|By Kadesha Thomas|
Nurses providing outpatient care may have as few as five minutes to connect with a patient, address their known and unknown clinical concerns and coordinate treatment. The time may seem short, but ambulatory care nurses at the Medical Center agree that five minutes is sometimes all it takes.
“The challenge for outpatient care nurses is to provide comprehensive care for a patient during their visit — clinical assessment, history, treatment, specific tests, referrals and education,” said Beverly Robins, RN, the Medical Center’s director of ambulatory care. “All of that has to take place in a short amount of time, especially in primary care settings.”
Aside from addressing the patient’s concerns, the nurses’ ability to pick up on the nonverbal cues is the key to maximizing the visit. “You have to dig deeper,” Robins said. “Let’s say the patient came in for their routine office appointment, but they have a grimace on their face or they’re holding a certain body part. The nurse has to notice that and ask the patient whether he or she is having pain, even though that’s not why the patient came in.”
The Medical Center has more than 250 nurses providing outpatient care in more than 30 ambulatory care areas, including the primary care group, orthopaedic rehabilitation and radiation oncology, to name a few. Many are housed in the Duchossois Center for Advanced Medicine (DCAM), though other ambulatory care services are based in the Bernard A. Mitchell Hospital for adults and Comer Children’s Hospital at the University of Chicago.
Patients often come in with their family members, which can make obtaining sensitive information within the short visit somewhat challenging. “You have to know how to work around awkward questions tactfully, like asking a teenager in front of the parents, ‘Is there a chance you could be pregnant?’” said Donna Lisec, RN, nurse manager in dermatology procedure and clinics. When this happens, Lisec has to get creative, often writing the question on a piece of paper and showing it to the patient or asking while the parent has stepped out. "In the ambulatory setting, that’s a difficult thing for everyone,” she said. “It’s a bit of a balancing act.”
Marc Matarelli, RN, spent more than 20 years as a nurse in various pediatric hospitals’ intensive care units, where he focused on one or two patients each day. Since switching to outpatient care three and a half years ago, he has grown accustomed to juggling between 5 and 20 patients each day. Some patients may need simple blood draws or vaccinations; others may need blood or chemotherapy infusions.
Matarelli said he found the inpatient and outpatient care experiences to be “night and day,” but they both offer opportunities to connect with patients and their families. “As an outpatient nurse, I may only see my patients for a few minutes, but many of them are ‘frequent fliers,’” said Matarelli, RN, a staff nurse in the Pediatric Specialty Center of the DCAM. “I see them one or two times a week, so I try to build on each visit to learn more about their treatment, their personal life, their hobbies. I bring that up in their next visit so they know that, despite the short time, they are not just a number.”