Advice or Ideas Regarding Patient Compliance...

Specialties NP

Published

Just looking for some insight about how things run at my clinic, and what tools or methids I can implement to have the desired effects.

Background: My clinic is touted as a general practice clinic, but we primarily treat pain. This is the job that I left and came back to, after the growing pains sorta tapered off. Since my return, we've really cracked down on dismissals for positive drug screens, verbal abuse, threats, etc. But there's one area where I could use some help.

We have had a sign posted for aeons at the door that plainly states "Do NOT stand and wait at this door. Wait in your car. If the door is locked, DO NOT rattle, shake, knock, or yell through the door. Violating this policy is grounds for immediate dismissal. If the door is locked, anyone caught coming through the back door will be considered a trespasser and dealt with accordingly."

So far, it's not done a lick of good. Yesterday, they started lining up a half hour before we reopen after lunch. This is irritating, not only because it's a violation of rules, but when we open the door, these folks descend like locusts, every last one hollering to be heard over the other, and all try to beat each other to the sign-in sheet. Not that it matters, we see according to appointment time. One memorable day, one patient stood at her car and screamed to the others in line that they better move cause SHE got there first!

The back door statement is not without warrant, people come in through the back when the front is locked, for any and all reasons. People will stand at the door and rattle and scream, sometimes for the whole lunch period.

My question, short of dismissal from the practice, how can I get my patients to comply? Most are not bad, and I love them dearly, but these chosen few, as we call them, just think it shouldn't apply to them.

Any ideas would be much appreciated. Thank you.

Specializes in LTC Rehab Med/Surg.
We considered that... that and shock collars.

:roflmao:

Specializes in LTC Rehab Med/Surg.

Agree with GrnTea. Rules have no teeth if they're not inforced.

Just a couple of thoughts from the perspective of someone who transitioned from walk-in to appointment-only clinics (albeit immunization clinics):

1) Whatever you try differently, give it at least a month for clients to adjust before you decide it's not working.

2) Over-communicate the policy changes, both verbally and in writing.

I agree wholeheartedly with GrnTea, especially in the last paragraph: either enforce your statement 100% or remove the sign. Likely, some believe that sign is "for the rest of them - certainly not ME." There's perceived "royalty" in every practice, everywhere, and they ARE difficult to deal with. . .been there, done that one, too.

Good luck - hopefully, the crowd out here will offer some more great ideas. :up:

Specializes in med-surg, psych, ER, school nurse-CRNP.

Update...

The sign is being adhered to, bar none. We are also implementing the revamping of the pain contracts to include our new policies. This will aid in getting the message to our illiterate patients, as we will read it to them.

As to the perceived disrespect on the sign, well, think what you must. Nice didn't work. Direct and to-the-point has to be the norm here. Action, meet consequence, or they won't comply. It's been tried. It's not sweet, but it's what works.

Thank you all for the responses and helpful tips. I do appreciate it.

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