Completely idiotic things admin are capable of

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RustedFox said:
That's what they did with our ER unit clerk/secretary. They made the charge nurse do all that work. In addition to being a charge nurse, and a floor nurse, and a tech, and a partridge in a pear tree.
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Now they can pay themselves a larger christmas bonus yay
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RustedFox said:
That's what they did with our ER unit clerk/secretary. They made the charge nurse do all that work. In addition to being a charge nurse, and a floor nurse, and a tech, and a partridge in a pear tree.
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That extra $4/hr has to be earned.
 
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smq123 said:
I was a medical director for two years, and have sat in on those meetings.

You really don't want to know what gets said.
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I'd like to hear some of the things that are said.
 
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Not ED specific but csuite recently told all of our residents they not only couldn't park in physician spaces but couldn't park in employee spaces or the general on property spaces. They have been told to park two blocks away at a tertiary lot.
 
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Is it temporary, is there construction going on? That's ******ed


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bravotwozero said:
Is it temporary, is there construction going on? That's ******ed


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It's only illogical if there's more than enough parking in either the physician or employee lot to accommodate all the residents plus the entirety of the group for which the lot was originally dedicated. It doesn't make sense for admin to ignore private physicians complaining about lack of parking or to hold an OR for 15 minutes while the surgeon looks for parking. It doesn't make sense to piss off employees who you hope will be at the hospital for multiple years and who, unlike residents, have a choice about where they are employed. A program is not going to go unmatched because parking sucks and it's unlikely to be a big enough factor that the applicant quality will decrease enough to noticeably effect patient safety. So it definitely sucks for the residents but from a hospital perspective those are the arguments to be made.
 
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Yeah but if you treat me poorly as a resident I'm highly unlikely to stay on when I graduate.
 
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TeamZissou said:
Yeah but if you treat me poorly as a resident I'm highly unlikely to stay on when I graduate.
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If there are other factors at play, sure. If literally your only complaint is that you don't get parking... and now as an attending you get parking... I don't see where the issue is.
 
TeamZissou said:
Yeah but if you treat me poorly as a resident I'm highly unlikely to stay on when I graduate.
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<shrug> They've gotten their money's worth from you (i.e. none; they got paid to take you). And if they're in a reasonably desirable area of the country, they will probably find someone to hire, without difficulty. They may not be hiring in your department, even, so they may REALLY not care.
 
I brought that up not to be a jerk but as an illustration that not everything that pisses us off is because our overlords are stupid and clueless. Stupid/clueless sometimes improves with continued and focused attention to the problem. Cases like parking balance competing interests. Highlighting the issue has zero chance of effecting change unless you can alter the value proposition.
 
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It might sounds stupid but what if there was a nation wide doctor's union to fight this massive widespread human rights abuse ?
 
I like to hate on admins as much as anyone, but "human rights abuse" seems a bit hyperbolic to me.
 
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Spectre of Ockham said:
It might sounds stupid but what if there was a nation wide doctor's union to fight this massive widespread human rights abuse ?
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It does sound stupid to compare arbitrary and occasionally counter-productive management decisions to the experiences of people who are victimized because of where they were born, who they worship, who they love, or how they look. No one forced any of us to become physicians; occasionally we have to deal with bull**** (or actual ****) which does suck, but to compare that to human rights abuses makes you less than awesome.
 
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I've worked at a couple of places in my relatively short time as an attending (9 months) where the CMO was also a practicing hospitalist that admitted patients, and predictably gave considerably more pushback than was reasonable, or the norm when compared to his/her peers. Basically refusing admissions, pushing for unsafe discharges and asking for nothing less that 2 years of old records prior to admission regardless of whether it was 2 pm or 3 am. Anyone work in a similar place and not have it be a massive conflict of interest?
 
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racerwad said:
My apologies. Was saltier than expected after a shift. The argument offered by @Spectre of Ockham (and others elsewhere) drives me nuts but I could do better in my reply.
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yeah...I don't think smq was responding to your comment specifically...if at all
 
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OccupyTheED said:
I've worked at a couple of places in my relatively short time as an attending (9 months) where the CMO was also a practicing hospitalist that admitted patients, and predictably gave considerably more pushback than was reasonable, or the norm when compared to his/her peers. Basically refusing admissions, pushing for unsafe discharges and asking for nothing less that 2 years of old records prior to admission regardless of whether it was 2 pm or 3 am. Anyone work in a similar place and not have it be a massive conflict of interest?
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our CMO is a practicing specialist and pretty much refuses to see patients in the ED while on call. That is too small ohh that is too big. just do so and so and send them to clinic in 3 days. Its ridiculous. And my group wonders why we get push back on everything when leadership does sh## like this.

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At one of our sites, they're trying to make the doctors move out of our work area and sit with the nurses/techs/medics/whoever. They've decided this brilliant plan will somehow improve patient flow. I already have the nurses hospital phone numbers and we're getting or already have the Epic secure chat function. Sitting next to them isn't going to help. I already know my patient didn't get pain meds / antibiotics / discharge papers because the nurses are busy on Facebook, shopping for cars/houses, or just not doing anything.
DocEspana said:
this needs to be refreshed. I need to hear new horror stories of admin.
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TooMuchResearch said:
At one of our sites, they're trying to make the doctors move out of our work area and sit with the nurses/techs/medics/whoever. They've decided this brilliant plan will somehow improve patient flow. I already have the nurses hospital phone numbers and we're getting or already have the Epic secure chat function. Sitting next to them isn't going to help. I already know my patient didn't get pain meds / antibiotics / discharge papers because the nurses are busy on Facebook, shopping for cars/houses, or just not doing anything.
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Interesting, as I find sitting out front instead of in a dedicated physician work area reduces work flow, as I get interrupted nonstop by nurses, and by patients/patients families themselves.
 
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TooMuchResearch said:
At one of our sites, they're trying to make the doctors move out of our work area and sit with the nurses/techs/medics/whoever. They've decided this brilliant plan will somehow improve patient flow. I already have the nurses hospital phone numbers and we're getting or already have the Epic secure chat function. Sitting next to them isn't going to help. I already know my patient didn't get pain meds / antibiotics / discharge papers because the nurses are busy on Facebook, shopping for cars/houses, or just not doing anything.
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Oh yeah, that’s been going on in one of our facilities for a long time. I don’t mind helping people but it’s a constant issue to be interrupted frequently. For blankets. Water. My mom needs to go to the bathroom. When can Johnny eat... can he have a sandwich! The worst is when someone asks for a pillow because we have like two pillows in the whole ER. Actually, no, the worst is when the old men just stand next to my work station, lean onto it with their chin resting in their hands like they’re totally bored and just zone out. While I am trying to dictate. I can never refrain from asking “Can I help you?” With a little bit of attitude.

Dumb new admin stuff... let’s see. Our nursing director is putting patients in hallways when we have beds available. I don’t mean a med refill. I mean anything. And “it’s okay if the patient agrees to it.” Am I really supposed to do an I and D in the hallway? Why am I doing this when there’s five patient rooms available? Time and time again I am forced to see back pain patients in tight jeans with a button up and undershirt in the hallway. And I get attitude from the nurses when I ask if they can get a room for the patient because they need to be in a gown. “In a GOWN? For back pain?” Yes, a gown. “Why? No one has ever asked that.” Belly exam, I need to HMM LET’S SEE, look at their back, test the sensation of their lower extremities, reflexes... can’t do that very well with Levi’s on. “There’s a girl with lower abdominal pain in Hallway 5 I need you to see.” Sure... okay, what’s going on? Oh, you’re having some pelvic pain and fevers, huh? Well, we need to do a pelvic exam. Let me get you moved into a room. Hey, charge, this girl needs a room. “Why? She’s totally fine; she walked in here talking on her cell phone.” Well, she’s having pelvic pain and fevers and I need to do a pelvic exam. “I asked her if she was having discharge and she said no.” I kid you not, the arguments like this don’t stop and it’s ALLLLLLLL a result of pressures from admin.
 
Let's remove the fixed restraint points from the psych holding area because they're a hanging risk! And let's require 1:1 sitters for all suicidal patients, even the ones in the locked, 24/7 video monitored, suicide-proofed psych area! Never mind the physical risk to staff and other patients the former poses, or the stupidity and impossible staffing requirements of the latter...
 
TooMuchResearch said:
At one of our sites, they're trying to make the doctors move out of our work area and sit with the nurses/techs/medics/whoever. They've decided this brilliant plan will somehow improve patient flow. I already have the nurses hospital phone numbers and we're getting or already have the Epic secure chat function. Sitting next to them isn't going to help. I already know my patient didn't get pain meds / antibiotics / discharge papers because the nurses are busy on Facebook, shopping for cars/houses, or just not doing anything.
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Yeah, you're not going to tell me where to sit. I dealt with this at one site because their dungeon of an ER didn't have a doc box. It was awful with the amount of interruptions. I would get interrupted while being interrupted. It was like the "Inception" of interruptions.

Amazing how the number of these is cut down to about 25% when they need to physically get up from their chair to find you
 
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Do admins realize they constantly are creating an environment of no win scenarios full of opposing and impossible goals that make it nearly intolerable to work in?

I mean, they must know. They have to know. Do they just not care? Is it 100% about the money for them?

Or do they somehow see themselves as saviors of the system, protecting the "system" from the docs and nurses?
 
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GeneralVeers said:
Interesting, as I find sitting out front instead of in a dedicated physician work area reduces work flow, as I get interrupted nonstop by nurses, and by patients/patients families themselves.
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That's what we said. Nursing admin and an outside "consultant" made the decision before the discussion started. We don't have much intention of going along with the plan.
 
GonnaBeADoc2222 said:
Yeah, you're not going to tell me where to sit. I dealt with this at one site because their dungeon of an ER didn't have a doc box. It was awful with the amount of interruptions. I would get interrupted while being interrupted. It was like the "Inception" of interruptions.

Amazing how the number of these is cut down to about 25% when they need to physically get up from their chair to find you
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Incepterruption.
 
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GeneralVeers said:
Interesting, as I find sitting out front instead of in a dedicated physician work area reduces work flow, as I get interrupted nonstop by nurses, and by patients/patients families themselves.
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You mean it's not a good idea to be trying to figure out a subtle (and serious) medical complaint while all the nurses are keeping up with Kardashians in a circle conversation with you in the middle?
 
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Also when our infection control loser comes and writes "Shame!" on my coffee cup that I'm drinking at a doctor's station in an area that deals with no meds, bodily fluids or any patients. I sarcastically tell them that I'm designating it a "non-patient care area" and I will do as I please.
 
GeneralVeers said:
Also when our infection control loser comes and writes "Shame!" on my coffee cup that I'm drinking at a doctor's station in an area that deals with no meds, bodily fluids or any patients. I sarcastically tell them that I'm designating it a "non-patient care area" and I will do as I please.
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There's no "patient care area" rule either.
The best way to address this? If it gets brought up during a site visit, simply say "my drink is fine because no labs are processed here. Especially considering it's a TJC rule to label them at bedside."
 
RustedFox said:
Incepterruption.
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Nursing Incepticons ATTACK!

NurseFight1.png
 
Dr.McNinja said:
There's no "patient care area" rule either.
The best way to address this? If it gets brought up during a site visit, simply say "my drink is fine because no labs are processed here. Especially considering it's a TJC rule to label them at bedside."
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I love that one. Will definitely use it on our infection control troll the next time he shuffles through.
 
+cocaine UDS = EKG. no other requirements. wtf.
 
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DocEspana said:
Lube is now a controlled substance and needs a pyxis order. This includes taking all the lube out of the rescusitation bays, a real pain in the ass for people like me who like to lube their ET tubes.
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It's a real pain in the ass for patient's getting the ole DRE on a much more literal basis
 
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Lady with short gut syndrome came in on Sunday because her PICC line was clogged. She needs two liters of NS every day at home to live. Of course being Sunday there's no way I can get a PICC line placed. My solution was to have nurse place a peripheral line and have her return in the morning. Reasonable right? Admin says no way this lady with a PICC line can possibly be discharged with a peripheral IV because of......rules
 
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GeneralVeers said:
Lady with short gut syndrome came in on Sunday because her PICC line was clogged. She needs two liters of NS every day at home to live. Of course being Sunday there's no way I can get a PICC line placed. My solution was to have nurse place a peripheral line and have her return in the morning. Reasonable right? Admin says no way this lady with a PICC line can possibly be discharged with a peripheral IV because of......rules
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Completely ******ed (re-tarded since SDN wants to * it out). I don't understand things like this. It's perfectly OK to go home with a central line with more risks but not OK to go home with a peripheral IV.
 
GeneralVeers said:
Lady with short gut syndrome came in on Sunday because her PICC line was clogged. She needs two liters of NS every day at home to live. Of course being Sunday there's no way I can get a PICC line placed. My solution was to have nurse place a peripheral line and have her return in the morning. Reasonable right? Admin says no way this lady with a PICC line can possibly be discharged with a peripheral IV because of......rules
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Why was "admin" even aware of this case and making decisions about it?
 
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