CMA Is it me.

Whether or not every adult needs a height check at every office visit isn't really the issue; what got you in trouble is that the office's policy is to check the height every visit, and you were documenting in the medical record that you had checked the height when you hadn't. That is fraud. (I think that might be what Bucky was referring to.) It isn't your prerogative to decide that adults' height "shouldn't" change so you don't need to check. If the office policy is to do something every visit, you do it every visit. Or, if you don't, don't document that you did (you'll still eventually get in trouble for that, of course :), but at least it won't be fraud, which is serious).

In the second case, you were screwed as soon as the daughter decided she didn't like you. It was all going to be downhill from there (it's unfortunate, but it happens). If I were you, I would be cautious about working for offices in the future that have physician's family members working in the office.

It sounds like you are learning from your mistakes as you go and willing to take direction, which is good. My advice would be to stay away from small, "family" practices going forward, and to be more careful and consistent about documentation and double-checking your work as you go (like mixing up lab tubes). It sounds like maybe you are a little too casual and careless about what you're doing. Best wishes!

1. Make sure you use the right tubes for labs.

2. Documentation: You may think it's not a problem, but there was a perceived issue regarding documentation of height on charts and DOB on lab vials. You said "I document the way I want to, and I need to remember to document the way he wants it." That isn't just incidental to just one job...that's how it will be no matter where you go. Also, part of documentation is using proper spelling and grammar. While we tend to relax a bit when we post here, in order to be considered a professional, it's important to be able to write clearly and accurately.

3. NEVER, ever, ever, ever send personal emails on the company computer. Esp. if you are going to denigrate a co-worker, or, even worse, a family member of the owner of the practice. No, no, no.

It sounds like you had jobs with some dysfunctional family dynamics going on. Perhaps the next time you look for a job, look for one that isn't run by a Mom & Pop organization.

Good luck.

While shadowing for a job yesterday I noticed you are all corrected when it comes to documenting height. The person I shadowed mostly didn't take height or put it down, but one patient had osteoporosis so she took her height and marked that one down even though there was no change in height.

I like this job, and think I may have a good chance. I'm already familiar with the EMR they use but they ask more questions in the software than I am used to doing at my other job. They already know this. I will need to work on those questions with accuracy and speed. I wish there was a way I could practice at home, that is if I do get the job, because with this job I really need to room PT fast. The quicker I can get used to all the new questions and placement in the software the quicker I can get rooming done.

OCNRN63 sorry about the grammar/spelling mistakes, I still get very emotional when I think of what I've been through with the daughter. Thank you for telling me what I needed to hear, you are right. As for grammar and spelling when documenting I am very careful and have my words already thought out before I start, I'm much more careful. If I have to use a scratch paper first then I do. I make sure my documenting is much more thought out and professional.

If you're hired, depending on the type of EMR the practice uses there may be a "practice patient" function so you can do just that. That's what we did when we went live with our computer system.

I'm sorry you've had such a hard time and wish you the best in finding a job that's the right fit for you.

thank you for the suggestion, I was offered the job and I mentioned I'd like extra practice or study time at home she offered me more hours to sit in a private room and do like you said practice on practice patients which should really help. I still may see if I can take a few screen shots of the practice patients for at home studying because I'm kind anal but also really scared of this being job loss number 3. I really want to bring them my best A game I can.

Best wishes for the new job! :balloons:

We only deal with adults so when taking heights new patients get there hight taken and anyone with osteo... will always get a height check. All others the height shouldn't change so I just take it from the previous height check.

I was was fired for committing fraud. So they say, they think every adult should have a height check every time they come in or its fraud.

Technically, as others have said, it could be considered fraud.

However, I am not a fan of EMR as many of my fellow AN members know.

The new program our hospital uses didn't have outpatient wound care as part of the program so we had to jerry-rig the program for our use. One of the things the entire program doesn't allow is a way to bring information forward like an adult's height. I have to chart height and weight every time I see the patient. That means 3 days a week for me. There is no way height changes in two days. Redundancy drives me crazy.

Did you take a class in how to do medical charting? That was part of my pre-reqs for the nursing program and then it was also covered during the program. (As an example, we never say "I did this for the patient" . . .it is "this nurse" did this for the patient).

I agree that the daughter was a huge red flag. She sounds like she might have some mental issues.

I wish you luck with your future endeavors. And yes, practice and maybe take a class in how to chart.