I had a incident here today, I was wondering if anyone else has ran across it, or been on either end of the conversation.
I did a SOC today for a patient that had just got out of the hospital following a MVA. Pt and nursing were ordered for the patient. If both PT and nursing are involved, we (nursing) have to open the case first. I called the Doctor after I got home and sat down, and got a hold of his nurse (not sure if she was a MA, RN, LVN or what, I never got that far). She started reaming me telling me that they had no idea this patient had been in an auto accident let alone in the hospital and wanted to know why I didn't call her(the doctor's office) before I went to see the patient. I explained that the hospital Dr had requested the SOC, so we had the initial order for the SOC and PT eval, what I was calling her for was to make sure her Doctor (her primary care Doc) would sign the home care orders, and OK the following Nursing care for the patient. Before I could get out my frequency and what I was going to do for the patient, she states "are you the DON?" I said no, I am just the nurse that went to start patient for home care, and she said, you are calling after the fact of seeing this patient, and expect the doctor to OK care, we had no idea she was in the hospital. It is your responsiblity to make sure we get all the hospital paperwork, you need to fax it to me. I said to her "the home care company?" she states yes, you expect him to sign the homecare orders after you have already seen her when we had no idea she was in hospital, and without that paperwork from the hospital (for some reason I thought it was the hospital's place to fax paperwork to the doctor's, I have never had to fax the hospital paperwork to a doctor). I again explained to her that we have the initial order for the SOC and she states "look I use to run a home care company, I know what the rules are, you are responsible for calling the doctor's office before you ever go out to the patient, and to get us the paperwork from the hospital. She also said that she always called every doctor on each referral before her nurses ever went to see the patients. I said to her, I will have to call the office to see if I can get someone to fax you what paperwork I got and I will give you the phone number of the office and you should ask for C****** she's the nurse in charge. She angerily stated, no she should have already called me before you ever went out there. So I finally said fine, I will call her, and have her call you thanks, and hung up before I went off on her. I have never, never had a nurse at a Doctor's office talk to me that way, and have never had one refuse to sign because we had not called the office before we went out. Just wondering if this is common practice with office nurses (I have never had this happen before, maybe I've just been lucky)? I mean I understand where she was coming from to a certain extent, but most Doctor's are glad we are out seeing their patients especially after a hospitalization and MVA. Thanks for the input. I was so mad when I got off the phone because she was so very rude. BTW, I live in California not sure if that makes a difference.
I was an MA in primary care for years. I helped the docs get their records from the hospitals in most offices. You are the home health nurse not his/her personal assistant. I NEVER had home health call and give me records about a hospital stay, that would be you sending third party records. Most of the time the patient was told to make a follow up appt with their primary care after hospital stay and that would be the first we'd hear they were in the hospital. Then we'd hear from home health (patient was almost always first to call the office :wink2:) She was a big B and that's all there is to it.
med regs, you have to have either a verbal or written order, verbal you can see pt, but have secretary fax to him for signature.
The written order from the hospitalist is all that she needed to start the HH end of things. No order from the PCP is needed, but it's still a good idea to get a heads up.
My agency, we don't care who gave the orders no one is seen until our office contacts the doctor we're told will follow to confirm they want us to provide services.
Docs have agencies they prefer to work with, we've been shafted too many times because the hospital referred to us and the doc prefers to work with a different agency and re-writes the referral.
I've worked in two states with HH and neither of those allow the doc to pick the HHA, that is entirely at the discretion of the patient. HCP aren't even supposed to make a suggestion regarding agency choice.
Tampa121
104 Posts
med regs, you have to have either a verbal or written order, verbal you can see pt, but have secretary fax to him for signature.