Making the most of your Nurse

[SCPA]

I'm a new grad working in a busy FP and efficiency is the name of the game. I'm sure you all can relate. I'm curious how you all make the most of your nurse. My practice hires LPN's over MA's with the idea that their training will make the provider more efficient; I'm not sure I've seen that to be true. 

 

There are providers in my practice whose nurse does nearly everything: scribes the note, inputs and e-scribes medicines, plus all the other stuff like referrals, call backs, etc. 

 

Just curious how those with more experience are running things. I'd like to make the most of my LPN and bring less charting home. 

 

Thanks in advance. 

 

SC PA. 

 

 

[familygal]

Give him/her a list of "orders" to start on the patient before they are seen by you, depending on their chief complaint.

i.e.  Anyone coming in with:

 

Shortness of breath: get a pulse ox

Female with abdominal pain: get urine preg

Cough: Spirometry

"Lightheadedness": orthostatics

etc, etc.

 

Let them know exactly what you want set up in the room for procedures, pelvic exams, rectal exams, preventative care visits

 

As far as placing orders for xrays, labs, meds, etc...that can be up to you, but don't expect them to know what you are going to want to order.  I will have my MA load in the rx-refills the pt needs when they come in which makes it easier for me.  I think your basic SOAP needs to be done by you.

 

In our practice the MAs do almost all of the callbacks, we have a referral coordinator for referrals. they do not scribe the notes.

 

Some of these things take some time for you to learn about yourself, your habits and preferences, so it might take a while for you to be able to identify everything at once.  I am always evolving.

[KMD16]

^ agreed.

 

To add. Put your expectations in writing. Sit down with your nurse and go over your expectations. If possible, have him/her sign it.

 

For new pt visit. Gown pt. Entering both OTC & prescription med in the system while having pt complete new pt questionnaire. Prior PCP. Following any specialist? Starting ROS. Entering drugs allergies etc.

 

Procedure clinic. Inquire about med allergies. Get procedural consent for instance for simple office procedure like lac repairs or I&D. Your setup (surgical tray, needle size, lidocaine w or w/o epi, suture size etc). What's instruments needed for each procedures.

 

Expectations per pts complaints. Abdominal pain. Get UA. Female of child bearing age, do urine HCG. Asthmatic exacerbation. Do a peak flow while in the room completing vital sign. Cut or step on rusted nail. Inquire about Td status. If not updated get one ready. Severe allergies reaction. Get Benadryl prednisone inj epi ready.

 

Meet with your LPN regularly. Update your lists or expectations where you see necessary. Don't throw a lot at your nurse especially if they're new grad with no prior experience. For more sessional nurse, expect a fight as they're resistant to change and following orders. Hope this helps.