CMS Visit: "Your in my way - My patient is more important than this petty bull"

[abbaking]

The state health department and CMS was on my unit for their dumb survey (Quality of Care, Regulations, Blah Blah Blah). This shift was total BEDLAM! My patients were in serious condition and my one guy was going downhill really fast.

The State/CMS didn't seem to get the hint. They were pestering me about regulatory information (was asked about infection control, hand washing, Life/Fire safety, etc) THREE different times.

I was so busy running between the different room that even Helen Keller would have known I was busy. That still didnt stop the State/CMS from another round of questioning. I cut them off - I took a stand!

"You need to move, you are in my way. I am extremely busy with 3 very complex intermediate patients all going to **** right now. You are wasting my time. My patients need me more than anyone else right now. This is LIFE and Death and you of all agencies should be aware of how CRITICAL a lack of a nurse is with patient outcomes. Again Please leave me alone and talk to an upper level non-bedside nurse if you want to hear what you want to hear."

That Felt Good.....

My manager was initially angry but she realized that asking a busy bedside RN the same regulatory/HIPAA/JCAHO crap will not make my patients get better......pull a nurse away from the bedside and see how long the patient lives.

CMS/State Health - BACK OFF THE BEDSIDE NURSES!!!!

[belgarion]

In reality, it sounds like the OP used some pretty amazing restraint. You probably handled it better than I would have.

[leslie :-D]

op, i admire your chutzpah, not so much your tactlessness.

i seriously hope it doesn't come back to bite you or your facility, back in the butt.

leslie

[Bella'sMyBaby]

Your Administrator should have notified the Surveyors' boss that they were interfering during patient care.

[guest2210]

kudos....

[Spidey's mom, ADN, BSN, RN]

Your Administrator should have notified the Surveyors' boss that they were interfering during patient care.

Yes.

And I applaud your devotion abbaking, to patient advocacy. I have the same exact feelings and would probably do the same thing.

Kudos to you for standing up for yourself and your patients.

steph

[sunnycalifRN]

Right on!! (to use a 60's phrase) When those clowns show up, our policy is that patient care comes first . . . if they absolutely want to talk to a particular nurse, our resource nurse takes over the assignment to allow the nurse to speak to the inspector. If that's not possible, then the nurse cannot talk to them at that time . . . our manager is walking with them and will support us. (and she has!)

[drmorton2b]

The Joint Commission is a scam. You pay to be part of the club, pay for them to come fine you which you pay for and if you not part of the club no Insurance reimbursements. CMS is not as bad but very confusing also.

The only good byproduct of a survey is that the grounds of the hospital look like someone is going to get married there.

A lot of these surveyors either A. Haven't worked a floor since Carter was president or B. Have no real health care experience except on paper and are more of "inspectors" with no real creditably but an MPA Degree or something similar..

[wooh, BSN, RN]

I'd probably have said "Let's talk later. I'll buy you lunch." Either that or "Hey, could you give me a hand with this code brown?"

Why surveyor, I'll be more than happy to answer your questions, while YOU help me with this code brown!

[ExtraShotNoWhip]

LMAO@ helping with a code brown. I would love to see one of their faces:lol2:.

[leslie :-D]

abbaking, i want to clarify that i indeed, DO commend you for your advocacy...no doubt.

but, i would have likely kept it short and sweet(er): "i am dealing with emergent situations...if you would please excuse me", then walk away.

i don't like political bs either but do recognize they can and do penalize facilities at will.

and if you were anywhere near abrupt, they can and will hold it against you/facility.

my previous post was intended to be more cautionary versus critical.

but on principle alone, you did wonderfully.

leslie

[SmilingBluEyes]

I am with Leslie. Admire your advocacy, but your tact is lacking and its not the way I would handle nor teach others to handle, such situations. I bet you are a great bedside nurse. But you want to keep your job, you might want to cool down the approach just a bit.

[abbaking]

I am with Leslie. Admire your advocacy, but your tact is lacking and its not the way I would handle nor teach others to handle, such situations. I bet you are a great bedside nurse. But you want to keep your job, you might want to cool down the approach just a bit.

I agree with everything you and Leslie have said. However, the state regulatory agencies just for whatever reason did not seem to get the hint that i was in over my head (i had a patient in V-tach, another patient with a possible CH, and a poop LOL sitting in her poopoo).

It seems that when the regulatory agencies come, they want us (bedside staff) to forget about our patients and answer all their questions in a timely, correct manner. If you don't - your a bad employee (dangerous as one former employer told me).

The other nurses/tech's were involved in other care with their own patients. While I was running in between rooms, the state/CMS people figured I had free time since I was on the phone (you see where I am going - It appears as though I am talking to my BFF and not calling rapid response).

After asking me 3 different times about the banality of regulations, I too a stand and said NO MORE.

In my opinion, the bedside staff is already worked to death as it is....if the CMS/State/JCAHO want to pester any of the staff, then pester the staff that are paid well enough to put up with that kind of political red tape BS. Leave to bedside staff alone.

In my opinion Patient's are my top priority - Patient's level of care and ability to live without permanent brain damage are a top priority.

I may have done and said things to the CMS/State people a little wrongly but in certain situations - Your medical intuition takes over and you react.

I certainly have learned what not to say - But at the same time - the powers that be should have also realized that the bedside nurses on a poorly staffed intermediate/tele unit could care less about what you have to say to the higher ups during an inspection.

Okay I am off my soapbox now