Clinical: Medical

The value of having an ophthalmic RN on staff is not limited to the treatment of surgical patients. The ophthalmic nurse can be of benefit in every patient encounter in which pathology is present. The nurse can act as a second pair of eyes, ears, and hands, extending and complementing the physician's care.

Nurses have the knowledge to exercise independent clinical judgment. Their problem-solving capabilities are a resource to the team. Based on patient assessment and chart review, the nurse frequently initiates and modifies testing by the technicians without interrupting the physician.

As a patient educator who is aware of the patient's systemic status, as well as the psychological factors of chronic illnesses (e.g., glaucoma, diabetes, age-related macular degeneration), the nurse promotes realistic expectations and relieves the physician of repetitive explanations. Increased patient understanding leads to increased compliance and better outcomes. For example, the nurse can provide education and creative solutions to parents of a child who is beginning occlusion therapy.

Frequently, the patient's response to an illness can be more problematic than the condition. Depending on their experience or knowledge, patients may feel shock, anger, fear, or hopelessness when diagnosed with a condition. This is especially true when the condition requires surgery or is of a chronic nature.

These reactions can profoundly affect the patient's ability to adhere to a potentially complicated treatment regimen or to live with a permanent disability. The ophthalmic RN can assist patients to achieve a maximum level of wellness by helping them understand, accept, and live with the realities of their conditions. He or she can also coordinate future care with the necessary social service agencies.

Nurses are capable of handling more than 95% of patient telephone calls, including those coming through the answering service after hours. They can triage the calls as well as return calls from patients and other physicians. Other calls include communicating pathology to subspecialists and consultants, reporting to referring and primary care physicians, relaying physician's orders to hospitals and pharmacists, and approving prescription refills. By handling these calls, the nurse saves the physician time, which can be spent on direct patient care.

Many patients are more comfortable approaching nurses with questions. A nurse can evaluate early warning signs and triage emergencies, improving patient flow and timely care. Patients can report back to the nurse by telephone. By monitoring progress and reassuring the patient, the nurse saves the physician time and increases the practice's ability to provide high-quality care.

Other clinical responsibilities the RN can assume from the ophthalmologist include:

- Preventive care and wellness teaching;

- Development of patient education materials, chart and documentation forms, and operative report forms;

- Fluorescein injections;

- Community outreach programs - screenings and presentations;

- Meetings with industry representatives; Evaluation of the quality and cost-effectiveness of procedures, equipment, and supplies.

In addition, many RNs have adjunct staff privileges at hospitals, allowing them to write orders, make progress notes, and begin consultations.