So Stressed & Aggravated At My Job

  1. 2
    I have posted a few times before about my physicians office job as a LPN (the receptionist promoted to office manager because the hospital could find no one else for the job and the office being so disorganized..etc...) and it seems like now every week it's some different nonsense to deal with.

    So, anyway this is what happened today. I get confronted about a patient that left the office Friday because he had to wait too long to be seen about his back pain and went to the hospital. The patient went and signed in with the receptionist as a walk-in then went back to the parking lot to his car because he had a massaging seat in his car. He told the receptionist that he would come back in and check with her to see if he'd been called back. No idea of what type of car he was driving or where it was parked and the parking lot itself was full. I went upfront and called the patient's name several times and no one answered and that's when I got the story from the receptionist about the patient going to his car and he'll be back in to check with us and blah-blah-blah. So I told the receptionist that I was going to pull the next patient back because I'm not going to run this patient down in the parking lot when there is an entire roomful of people waiting and when he comes back in let me know so I can call him. I went back upfront at least seven times and called the patient's name and there was no answer and in between this I continued to triage the people that were waiting in the lobby. Then I got called into the room for dressing change that at least took an hour and that's where it ends with me.

    So today, the office manager told that I should have went to the parking lot to find the patient or sent one of the other nurses to the parking lot to find the patient when the patient wasn't in the lobby when I called him back even though the patient said that he was going to come in and check with us and that she has to write me up. No matter that there was a lobby full of people waiting to be seen or that the other two nurses were busy. I should have pulled the nurse from her telephone callbacks or the other nurse from her patients to search the parking lot or I should have gone myself to search for the patient in the parking lot. Apparently after I'd left for the day the patient's mother (patient is a middle-aged adult) came into the office and complained because he had to wait too long and they were going to the hospital. Don't ask me why the patient's mother couldn't have in checked to see if he had been already called back (more than once) or if he couldn't have checked to see if he had been called back like he said he would.

    So I went and talked to the nurse practitioner since she is supposed to be the advocate for the nurses to argue my case and according to her I did not use sound nursing judgment and she support me being written up. She said that when I came to the patient's name and he wasn't in the lobby I should have looked for him since the receptionist told me that he was in his car because his back hurt and he has a massaging car seat. I told her that I do not agree with this because it's ridiculous that anyone should have to go searching for a patient in a parking lot when I have no idea of car he is driving or where he is parked and it is not my responsibility or the responsibility of anyone else in the office to run a patient down. Apparently because it is only "one time" and "one patient" and "it doesn't happen all the time" this is something that the nurses in our office is supposed to do. My argument is where does the patient's accountability and responsibility come into play and should my nursing judgment extend to the parking lot? I guess I will receive the paperwork regarding the write-up tomorrow, but I refuse to sign it and I am writing a rebuttal. Am I wrong or does anyone agree with my position?
    Teresa Lewis RN and delete like this.
  2. 27 Comments so far...

  3. 10
    is searching for patients in a parking lot in your job description? people carry guns in their cars. you are not a police officer or a security guard and i feel searching a parking lot for a patient is way beyond your scope of practice. i wouldn't sign it either.
    caliotter3, mesa1979, DogWmn, and 7 others like this.
  4. 3
    I wouldn't sign it either. Walking around a parking lot is dangerous these days. Since when do we put our safety in jeopardy for our patients?

    Although, I might have walked outside and looked left and right...I wouldn't have been going from car to car.
    caliotter3, delete, and Crux1024 like this.
  5. 9
    I think the "Office Manager" should have combed the parking lot for this character!!!!
    caliotter3, RNROSER2011, mesa1979, and 6 others like this.
  6. 10
    Quote from Bella'sMyBaby
    I think the "Office Manager" should have combed the parking lot for this character!!!!
    I was thinking the receptionist who said it was OK to wait in his car should've gone and found him.
  7. 5
    nooooo way! i would never go looking for a patient who decides not to wait in the waiting room like everyone else. that is absolutely ridiculous.
  8. 1
    Why couldn't the receptionist look for him? Caring for your patients at hand would have precedence over looking for someone in the parking lot in my book. If the staff their doesn't have anything else to do other than "write you up" they must have a lot of time on their hands whereas you don't. Sucks when you can't rely on your "chain of command". Then they wonder why staff switch jobs so often. Make sure you write the rebuttal and keep a copy of your documentation and theirs just in case. Good luck and keep "nursing on".
    skittlebear likes this.
  9. 1
    I said the same thing and was told that the receptionist had said that she was the only one up front and could not go out to the parking lot looking for the patient and somehow the responsibility for making sure a patient is seen when he walks out of the building extends to the nursing staff. Oh and another argument is because I said that I would not go out to the parking lot and look for him (which I did say this). Not to mention the fact that I had no idea of which car the patient was sitting in or where it was parked and I knew no background information on this patient at all and there wasn't even a chart in the bin for him, only an encounter form and a triage sheet because the front office staff couldn't find his chart. So I don't understand how I was not using sound nursing judgment. I am of agreement that people harbor all sorts of dangerous weapons in their cars. The front office argued for a lock to the door so that patients couldn't just walk to the back (because they frequently did this) but now we are supposed to go searching for patients in their cars?!
    skittlebear likes this.
  10. 8
    Based upon the information you presented, I concur with your decision not to conduct a car to car search for the patient. Not to second guess, but didn't the guy have a cell phone? Couldn't he have left his number so that you could call him? Also, if the patient was in so much pain that he could not tolerate sitting in a waiting room, perhaps the E.D. was where he belonged.
    By the way, I have a real problem with non-nurses reviewing or evaluating a nurses performance. These people lack the expertise to make nursing judgements or determine the appropriateness of a nurses actions. While the "office manager" may be competent to evaluate certain facets of your job (attendance, dress code, etc.), the evaluation of your clinical decisions should come from another nurse. I would never work in a place where I was expected to accept a clinical evaluation from someone without R.N. after their name; it tells me that the office doesn't respect nursing as a profession.
    cookienay, alem-tsahai, skittlebear, and 5 others like this.
  11. 3
    I wouldn't sign it either. Don't let them bully you into it. Stay firm. You also need to start looking for a new job. This is a bad fit and isn't going to get better.
    alem-tsahai, Altra, and RNROSER2011 like this.


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