Do you ever feel like a social worker?

[BlueLightRN]

A lot of times I'll be talking to my patients about their labs, conditions, medications etc., and they want to talk about anything else in the world.

EG

ME: Mr. Soandso, your labs indicate that your blood sugars are elevated. Your doctor would like for you to start taking some Metformin. You should also try to watch your diet and eat fewer carbohydrates.

Mr. Soandso: Well, I only get 100 dollars in food stamps every month and my wife left me so I can't cook and I don't have insurance to cover this medication or any ride to the pharmacy, and I need ride to get back to my house and I have all this pain in my back so who cares about my sugars and I got denied for disability again and BLAH BLAH BLAH BLAH BLAH BLAH BLAH

Anyone else experience this 20 times a day? Or have any advice?

[SHGR, MSN, RN, CNS]

Advice? Highlight the patient's strengths. Everyone has at least one strength. Listen to find it. You can't solve every problem, but maybe you can solve one today and if the patient feels that you have listened, care, and have something of value he will come back.

Listening- active listening, not just being in the room while the patient repeats their litany again- and you not simply telling them what to do from the start-, is the only way to go. Listen first. Listen to what is going on in your area too (and cultivate connections). I keep my ear to the ground and pay attention to what is available in my community. It's ever changing, so it requires some effort on my part, but when I find out about a resource I write it down and keep a list.

Believe me, these patients have heard all of your well-intentioned advice a hundred times before and when they hear you with it again, they will push back. You would do the same.

You might try some motivational interviewing techniques. They can enhance your active listening skills.

[SHGR, MSN, RN, CNS]

I try to listen but we see 150 patients a day and I rarely even get a lunch let alone a break. Some days I do not even get to pee. I feel so helpless when the doctor asks me to talk to a patient but then I get into the room to hear about all the other problems I can't possibly solve. If the patient can't afford 4 dollar metformin, how am I supposed to help? I can't buy medicine for all 50 patients a day who tell me the same thing. I also do not have enough time to call medicaid/caresource/molina about every little complain or question, don't have time to do paperwork for TENS unit, backbrace, kneebrace, member pump, hospital bed, ensure, diabetes supplies, and 5 other things for just one patient. I also take all the clinic phone calls (patient questions, concerns) and have to do so many things that it becomes overwhelming. I don't know what to say or do for patients when I can't help them. I can't get you free diabetes supplies, free medicine, free rides, help with bills and food, and actually do my assigned duties. I just am really struggling with what seem like problems I can't do anything about, they're constant.

I'm sorry your workplace is like this. You know what though? Those requests for member pumps and back braces are a scam and fraud, it's Medicare fraud for real. I take a Sharpie (I buy my office supplies myself too, LOL) and write DENIED all over it and fax it back. If I have extra time I report it to the OIG. That's one reason there isn't enough money to go around. And the OIG does investigate(PM me, OP, if you want to chat about this).

Have you thought about holding groups? If you are encountering the same types of patients with similar teaching needs, that might maximize your time.

[BlueLightRN]

I definitely am tired of the constant requests for medicare supplies (back, knee, ankle, hand orthosis, member pumps, diabetic supplies for non-diabetics, etc.) I'm definitely interested in knowing more about the fraud. I feel like they find out a patient has medicare and then just send forms for everything imaginable, and sometimes the patient doesn't even want it or know about. They'll fax the same form 5x a day!

[BlueLightRN]

What is OIG?

[SHGR, MSN, RN, CNS]

What is OIG?

It's the office of the Inspector General for dept of Health and Human Services. They have actually called me back personally. The fraudulent requests seemed to have died down but now are resurfacing at least for us- direct solicitation of patients like cold calls, or "upselling" where the patient is getting their test strips and "by the way, would you like a member pump or this magnet-filled back brace?"

Office of Inspector General | U.S. Department of Health and Human Services main site

https://forms.oig.hhs.gov/hotlineoperations/ for fraud reporting

I hope that helps! No sense in wasting your time on that garbage. I imagine those back braces just end up in the bottom of people's closets anyway because they are too complicated to even figure out or just sweaty if they do get it on.

[BlueLightRN]

I will have to send them a few companies' names. They will fax to every fax in the building. Then call when we don't return the forms in 5 minutes. Like, are you kidding me?

[dulcet]

The issue here is this though. I CANNOT SOLVE THOSE PROBLEMS. I cannot get him more money or food. I cannot even get anyone else in for food pantries at this point because there are no openings. I cannot get him transportation. How am I supposed to solve these people's life problems?

She can at least show some empathy and get a case manager or social worker involved. Maybe she could even find a solution.

[BlueLightRN]

She can at least show some empathy and get a case manager or social worker involved. Maybe she could even find a solution.

I do have empathy for the patient, or I wouldn't bother listening to them. But I am not able to always get a social worker or someone right then and there, sometimes I can't get a patient in to see a social worker for several months due to no openings.