Admin/Clerical Staff in Scrubs, Observing Procedures

Nurses General Nursing

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I'm an RN in a hospital-based surgery clinic. Other hospital-based surgical specialties share our suite and hold clinic as well. Across our outpatient organization, there is a black-and-white policy that only clinical staff wear scrubs. However, a surgery scheduler for another specialty has begun showing up to work in scrubs for the past couple of weeks. That in and of itself is not a major deal to me as surgery schedulers are not typically patient-facing--their patient contact tends to happen over the phone.

However, I have twice in the past week randomly overheard this scheduler asking to observe nurse visits with minor procedures, and the nurses allow it. These nurses and the scheduler have worked together for years and exhibit a very close-knit dynamic. To complicate matters, their manager works at another clinic site; the manager of my suite is not technically their manager.

My concern is that this admin/clerical staff represents herself to patients as clinical. I doubt she straight-up says she's clinical, but she's in the room during procedures and the scrubs give the impression that her presence is somehow relevant. I do not like the idea of patients being an exhibit for someone who has mentioned to me more than once that she wants to be a nurse but for whatever reason it hasn't happened. Patients do not exist to be our personal learning experiences--whether we're clinical staff or not. It's one thing if we're a teaching facility and/or the patient has signed a form indicating they're okay with observers. That's not the case here.

Should I do anything? I am the last person to be a tattletale in ANY situation, or contribute to selling the drama in our already drama-filled ambulatory setting. My philosophy is to fight the important battles (exceedingly few and far between) and to fly below management's radar while being the best nurse I can be the rest of the time.

Should I just let it lie?

Specializes in Psych, Corrections, Med-Surg, Ambulatory.

I agree with Hoosier. If everything is above board, the compliance officer will note that and be done.

If patients are being observed without their knowledge and consent then it will be stopped. This isn't about kids in school getting each other in trouble. Professionals are expected to be patient advocates and have a duty to report concerns.

On 3/6/2020 at 8:29 PM, jena5111 said:

I do not like the idea of patients being an exhibit for someone who has mentioned to me more than once that she wants to be a nurse but for whatever reason it hasn't happened. Patients do not exist to be our personal learning experiences--whether we're clinical staff or not.

I have been a patient that felt like they were put on exhibit and now years later I know exactly what I should have done after the experience. A person walked in a highly sensitive procedure just stood there staring. They had on scrubs but seemed more interested staring at what was exposed until the doctor realized the presence and told them to leave. If it happened today once my procedure was finished I would go straight to the patient advocate of the facility and file a complaint. I have no idea who that person was. Could have been part of the janitorial staff wearing scrubs.

If a patient realizes this has happened in this day and age, not only will the clerk be in trouble, the nurse and the facility may have to answer for the flagrant display of disrespect. There is no excuse that just because someone has not gotten to fulfill their dream that they should be in a room during a procedure. That is plain and simple.

Times have certainly changed.

Used to be patients just accepted whatever took place.

Now everyone questions everything.

I guess that's as it should be but it sure is a whole lot of work.

Just curious - why has she not yet become a nurse?

Specializes in Tele, Interventional Pain Management, OR.
10 hours ago, Kooky Korky said:

Times have certainly changed.

Used to be patients just accepted whatever took place.

Now everyone questions everything.

I guess that's as it should be but it sure is a whole lot of work.

Just curious - why has she not yet become a nurse?

I don't know tons of specifics. It sounds like a combination of a "life happens" story (husband and kids) combined with difficulty passing entrance exams.

Regardless, a surgery scheduler/clerk, who arranges elective surgeries in the OR, doesn't need to witness in-office procedures to do his or her job better. I read a few comments on this thread suggesting that it's a learning/job enrichment experience. I get that perspective, but I disagree. I would sort of understand OR observation time, which requires extensive vetting by the hospital, over the in-office stuff. Seems like the in-office observations happen under the radar because of a couple of nurses who allow it due to their team's longstanding working relationship.

I don't have firsthand proof but I think this person is present and wearing scrubs and patients don't know to question it.

Specializes in Tele, Interventional Pain Management, OR.
On 3/7/2020 at 5:28 PM, CrunchRN said:

Maybe she just wants to understand the patient experience better in order to better do the job?

I hear you, but a surgery scheduler/clerk who schedules elective cases in the OR should not need to witness in-office procedures to do his/her job better.

Specializes in Tele, Interventional Pain Management, OR.
On 3/7/2020 at 8:42 PM, Hoosier_RN said:

I was going to ask the same thing, but then re-read

The OPs boss isn't this person's boss, so probably wouldn't be able to do anything about it.

This clerk isn't in nursing school, so they shouldn't be observing as a learning experience.

OP: I would call the compliance line, anonymously, to express your concerns. It's up to them to investigate. If nothing is amiss, then someone will likely make the statement to all in the area of what's going on. If there is an issue, TPTB will make the nonsense stop. Either way, no harm no foul

Totally agree.

If there's some legit/above-board arrangement I'm not privy to, then cool--I am done talking about it and won't bring it up again.

I don't care about getting this specific person in trouble. I want to make sure patient privacy is respected. That's it.

Specializes in Med Surg, Tele, PH, CM.

Pick your battles is always good advice, and technically, this is not your business, as far as dress goes. Years ago, I was a Practice Administrator for a busy Family Medicine Practice owned by a large Health System. Our clerical staff did not wear scrubs, but expressed to me on many occasions their desire to do so. I had inherited a practice with long-standing morale issues, and since our work badges clearly labeled us by job, I honestly couldn't think of a reason not to, but it was a real uphill battle to get permission. I couldn't believe the difference it made...we were no longer clerical staff and clinical staff, we became team mates. That having been said, I would be totally opposed to clerical staff observing procedures, or even accompanying clinicians on home visits. There is no reason for it, and could easily be interpreted as an invasion of privacy. Your co-worker has had enough opportunity to decide if she wants to go to nursing school, her reasoning is ridiculous.

3 hours ago, Katie82 said:

I would be totally opposed to clerical staff observing procedures, or even accompanying clinicians on home visits. There is no reason for it, and could easily be interpreted as an invasion of privacy. Your co-worker has had enough opportunity to decide if she wants to go to nursing school, her reasoning is ridiculous.

If she wants to be a nurse then she needs to go to school. As a patient, if I found out that a nonprofessional was allowed to observe my procedure without my permission I would be very upset. I would be talking to the manager and requesting an explanation and probably filing a complaint.

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