clinic nurses-late patients?? What to do?

  1. Hi again!! I am wondering if any of the clinic nurses out there have a clinic policy on what to do with you patients who are late. I vented earlier on another thread, cuz I am having THE WORST day ever. It is the day before a holiday weekend, we have on doc out on vacation, and we are SWAMPED. We have this thing called "open access" here-where we have to squeeze people in left and right even if we have a full schedule. Fine and dandy, right? Well, sometimes. But here we are today, with everybody and their brother coming in because they just HAVE to be seen before the long weekend. Not only that, but our last 5 patients have been late!!! My last patient was half an hour late, and offered up no excuse or appology. Am I being fecicious? (unsure of spelling on that )I just can't wait for my day to be over, and I am not usually like that. Our lead nurse says we cannot have a policy up stating that if pateints are a certain amount of time late, they may be asked to reschedule. Do any of you have such a policy, and if so, do you feel it helps? I guess the big "fear" of our lead nurse is that it wouldn't be good 'customer service' I beg to differ. I feel that when some patients are late, they make the whole schedule goes downhill faster than a well-greased sled on ice. Then the patints who come after them and are on TIME have to wait, blah, blah, blah. Let me know what you think, I have to tend to another one of my LATE patients.


    Sorry if that was too 'snippy' but I REALLY needed to vent
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  2. 26 Comments

  3. by   BadBird
    If the patient is half an hour late, then I would tell them that they may not be seen, if they choose to wait they will be added to the list but all other patients will be seen first.
  4. by   Vailgang
    The office that I go to has a policy if you are 20 minutes past your appointment you have to reschedule. In our office usually we run behind and so if you are late, sorry but you just helped us catch up!! I sometimes will bend the rule if you call and let us know that you are running late. If you show up without your MRI's then you will be rescheuled.

    Your patients will get upset at first but eventually they will learn that they have to show up on time or not be seen. I would put something at the front desk that informs the patients that you ae implementing an office policy regarding late arrivals. It will work and they will start to respect you and your Doctors will love you.

    If you need any support let us know.
    Jill
  5. by   gwenith
    I think what you need is a a BIG sign. "Due to tight scheduling patients arriving late may not be seen until the end of the working day". This sets the limits so that EVERYONE is aware and then you can "be nice" and "bend the rules" for those who show the consideration to ring first. This should actually INCREASE customer satisfaction (at least after a little while) as people will be grateful that you made a "concessioon" for them.

    You may loose one or two patients but I would bet they were the ones causing maximum headache.

    BTW - my warped sense of humour kicked in when i read the title of the thread "What do you do about late patients" I had a mental image of a waiting room filled with skeletons and the nurses saying "It looks like they are all "late"".
  6. by   Nurse Ratched
    I work with college students who (I think) are a little worse than average in thinking that the world revolves around them (sorry to our nursing students here!) We have 12 minute appt blocks for uncomplicated problems. Someone is 10 minutes late, and their appt time is lost. *If* I can work them in, I do. But typically we require a reschedule or we (worst option) divert them through the "walk-in" area. I have a few patients who are regulars who need to see specific MD's or NP's and who repeatedly test the boundaries by showing up late and I do make them reschedule every time. And I assess the late/no show fee. Working with that population, I feel it's a HUGE part of my job to instill a sense of responsibility in my patients.

    If providers are running behind, it is almost always traceable to patients being late or bringing up a bunch of other "while I'm here" problems (again - to cram into a 12 minute appt slot) so I use that when I explain why timeliness is so important. And no - we will not be fixing every health problem you've had for the past 10 years "while you're here" when all you were scheduled to be seen for was a cold. (Sorry - kind of a rough week here, too! ; - big empathy hugs coming your way, sister!)

    Had one patient gripe that we shouldn't have "given my appt away" because he was 15 minutes late. I explained that the appt wasn't given away - the provider's time was lost to everyone because it was alloted to him and he didn't make it in. We don't double book, so missed appts are lost time.
  7. by   RN2007
    I just had to bring this up, because respect for peoples time works both ways. What about the drs. that have their office staff to double and triple book their patients appointments, and make their patients wait in the lobby for 2 hrs or more on a regular basis, while those pesky pharmaceutical reps zoom in and out of the office without an appointment? How are the patients respected when this happens and where is the "patient service" when it happens? Oh, and this used to happen to about 3 of my primary care dr. offices, all of which I had to quit seeing each because of the office problems such as this. Sure, I understand that all offices are not this way, so kudos to your office for not being that way and be glad that it is not. And most definitely, patients should be on time for their appts. or call if they are late, and they need to be more understanding and should know that if they are late that they just might need to be rescheduled.
  8. by   boggle
    My opinion- If you arrive late, you get bumped to the back of the line. All those other folks sitting in the waiting room will be seen ahead of you.

    But, if you are late, say more than a half hour, I feel the office has every right to give your time away to anyone who calls in hoping for a visit that day. Then the latecomer is out of luck and will have to reschedule.

    I see RN2007's point of view too. I think that much of the casual attitude about being on time for doc appointments is a result of the crazy way appointments are scheduled. Respect is lost for the whole appointment schedule after you repeatidly sit captive in the waiting room ( or worse, in a paper gown in the exam room)for over an hour ( or 2) for your scheduled appointment, or after hearing two people walk in after you stating they are here for THEIR 2:00 appointment with Dr. Jones. (Say, MY appointment was for 2:00 too!?)

    I often call before I leave my home, or my work, to ask if the doc is running on time, should I delay my arrrival. I usually get "oh we are right on time". Last time I did that, I arrived 15 min. after my call and sat in the waiting room for 90 min past my appointment time.

    Oh I'm ranting and raving here. Hope I didn't side track your thread Luvbug.
    Last edit by boggle on May 23, '03
  9. by   RN2007
    Boggle, you are sooo right. However, I have found that calling them ahead of time is a waste of time, because the receptionists never have told me the truth because according to them when I call ahead of time, all is well, but when I get there it becomes apparent that I am one of around 4 or more people with the same appt. time, and of course the pharmaceutical reps have bribed their way ahead of us with a box of Krispy Kreme doughnuts, lol... And when the nurse finally weighs me., put me in a room, I normally put on my gown and lay down and try to get some sleep till the doc appears. I usually have to take off of work a minimum of 3 or more hours... Yeah, fun!
  10. by   niteshiftnurse
    The other side to this is what if the doctor is running behind????? I have been seeing a neurologist for the past 3 1/2 years and its nothing for him to be 3 hrs behind, even if you have a 10am appt. I have always told the office people that if he is late, please call me as it takes me 45 minutes to get to his office, but that doesn't always happen. I had an appointment 3 days ago and I called and he was behind, so they told me to come in at noon. I called again before I was going to leave and he still wasn't there. I then told them to call me and give me enough time to get there (45 minutes). guess what time they called me 2:15. I was really po'd. my whole day was shot
  11. by   Vailgang
    Scheduling is more difficult than a person knows until they work on the other side. I never realized the difficulty in scheduling until I worked in the clinic. It is very difficult in speciality. I work for neurosurgeons and they are only in the office 2 days a week. I wish I could explain to you all the dynamics that go with scheduling but hope that you will trust me that it is more difficult than one would think.
  12. by   ShelleyERgirl
    I definitely understand the vent here about late patients! I work in an internal medicine office and we are constantly getting late patients. We try to be understanding in the case of a 5-10 minutes but it is the people who are like a hour late, sign in and then sit down like it is no big deal! Hellllooo? No apology, no nothing, then they have the nerve to get mad at you when you have to reschedule their appt! Give me a break. ... And another thing....I CAN"T STAND DRUG REPS! Well, let me amend that, there are a few that I actually like, but there is this one woman that comes into my office and has got to be the rudest woman on the planet. She actually butted in front of a patient I was trying to give instructions on how to use an inhaler to try to tell me about her new drug that was coming out! I told her while that was extremely fascinating, could you please get out of my way so I could finish talking to the patient that she had just interrupted! Our doctors even hate her and she always tries to use that she has to witness the signature for the samples she leaves ruse just so she can talk to them. URGGHH!
    whew... I feel strangely better, thanks for the vent guys!
  13. by   Agnus
    I agree with you. Let me give it to you from a patient stand point. I consider it very poor customer service to be seen late when I am early or on time. I completely understand about the need to keep appointments on time. If I am late it is reasonable to require me to reschedule. I would not appreciate being kept waiting because others were late. My time is valuable too. To keep me waiting is an insult.
    I realize it is sometimes unavoidable. Too many physicians are late consistantly due to poor scheduling and clinic policies. This is avoidable and there fore unexcusable. I do not continue to use the services of anyone who does not respect my time. No doctor is more important than me. Late patients should be required to reschedule. If you choose not to do that then make them waite until all the scheduled patients are seen. Do NOT make me waite for them.
  14. by   jadednurse
    At the clinic I managed there were 4 physicians, each w/ her own approach to dealing w/ late-arriving patients (which of course made my job miserable!). It took awhile for new nurses there to get to know the doctor's styles. One would see all her patients, no matter how late they arrived...and she was ALWAYS behind; another would require that patients reschedule if they were more than 15 minutes late...and she was rarely behind. Does anyone else see the connection there?

    I recently visited my doctor and had to sign the wonderful HIPPA inspired Disclosure of Privacy paperwork. In addition to that I had to sign a form that I understand that if I miss an appointment, cancelled less than 24 hrs before an appt or arrived so late for an appt that it had to be rescheduled, that I would be charged for it. OK, since this has become a rather standard practice, fair enough. Although, I'm toying w/ the idea of making the doctor sign a form that states that if the same courtesy is not extended to me than I get some sort of reimbursement for my valuable time being wasted!

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