Oasis Coordinator, ARRGGHH! Does this happen to everybody?

  1. Please be honest with me either way.....I need to get this woman off of my case.

    Every admission, recertification, resumption or discharge oasis that I turn in I end up getting questioned. First she started calling at 6:30 am. I spoke to the DON. She was told not to call until 8:00. Now she calls me on my day off at 8:00 and wakes me up.

    She told me that a lesion is anything on the body that needs monitoring, even a mole and that an old surgical incision is considered a lesion even if fully granlated.

    I admitted a patient with a brand new PICC and a fully granulated pacemaker site. Now she says these are not lesions or wounds. If I don't count something as a lesion or wound then she gets mad. Gees, she is driving me crazy.

    She always wants to know why PT says i.e. minimal exertion and I may say moderate. Hello, they were done on different days. Also I've been present at some of the PT evals and the PT never walked the pt and called them "no dyspnea". I walked the same patient with an ejection fraction of 17%, acute CHF, I walked her and most definately she was minimal exertion.

    This new coordinator is making me nuts. Please help!
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  2. 8 Comments

  3. by   Jolie
    I feel for you.

    Please start setting limits immediately. No one is to EVER call you at home or on your day off unless it is an EMERGENCY. (And discrepancies on forms are NOT emergencies!) Do not tolerate this from her, or anyone else.

    If she doesn't knock it off, turnabout is fair play.
  4. by   Cattitude
    dgirl,

    this woman is *******' nuts!!! i am plain nasty when someone wakes me up so bless you for putting up with this. set limits. this is totally invading your privacy. tell her respectfully of course that she is to discuss all this stuff with you on your scheduled days, period, end of discussion.

    and really, i seriously doubt that anyone else is ever going to go back and search all your pt's bodies for the lesions you didn't or did chart. come on!!!! i don't know all the darn moles my pt's have!!?? unbelievable... she needs a life..

  5. by   bethin
    You need to tell her that these kind of discrepencies are not TRUE emergencies and do not warrant a phone call at 0800! Tell her if she has a problem, to leave notes for you at work, email you, etc. No more phone calls until she can decide what a real emergency is.

    I work 7a-7p. I've been woken up at 0300 because the RN wanted to know where the accuchecks are for the day. Asked her if she looked on the computer, I know I charted them and day shift didn't say anything about them missing. She replied "oh, I never looked there." Everything goes on the computer so I don't know where her head was at. Then she asked me about so and so's 2100 accucheck result. I wasn't there!
    Last edit by bethin on Feb 9, '07
  6. by   homehealth43130
    For answer to MO440, does this patient have a skin lesion or an open wound, is you look at the guidance in Chapter 8 of the OASIS implementation manual, CMS considers the following lesions: "A lesopm is a broad term used to describe an area of pathologically altered tissue. Sores, skin tears, burns, ulcers, rashes, surgical incisions, crusts, etc. are all considered lesions. All alterations in skin intergrity are considered to be lesions, except alterations ending in ostomy...or peripheral IV sites. Persisitent redness without a break in the skin is also condisered a lesion." Under Tips: " a skin lesion is an area of pathologically altered tissue - primay lesions i.e. vesicles, pustules, wheals; secondary lesions - i.e. crusts, ulcers, scars; Changes in color of texture such as maceration, scale, lichenificaiton; Changes in shape of skin surface such as edema, cyst, nodule; breadks in skin surfaces such as abrasion, excoriation, fissure, incision; Vascular lesion such as petechiae, eccymosis. It includes but is not limited to: wounds, ulcers rashes, crusts, bruises, sores, skin tears, burns, surgical incions, pin sites, wounds with staples or sutures, central lines, PICC lines, prtacath, mediport, implanted infusion devises, venous access devices, current surgical wound or healed scar of pacemeker insertion, scars, femoral puncture site resulting from heart catheterization. "

    Almost all patients of a certain age have a skin lesion as described, moles, freckles, age spots all count.

    As to why she calls you on your day off, the OASIS must be done and transmitted before your agency can bill for the RAP - if you donot answer all questions or there are questions regarding consistency within the OASIS document itself, it directly affects payment and depending on how your agency is set up, they could bill the raps daily to ensure enough cash flow so that you get a paycheck.

    If you haven't already, please get a copy of chaper 8 from the OASIS implementation manual - it answers each OASIS MO question. You must learn to speak OASIS speak, which is entirely different than clinical nursing.

    https://www.qtso.com/hhadownload.html
  7. by   Cattitude
    Quote from homehealth43130
    for answer to mo440, as to why she calls you on your day off, the oasis must be done and transmitted before your agency can bill for the rap - .
    are you kidding? that can still be done on dg's work time. no employee should be harassed continuously on their time off. nope.
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  8. by   caliotter3
    I have never had a Director of Nursing, Director of Clinical Services, or facility/agency administrator or general manager that would allow themselves be interrupted after hrs for anything short of a truly important problem: such as questionable death of the patient. As you describe it, this is ridiculous. There is something wrong with this person. Do not allow her to continue to interrupt your non-work time. Go above her and complain if she will not respond to your direct requests. She needs some direction that only her boss can effectively deliver. Good luck.
  9. by   ladytraviler
    I admire you cause you are speaking way above my head. Take a deep breath and tell this woman how the cow ate the cabbage in nursing speak.
  10. by   DutchgirlRN
    Quote from ladytraviler
    I admire you cause you are speaking way above my head. Take a deep breath and tell this woman how the cow ate the cabbage in nursing speak.
    Huh????

    Anyway, everything is better now. I actually have not heard from her in several days and the phone calls have stopped. I don't know if administration finally said something. I had another nurse tell me about a 7am call on her day off. I encouraged her to report it as well. Now when she needs something she'll see me in the office and ask if she can talk to me about so and so patient for a minute if I have time. This is working soooo much better.

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