An interesting thing happened with an ER RN

[ghost dog]

I thought I would share my recent experience with the RN members on this board, and get some insight here.

I am a chronic pain physician.

Approximately 2-3 months ago I dropped by my local nearby ER to get some advice from the ER Nurses, as I was interested in hiring an RN in my pain clinic. In particular I wanted to ask them i) what the best place / manner in which to hire a Nurse (i.e. RNAO, craig's list, the newspaper, etc.) and ii) how difficult it may be to hire an RN in the current job market.

I mean, who better to ask then an RN, right?

Apparently, wrong.

I politely asked the front desk administrator if I could speak to the charge RN, told him I wasn't in hurry, when she had a minute (etc.). The RN came over and we chatted for a minute. She wasn't very helpful, as she had been working there for awhile, and didn't remember how she got hired.
I thanked her for her time regardless, and we concluded our conversation amicably.

To paint a picture of myself: I was dressed in my office attire (i.e. a suit and carrying my briefcase). That is to say, looking reasonably professional.


I could not believe what happened next: I was approached by Security, and informed that they had received a complaint. This could have only been from the RN who I had just spoken with. They asked me to leave the hospital premises.

I find this simply unbelievable, and not to mention extremely uncollegial. At no point in our conversation was there any indication of unfriendliness or anything of this nature.


This sort of behavior does not lend itself towards good RN / MD relationships.

I did manage to find an RN for my clinic, and she is excellent. I couldn't be happier with her.

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[deleted87716]

Not really surprising. They probably thought you were trying to poach their employees.

I wouldn't take it as an indictment of nurses. You were just acting weird.

 

[Apollyon]

Were you wearing a nametag? And, even though you say it was your "local, nearby ER", how close was it to your practice, actually? And they didn't recognize your name?

Recall the extremes to which drug seekers will go. A suit and a briefcase? Easy one.

 

[ghost dog]

Were you wearing a nametag? And, even though you say it was your "local, nearby ER", how close was it to your practice, actually? And they didn't recognize your name?

Recall the extremes to which drug seekers will go. A suit and a briefcase? Easy one.

This hospital was approximately 1000 metres from my practice (2 blocks). Close enough for ya? However, I don't send many pts to the ER;
I'm not a hair trigger ER referral MD.

Do you wear a nametag to work in your ambulatory practice (unless your name is Melvin C. Finkelberg?) No, I didn't think so broheim. Give me a break.

A drug seeker, asking an RN for employee advice ? No that dog just won't hunt. That doesn't make any sense at all.

The " poaching employees " theory makes a bit more sense.

If I wore a name tag to work, I think I'd have to give myself a swirly!

 

[ghost dog]

Not really surprising. They probably thought you were trying to poach their employees.

I wouldn't take it as an indictment of nurses. You were just acting weird.

I guess. You know what else is weird? Accepting RNs as patients. I actually have a few at that particular hospital as regular patients (just not ER RNs).

 

[Apollyon]

Do you wear a nametag to work in your ambulatory practice (unless your name is Melvin C. Finkelberg?) No, I didn't think so broheim. Give me a break.

A drug seeker, asking an RN for employee advice ? No that dog just won't hunt. That doesn't make any sense at all.

The " poaching employees " theory makes a bit more sense.

If I wore a name tag to work, I think I'd have to give myself a swirly!

Then you, as a pain doc, might be getting burned a lot more than you think. Umm...why a drug seeker ask an RN for employee advice? To get ideas how to get someone who has access that is more convenient, maybe? Yes, that dog hunts. It definitely makes sense, but, if you don't see it, well, hope you don't get burned. Maybe you haven't seen the brazenness or ingenuity of some of the seekers. Ever had one generate a computerized script and print it on security paper (which only got caught because the name added on the script, although a family medicine doctor - only was not part of that group - otherwise indistinguishable from a genuine Rx)? Ever had one call you and tell you that they were "Dr. Smith" or whatever? Then show up in a suit?

And at my last doctor's office - an ambulatory practice - everyone wore a nametag. Yes, even the doctors.

But your outrage seems out of place, so whatever. I am giving you the perspective from the other side (working in the ED). You can take your sarcasm, broseph, and, well, I won't say it (so I don't get in trouble).

edit: to your edit - 1000 meters, and they don't know you? You don't even stop in to make yourself known? Saying you're not a "hair trigger referral MD" is going to absurd extremes. Your name didn't ring a bell? Even if you only send one patient a year, your name should ring a bell. And that you were escorted off the property makes me think something was off about your presence, but you don't seem to get that.

 

[ghost dog]

Then you, as a pain doc, might be getting burned a lot more than you think. Umm...why a drug seeker ask an RN for employee advice? To get ideas how to get someone who has access that is more convenient, maybe? Yes, that dog hunts. It definitely makes sense, but, if you don't see it, well, hope you don't get burned. Maybe you haven't seen the brazenness or ingenuity of some of the seekers. Ever had one generate a computerized script and print it on security paper (which only got caught because the name added on the script, although a family medicine doctor - only was not part of that group - otherwise indistinguishable from a genuine Rx)? Ever had one call you and tell you that they were "Dr. Smith" or whatever? Then show up in a suit?

And at my last doctor's office - an ambulatory practice - everyone wore a nametag. Yes, even the doctors.

But your outrage seems out of place, so whatever. I am giving you the perspective from the other side (working in the ED). You can take your sarcasm, broseph, and, well, I won't say it (so I don't get in trouble).

edit: to your edit - 1000 meters, and they don't know you? You don't even stop in to make yourself known? Saying you're not a "hair trigger referral MD" is going to absurd extremes. Your name didn't ring a bell? Even if you only send one patient a year, your name should ring a bell. And that you were escorted off the property makes me think something was off about your presence, but you don't seem to get that.

I am in solo practice, and thus don't require
a name tag.

If you bothered to read the above questions
I asked of the RN I can't really think of
how these would assist a drug seeker.

In terms of being "burned", I am extremely cautious in regards to opioid monitoring
protocols :

1. Random urine drug screens with opioid breakdown / chromatography.

2. Opioid pill / patch counts.

3. Utilization of the opioid risk tool / CAGE questionnaire.

4. Checking of collateral sources of opioid related information.

( unlike some ER mds I could mention - here's some percs / Oxys and don't come back- just leave ).

But thanks for your concern.

As to dropping in to "make myself known" : this worked out so well.

 

[Starpower]

I think a phone call or two would probably have gone a lot better than just walking into the ER

But I find your sincerity sweet. F**k 'em if they can't take a toke! Or is it joke? Oh dear ...

 

[Paseo Del Norte]

Nametags and proper identification are a pretty big deal where I work. It doesn't matter if you are well known and employee of the month. No nametag and you are asked to leave the hospital.

I would not take it personally. The nurse or possibly somebody else wasn't getting warm fuzzies and errored on the side of caution. Unfortunately, there have been a few major incidents in my area of the world where people disguised as physicians or other health care workers attempted to access patient care areas and/or staff members. One incident was so profound, that one of the hospitals has a policy that they can dump an entire college if one of the college's students is found in a clinical area without identification.

 

[ghost dog]

Nametags and proper identification are a pretty big deal where I work. It doesn't matter if you are well known and employee of the month. No nametag and you are asked to leave the hospital.

I would not take it personally. The nurse or possibly somebody else wasn't getting warm fuzzies and errored on the side of caution. Unfortunately, there have been a few major incidents in my area of the world where people disguised as physicians or other health care workers attempted to access patient care areas and/or staff members. One incident was so profound, that one of the hospitals has a policy that they can dump an entire college if one of the college's students is found in a clinical area without identification.

This makes sense.

You know, it would have really helped things if the RN in question had simply stated that she was uncomfortable answering my questions as I didn't have a hospital ID badge. I could have showed her the relevant MD identification (in my bag).

Instead , she elected to call security.

 

[ghost dog]

Then you, as a pain doc, might be getting burned a lot more than you think. Umm...why a drug seeker ask an RN for employee advice? To get ideas how to get someone who has access that is more convenient, maybe? Yes, that dog hunts. It definitely makes sense, but, if you don't see it, well, hope you don't get burned. Maybe you haven't seen the brazenness or ingenuity of some of the seekers. Ever had one generate a computerized script and print it on security paper (which only got caught because the name added on the script, although a family medicine doctor - only was not part of that group - otherwise indistinguishable from a genuine Rx)? Ever had one call you and tell you that they were "Dr. Smith" or whatever? Then show up in a suit?

And at my last doctor's office - an ambulatory practice - everyone wore a nametag. Yes, even the doctors.

But your outrage seems out of place, so whatever. I am giving you the perspective from the other side (working in the ED). You can take your sarcasm, broseph, and, well, I won't say it (so I don't get in trouble).

edit: to your edit - 1000 meters, and they don't know you? You don't even stop in to make yourself known? Saying you're not a "hair trigger referral MD" is going to absurd extremes. Your name didn't ring a bell? Even if you only send one patient a year, your name should ring a bell. And that you were escorted off the property makes me think something was off about your presence, but you don't seem to get that.

I don't appreciate your implication that I was somehow acting strangely, when I clearly stated that I acted in a collegial manner towards the RN in question.

However, being an ER MD, I realize that the population you deal with has you likely to question a person's story which I can appreciate. Treating chronic pain has a somewhat similiar pitfall.

I certainly hope this particular RN doesn't suffer from a chronic pain condition. The legislative machinery in my neck of the woods has led to approximately 50% of clinics closing (and her hospital doesn't have such a clinic).

I will certainly not be seeing her.

 

[Apollyon]

I don't appreciate your implication that I was somehow acting strangely, when I clearly stated that I acted in a collegial manner towards the RN in question.

There was no implication that you were acting strangely - I was just going on "facts in evidence". You may have been too perfect and professional and proper - what is your daily style of professionalism, the nurse in the ED may have thought it was rehearsed and too good, when that's just how you roll.

It's a sad indictment of society today, when professionalism is perceived as an act.

 

[chimichanga]

... I am a physician and Naval Officer in a predominantly military town, talking to an ER that makes all its money off Tricare. This is nothing more than obnoxious ER staff taking their chance to screw with physicians, with zero concerns about how it affects patients.

I'm with you; this isn't a huge deal, and I ultimately got what I needed. I've been humiliated in far worse ways than this little incident. But at some point, some nurse from that facility will need something from me, and they won't get it.

Always the nurses' fault eh Tired?

Some things never change here...

First off, the nurses don't know nor care if the hospital "makes all its money off Tricare" There's no conspiracy theory here dude.. The fact that you mention this 'nugget' implies you think this somehow should matter...
I could care less who the payer source is...It's bad nursing/medicine to care, period...


Why didn't your patient produce discharge paperwork from his visit? It's his responsibility, NOT the ER staff's responsibility..
(Didn't he have the pill bottle at least;or d/c paperwork...he likely knew a + UA would be trouble, so why not have some documentation...doesn't make sense)(and certainly there is a base pharmacy? you could have called his pharmacy to verify)

Why didn't you make your personal trip to medical records during business hours? You bothered the ED staff??!!
You could have at least called the house sup before coming, or the ER director ahead of time (during business hours)

What you did was very intrusive, rude, and out of line..And it falls under the category of what the general public does every day in our EDs across the country...People come at all hours of the day and night demanding stuff that they think is justified...

How about I barge in to your office asking your staff for records? sheesh..
Just b/c you're a physician, we're supposed to roll out the red carpet?

Having been an ED charge nurse for many years, I have seen many people request some strange things, and your request would be near the top of that list...

dude, I think you're way off base here..just giving my opinion..And I really am helpful to the public, dressed nice or not, but when it comes to the release of records, or ANY pt info, and you're not the patient? NOT HAPPENING...

HIPAA, period...No one you described fits the bill of "obnoxious ER staff taking their chance to screw with physicians, with zero concerns about how it affects patients."

That's you being egocentric, period...

All you wanted is to know is: "if he'd been there"
And you went to all that trouble?
Would have raised a red flag for me too, and so far, the other two DOCS in this thread have agreed with that sentiment...

Tired, seriously though, you could have been an angry father, boyfriend, brother, boss, etc.
The lengths people go to just to get info is staggering...I have seen it all, and then some...
What if you were a boyfriend, and you just wanted to know if he'd been there one more time. (For all I know you told him if he went to an ER again he'd be sorry). Then the pt ends up dead in some bizarre domestic dispute? Now I, as the charge RN, am on the hook in a criminal trial...

The possibilities are endless of what pts will do, and have done...

It's really nothing more than that...

This time I don't think the nurses were out to get you dude...


I wouldn't take it personally..

However, one thing I cannot defend in both earlier anecdotes, is nursing punting to security so quickly.
I am happy to explain to anyone, doc or not, why I made a particular decision.
Punting to security, without discussing the issue (especially in Tired's account) is lame on the nurse's part, and is just chicken ****. And to not at least verify his story (I might have even called the pt in question to verify, then helped tired out)..
If a doc comes in to my ER, I extend professional courtesy and try and go the extra mile, if I can.

 

[chimichanga]

My story:

CEO's neighbor was admitted to the (CEO's) hospital...

CEO stopped by the ward asking about patient (CEO was dressed in a suit) and wanting to look in pt's chart...

Traveling RN was approached by CEO (she did not know him) asking for pt info..

CEO had left his badge in his office...

Traveling RN refused request, and sent CEO away...
CEO complained to all who would listen later...
The MEDICAL DIRECTOR stood up for the RN's actions and chastised the CEO (also a physician) for not wearing his badge, and for thinking it was okay to look through the chart..

 

[sarjasy]

i) what the best place / manner in which to hire a Nurse (i.e. RNAO, craig's list, the newspaper, etc.) and ii) how difficult it may be to hire an RN in the current job market.

I mean, who better to ask then an RN, right?

Who better? How about one of your colleagues who has hired recently? Not trying to pile on here, but asking nurses how to hire nurses probably isn't the best way to go about it. I'm relatively new to healthcare, but I spent a number of years working in information technology as a manager. Whenever I wanted to hire, say, a help desk technician, I did not go to help desk technicians for advice on hiring -- I went to fellow IT managers. Not to say your approach is bad (I actually think it's somewhat creative), but it is unusual, which probably, in part, is why it was met with suspicion.

 

[chimichanga]

Same old, same old. Hide behind a law you don't really understand.

Did you miss the part where I had a copy of my medical license, my military ID, and a signed consent for release of records from the patient? You bring me a signed record release and your ID, and I give you the records after I make a copy. That's how it works in the medical world...or maybe I should say the adult world?

But please, keep offering up excuses for rude behavior. Remember, you can't expect anyone to take you seriously if you refuse to act professionally.

There's a time and a place for everything...You chose the wrong time and wrong place...It's hospital policy everywhere...No release of records in the ER, period.

It's SOP to go through medical records/H.I.M.

And you haven't addressed your patient's responsibilities. It was his visit, his Rx...He can produce the proof...

You, lurking around in an ER, flashing badges and licenses, to quote Blue Dog, is "weird"

 

[chimichanga]

And to be honest, in my many years as a patient,I have walked into physician offices with a signed consent,and many will only fax records to an accepting physician provider, not release in person...

Each office has their own way of doing things...Just because you allow your staff to photocopy records with a consent, does not mean the rest of the world works that way...Many places have legal look at records before just releasing them..

I'm an old guy with bad joints...Believe me,I have run into my share of (orthopod) office (MR) policies that make me scratch my head...

It doesn't mean all offices are that way...

Please stop chastising all nurses based on a couple of suspect ones, Tired...It gets old..

 

[chimichanga]

Tired, Sir: I quote myself in this thread: (7 posts upward)

"However, one thing I cannot defend in both earlier anecdotes, is nursing punting to security so quickly.
I am happy to explain to anyone, doc or not, why I made a particular decision.
Punting to security, without discussing the issue (especially in Tired's account) is lame on the nurse's part, and is just chicken ****. And to not at least verify his story (I might have even called the pt in question to verify, then helped tired out)..
If a doc comes in to my ER, I extend professional courtesy and try and go the extra mile, if I can."

You continue to want to extrapolate anectodes into real life...

Nurses are not out to get you...
You left without what you wanted...Irrespective how the nursing staff would have handled it, you would have been angry...

I maintain you should hold your patient to a higher standard, and have him produce the proof...It was his visit...
Certainly you could have found another route...You hold nurses in complete contempt, yet you choose a social interaction whereby you sought out an RN...makes no sense...

Your patient has the burden of proof...

And I have yet to call an MR dept during business hours without having someone there..Are they now out to get docs too?

your doc peer called the behavior weird..

stop hating
I agree, she erred by calling security...
get over it

 

[chimichanga]

and if you hadn't noticed, hospital employees are getting fired for minor infractions in the privacy realm...

dude,people come in all the time lying about who they are...

yea, i know,you whipped out your ID...that's never faked

 

[chimichanga]

No sir, you showing up unannounced (to the ER),and whipping out credentials, is, as you so eloquently say, garbage...

We won't agree on this...No problem...

As I said, they erred in so quickly calling security, as I would have spoken with you and we could have come up with a solution...

And your attitude has been predicted (and played out) countless times, on many threads...

You sir, cannot stand nurses, and think they are your handmaidens, period...You have always been quite clear on that...

Yes, people fake stuff all the time...And I actually have two stories where physicians came into the ER where I was charge, and had fake documents/paperwork...Non docs do it every day...

Talk to me when your confidentiality has been breached, as a patient..

Isn't it neat how...never mind...

You have two docs in this thread that have taken a position for the hospital, essentially contrary to your opinion, yet you vilify the nursing staff...

Talk about predictable...

Look, I digress...I have been charge in over 10 ERs in AZ, Oregon,and Cali...It's the policies of the hospitals that prevent ANYONE from giving out MR info from the ER,period...
The behaviors of the RNs notwithstanding, their decisions to not give this info was commensurate with the p&p of the hospital...

 

[Therapist4Chnge]

I could not believe what happened next: I was approached by Security, and informed that they had received a complaint. This could have only been from the RN who I had just spoken with. They asked me to leave the hospital premises.

I had that happen to me too, but in an affiliated office (my PCP). The whole fiasco started because they called me the day before to pick up some paperwork, so I stopped by during lunch. The nurse told me that no one called and that I didn't have any paperwork because nothing was in the "pick up" tray. I told them to check my medical record, as there was a note in there from the day before documenting their call to me (I checked). At that point the nurse got angry because she was caught in a lie and refused to admit it. Evidently "I was telling her how to do her job", which gave her the right to yell at me, loud enough to have a bunch of people in the waiting room take notice. I asked to speak to her supervisor and/or my PCP, and she just kept on yelling.

The irony is that the security guard recognized me from the main hospital and asked me if the patient disturbance had been handled. It took me a second to catch on that the nurse called and complained that *I* was the problem. We talked for a minute, and then the security guard went to talk to the nurse. He wasn't there 10 seconds before she started yelling at him to do his job, that whatever I said was a lie, and that I was harrassing them, etc. The security guy later asked me if I wanted to file a complaint, and he let me know that he had taken the liberty of writing it up for me, I just needed to read through and sign if I agreed to how everything happened. He was less judicious than I would have been with how he described the event.

 

[ghost dog]

Tired, Sir: I quote myself in this thread: (7 posts upward)

"However, one thing I cannot defend in both earlier anecdotes, is nursing punting to security so quickly.
I am happy to explain to anyone, doc or not, why I made a particular decision.
Punting to security, without discussing the issue (especially in Tired's account) is lame on the nurse's part, and is just chicken ****. And to not at least verify his story (I might have even called the pt in question to verify, then helped tired out)..
If a doc comes in to my ER, I extend professional courtesy and try and go the extra mile, if I can."

You continue to want to extrapolate anectodes into real life...

Nurses are not out to get you...
You left without what you wanted...Irrespective how the nursing staff would have handled it, you would have been angry...

I maintain you should hold your patient to a higher standard, and have him produce the proof...It was his visit...
Certainly you could have found another route...You hold nurses in complete contempt, yet you choose a social interaction whereby you sought out an RN...makes no sense...

Your patient has the burden of proof...

And I have yet to call an MR dept during business hours without having someone there..Are they now out to get docs too?

your doc peer called the behavior weird..

stop hating
I agree, she erred by calling security...
get over it

Actually, bluedog was referring to my incident. Not the above poster's.

Try to keep up now.

This sort of stuff just makes me glad I don't do hospital related work. It really takes me back to med school and residency. Nurses screwing with med students, residents and nurses screwing with each other.

Ah, ambulatory practice where you are your own boss, and there is none of this sort of nonsense to deal with.

What could be better?

 

[Paseo Del Norte]

Shoot, where I work, a staff member can be fired for looking up their own records and if you show up without your ID, you are told to leave. This applies even if you are going on shift, known by everybody and employee of the month. I don't necessarily agree with it, but bills do not pay themselves.

 

[jwk]

Actually, bluedog was referring to my incident. Not the above poster's.

Try to keep up now.

This sort of stuff just makes me glad I don't do hospital related work. It really takes me back to med school and residency. Nurses screwing with med students, residents and nurses screwing with each other.

Ah, ambulatory practice where you are your own boss, and there is none of this sort of nonsense to deal with.

What could be better?

So you come here asking for an opinion and then rag on the people who don't agree with yours, some of whom are giving perfectly reasonable answers?

And honestly, IMHO - this is one of the strangest ways I've ever heard of to go about hiring an employee. Clearly you don't like hospitals, yet that's the first place you go to "look for a nurse"? That doesn't strike you as strange?

 

[pamac]

in the case of the marine, why not just go the formal route and obtain the records from medical records... this marines future hangs in the balance, and a full accounting of the situation is more appropriate for your situation than simply a peek at the patient registry. maybe he was there, but not treated for dental pain? then you got snowed, and he is holding a firearm next to another marines head in drill. maybe the hospital staff was forward thinking enough to know that they didnt want to accomadate an unusual request on the spot that they were unfamiliar with.

this is a new kind of world we live in where you cant just float in wherever you want and get whatever information you want without some kind of verification... the kind of verification that has a significant degree of followup and protocol. as for requests about work arrangements from anonymous staff members, those requests are better fulfilled via human resources. im sure that the charge nurse knew exactly how she was hired, but didnt feel comfortable discussing it while she was on duty, or at all. better safe than sorry, especially when my job and license are on the line.

 

[plauto]

I thought I would share my recent experience with the RN members on this board, and get some insight here.

I am a chronic pain physician.

Approximately 2-3 months ago I dropped by my local nearby ER to get some advice from the ER Nurses, as I was interested in hiring an RN in my pain clinic. In particular I wanted to ask them i) what the best place / manner in which to hire a Nurse (i.e. RNAO, craig's list, the newspaper, etc.) and ii) how difficult it may be to hire an RN in the current job market.

haha, this is hilarious. You just dropped by the ER to talk?
I'd be thankful that somebody even came out to talk to you for a minute.

-What makes you think you can just show up announced at a workplace and pretend someone gives you their time? And this is an ED, where people go with pressing health issues
-What makes you think you can talk to a nurse while the hospital is paying for him/her to work on patients? How would you feel if one of your employees you pay by the hour walked away from your patients to talk to a dude in a suit during the work day?
-You are a physician and have your own practice. Do you really think dropping by the ER to talk to a nurse about business was normal behavior?

And all this would apply even if you went there to talk to a physician. Except the physician would have probably either kicked you out of the ER himself or have you hospitalized for a mental condition...
Keep 'em coming man, could not make this stuff up!

 

[Shinken]

I have to agree that a physician showing up to the ER is quite strange. With or without credentials, with or without ID. I've never heard of this happening, and if I was working in the ER I would think to myself "doctor looking for information? Yeah, right!".

I don't know how other people practice medicine, but even just out of residency I'm awfully busy. If I need medical records I have my staff obtain the proper signed forms from the patient and then obtain the records for me...a few days after I ask my staff to take care of things, poof! medical records in my inbox. There is no way I have the time to handle it on my own or I would never get through the day's patients and paperwork, refill requests, etc (and I've only been in practice out of residency since July 2011!!).

I've never heard of a physician personally showing up anywhere to verify records or ask for records. If a physician stopped by my office personally to ask for patient's records or verify something on a patient I'd probably either think (1) he's a fake or (2) he's weird (yes, to quote Blue Dog). Why didn't he send someone else? Or just call?

Now, don't get me wrong. I think it's admirable if some physicians out there are willing to go the extra mile and do things themselves, but verifying patient information or obtaining patient's medical records are activities that do not require a doctoral degree and several years of advanced training, staff can (and should) handle it while you use your time doing other things that do require medical judgement.

 

[ChillyRN]

There are some weird stories on this thread.

I'd have thought the OP to be a total loon, possibly dangerous, and probably called security too. Not that he is actually crazy or dangerous or did anything to deserve such an assumption, but that sort of thing just isn't done IME. I believe that it was totally innocent, but because it is such an extremely odd scenario, we'd all assume the worst I'm afraid. FWIW, my advice for future reference, is hire a recruiter like everyone else.

In the case of the marine, I might have stopped short of calling security unless he'd gotten belligerent, but no, there would have been no records handed over, lol. Only the medical records department releases medical records. duh.

The crazy nurse in the office sounds like she should have been an inpatient someplace. Bizzaroworld.

 

[Therapist4Chnge]

The crazy nurse in the office sounds like she should have been an inpatient someplace. Bizzaroworld.

I've only been back there once, and she was nowhere to be seen. I was tempted to ask, but I decided to take the high road.

 

[chimichanga]

So the OP has vanished..

hmm

ask for opinions, nobody (except our old friend) agrees, so hiding is the answer?

 

[410322]

Always the nurses' fault eh Tired?

Some things never change here...

First off, the nurses don't know nor care if the hospital "makes all its money off Tricare" There's no conspiracy theory here dude.. The fact that you mention this 'nugget' implies you think this somehow should matter...
I could care less who the payer source is...It's bad nursing/medicine to care, period...


Why didn't your patient produce discharge paperwork from his visit? It's his responsibility, NOT the ER staff's responsibility..
(Didn't he have the pill bottle at least;or d/c paperwork...he likely knew a + UA would be trouble, so why not have some documentation...doesn't make sense)(and certainly there is a base pharmacy? you could have called his pharmacy to verify)

Why didn't you make your personal trip to medical records during business hours? You bothered the ED staff??!!
You could have at least called the house sup before coming, or the ER director ahead of time (during business hours)

What you did was very intrusive, rude, and out of line..And it falls under the category of what the general public does every day in our EDs across the country...People come at all hours of the day and night demanding stuff that they think is justified...

How about I barge in to your office asking your staff for records? sheesh..
Just b/c you're a physician, we're supposed to roll out the red carpet?

Having been an ED charge nurse for many years, I have seen many people request some strange things, and your request would be near the top of that list...

dude, I think you're way off base here..just giving my opinion..And I really am helpful to the public, dressed nice or not, but when it comes to the release of records, or ANY pt info, and you're not the patient? NOT HAPPENING...

HIPAA, period...No one you described fits the bill of "obnoxious ER staff taking their chance to screw with physicians, with zero concerns about how it affects patients."

That's you being egocentric, period...

All you wanted is to know is: "if he'd been there"
And you went to all that trouble?
Would have raised a red flag for me too, and so far, the other two DOCS in this thread have agreed with that sentiment...

Tired, seriously though, you could have been an angry father, boyfriend, brother, boss, etc.
The lengths people go to just to get info is staggering...I have seen it all, and then some...
What if you were a boyfriend, and you just wanted to know if he'd been there one more time. (For all I know you told him if he went to an ER again he'd be sorry). Then the pt ends up dead in some bizarre domestic dispute? Now I, as the charge RN, am on the hook in a criminal trial...

The possibilities are endless of what pts will do, and have done...

It's really nothing more than that...

This time I don't think the nurses were out to get you dude...


I wouldn't take it personally..

However, one thing I cannot defend in both earlier anecdotes, is nursing punting to security so quickly.
I am happy to explain to anyone, doc or not, why I made a particular decision.
Punting to security, without discussing the issue (especially in Tired's account) is lame on the nurse's part, and is just chicken ****. And to not at least verify his story (I might have even called the pt in question to verify, then helped tired out)..
If a doc comes in to my ER, I extend professional courtesy and try and go the extra mile, if I can.

My story:

CEO's neighbor was admitted to the (CEO's) hospital...

CEO stopped by the ward asking about patient (CEO was dressed in a suit) and wanting to look in pt's chart...

Traveling RN was approached by CEO (she did not know him) asking for pt info..

CEO had left his badge in his office...

Traveling RN refused request, and sent CEO away...
CEO complained to all who would listen later...
The MEDICAL DIRECTOR stood up for the RN's actions and chastised the CEO (also a physician) for not wearing his badge, and for thinking it was okay to look through the chart..

There's a time and a place for everything...You chose the wrong time and wrong place...It's hospital policy everywhere...No release of records in the ER, period.

It's SOP to go through medical records/H.I.M.

And you haven't addressed your patient's responsibilities. It was his visit, his Rx...He can produce the proof...

You, lurking around in an ER, flashing badges and licenses, to quote Blue Dog, is "weird"

And to be honest, in my many years as a patient,I have walked into physician offices with a signed consent,and many will only fax records to an accepting physician provider, not release in person...

Each office has their own way of doing things...Just because you allow your staff to photocopy records with a consent, does not mean the rest of the world works that way...Many places have legal look at records before just releasing them..

I'm an old guy with bad joints...Believe me,I have run into my share of (orthopod) office (MR) policies that make me scratch my head...

It doesn't mean all offices are that way...

Please stop chastising all nurses based on a couple of suspect ones, Tired...It gets old..

Tired, Sir: I quote myself in this thread: (7 posts upward)

"However, one thing I cannot defend in both earlier anecdotes, is nursing punting to security so quickly.
I am happy to explain to anyone, doc or not, why I made a particular decision.
Punting to security, without discussing the issue (especially in Tired's account) is lame on the nurse's part, and is just chicken ****. And to not at least verify his story (I might have even called the pt in question to verify, then helped tired out)..
If a doc comes in to my ER, I extend professional courtesy and try and go the extra mile, if I can."

You continue to want to extrapolate anectodes into real life...

Nurses are not out to get you...
You left without what you wanted...Irrespective how the nursing staff would have handled it, you would have been angry...

I maintain you should hold your patient to a higher standard, and have him produce the proof...It was his visit...
Certainly you could have found another route...You hold nurses in complete contempt, yet you choose a social interaction whereby you sought out an RN...makes no sense...

Your patient has the burden of proof...

And I have yet to call an MR dept during business hours without having someone there..Are they now out to get docs too?

your doc peer called the behavior weird..

stop hating
I agree, she erred by calling security...
get over it

and if you hadn't noticed, hospital employees are getting fired for minor infractions in the privacy realm...

dude,people come in all the time lying about who they are...

yea, i know,you whipped out your ID...that's never faked

No sir, you showing up unannounced (to the ER),and whipping out credentials, is, as you so eloquently say, garbage...

We won't agree on this...No problem...

As I said, they erred in so quickly calling security, as I would have spoken with you and we could have come up with a solution...

And your attitude has been predicted (and played out) countless times, on many threads...

You sir, cannot stand nurses, and think they are your handmaidens, period...You have always been quite clear on that...

Yes, people fake stuff all the time...And I actually have two stories where physicians came into the ER where I was charge, and had fake documents/paperwork...Non docs do it every day...

Talk to me when your confidentiality has been breached, as a patient..

Isn't it neat how...never mind...

You have two docs in this thread that have taken a position for the hospital, essentially contrary to your opinion, yet you vilify the nursing staff...

Talk about predictable...

Look, I digress...I have been charge in over 10 ERs in AZ, Oregon,and Cali...It's the policies of the hospitals that prevent ANYONE from giving out MR info from the ER,period...
The behaviors of the RNs notwithstanding, their decisions to not give this info was commensurate with the p&p of the hospital...

So the OP has vanished..

hmm

ask for opinions, nobody (except our old friend) agrees, so hiding is the answer?

I can see why you were a nurse. Learn how to punctuate. Ellipses are not periods, and you look unintelligent when you end every sentence with them.

 

[AnnoyedByFreud]

I can see why you were a nurse. Learn how to punctuate. Ellipses are not periods, and you look unintelligent when you end every sentence with them.

Are you seriously criticizing the way someone writes on an internet forum? Oh and a "nurses r dumbbbb" dig. Classy.

 

[sarjasy]

I can see why you were a nurse. Learn how to punctuate. Ellipses are not periods, and you look unintelligent when you end every sentence with them.

Just so you know, commas are not to precede an "and" unless it is in a list. Yours is not.

 

[410322]

Are you seriously criticizing the way someone writes on an internet forum? Oh and a "nurses r dumbbbb" dig. Classy.

Yes.

Just so you know, commas are not to precede an "and" unless it is in a list. Yours is not.

Not sure if srs
Here's an English lesson:
"Ellipses are not periods." is a full sentence.
"You look unintelligent when you end every sentence with them." is also a full sentence.
When you join two full sentences, you use a conjunction preceded by a comma.

 

[AnnoyedByFreud]

Yes.


Not sure if srs
Here's an English lesson:
"Ellipses are not periods." is a full sentence.
"You look unintelligent when you end every sentence with them." is also a full sentence.
When you join two full sentences, you use a conjunction preceded by a comma.

cool story, bro

 

[Starpower]

Just so you know, commas are not to precede an "and" unless it is in a list. Yours is not.

Hmmm... I'll use it in such a way at times simply for pause effect, and that's just the way it goes.

 

[ghost dog]

So the OP has vanished..

hmm

ask for opinions, nobody (except our old friend) agrees, so hiding is the answer?

Actually, I went on vacation for a week.

The scenario I described in the opening post bears a little similiarity in my practice of chronic pain management: trusting someone (given in my scenario, said trust would not require that much of a leap of faith, but , as debated in this thread - this is apparently not as straightforward as I thought). What I mean by this, is that I came into the ER, and wanted to have a brief chat with an ER nurse in regards to RN employment issues.

This particular hospital happened to be on my way home from work, and it occurred to me (on the spur of the moment) that it wouldn't hurt to bounce some ideas off an RN in regards to how to hire an nurse. Apparently, it would.

When I evaluate a potential opioid candidate, I try to be as fair as possible and give them the benefit of the doubt (i.e. try not to assume that every word coming out of their mouth is a lie).

I believe that one poster brought up the fact that I would kick out an RN or nicely dressed individual coming into my clinic, if she started asking questions. I would like to believe that I would direct her to my nurse and allow her to ask her career related questions (for a short period of time, and if it didn't interfere with patient flow too much). Again, this is the nice thing about working in ambulatory care - I am allowed to engage my brain , and am not hampered so much by rigorous protocols. I am also very busy, as are most physicians I know.

 

[ghost dog]

double post.

 

[ghost dog]

haha, this is hilarious. You just dropped by the ER to talk?
I'd be thankful that somebody even came out to talk to you for a minute.

-What makes you think you can just show up announced at a workplace and pretend someone gives you their time? And this is an ED, where people go with pressing health issues
-What makes you think you can talk to a nurse while the hospital is paying for him/her to work on patients? How would you feel if one of your employees you pay by the hour walked away from your patients to talk to a dude in a suit during the work day?
-You are a physician and have your own practice. Do you really think dropping by the ER to talk to a nurse about business was normal behavior?

And all this would apply even if you went there to talk to a physician. Except the physician would have probably either kicked you out of the ER himself or have you hospitalized for a mental condition...
Keep 'em coming man, could not make this stuff up!

I'm glad this scenario amuses you.

If you took the time to read the opening statement, you would note that I made it quite clear that I was willing to wait when this RN had a minute to spare. At this time, this person did not appear to have an issue with my request.

There is such a thing as being collegial; unfortunately, this is frequently lacking in many health care settings.

In this scenario, I would much rather have preferred that this RN have stated that they were unable to assist me (rather than
provide no information - and then call security).

I see this attitude of being "too busy" (for whatever reason) all the time. I frequently make a point of calling referring family physicians in regards to their consults; unfortunately doctor to doctor communication is a rare phenomenon (i.e. laziness). I am always willing to make time when someone calls me (whether it be a patient, RN or MD). You should too, med student, as it can lead to poor patient outcomes and occasionally medical malpractice lawsuits (particularly in the US).

Still amused?

 

[Starpower]

I am always willing to make time when someone calls me (whether it be a patient, RN or MD).

Calling is one thing ... it allows for peoples' time schedules. They can call you back if they can't talk at that moment. But how would you feel if, say, a pre-med walked into your office and wanted to ask you questions about med school applications? Or if a med student came in to ask you for advice on matching residencies? Or if another MD/DO came in for advice on searching for work in your area? Or if they wanted to speak to you for some pain management advice? Wouldn't you find it the slight bit odd that they hadn't called, or at least called before they came? Granted, I think calling security was uncalled for ... it would have no doubt been different if you had been there for medical care, as most Docs get ushered in ahead of others!

 

[ChillyRN]

I am amused by the side conversation on ellipses. Little cocktail party factoid for you, Charles Schultz never used periods, only ellipses. Here's more grammar fun http://grammar.quickanddirtytips.com/ellipsis.aspx

As to the main topic, I can only say that people on both sides of the argument are getting a tad unreasonable, lol. It was a weird thing to do, highly irregular, but hardly worth calling out the stormtroopers. Defending weird relentlessly is uh, just weird. Attacking a simple error in judgement so viciously is more than weird, it suggests a real pugnaciousness that is hard to understand.

 

[plauto]

I'm glad this scenario amuses you.

If you took the time to read the opening statement, you would note that I made it quite clear that I was willing to wait when this RN had a minute to spare. At this time, this person did not appear to have an issue with my request.

There is such a thing as being collegial; unfortunately, this is frequently lacking in many health care settings.

In this scenario, I would much rather have preferred that this RN have stated that they were unable to assist me (rather than
provide no information - and then call security).

I see this attitude of being "too busy" (for whatever reason) all the time. I frequently make a point of calling referring family physicians in regards to their consults; unfortunately doctor to doctor communication is a rare phenomenon (i.e. laziness). I am always willing to make time when someone calls me (whether it be a patient, RN or MD). You should too, med student, as it can lead to poor patient outcomes and occasionally medical malpractice lawsuits (particularly in the US).

Still amused?

I, med student, am still amused. I agree with your spiel about communication. Except your visit to the ER was dictated by a different motivation.

 

[Apollyon]

As to the main topic, I can only say that people on both sides of the argument are getting a tad unreasonable, lol. It was a weird thing to do, highly irregular, but hardly worth calling out the stormtroopers. Defending weird relentlessly is uh, just weird. Attacking a simple error in judgement so viciously is more than weird, it suggests a real pugnaciousness that is hard to understand.

Seriously? You thought that there was unwarranted, naked aggression? I look at this same thread, and do NOT get the same vibe that you do. I wonder what you would say if it really was vitriolic.

An honest question - have you ever written someone up at work? If yes, was it for a trivial/nonimportant issue that could have been handled without being written up and going into someone's file?

 

[Instatewaiter]

Yes.


Not sure if srs
Here's an English lesson:
"Ellipses are not periods." is a full sentence.
"You look unintelligent when you end every sentence with them." is also a full sentence.
When you join two full sentences, you use a conjunction preceded by a comma.

This is an online forum. Punctuation on these forums often isn't used. But, if you're going to be a grammatical nazi, then so will I.

Technically the two clauses in your example are not sentences. Rather, they're independent clauses. Quite frankly I feel a semi-colon would have been been the best punctuation to use as they are two discrete, tangentially related ideas. Anyone else see how dumb this argument has become?

- love instatewaiter

 

[fab4fan]

I thought I would share my recent experience with the RN members on this board, and get some insight here.

I am a chronic pain physician.

Approximately 2-3 months ago I dropped by my local nearby ER to get some advice from the ER Nurses, as I was interested in hiring an RN in my pain clinic. In particular I wanted to ask them i) what the best place / manner in which to hire a Nurse (i.e. RNAO, craig's list, the newspaper, etc.) and ii) how difficult it may be to hire an RN in the current job market.

I mean, who better to ask then an RN, right?

Apparently, wrong.

I politely asked the front desk administrator if I could speak to the charge RN, told him I wasn't in hurry, when she had a minute (etc.). The RN came over and we chatted for a minute. She wasn't very helpful, as she had been working there for awhile, and didn't remember how she got hired.
I thanked her for her time regardless, and we concluded our conversation amicably.

To paint a picture of myself: I was dressed in my office attire (i.e. a suit and carrying my briefcase). That is to say, looking reasonably professional.


I could not believe what happened next: I was approached by Security, and informed that they had received a complaint. This could have only been from the RN who I had just spoken with. They asked me to leave the hospital premises.

I find this simply unbelievable, and not to mention extremely uncollegial. At no point in our conversation was there any indication of unfriendliness or anything of this nature.


This sort of behavior does not lend itself towards good RN / MD relationships.

I did manage to find an RN for my clinic, and she is excellent. I couldn't be happier with her.

I apologize, on behalf of the beeyotches who were working that day.

Nurses wail and moan (for good reason, sometimes) about how they are treated by physicians. But I have seen nurses treat physicians badly, too. If we want to have good working relationships with docs, we need to do our part.

I'm glad you were able to find a nurse who suited your practice.

 

[fab4fan]

The whole, "You might have been a threat" thing is kind of silly. You went to where you knew there were nurses, asked for help, and were escorted off the premises by security. I think that most posters here are searching for some kind of hidden reason that they would do this, because they find it hard to believe that anyone would react that way. Unfortunately, having had a similar thing happen to me, I can understand your sense of disgust.

I am a military physician. I had a Marine who tested positive for oxycodone during one of our random drug tests. He insisted (very convincingly) that he had been seen in one of our local ERs for dental pain on a specific date, and was given Percocet. I tried multiple times to obtain copies of his records from their admin office, but never recieved a response.

A positive drug test in the Marine Corps gets you disciplinary action and an "other than honorable" discharge, so I was willing to go the extra mile to verify his story. I went to the ER in professional clothes, with a copy of my medical license, my military ID, and the signed record release form from him. All I wanted was someone to check their log book to tell me if he had been a patient. I wasn't asking the ER for copies of the records; I just wanted to know if he had been seen.

I explained my situation to the triage nurse, who was very nice and took me into the main ER area to speak with the charge nurse. I explained what I was looking for to her, tried to show her my documentation, but she cut me off and said, "You need to contact medical records." She then gestured to security, and I was immediately escorted out of the ER by two security guards.

I'm sure many nurses would explain this along the lines of, "You could have had fake documents. They were probably busy saving lives. This isn't the ER's problem." All this is garbage. You are a physician who ought to be known to the hospital you were at. I am a physician and Naval Officer in a predominantly military town, talking to an ER that makes all its money off Tricare. This is nothing more than obnoxious ER staff taking their chance to screw with physicians, with zero concerns about how it affects patients.

I'm with you; this isn't a huge deal, and I ultimately got what I needed. I've been humiliated in far worse ways than this little incident. But at some point, some nurse from that facility will need something from me, and they won't get it.

I don't know how long you've been back, Tired, but welcome back.

 

[sarjasy]

He...He...He...

Here's an English lesson:
"Ellipses are not periods." is a full sentence.
"You look unintelligent when you end every sentence with them." is also a full sentence.

Not sure if you should end the quotations with a period...Looks weird to me...a comma maybe...mind looking that up for me on Purdue Owl?

 

[ChillyRN]

Seriously? You thought that there was unwarranted, naked aggression? I look at this same thread, and do NOT get the same vibe that you do. I wonder what you would say if it really was vitriolic.

An honest question - have you ever written someone up at work? If yes, was it for a trivial/nonimportant issue that could have been handled without being written up and going into someone's file?

Are we misunderstanding each other? I was saying it wasn't worth the brouhaha.

Excluding falls and complaints about the food, I recall having written 2 incident reports in my 20 year career. One when someone attempted to infuse something through an arterial line, and the second regarding an error that I made. We didn't regard them as writing up an individual, they were more a process review -as in what led to the error, performance improvement opportunity, etc. They didn't go into our "files." I have never "written someone up" in any other manner. I don't even know how I would do that. To my knowledge, no one ever did it to me either. I don't think we had a tool for that, and I don't really understand the notion of a "write-up." Why do you ask?

FWIW, I did call security and have someone thrown out once. He was drunk and screaming at his apparently soon to be ex-wife (my patient), while she was in the critical care unit. It seemed appropriate at the time. I dunno, in retrospect maybe I over reacted. Oh, we also threw some dumb ass out of the ED for bringing in a live snake (thrashing around in a pillow case) to ask if it was poisonous. It was (rattler). The doc was very excited, and followed the guy out to the parking lot to investigate. Boys.

 

[Apollyon]

Are we misunderstanding each other? I was saying it wasn't worth the brouhaha.

I wasn't saying that it was or wasn't worth it - I was saying that there was no brouhaha. That you saw something that, on my rereading, was not evident with any modicum of clarity made me wonder if you were one of those nurses that were prone to do that - find conflict where there was none. There was a nurse with whom I had worked for 3 hours in the ED - that's it - who felt compelled to write a 4 page, single spaced, complaint letter to the ED director - but didn't send it for 6 weeks. Huh? I didn't see her again in between. No one else complained, and no one else had any idea about which she was complaining.

And that's why I wonder from where comes the "write 'em up" mentality of nurses; elsewhere on SDN, I wrote last week about a nurse that started fuming, and histrionically stormed off, when I referred to her as a "minion" as she followed the nursing supervisor around. Later, I found that the supervisor had counseled HER (the nurse) about unprofessional behavior.

I refuse to walk on eggshells - that doesn't mean that I am spouting obscenities and slurs and distasteful things, but I am not going to measure each and every word I say before I utter it because some wilting lily might find her Puritan ears tainted, more than the average person - and those are the people tending to write up others.

 

[FireCloud9]

Shoot, where I work, a staff member can be fired for looking up their own records and if you show up without your ID, you are told to leave. This applies even if you are going on shift, known by everybody and employee of the month. I don't necessarily agree with it, but bills do not pay themselves.

A staff member, as a patient, does not have the right to look at their own records? So much for a patient's bill of rights....