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hotflashion, BSN, RN 8,799 Views

Joined: Oct 8, '09; Posts: 282 (29% Liked) ; Likes: 173
from US
Specialty: 3 year(s) of experience in Foot care

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  • Oct 16 '15

    I work an an RN in a walk in clinic also. I do all aspects of patient care. Including injections and blood draws. We are a small clinic and have 3 MAs and one other RN. The clinic manager wants me to 'learn the front desk'. I have resisted. I'm a nurse not a medical biller. The front desk receptionist is responsible for verifying insurance and collecting payments. The manager is adamant about payments and veryifying insurances. If a mistake is made she has a meltdown. I'm not putting myself in that situation. The ICD 10 is a horror show. Coding lab slips and referrals is difficult. If the doc is not doing his job calling patients and doing scripts there is nothing you can do. You can't force him to do his job and I would not be covering for him. Personally I would look for another job. Because he is not going to change and you are just going to remain frustrated stressed.
    I left my previous job afrter 14 yrs when the doc wanted me to 'change a record to keep an employee at work when the patients ortho had clearly told me that he needed to be out of work. I refused and the doc threatened to fire me with not following her orders. I spoke with human resources and reached the conclusion that another situation would occur and I would never win. By the way the doc was ex-military and used to never being questioned. I told the doc that I don't change records. That's when I realized that it was going to be a permanent no win situation.
    So you will have to come to your own conclusion as to what is worth to you. Your sanity or your job. I found a better job.

  • Oct 16 '15

    Quote from hotflashion
    I don't know if this is even appropriate for Allnurses, but here goes. I'm working in a one-doctor office. Though I am an RN, I was hired to fulfill a medical assistant role, which was ok with me as a means to an end beyond this particular job. I thought I'd work there for a year, learn what I could and then move on. I've come 2/3rds of the way.

    Long story short, I am the only one left in the office besides the doc and because of this I have had to do the front office tasks, i.e., answer the phone, re/schedule patients, check in/out, take payments, all the administrative tasks associated with a doctor's office. Plus I room patients and do some minor documentation in the charts.

    There is more work than I can do, and it is of such an intensity that I am exhausted. The doctor massively mismanages the business, and I regularly field calls from patients who do not get their tests or prescriptions called in as requested, who do not get test results once the tests are done, who are confused and angry because there is no follow up or from creditors who shut off accounts for nonpayment. On top of this the paycheck does not come regularly: I am paid biweekly, am 1 paycheck behind, and the latest check is late.

    The doctor was totally unprepared for ICD-10 adoption on October 1, and we are now unable to bill. It is a setting of utter chaos. I also happen to know that the doctor is now under warning from the local hospital professional organization for not paying dues and not charting within the required time frame.

    I am currently training a medical receptionist. I'm very organized, have kept the front desk "together," and feel like a complete and utter fraud with this woman, a very nice woman who needs her paycheck to be regular. She likes me, and I evidently put on a good show of having it all under control. I am not telling her that she should run away now, though that is what I think she should do.

    I got into this mess because I wanted the job, I wanted it for a year, and I was willing (and able) to put up with alot of nonsense. Then things happened and I ended up being the last employee on staff. I'm not sure what I'm going to do, but I'm miserable right now and having a tough time sleeping.

    I'd love to read your thoughts. Opinions, please.
    It sounds like a "get the hell out of there" especially if you aren't being paid, but there are some puzzling things in the story. How long has this doctor been in practice and what is their attitude toward the apparent devastation and chaos surrounding him/her? While it's true that being a doctor doesn't mean you're a good businessperson most will take a stab at it or go to a seminar or hire outside help, such as an accountant. Actually, calls from creditors are the one thing I would refuse to deal with at all.

    If the person is simply an incompetent manager you could probably suggest some ways to streamline things such as having the doctor call in their own patients when you're swamped. Lots of docs will actually do that without being asked. Also it's much easier for us to handle pharmacy callbacks than deal with irate patients waiting for their routine refills or "your test results are normal" because the doctor hasn't gotten around to it yet.

    There are lots of tricks of the trade in ambulatory care to create a smooth-running environment assuming the person who's running the place cares-- perhaps he/she doesn't care. If they don't care about their own practice I sure wouldn't feel guilty for leaving!

    Best wishes!

  • Oct 16 '15

    Get out now. You're essentially working for free if he's behind on paying you, and so you owe him nothing. Put on your big girl pants, give 2 weeks notice and start sending out resumes.

  • Oct 16 '15

    Run, run away. I just finally, after two AWFUL years, got away from a terrible office. It was quite as bad as your situation though. Many members here did not understand why I just could not up and leave, and why I was so afraid to leave my coworkers short-handed in such an environment. My torture finally ended when my doc moved to a new office. And, at the end of the day, that doc did not give a CRAP about how hard I had worked. She left on our last day without a single good-bye, 'thanks' or 'good luck.'... and the coworkers? After a month we hardly talk or text anymore. I was told many times that life goes on and they will get along without me. And the same is true for your office. Your boss might not fare too well, from his own disorganization and not by your doing. Give your notice and get out.

  • Oct 14 '15

    I admire your desire to "do the right thing", however, you really need to get out. Loyalty will only get you so far, and you have been far beyond loyal. This is no the time to think of yourself. Get out and move on. You have learned a lot of skills and good time management. If things are mismanaged from the MDs end and something happens you may also get in trouble. It sounds like you have to now start thinking about your future and not worrying about the loyalty. There are plenty of better places to be that would love your loyalty and actually pay you and give you a better working environment

  • Jan 11 '15

    Yes, it's true. Different states have different scopes. In my state an LPN cannot hang IV meds (unless they recieve an additional certification for IV meds), cannot hang blood, cannot complete assessments, and cannot do IV push meds under any circumstances. There are a few other items on the "Cannot" list as well.

    The thing is, NCLEX is a national test. For the brief time you spend at PearsonVUE completing your test you are not in your state. You are in NCLEX National Utopia Land where everything is uniform, you have all the supplies and assistive personnel you need and all of the options you have to choose from already have a practitioners order. No matter what your state's LPN practice act says about the LPN scope, NCLEX assumes that there are a number of things LPN/LVNs cannot do. It's in your best interests to learn what they are. You can forget them as soon as you pass your boards, but until you get your license it's a good idea to know them. If you get delegation questions on your test you must assume that you can't delegate certain things to the LPN/LVN.

  • Aug 14 '14

    She added: ‘There simply weren't enough staff looking after the ward. People were asking for help and it was falling on deaf ears.

    ‘The poor nurse was running around and didn't have time to help everyone. I couldn't just sit there and watch so, being quite agile, I got up and helped them myself

    Read more: Grandmother disgusted at filthy hospital nursed and bathed other patients on her ward | Mail Online

    I would have to conclude from the articles that the UK hospitals are just as short staffed as the American, if not worse.!! Got to love the English- everything they put in print or speak, sounds alot more captivating and polished than that of us old americans. They can make body fluids sound like a Shakespearian sonnet.

    My honest opinnion of these articles: I think this is a major Nursing staff shortage. As admitted by the old woman who was interviewed above. I think it is drama added to the story- referring to the comment:"falling on deaf ears" Drama and catchy headlines sells newspapers.
    Another article mentioned "refusal to give a patient water for hours" and noting that England has set standards of care that are in place- sounds to me like their equilavant of the Dept of Health needs to investigate their hospitals' staffing ratios and why the patients wasn't given water- maybe the pt was ordered NPO as a potential case for surgery. Guess it would be better for the patient to vomit and aspirate under general anesthesia and burn out their lung lining??? These issues soundto me like short staffing issues and a lack of understanding on medical standards of care and rational for safe medical practice on the part of the alarmed posted. Over her in america we dont feed or give water/fluids patients that may possibly be going to the operating room or in certin disease states either(pancreatitis, patients with ulcerated intestines- it's called "bowel rest). This is a total legal and expected standard of care. if it's not done- that is cause for a law suit. Many patients who come into our american Ed's complaining of abdominal pain are quite angry that we don't send them to a hospital bed with steak, french fries and a beer waiting for them. A lot of then want their IV drugs but don't want the rest of the medical treatment that goes with the admission of abdominal pain.
    As for Tricare- TRICARE is the US Dept of Defenses' medical insurance for it's military and it's members- active duty, dependents, reservists and retirees. TRICARE is a managed care. If a patient want's botox or any non essential, cosmetic proceedure done- TRICARE is not paying and the patient has to fork out of pocket money. TRICARE doesn't provide for a day at the spa, No health insurance does -either here in the US or across the pond- neither an american healthcare insurance company or the NHS. Tricare a few years back started covering bariatric surgery- Bariatric surgery is supposed to be ffor 'MORBIDLY Obese" people, meaning they have tried all els and failed and to continue being obese is life threatening- it's not just I want a 'bikini bod' for this summer. these people art a great percent over weight and have heart, diabetes, respiratory and other medical problems that threaten their life.

    I fail to see where these conditions reported in these articles have anything to do with the NHS type of insurance. If I'm not mistaken- didn't the Priminster of Newfoundland go to Miami Florida for his bypass surgery a few years back. He wasn 't charged with any illegal act but he was scorned and criticized for not seeking care in his own country of Canada- he made the Canadian health care system look bad when it realy shouldn't- i just think he want to spend his post op days/vacation in Miami as apposed to Canada. i don't think he is any different than any other rich businessman/politician- guilty of selfishness and poor judgement as the result of them. it's global- "it's all about me!!!"

    Perhaps it would be in the best interest of the UK citizens for the newspapers to report on and investigate how much their hospital CEO's make!!Ppossibly the reason for the lack of number of nurses to take care of patients. Also, it may be a good idea of it Royal Acadamy of Nursing to start doing some research into why their are such a shortage of nurses, the attrician rate for their hospital nurses, the number of nurses who go inactive each year and the reasons for this- BURN OUT!!????

    I can't totally blame the Brits- very conservative and respectiful, always doing the right thing and behavior I do love them- my family heretige. I do have to say we american's on th other hand are quite well known for creating an uproar, harsh reporting and not being very well behaved, especially in our news reporting. we are more blunt and cut the crap people.

  • Jan 12 '14

    Quote from hotflashion
    I wanted to talk to someone who has worked for Nature's Classroom. Looks like a lovely operation. There are 13 sites in New England and New York, and other "associated" sites around the US.

    If you have worked for Nature's Classroom, please respond here with your experience or message me.

    I worked for Nature's Classroom for 3 and one half seasons. I had a great time, and John Santos is a wonderful boss, he is the founder of Nature's Classroom. It was a lot of hard work, but soooo much fun. I worked at the Silver Bay site. Not sure what you want to know about it, but calling the office and talking with staff is a good place to start. Please feel free to private message me.

  • Jan 10 '14

    Nature's Classroom was my single best experience of middle school. 1,000x better than the Washington, DC trip we went on the following year. Mine was in Connecticut. I don't recall there being a nurse on site though there must have been with 200+ 12 and 13 yr olds.

  • Jan 9 '14

    yup, there used to be some famous greek guy called Socrates, who had a student by the name of Plato,
    Plato later had a student by the name of Aristotle, and Aristotle was mentor to Alexander the Great...

    Point is, Mentorship and Success leaves clues. All the successful people at one time or another had a mentor
    or looked up to someone that had done great things.

    We need to associate ourselves with as many people as we can that have the same or greater
    visions as ourselves.


  • Jan 9 '14

    I haven't worked there BUT I went there when I was 6th grade for a week and absolutely loved it. We dissected owl pellets, and my luckier friends decided pregnant pigs and sharks. We also re-enacted the underground railroad and the salem witch trials. I wished it lasted longer!!!

    One of my favorite childhood memories. And my dream job because everyone there were amazing

  • Aug 23 '13

    As far as I know, nurses are not employed in marijuana dispensaries.

    I've cared for many patients who use MM. Since smoking is prohibited at my facility, they are not allowed to smoke it while at the facility.

    I think, with the question of dispensaries staffing nurses aside, the role of the nurse with MM is the same as the role of the nurse with any type of CAM.

    I want my patients to trust me enough to tell me what other modalities they use. This is important information for the health care team to have. For example, nutritional supplements and herbals have many interactions with pharmacalogical preparations (St. John's Wort is a biggie).

    Even if their CAM doesn't have any known interactions, it's still important information to have. For example, if my patient sees a Reiki practitioner twice a month to help with their PTSD symptoms, that's good information. It tells me a lot about that person, and can open the door for further communication.

    How I might feel personally about any particular CAM does not matter, and should not interfere with the patient's ability to trust me enough to disclose their use. I want my patients to trust me, and I work to make sure that trust is well deserved by being nonjudgmental about their health care choices.

  • May 17 '13

    I loved this article too and sent it out to a lot of nurse friends. One, who is a geriatric specialist, said..." If only the economy was in better shape to support doing things the best way." I think we could find a way, if there was the political will. And I know for sure that nurses would lobby a lot more, and be a lot more politically active, if we weren't so exhausted all the time!

  • May 17 '13

    I almost wept when I read this article a few days ago, because that is where I want to work! For so many confused patients, a hug, talk, and a snack can go a long way. I get really ticked when we're so fast to hand out ativan - it is easy to sedate someone for your shift, but the next shift bears the brunt of it when the resident is up and crazed! Sleep cycles get totally out of whack and it is sooo hard to get back to a somewhat normal schedule. I had to fight a few months ago to get an order for a resident to have a shot of whiskey at bedtime - but now he drinks it and stays asleep all night. The sweet fella has been drinking since he was 15 (only about 75 years), so who the heck are we to say that he cannot have a drink? It is appalling the way we make residents give up so many of their pleasures and rights in the name of "safety" and "for their own good".

  • May 17 '13

    Never happen in for profit LTC