1st nursing job in a doctor's office - a little wierded out

[sakura_RN]

hello to you all fellow nurses!

I was super excited when I was finally offered an RN job, but I was extremely nervous too. I always thought i would start in a hospital setting, but instead i was offered a job at a doc's office (internal med) where the staff is split right in the middle - 1/2 are vietnamese, 1/2 are spanish-speakers (me = spanish speaker :) And right off the first day, i was majorly weirded out.

Ok, so tell me why all the people that give the shots and draw labs and collect samples are called NURSES? I'm the only RN there, the other 2 are Med. assistants, 1 is a phlebotomist, 1 is a CNA working part time here, and 1 doesn't even have a degree in anything related to health care. And get this - that last one - the one with no health care degree - is the one in charge.... what the FLIP!?!?!? Here's the thing - He is the one that is orienting me, when he introduces himself, he says "I am one of the nurses", he draws blood, starts IV's (!!!!!!!), gives meds (almost all are IM injections).....

Am I delusional? While I was in nursing school (and please feel free to chime in on this one), it was expressed to me in VERY STRONG words that I should NEVER introduce myself as "I'm one of the nurses" but rather "I'm a STUDENT nurse". Every time I charted something, it had to be signes ",SN" not "RN" - why? I thought it was b/c it was illegal to be representing myself as a nurse when in fact I was only a student nurse. Even on this Allnurses forum, I specifically remember that when I chose my username at first, I chose "Sakura_SN" b/c it was in the guidelines that I could not represent myself as an RN until I got the title.

So why is it that in this doc's office it is ok for this gentleman, as well as the other ppl, to represent themselves as nurses???

and most importantly - I am worried that by me, as an RN, being there might put my license in jeopardy. I know that certain advice can't be posted in here, but maybe i can be directed as to where to find info about this.

...... the other less important thing that weirded me out was the Point system. Apparently, when you do something wrong, you get a "point". This point is then sent out to EVERYONE in the office, for example, "Jane doe has received a point b/c she did not key in the right code for the CBC machine". Well now everyone knows what you did wrong. So I asked, well what happens when you get a point? This was the explanation: "You don't want to accumulate too many points, you may get a verbal warning. If you want the point taken away, it may be docked from your pay or YOU MAY BUY THE DOCTOR LUNCH"

what?!?!!??!

Why is it that that explanation made a big siren go off in my head???

ugh... I already hate my job and I've only been there a week. I have no idea how I am supposed to stick it out for a year (that's my goal - I want to be able to put my experience in a piece of paper and write my ticket elsewhere)

sorry for the long entry

p.s - please don't close my thread - I really do want feed back

[jamieslovingmom]

Hi,

In Washington State, an MA can administer injections, including immunizations. I believe CNA's are also authorized to do this. As far as starting IV's, I would have some objections to having a CNA or MA doing that. I would check your state's DOH for scope of practice laws and investigate this yourself before reporting the activity at your clinic, just to be sure. I also work in a doctor's office (fam practice) as an LPN and the MA at our clinic does pretty much everything that the LPN's do, but we don't draw blood or start IV's there. (Thank God!) :)

That being said, I would be cautious about staying in that environment. As you stated in a previous post, you should worry about your licence since, technically, the CNA is working under your supervision. An MA would not be, I believe, since they are technically working under the physician's supervision.

HTH,

monica

[DolceVita, ADN, BSN, RN]

Hi,

In Washington State, an MA can administer injections, including immunizations. I believe CNA's are also authorized to do this. As far as starting IV's, I would have some objections to having a CNA or MA doing that. I would check your state's DOH for scope of practice laws and investigate this yourself before reporting the activity at your clinic, just to be sure. I also work in a doctor's office (fam practice) as an LPN and the MA at our clinic does pretty much everything that the LPN's do, but we don't draw blood or start IV's there. (Thank God!) :)

That being said, I would be cautious about staying in that environment. As you stated in a previous post, you should worry about your licence since, technically, the CNA is working under your supervision. An MA would not be, I believe, since they are technically working under the physician's supervision.

HTH,

monica

This isn't just about scope, it is about these people misrepresenting themselves as nurses.

[jamieslovingmom]

I realize this is also about misrepresentation...I did not feel the need to reiterate that. The OP asked for opinions about how to handle her situation...I stated my opinion.

monica

[Jerico, BSN, RN]

I was in a dr office one day and the recept told me "the nurse" is going to discuss your procedure with you (colonoscopy). So "the nurse" takes me into a business office area, sits me down and starts to discuss the procedure. I start asking technical questions, things an informed patient would ask...and she could not answer the questions. Not only that, she never even introduced herself. SO I said: "Are you a nurse?". She said: "Yes". I said, "Where is your ID tag?". She says, "Oh, it is in my desk". I said: 'May I see it?". She takes it out of the drawer and it has her name on it but no professional designation. I said, "Where is the RN or LPN identifier, as I was told I was going to speak with a nurse, to give me my procedure information and discuss...". She says, "Oh, I'm not that kind of nurse....".

I stopped the conversation right there and asked to speak with an office manager. I informed the office manager I was an RN, and "Your officer personnel are calling themselves nurses, I think you need to take care of that, because they are not licensed nursing personnel...I AM...and I don't think the BON of Texas would approve". She was falling all over herself apologizing.

I left, and needless to say I did not use these GI docs for my procedure. A week later I got a letter of apology from the office manager telling me she sent out a letter to all her employees requiring they NOT call themselves "nurses" if they were not RN/LPNs etc.

[DolceVita, ADN, BSN, RN]

I was in a dr office one day and the recept told me "the nurse" is going to discuss your procedure with you (colonoscopy). So "the nurse" takes me into a business office area, sits me down and starts to discuss the procedure. I start asking technical questions, things an informed patient would ask...and she could not answer the questions. Not only that, she never even introduced herself. SO I said: "Are you a nurse?". She said: "Yes". I said, "Where is your ID tag?". She says, "Oh, it is in my desk". I said: 'May I see it?". She takes it out of the drawer and it has her name on it but no professional designation. I said, "Where is the RN or LPN identifier, as I was told I was going to speak with a nurse, to give me my procedure information and discuss...". She says, "Oh, I'm not that kind of nurse....".

I stopped the conversation right there and asked to speak with an office manager. I informed the office manager I was an RN, and "Your officer personnel are calling themselves nurses, I think you need to take care of that, because they are not licensed nursing personnel...I AM...and I don't think the BON of Texas would approve". She was falling all over herself apologizing.

I left, and needless to say I did not use these GI docs for my procedure. A week later I got a letter of apology from the office manager telling me she sent out a letter to all her employees requiring they NOT call themselves "nurses" if they were not RN/LPNs etc.

That is very scary. I would be interested to know what kind of nurse this person thought they were (a nurse in their head I think)? Dreadful.