Nursing: What is the Future of Doctor's Office Nursing?

Doctor's office nursing: An expanding horizon

"What is the future of doctor's office nursing?" is a timely question, for this era. Responding involves taking a close look at the changing roles and responsibilities of registered nurses working with doctors, in their offices.

Doctor's office nursing offers a rapidly expanding horizon of employment for prospective registered nurses, for a number of different reasons. The health care field is constantly growing and changing. The population of the world is exploding and there is a marked shortage of health care professionals, on every level.

There is already a shortage of practicing doctors in every country of the world. There are not enough doctors being trained to meet the future demands of global health care.

A cry for help resounds around the world.

"If not doctors, then who will provide our health care? Is there anyone able to meet that need? Who can fill the gap in our health care system?"

"Will this demand have to be met by nurse practitioners and registered nurses?"

It would appear that nurse practitioners and other registered nurses, as health care professionals, will be called to help meet the increasing demand for global health care, in the near future. There will be a need for more doctors' office nurses and the future of doctor's office nursing is assured.

Registered nurses have always had an open door for employment in the majority of doctor's offices. Not all doctors require registered nurses, but registered nurses have always worked in conjunction with doctors in their offices in many areas of health care, all around the world. This will continue as a trend into the future.

On the whole, working in doctor's offices can be a rewarding and a wonderful experience for registered nurses. It can be a demanding job intellectually, emotionally, spiritually and physically. Registered nurses employed in doctor's offices may experience fear or frustration and have feelings of helplessness, because the needs of people are not being met, in many parts of the world.

Take this one step further in a positive direction.

Registered nurses are currently required to obtain higher levels of nursing education than has ever been demanded previously. In the past, many registered nurses attained nursing diplomas from various schools of nursing. Gradually, these schools of nursing have been phased out, in lieu of higher nursing education, on a college or a university level.

Registered nurses with advanced education, experience and training have always been employed in numerous areas of extended health care under the guidance of doctors. In many instances, the doctors assessed the skills, experience and level of expertise of registered nurses. They decided what the registered nurses were qualified to do. If necessary, the nurses received further training.

As an example consider the role of mid-wives.

Often, the qualifications of registered nurses employed as midwives were subject to scrutiny and severe criticism, by others in the medical profession. Midwives were not regarded as having attained sufficient medical training to assume the role of doctors with regard to maternity care and the delivery or care of new born babies.

As a result of this controversial issue and other questions about what registered nurses could and should be allowed to do, registered nurses began to seek additional training. They recognized the feasibility of establishing a new category of registered nurses, called nurse practitioners.

The official recognition of registered nurses as nurse practitioners, took place in 1965. These nurse practitioners were highly educated registered nurses with Master's degrees. Increased educational opportunities in nursing have allowed the role of the professional nurse practitioner to expand even further. Today, this field is broader in scope.

How does this fit into the picture with respect to the future of doctor's office nursing? The horizon of nursing in doctor's offices is expanding, but probably not in the way that many people expected to see it happen. In the future, there will be room for registered nurses to work in doctor's offices. Many registered nurses will more than likely go that route. A more advanced horizon awaits registered nurses with the desire to seek higher levels of nursing education.

For those undergoing training as registered nurses now, rather than do that, why not become nurse practitioners? Certification and licensure as professional nurse practitioners, enables registered nurses to work on an entirely different level with doctors.

For new registered nurses, seeking future employment in doctor's offices is a valid option, but attaining a higher level of nursing education enables the same registered nurses to be employed as nurse practitioners.

The opportunity is there for both women and men, who demonstrate the interest, courage, commitment and dedication to pursue that career option.

Doctor's office nursing demands registered nurses with a high level of interpersonal relationships skills, as there is continuous interaction with patients. Registered nurses have to love people to thrive in this work environment. They meet and greet dozens of people during the course of a day. They must have a high level of concern and compassion, coupled with high standards of nursing care. Quality nursing care is important in doctors' offices because these offices set an example for communities. Doctor's office nursing demands a high level of energy from registered nurses because of the rapid turnover of patients. Seeing new patients every five to ten minutes for hours at a time, entails a lot of work. Good organizational skills are needed by registered nurses, as each patient has unique, health care needs that must be met in the doctor's offices. For example, in a family practice office, the registered nurse may be taking blood pressures, doing dressings, giving injections and doing well baby care or a collection of medical tests, treatments or procedures.

If the doctor's offices are highly specialized, more advanced skills may have to be acquired by registered nurses, in order to assist the doctors. Even a variety of lab skills may be needed, if there are no laboratory facilities available.

In a doctor's office, telephone and office skills are vital, as registered nurses replace receptionists or 

clerks who book appointments, file various kinds of medical reports or other clerical work.

There are continual changes in the field of medicine and registered nurses must stay current with regard to what is happening. Medications, procedures and treatments are always in a state of transition and registered nurses discuss these with patients. Sometimes patients need teaching, counseling, guidance or reassurance.

Good communication skills are vital, as appointments have to be booked with other doctors. Staff 

scheduling, bookkeeping and payroll issues may be part of their job. There are times when registered nurses assist in the orientation and training of new doctors.

Computer technology is enhancing doctor's office work for registered nurses, everywhere in the world. Continual technological advances in computer require ongoing training for everyone, so this may also become the task of registered nurses in doctor's offices.

For those registered nurses who are seeking future employment in doctor's office settings, placement in a doctor's office, while in training, is an option to consider.

Working in a doctor's office can be an excellent learning experience for registered nurses, but for those seeking to go beyond that experience, there is a rapidly expanding horizon of discovery, with increasing challenges for registered nurses as nurse practitioners, on a global level. Consider it a challenge of our time.