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A Nurse’s Guide to Your Pediatrician Office

Winter is by far the busiest time at a pediatrician’s office. Before having my daughter, I was a nurse at a very busy family practice and walk-in clinic—so I’ve seen it all. It wasn’t uncommon in the winter to have longer waits, sick kids coughing in the waiting room, moms screaming for last minute appointments, parents begging for prescriptions over the phone, and even kids arriving who should have been in the Emergency Room.

Let’s help you avoid these issues – and help out my fellow nurses out there!

Nurses Guide to Your Pediatrician

Waiting

Some times you walk right in, other times you’re pushing into nap time you aren’t even next.

  • Afternoon and evening appointments are far more likely to be running late. If you really need to get in and out, go early.
  • Morning appointments book up first. So when reception asks if you want to book out 6 months from now, do it. 
  • If you work or have other schedule issues and need afternoon/evening appointments, ask reception which days are usually fastest. We were behind more on Mondays/Wednesdays because we had more new patients appointments those days. Every doc is different.
  • If you’re heading to a walk-in clinic, call first to check the wait. Six people could have just walked in. They may also have a call-ahead list or open appointment later in the day.
  • Being on time means at least ten minutes before your appointment. There is NOTHING that will frustrate your nurse more than you walking in one minute before your appointment time or saying “well, he’s always behind.” Most of our wait time issues were because patient’s were late—not because of our docs.

Sick Patients

Sick patient waiting rooms are mostly a thing of the past (because they don’t really help). But you shouldn’t be afraid of the waiting room.

  • The best way to avoid germs in a waiting room is to wash your hands and wear a mask.
  • During cold and flu season, most practices will have masks on the reception desk. If you or your child is sick, use them! If you just don’t want to breath in the little kid’s cough across the room, use them. No one wants to look ‘infected’ or be the only person with a mask on, but it really is a great way to reduce germs. 
  • Are they comfy? No. But they work!
  • Just being around coughing and sneezing is not actually a major risk. Doctors and nurses are around dozens of coughing, sneezing, dripping kids all day every day and are rarely sick. I got one cold in two years. Hand washing and good general health (nutrition!) does most of the work.
Nurses in masks

Even I wore a mask sometimes!

Getting an Appointment

How hard it is to get an appointment all depends on the practice. Even within a practice, some doctors may be much busier than others.

  • If your child is very sick and needs to be seen ASAP, call THE MINUTE they open. Even if you called overnight, the nurse may not see that message until 8:15 — and multiple other parents could have called by then. 
  • Doctors typically have several sick visit slots per day that can’t be booked until the day – but they fill quickly.
  • If they are completely booked, ask about seeing another physician at the practice. Urgent sick visits are really the only time you should be asking to see a different provider.

If your office has nurse practitioners, physician assistants or a walk-in clinic available, use them. I heard “I want to see a real doctor” every. single. day. Physician Assistants and Nurse Practitioners are well trained and a Godsend for busy practices!

  • They see sick or urgent patients that the docs would otherwise have to send away.
  • Your child’s medical records? They have access to them (which urgent care doesn’t have). So they can see what medications have worked or not worked in the past.
  • They can — and do — talk to your pediatrician about the case.

Medications

You’re not going to get a prescription over the phone. Sorry. If you call and say, “Little Timmy had the EXACT same thing last year, and we got a steroid pack that fixed it,” your nurse will say, “That’s great to know. You can tell the doctor that when you see them.”

  • The doctor HAS to see the patient before prescribing medication.
  • Refills or additions to treatment can sometimes be written after a phone call, as long as there are no new symptoms.
  • Antibiotics don’t work for everything. Colds, the flu, some causes of tonsillitis, and even many ear infections are from viruses. Antibiotics can’t kill these.
  • Always wait at least 24 hours after starting an antibiotic to send kids back to school. If they had a virus, they should be totally fever-free for at least a day as well.
  • Use AS DIRECTED. Some medications take a while to work. If something isn’t working, call before you change anything.  

Appointment Do’s and Don’ts

  • If your child takes a lot of medications, has any other specialty doctors prescribing medications, or is taking supplements/vitamins, make sure you bring a complete list of everything they take.
  • Taking pictures of bottles can be helpful, especially with supplements or if medications are changed frequently.
  • Never hide a supplement or vitamin from your doctor. I’ve seen moms be embarrassed they are trying herbs, homeopathy, or supplements that are not-so-mainstream and not disclose them for months or years. But these can interact with other medications, so they really do need to be on the list!
  • Don’t lie about shots. Promising no shots today then coming in for a surprise attack right before you leave makes the next visit nearly impossible and can cause full-on-panic. I’d much rather start a visit with a nervous kid and be able to reassure them and build some trust during an appointment. They trust us more at the end when it’s time for shots when we’ve talked about it throughout — especially with elementary ages.

You May Need To Go To the ER

My scariest moments as a nurse all involved the front desk calling (or yelling) that there was something wrong in the waiting room. Those receptionists are used to sick people, so they ask for a nurse to come check someone? We run.  

  • Know what your pediatrician’s office is able to do. Our office did some urgent interventions like IVs, breathing treatments, X-rays, and stitches. However, not all practices do these, and there were many things no outpatient practice can do.
  • Stitches on the face, head, or fingers usually require a surgeon and trip to the ER, even if your doctor will do other stitches in the office.
  • In general, sudden breathing issues, very deep cuts, facial injuries, possible broken bones, severe dehydration (like from days of vomiting or diarrhea), or concussions with loss of consciousness should be seen first in the ER.
  • Call your pediatrician to let them know you were in the ER. They can make sure your records are sent, the ER records are received, and can often do any follow-ups needed.

Don’t Forget

Your doctor and nurses really are there to help. If you have questions, ask. If you’re upset, tell them (nicely of course). Not sure about something? Let them know!

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