To the patients in the lobby complaining about waiting…

I work in a doctor’s office as one of the nurses. In our office we have 6 providers at one time. it is a very busy office.

i’m not sure if it was just that kind of week but every pt that I brought back to the exam room complained about the waiting time. by Wednesday hearing the same thing over and over again I needed to write about it to get my frustrations out. I have been working on this post for a couple of days because I kept rewriting thing to not sound like a bitch. lol.images (1)

so this is to everyone that complains about waiting in the doctors office lobby.

Just to clarify to anyone:

I know when you come into a doctors office it is for a reason. your sick, your child/husband/mother/grandfather/grandmother is sick. they need taken care of. I’m not saying that you aren’t important because you are but I want you to understand it is not intentionally the doctor, nurse, receptionist, or images (2)anyone else to make you wait for you appointment.

To the patients that are complaining… I know that all you see is the receptionist. please do not take your frustrations out on them. most the time they don’t know exactly what we are doing in the back. we know the door closes back to the exam room and you can’t see either but we promise you we are busy.

To the patients that are complaining…you might think the doctor is in the exam room way to long when a patient walks out and your thinking that they don’t look sick! just remember, not all sickness is visible. that pt could be here to talk about how they are fighting depression because they just lost their spouse or they were just given a horrible diagnosis like cancer. there are many different reasons that people come into the office, just remember they come in because they think it is important and we are here to take care of them no matter how small. we do it for you.

to the patients that are complaining …yes, the doctor walked out of the exam room and you are wondering why am I still waiting?!? it is because at the desk we are calling pharmacies because we just found out that one is out of your medicine and we need to send it to another but that one doesn’t accept your insurance so we have to send it to another one but that one is way to expensive so we are sending it to another one. we deal with this all the time! you don’t see it because we make sure you don’t.

to the patients that are complaining … we know that you need your medication. but when the pharmacy comes back and states that you need a PA (prior authorization) from your insurance company, we aren’t the ones that are delaying your medication. we get the request for the PA, send it immediately to the PA department who specializes in getting these completed. IT IS YOUR INSURANCE THAT IS NOT PAYING FOR IT. NOT US! it is also NOT THE DOCTORS fault that your insurance is not paying for the information. we usually know what insurance will pay for what medication but THEY CHANGE ALL THE TIME!

to the patients that are complaining… everything takes time to complete. referrals to another specialist are the worst. we know you need to be seen by a certain time and we are doing everything that we can to get you seen. the doctor notifies us to make sure you are seen right away. we are calling the specialist and giving them all the information verbally then we have to fax all your chart information. usually the specialist then has to review your information to see if the would even like to see you. once they agree they give US the date. yes, it might be 2-3 weeks later but it ISN’T OUR FAULT. it also isn’t the specialist fault. they are seeing people as well. they are making sure everyone is seen and trying to get you in. don’t let me get started on insurance… you need to see a certain specialist but your specialist has to be an hour away because of your insurance. AGAIN ITS YOUR INSURANCE!

to the patients that are complaining… we know when your appointment is. the doctor knows when your appointment is. yes, you might be waiting a little longer because the doctor is still at the hospital. yes, your time is important. but think for just one minute. if your loved one is in the hospital wouldn’t you want your doctor to spend just a couple more minutes to explain the situation to you?? or what happens if you just lost your download (4)loved one and you want to talk to the doctor? what If that pt in the hospital was your CHILD, you would want that time. yes, we know you are waiting but it isn’t because the doctor is being lazy or taking their time. they are dealing with millions of things going on in the hospital.

there are lots of other things that I can bring up to you about why patients complain. again, i’m not trying to sound mean that patients don’t matter. but just because you don’t see something doesn’t mean we are not doing anything for you. on a daily basis I am dealing with any where from 20-30 pts A DAY! I am calling them, filling medications, triaging, giving injections, etc. I love my job and I would not change it for the world, I just wish that patients would understand that everything that goes into an office visit. I didn’t even touch on the little things that we do.. like ordering labs, renewing medications, ordering injections and administering them.

after writing this I feel so much better. I got my frustrations out. now i’m off to work to start it all over again. images

 

 

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Life as nurse- Leaders

Are you a leader in your job? every day, when i walk into the office i need to be leader. leader4Not because i want to, but because of the RN behind my name. I earned my RN when i went to show. I wanted to a be a leader one day. i want to lead my patients to the right information when it comes to there health.

I have been in many different leader positions as a nurse. leader1

I did house supervisor for a while in the hospital. a house supervisor is basically the person that decides what is going on in the hospital. your the leader. the resource that is available when another needs assistance. it can be a good or a very bad position. some days you are caught up in so many things going wrong you don’t know which way is what. i enjoyed it at times. i did not enjoy it when i had 5 patients and was caring the “house” phone that kept ringing every 5 minutes.

i was a leader when i went to the doctors office and was the only RN in the office. i lead my team. i made sure that they were doing work correctly, keeping them on task, being the resource, teacher, friend when needed. it was hectic at times but i love it.

in this new doctors office that i am working in, i am not the only RN. i work with another one. I might not be the leader that i was before but I am still in a leadership position as a nurse.

every nurse is held to the same standards typically. leader2

  • commit to be excellence
  • passion for their work
  • vision and focus
  • trustfulness
  • respectful
  • accessible
  • knowledgeable
  • empathic
  • caring
  • leadership

these standards they drill into your head in college. you do multiple papers on attributes of nurses and how you are going to fine tone them. some come easy…others not so much.

even tho i have been a leader position in the past and continue to show how i am a leader when working with others, i have so much to learn. leader3

to be a nurse, you have to except that even when you are out of school, you continue to learn. i think any job that you are in you learn something every day. there is always a new technique, medication, health problem, or goal that they want us to follow. i am constantly learning new things every day.

my acceptance every day that i continue to want to learn and be better makes me a great leader as a nurse.

 

 

Life as a nurse- Kindness

kindess4

It is what you think about when you think about a nurse, right? yes, I know that some nurses are not very nice. I know, I’ve met them. I also have been one of those nurses at the time. I’m not sure if some nurses lack kindness or what.

To be a nurse tho, you need to be kind, caring, empathic. you need to have a kind nature because you are caring for patients. you are caring for patients that are ill, vulnerable, or scared. you provide comfort and kindness to them. kindness1

you show your kindness to your patients by showing empathy. being there to take care of them as well as developing a bond or establishing a trust while you care for them. they are in the hospital, doctors office, etc because their health is in need. you are the person that is going to provide help for that need. putting yourself in their shoes to understand how they are feeling and dealing with certain situations. providing the emotional support that they need.

kindness5kindness goes a long way in nursing. it might just a smile, giving out water, asking about the family. it shows that you have a connection with the patient. it shows that you care and want them to trust you. some patients do not trust easily.

I started a new job about 3 months ago. I went from one doctors office to another. I was at the previous office for about 2 years. my patients became dependent on me. I gained a lot of their trust and loyalty. they knew that if there was a problem, all they had to do is let me know and I would take care of it for them.

at this new job. I am having to establish that trust all over again.kindess3 i am showing to the patients that do not know me that i am a trustful, loyal, and kind nurse. they can trust me to take care of there problems. if they need something, i am there.

i have to admit there was a time that i was not a kind nurse. i was working as a brand new nurse, on a medical surgical unit. my shift was 3 am to 3 pm. my day started at 1 am where i would get up, drive 45 minutes to work, and start my day. some days were good, more were bad. medical surgical unit is a hard unit. it is where you get broke in as a nurse. gain all your skills. i was there over 6 months and i hated my job. i hated myself. i hated nursing. i became unfriendly. i didn’t want to be unfriendly but the demands that management was putting on nurses at the time with patient to staff ratio and difficult patients, it was hard.kindness6 i would go to work, hit the ground running, and would always rush around. i thought with switching to a more community hospital that things would change. they did…for a while. i wasn’t happy. i wasn’t unkind, i just didn’t love my job and it showed.

kindness was hard to show to my patients when i was unhappy. i think that some nurses stop showing kindness, caring, and empathy because they are burned out. no one knows what you go thru as a nurse unless you are a nurse yourself. my parents try to put themselves in my shoes and they can’t, they don’t understand.

trying to explain to someone that is not a nurse what it feels like to be a nurse is hard. i guess it is problem the same for a teacher, cop, artist, etc.kindness2

i know that working in a doctors office now that i love my job. i am happy. the reason why i wanted to be a nurse has come back to me.

i know that i want to take care of patients for the rest of my life.

I am a nurse.

Life as a nurse- J

J.

J?

really…. what starts with J related to nursing? joints, jugular, jaundice, JP drains, juvenile?

I could talk to you about all those things related to nursing… but i’m sure they are not very interesting. no one wants to hear about joint injections or dislocation of joints. dislocations that are so scary to see that everyone rushes in the room to see the xray.

instead of focusing on medical terms that are not very interesting…. how about some nursing JOKES?!?!?

Q: How do you know that a dead body found by the side of the road is a nurse?

A: Because its stomach is empty, its bladder is full, and its ass is chewed.

nursejoke2

Q: How many nurses does it take to screw in a light bulb?

A: None. They just have a nursing student do it.

 

Q: What did the nurse say when she found a rectal thermometer in her pocket?

A: “Some asshole has my pen!”

 

 

life as a nurse – I

there is a lot of terms that I could talk about with the letter “I” for this post of life as a nurse. if you are not already following or reading my other posts, look at the other ones I have done already regarding life as a nurse. let me know what you think!

what i wanted to do a little differently with the letter I, is tslk about the image of the nurse. everyone sees on tv how a nurse is portrayed. in grey’ s anatomy you barely even see a nurse, like they don’t exist in a hospital that is run only my doctors? 

in code black, Chicago med, the night shift they are seen differently as well. they seem to be the ones that call the shots in the hospital. 

the image of nurses has changed drastically over the years. In the year when Florence nightingale was around, it was the angel of mercy. you were respectful, pure, thoughtful, and diligent. you were inferior to a doctor. 

then the image changed over the years. you had images of the nurses in soap operas and t.v. shows where they barely wore any clothes, red lipstick, and dumb. why are we portrayed like this? 

I did a little research and found out that in 2001, the center for nursing advocacy wanted to raise the issue of the nursing shortage. they took charge of this problem by having campaigns that went after shows and producers, including house,ER, and the coors ‘naughty nurse.’ they wanted it to be known that nurses are really not like that and wanted to show them in a more positive light.

why are we not seen in a more positive light? nurses are rate as the most respected and ethical job in the top 10 for the past 5 years. 

does it have something to do with what we wear? some seem to think so. they fight that nurses are taken seriously when they have scrubs that have cartoon characters all over their shirt. 

another thing that pops up when you talk about the image of a nurse is a woman. predominantly, the nursing work force is women. yes, there are male nurses. you don’t see it a lot but as changes are coming in healthcare, more men are joining the workforce. 

the image of nurses doesn’t just occur in the workplace. you have to be professional outside as well. I work in small town. I see a lot of patients on a daily basis out and about. I can’t wear something in appropriate or act rude in public. I have to be professional, respectful, honest, and caring even outside of work. yes, we all like to have a good time. I’m just careful if we go out to a bar or public place that has drinking or even when I’m at the lake. I just try to make sure that nothing  can come back to me at work. some tell me, why pick a profession that you have to be careful all the time? I just tell them, I am already all those things in real life, I’m just making sure my patients continue to see that so they can trust me. I am the go between for their doctor. I want them to understand and trust that.

the whole point that I am trying to make about the image of a nurse is that we are more then just the skimpy nursing uniform. 

Life as a nurse– H

hWow, I am already on the letter H. I never thought that I was going to be able to get this far. I figured I would not have enough words and that the blog would start to diminish. yes, I did kinda forget to post for about a week. but I have a lot of reasons for that. not good ones really, since I said I was going to post no matter what and take advantage of scheduled posts.

life as a nurse has its advantages and disadvantages. advantages are you develop a sense of humor. you have to! you have to have a way to deal with the stress. plus, nurses kind have a sick sense of humor. yes… we prob sound like we are making fun of patients. its not that we mean to but its our way to deal with the stress. working in the ICU, you learn how to curse. in a doctors office, you learn how to make fun of yourself with stupid mistakes.

disadvantages? if you have been reading my series and might think that I am complaining about the long hours or patients. i’m not. I love what I do. I love that I do not have to work holidays any more. my heart is in this profession. not many nurses can say that. they get into the profession, get burned out, and become mean, uncaring. but one of the biggest disadvantages that I have encountered? being sick when you are at work. I know it doesn’t sound that bad, but it is hard. you don’t want your food being served toshiftending you by a sick employee at a drive though. so why would you want a sick nurse taking care of you in the hospital/office? it is also hard to be sick in this field because you have a huge amount of people that know symptoms of what is contiguous and what is not. they know if you really can come to work or not. to this day, I remember calling in for hand foot mouth disease. yes, it is real. yes, it is rare for adults. yes, I did get it. how? I think my nephew or the tons of kids I saw. I had blisters, a fever, and developed pneumonia on top of it. I was sick. my health took a turn. I was not able to do my job of taking care of my patients.

I felt like that paragraph took many different turns. lol. sorry about that. I wish I could tell you many stories about being a nurse. I have tons. I can tell you about somethings, but some stories have to remain secret due to HIPAA. I never tell you names, dates, or places. you do not know where I work and i’m not sure if I have even mention my name or where I live, other than a northeastern state. I would love to share some more things about myself with you but I need to keep some things private.

Life as a nurse. H. somethings that start with the letter H:

HTN (hypertension) A very big complaint in a patients health history

Health history– surgeries, diseases, family history. everything that you ask a patient to better understand them and how to care for them.

HIV– it’s real. it’s scary.

Herpes– safe sex people. get our shingles shots!

hiccups– yes, having hiccups is a problem and there is a medication to help with it.

herbal– weather it is herbal medications that you get at a drug store, vitamins, or health food store. or herbal as in marijuana.

hygiene– it is not hard to wash your face or at least brush your teeth, change your clothes, or brush your hair before you come into the doctors office!

hospice– a difficult talk with patients and families.

hangover– no not me. well, I do get hangovers lol. the day after holidays biggest complaints we get calls about? hangovers.

there are tons of other terms with the letter H for life as a nurse. I had a hard time writing this post tonight. I’m not sure why. hopefully, it makes sense. if not, sorry!

nurse1

Life as a nurse-F

f letterFatigue, family, FDA, faces, feces, fever,flu, farting 

Life as a nurse became a little hectic this week and I didn’t post on time for about a week. sorry folks! I am working five days a week and we are down to the last two weeks of school. so working, housework, school, and activities took over my life. I vow to be a little more efficient in the next week. this blog post about the letter F is a little long, but hopefully you still enjoy it! are people enjoying these??!?!

also..on a side note.. I do know the alphabet. I just forgot the letter F??!?!? yeah, i’ll be your nurse! hahahaaaa

FATIGUE

I understand this term oh to well. I’m tired. everyone in the hospital or coming into a doctors office is tired. the nurses are tired. the doctors are tired. it a never ending story. when I worked in the hospital, I work up to 3 days a week, 12 hour shifts. they sometimes went fast, sometimes so slow. it seemed the busier you were the faster the day went. typically that is how it works. what used to make the day even longer was being up staffed or mandatory overtime. up staffed is when they don’t have enough staff for the next shift and you are required to stay longer. typically they can only hold you another 4 hours, making you work a 16 hour shift. but… in reality you sometimes worked closer to 20 hours. yeah.. not safe. mandatory overtime usually happened with snow storms. everyone would have to come in before the storm hit and you would sleep in the hospital beds until your shift. you would work your shift, take a couple hours to sleep, then work again. you were not allowed to leave until they let you.

i’m thankful that I don’t work in the hospital any more for these very reasons. when I worked the 3 am to 3 pm shift. I was getting up at 1 am and not off work till closer to 7 or even 9 pm. just to go home and sleep for about 4 hours to do it again.

I was tired. I was so tired that I was not a nice person. my family hated me working at these times. they couldn’t stand my attitude because I was so tired I couldn’t function.

even though I work in a doctors office now, I still get tired just like everyone else that works a full time job. I think I get tired because it is such a mentally and emotional job. sometimes it is an easy day seeing patients. you have a bunch of well child visits and no one needs shots. then you have a day where it is nothing but huge health problem pts that are not in good health. I love what I do, don’t think I am complaining. I’m just trying to show you what it is for a nurse. when I am working as the phone nurse, sometimes good days about rashs. others its about chest pain, fractures, mental emergencies. those are the days when it is tiring.

family tree

family is important not only to patients but to a nurse’s family. first, the patient family. you can either have an awesome family… or one that you want to get out of the office as fast as you can. yes, I know that families are just concerned and want what is best for their member but it is how you come off to others that is horrible. sometimes no matter how much you do for a family member, they treat a healthcare member like shit. is it because the member is in the hospital/office? is it their anxiety coming thru? who knows?

a nurses family is just as important. I met my bf when I was a junior in nursing school. he knew getting into a relationship with a nurse was going to be complicated. he knew the long hours of school. it wasn’t until I went thru my boards, interviews, and job training what he really was getting himself into. he didn’t realize the long hours, the sacrifices I had to make when it came to holidays or events. he became my rock and stable place that I could turn to. he was the person I could come home and cry to after a long day. or stress out with because a patient was screaming at me over the phone for 2 hours. my family is a big part of my life. they understand what I go thru at work and understand if I come home upset and moody. they are also my safe place. I know that when I am with them that I can leave my bad days, long days, good days, at work. I’m ever thankful for their support.

fda

you know the label on medications that are approved and safe to use that they have reviewed? they are present there for a reason. they tell you if they have looked at the pros and cons of the medication. they basically are staying the medication is ‘safe’. have you ever gone to the store and you come across things that lack that label???

welcome to nursing. where all the unlabeled things that the FDA has not approved. including vitamins and supplements. all the weight loss medication that gives you the quick fix. or the quick fix medications for energy, adhd, blood pressure, cholesterol, etc. sometimes these quick fixes land you in the hospital for a not so quick stay. I see a lot of these things. yes, some of them are ok for you to use. like the herbals and the vitamins instead of the medications. but I have heard more than my fair share of things that are not approved by the FDA. I could prob write a book!

blueface

faces tell you a lot about a person. I can read faces prob better than a poker player. I am able to tell when a child isn’t tell the truth and I have to ask my questions differently. I am able to spot a pt that is lying about taking their blood pressure medications. I can spot down the hallway a pt that is trying to get out of a drug test for narcotics. you have to be able to read faces because some patients are not going to tell you when they are scared, fearful, or even in pain.

poopemoji

as a nurse I ask about your poop. it always comes down to the pooping. I need to know when, how much, color, texture, consistency, smell. I want all the information. I want it all!  yes, I even ask the little kids. some will tell you with a smile on their face because they can actually talk about their poop to someone! some just look at your afraid because that is just weird. older generations??? they answer the question without a blink of the eye. sometimes and most of the time they tell me before I even ask!

feverhead

I think one of the biggest lies that I hear on a daily basis is about fevers. parents call in about their child having a fever. telling me that they have it and when asked how high…”well I don’t know, I just know they have a high fever.” or the famous, “it was over 104!.” really? over 104? why weren’t they in the hospital then???!? take them to the damn hospital! or are you just lying to me to get an appointment by making up a number that you think is believe able.. because honey 104 is not believable.

I will only say two things:

  1. get your damn flu shot.
  2. the flu is not about just abdominal pain and throwing up. look up the symptoms!
  3. ok I lied, get your damn flu shot!

fart diagram

we all do it. its a basic human function. what I don’t like is when you walk past me when I am eye level with your butt and you fart. in my face. or when we put you up on the exam table getting ready for a pap and you fart….with no apologizing. yes, I know human basic function. but come on now!

wooo hooo!!!! you made it to the end of this long post about the life as a nurse– letter f.

I hope everyone is enjoying these as much as I like writing them. do you like them? do you want more? less? i’m not sure anyone is even reading these !

life as a nurse– G

good, grieving, glaucoma, and GAD


every patients wants to hear that they are good. good health, good weight, good diet, good decisions. it’s a constant questions “is that good?” “I’m I good?” 

I answer this question every day.somwtimes I have to say, no your not. your numbers are to high, you disease is out of control etc. 


grieving. it’s a process. they don’t really teach it to you in nursing school. you are not taught how to talk to a family member when their loved one dies. you are not taught how to talk to someone that is grieving. 

you are also not taught about the grieving that you go thru as a nurse. I grieve all the time. I grieved and still do when I worked in the icu and would lose a patient. I didn’t have anyone to talk to or hold my hand to tell me I did everything right. I grieve in the office when we lose a pt. patients aren’t the only ones that grieve. nurses do as well. we don’t get the attention as much because we are the ones helping those that are grieving and are not seen that we need help as well. 


glaucoma. ok..i think it might be on the area that I live. we have a lot of pts that tell us “I’m taking my glaucoma medicine. ” no they aren’t talking about pills or eye drops. they are talking about marijuana. I’m not sure why so many people refer to it as glaucoma medicine. but I hear this quite a bit. 

GAD. also known as generalized anxiety disorder. at one time in my nursing career, about the time I was in school, this wasn’t a big subject people wanted to talk about. no one wants to talk about that they have anxiety. mostly it is because it is known as a mental illness. it’s a stigma. patients have it. nurses do as well. 


nurses have anxiety going to work knowing that your short staffed, you know you will have to pick up the slack. you know that the 101 things you usually have to do turn to over 300. 

nurses have anxiety when you deal with bullies. yes, there are bullies in health care. I was a victim of been bullied. a house supervisor was not very nice when I was working the floor. it caused me to become anxious and I dealt with it. I have anxiety and depression and just that little thing of bullying tipped me over the edge. 

now a days, people are more open talking about anxiety and depression. why? maybe it’s because more people are wanting to talk about it and get help. 

life as a nurse -e

ears, expectorant, exit, exercise 


as a nurse, ears are a big deal. they collect things when you are small.. peas, stickers, marbles. when you are older they collect wax and dirt that is disgusting when they come out. working in a doctors office, I sometimes have the duty of flushing a patients ear out. it’s disgusting. the gunk that comes out of the ears. it’s amazing how something so little can hold so much. just talking about it makes me gag. yuck.


expectorants. you go to the doctors and we ask a million questions including are you coughing. what are you coughing up? color? thick ? thin? pts look at you crazy. why would you look at it and why would be ask. it’s my job to find out so that we can help you. it might be gross but it we gotta ask.

exit. every nurse knows the quickest exit to get out of your work place. not because of fires or emergencies. even tho you should know the exits in case of an emergency. no, a nurse knows the exits because she knows exactly how many hours it is until she gets off work. you get closer to that door every hour and second. 
exercise. you preach it to your patients. you need to get up, walk around, eat better, and exercise every day. but how do you practice what you preach when you don’t even exercise yourself? how do you say cut out the sugar, caffeine  and carbs. I’ve decided that the only way I can practice what I tell patients, be more healthy. I’m having bad days but I’m only human. when I encounter patients I tell them, it happens we can’t all be perfect everyday .