Monday, September 18, 2006

Office staff rant

A tough thing about being newFNP (or supervising MD or co-worker NP) is that there are no other employees in the clinic as responsible or as knowledgable as you. In some ways, that's fine. In other ways, it makes newFNP want to yell at people and throw her pens at them.

NewFNP's biggest pet peeve in not having labels in the chart.

NewFNP is the third stop in the clinical flow. First stop - front desk. Second stop - MA/vital signs. Third stop - newFNP.

As evidenced by the above written flow chart, here are at least two people ahead of newFNP who can open the chart and see that there are, in fact, no labels. Ultimately, the front desk needs to take a split fucking second and look in the chart. Are there labels? No? Print them out!

Ten minutes later, when the MA writes down the chief complaint and sees that there is no label with which to identify the patient on a new progress notes page, she then has the opportunity to ask the front desk to print out some labels.

Now, newFNP is not sure how often the aforementioned scenario occurs, but she is quite sure that it did not happen three times today, a day in which newFNP was responsible for the care of thirty-four patients. On such a day, newFNP finds it difficult to be polite when wasting precious minutes of her time to go do someone else's job. It is not as though newFNP has neglected to mention this ever-present need for labels to all clinical staff during weekly staff meetings. To the contrary, time and time again, newFNP has pleaded with her co-workers to throw her a fucking label bone. Alas, no.

Ranking second on newFNP's list of pet peeves is incomplete or an absolute lack of lab results in the chart when a patient's clearly stated CC is "lab results." Should it ever happen? No. Should it happen daily? Hell no. Does it? Shit, yes it does. This causes newFNP to hunt down her MA and request the results. Sure, newFNP could find them faster herself, but fuck that just on principle.

There are many other things our MA's miss. Some of it a simply a lack of knowledge and newFNP is not going to fault them for having next to no education. However, newFNP attributes a decent amount of MA oversights to sheer laziness. And newFNP is pissy about that. NewFNP has struggled all year with the fact that she is working like she is on the chain gang all day long while she sees other employees looking on MySpace and taking 10 minutes to figure out from which fucking fast food restaurant everyone wants to order lunch.

Being at the top of the intellectual food chain in one's community health clinic is at times a welcome responsibility and a frustrating burden. NewFNP sincerely believes that it would not take much effort on the part of other staff to ease the workload of the clinicians. Sure, we'll see the 25-30 patients per day. Just make it a frigging smidge easier on us.



Anonymous said...

You have opened an ugly door here - and it is all I can do to not get started here and still be typing or ranting away long after I should stop. How about not getting temps on sick visits? Or pulse ox a wheezer? So, I have to leave the room, hunt down a thermometer, usually found in the POCKET of the MA. Or my COPD'er with 2+ pitting edema who "didn't wanna get weighed this time..."(per MA). And the patient who is here and the CC says "to review labs - and there are no fricking labs in the chart...And don't call them NURSES - whatever you do patients, cuz they are certainly not. Okay thanks, for letting me vent that.

Nurse Practitioners Save Lives said...

Right now I work at the hospital and I have to say the same of several of the CNAs that I work with. Lazy to the freaking bone! I am forever getting patients up and down to the bedside commode and answering call lights. I know as a nurse, these things are part of my job as well but I just want to be able to get MY job done without taking care of everyone else's! Come on graduation! My knee is killing me..

NP Miller said...

Oh my goodness, you hit the nail on the head . thanks for all you write about . makes me feel normal.

Anonymous said...

God did you ever nail this one! What gets me is that they call themselves "nurses"! Ha! Noooo.. If your school advertises on tv late at night? You did NOT go to nursing school. Oh... and if the advertisement begins with, "You too can have an exciting career in the medical profession"? You didn't go to nursing school.

nursing continuing education said...

Well, it is one of the responsibilities of being in the top places. Having to yell or shout can be a part of the job sometimes but it wouldn't be good if it happens all the time and if it happens without any reason or basis and if it becomes hurtful to others.