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Ambulatory Care

Ambulatory Care

AAACN Viewpoint

Only an ambulatory nurse could transition from working in a jail, to a childbirth center, a family practice clinic, telephone triage, and finally to ambulatory clinical education without breaking a sweat.

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Meet Renee E. Maynes, BSN, RN, BC, AAACN member, and currently the Ambulatory Clinical Educator at Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire.

Renee admits that she has had a very interesting career that began twelve years ago when she graduated from an ADN program. After two years of inpatient medical-surgical nursing, Renee was ready to try something new and different. She took a position at a county jail and loved it! “It was a great experience, and I learned a lot about preventive care, health education, and psychiatric and emergency assessment. I also decided it was time to return to school to obtain my BSN degree,” Renee remembers.

To help finance her education, Renee went back to the hospital setting where she would qualify for tuition reimbursement. At that time, the hospital was having a critical shortage of nurses in the childbirth center, and they offered to provide Renee with all the training she would need if she made a two-year commitment. Renee felt she was ready for the challenge and plunged into the uncharted waters of labor and delivery. She recalls, “Labor and delivery was a whole new skill set, and I worked with a wonderful group of nurses who were very proactive and practiced shared governance. They were strong ”http://nursinglink.monster.com/training/articles/7881-make-a-difference-as-a-patient-advocate">patient advocates, and I learned a great deal in the two years I was there."

As our lives and priorities change, so do our jobs. Renee needed a position with a little more flexibility so she could spend more time with her teenage children. Keeping to her ambulatory roots, she began working in a small family practice office. Thinking back on that position, Renee wonders how she was able to do it all. “The providers really believed in providing one-stop shopping. I learned how to perform hearing tests, strep throat cultures, and pulmonary function tests, and assisted with sigmoidoscopies. I also became the vaccination expert,” Renee recalls.

After four years in family practice, Renee decided that it was time to begin work on her master’s degree in nursing education. She accepted a position with her current employer, Dartmouth Hitchcock Medical Center, working in the area of telephone triage. Renee admits that it was truly a culture shock. She was one of only two nurses with 13 providers and “the phones never stopped.”

Renee has tremendous respect for those nurses who have chosen to work in telephone triage because “it utilizes all your nursing knowledge, and every call is a new challenge.” After one year in telephone triage, a new position was developed, and Renee became the Ambulatory Clinical Educator. Renee is thrilled with this new position because she feels she can make a positive impact on ambulatory nurses in the clinics. She states, “Prior to my current position, new nursing staff were given a one-day general orientation and were then left to sink or swim. The clinics were so busy that no one really had time to orient new people. My first priority was to develop a centralized nursing orientation for ”http://nursinglink.monster.com/careers/articles/554">ambulatory nursing staff, and we are now in our second year."


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