I'm referring to problems with supplies, suppliers, insurance and DMEs. Every week I have a crisis with these things. The patients and their families are going nuts. They think I am a miracle worker and can get things approved with a mere phone call and if I don't get them what they need, I am lazy or stupid or not advocating for my patient. ie: Nurse Nancy ALWAYS did the ordering and everything went fine, grrr. Of course the families won't make any effort themselves. They claim the agency supervising nurse stated it was the nurses' job to order supplies and equipment. Order them I can do, but this is an exercise in frustration. How does everyone handle these problems? Looking for suggestions. Thanks in advance!
I order supplies for the family if the family wants me to do that function. Some families take care of all of this themselves. When I have brought problems up to my supervisors at the agency, they have told me that it is not their responsibility. They expect the family to fend for themselves. I have never worked for an agency where the managers advocated for the patient when it came to supplies. This is not in reference to whatever might have transpired when the case first started way back when. The best supply chain situation I have seen was when the DME company representative was very cooperative.
What company do you order from? Can you develop a professional working relationship with a local representative? They are a WEALTH of knowledge because they want to be your supplier. Most reps have a little guide that shows supply ordering limitations by insurance (e.g. Medicaid will cover X amount of catheters per month). Might help to reach out and ask about a reference like this, which you could then show the family.
Our supervisor probably did say nurses will do the ordering, customer svc. The main problem is these two families are Medicare and there have been changes going on lately. The one family had private insurance, Medicaid only and now Medicare. They are mad about not getting what we used to. The wound supplies are through the clinic. They are on their third clinic and third woundcare supply company this year.
Gotcha. So it sounds like the family switched insurance and is angry about the limitations of Medicare? We deal with similar situations in our outpatient clinic...clients that have been stable on a med for years and then they either switch on their own or are forced to make a change, and we can no longer get a Prior Authorization approved. It is SUPER frustrating trying to convey this with both the patient and provider and find a compromise that is clinically appropriate. I'm convinced that PARs are actually an art form...it takes a good provider to document the right information to get something approved, and some sleuthing for chart info for the person calling. But that is a rant for another day.
The only thing I can really suggest is if you can obtain some sort of handout that clearly shows insurance limitations...and active listening/acknowledging frustrations. I've been in Psych FOREVER and it really does help people calm down. It can feel really dumb and obvious to change a few words and essentially repeat a client's concerns back to them, but 9/10 times people express appreciation and shift blame away from you. Hope that is helpful, I did not enjoy having to order supplies and dealing with wound care order changes and monthly limits of supplies. It is challenging and stressful and is not something home health nurses should have to deal with on top of everything else.
Thanks Oceanblue. I will ask the clinic for some Medicare guidance.