, these RNs have several years of experience in a hospital before taking a triage job, or they have several years experience as LVNs in a clinic before getting their RN license. I don't think they spend much time doing health promotion other than what they might say to patients in the course of a triage call. The issue is money (of course it's money - everything is about money). Our clinic only gets paid if someone comes in for a medical visit and is seen by a doctor, PA or NP. Triage doesn't bring in money for the clinic, but there has to be some sort of triage else the clinic would be overwhelmed with patients wanting to be seen for very minor issues, and charging Medi-Cal for those very minor visits might be considered fraud against Medi-Cal. If by "health promotor" you mean teaching patients about their illnesses, who is going to pay for that? Not most insurance companies unless they have a very robust wellness plan. You might find such a job working at a public health department.

Was that answer helpful? If you are just starting to consider pursuing a career in nursing, I recommend searching for nursing jobs and seeing what is out there. Remember that no one wants to pay an RN salary if they can hire an LVN, medical assistant, or unlicensed "medical education specialist" to do that job. Still, some jobs in clinics are available. There is also case management, if that is what you consider health promotion. Also, there may be some RN jobs in specialty clinics, maybe a cardiologist's office, where an RN does some of the education or health promotion to save the doctor time. Best of luck to you!

[GoodNP]

An RN in an outpatient clinic would be of tremendous value. Mostly for phone work as the previous poster mentioned. MAs are very proficient at skills such collecting VS, ECGs, giving vaccines and other injections, breathing treatments, etc. And I am fortunate to have wonderful MAs! However, they don't have the knowledge base to appropriately handle phone triage or answer questions re: medications and diagnostics. An experienced RN would be a more qualified, more efficient, safer candidate for that role. In specialty clinics one may find RNs functioning in this capacity, and it makes sense - specialists enjoy higher reimbursement, therefore they can more easily afford to pay an RN, and it is definitely worth their money. But in primary care - rarely willing to pay for an RN.

[guest8888]

I work in a primary care clinic, it is so different than what I expected.

[djmatte, ADN, MSN, RN, NP]

Our VA uses RNs in their primary care team-lets. They do mostly telephone work and handle the lab/medication/etc reviews for patients with chronic conditions such as DM. Where they see problems or trends, they notify the MD of the team and he/she makes changes as needed. A lot of it though is follow-up/triage.

[GeminiNurse29]

I do phone triage in a busy primary care clinic. I came from psych so my ability to talk to diverse groups of people helps.

If you're inexperienced, look at underserved clinics. The pay may be lower but they might be willing to give you a shot. If you have other skills like a second language, it helps too.

[ivyleaf]

In my area more and more clinics seem to be hiring RNs. I think the shift here is moving away from having medical assistants do everything. In our clinics (I'm a float for a large clinic/hospital afilliated group), RNs do case management, follow up/discharge calls, higher acuity triage calls (abd pain, chest pain), meds/injections (MAs do most vaccines), and teaching (DM/insulin/glucometer, self injection). And also coumadin/anticoagulation management. In urgent care they also do IV therapy. We have a few providers who are very busy who have a nurse and a medical assistant, or a nurse in place of a MA- those nurses "room" the patients-- take vitals, do a brief assessment. Other tasks include nursing visits for BP checks, helping with vaccines (esp during flu season), helping with pedi vaccines, supervising MAs, answering pt messages, helping with RX refills, prior authorizations (esp in specialties), help w/ED follow up calls for more acute/complex ED visits...there's a lot! It can get a little redundant, but it seems a lot more relaxed than the hospital.