What can an RN do in a clinic??

[beachnrse]

Please help,

For those of you who work in a family practice/Internal medicine/pediatric clinic what are some of your elevated duties as an RN? My employer wants me to help the MD's more, and is asking me for suggestions to elevate my role-- then they will make a standardized procedure for it. The only thing I can think of is triage?

I am am not sure if I can refill meds like birth control, sign off on normal results or enter lab orders?? Can I enter orders for pediatric immunizations?

Do any of you do these things?

What are some of your protocols where you work that allow you to work at a higher level?

[Closed Account 12345]

Hi, I've never worked in a clinic, but from a legal standpoint, RNs do not have prescriptive authority. You may be *asked* to casually refill medications or enter lab orders in a clinic, but that doesn't add those tasks to your scope. If the doctor wants you entering medication orders, he/she needs to give you all required components - 2 patient identifiers, medication, dose, route, timing/frequency, number of refills, etc. An easy alternative to this would be for your employing physician to develop standing orders for common orders - i.e. a standing order saying you can authorize a 3 month refill on the patient's existing birth control one time, a standing order to order a CBC for patients with abnormal bleeding, etc. Standing orders make it easy for nurses to use nursing judgment and complete tasks without having to constantly interact with the provider. For example, as an ER nurse, depending on chief complaint, I could enter and quickly implement orders for IVs, fluids, labs, cardiac monitors, Foley or i&o caths, antipyretics, etc. Our unit had many standing orders in place signed off by the ER medical director.

[Monkey Nurse, ASN, RN]

My facility is a little weird because we are not urgent care but we have a rule that everyone who walks in at least sees an RN. We have standing orders for certain routine illnesses (not needing antibiotics)-- like guafinesen and ibuprofen and protocols to order these. We have a pharmacy, lab, and radiology dept all under our roof so we can have certain standing orders for these things. Also suture removal and scheduled injections have standing orders (and of course immunizations). I always hoped we'd get some sort of wound care and/or IV infusion clinic underway just to add some more 'fun' things to do.

My clinic is also having me work on a case management certification so I can have a broader role in that regards.

[Dembitz, APRN]

Our nurses have standing orders to triage UTIs, and if low risk, treat with antibiotics per protocol. They let the provider know after the fact. We're maybe working on a standing order for nurses to see patients with sore throats, do rapid test, and send antibiotics per protocol.