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Ethical dilemma

Nurses   (5,083 Views 44 Comments)

hotflashion has 4 years experience as a BSN, RN and works as a Independent foot care nurse.

9,727 Visitors; 280 Posts

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You are reading page 4 of Ethical dilemma. If you want to start from the beginning Go to First Page.

ixchel works as a RN.

4 Likes; 57,043 Visitors; 4,546 Posts

And, of course, the feeling things might get better.

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RNperdiem has 14 years experience.

210 Likes; 1 Follower; 28,993 Visitors; 4,113 Posts

I am somewhat surprised to hear about loyalty to an employer who is not treating you right. If the roles were reversed, do you think the doctor feels the same loyalty towards the MA/RN? If you left tomorrow, would it be you personally they would be missing, or would they just be annoyed because now it is time to hire someone else who is interchangable?

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6 Likes; 45,108 Visitors; 4,978 Posts

On TV's NCIS, Gibbs has his rules. Well, I have some about being employed -

#1 - when you're gone they'll miss you for 2 weeks. That's about how long it'll take for them to USUALLY get someone off the payroll. Your situation is a bit different.

#2 - freq it's 'same problems, different faces'. When folk quit or threaten to quit and they're in a tizzy.

(Also have some rules re love & life in general. I need to write them all down like Gibbs' rules. I think it's his #11 when he says something like "when it's over, just walk away". That's a good general one.)

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nursel56 has 25+ years experience and works as a Home health, private duty.

15 Likes; 1 Follower; 43,113 Visitors; 6,643 Posts

I don't know if this is even appropriate for Allnurses, but here goes. I'm working in a one-doctor office. Though I am an RN, I was hired to fulfill a medical assistant role, which was ok with me as a means to an end beyond this particular job. I thought I'd work there for a year, learn what I could and then move on. I've come 2/3rds of the way.

Long story short, I am the only one left in the office besides the doc and because of this I have had to do the front office tasks, i.e., answer the phone, re/schedule patients, check in/out, take payments, all the administrative tasks associated with a doctor's office. Plus I room patients and do some minor documentation in the charts.

There is more work than I can do, and it is of such an intensity that I am exhausted. The doctor massively mismanages the business, and I regularly field calls from patients who do not get their tests or prescriptions called in as requested, who do not get test results once the tests are done, who are confused and angry because there is no follow up or from creditors who shut off accounts for nonpayment. On top of this the paycheck does not come regularly: I am paid biweekly, am 1 paycheck behind, and the latest check is late.

The doctor was totally unprepared for ICD-10 adoption on October 1, and we are now unable to bill. It is a setting of utter chaos. I also happen to know that the doctor is now under warning from the local hospital professional organization for not paying dues and not charting within the required time frame.

I am currently training a medical receptionist. I'm very organized, have kept the front desk "together," and feel like a complete and utter fraud with this woman, a very nice woman who needs her paycheck to be regular. She likes me, and I evidently put on a good show of having it all under control. I am not telling her that she should run away now, though that is what I think she should do.

I got into this mess because I wanted the job, I wanted it for a year, and I was willing (and able) to put up with alot of nonsense. Then things happened and I ended up being the last employee on staff. I'm not sure what I'm going to do, but I'm miserable right now and having a tough time sleeping.

I'd love to read your thoughts. Opinions, please.

It sounds like a "get the hell out of there" especially if you aren't being paid, but there are some puzzling things in the story. How long has this doctor been in practice and what is their attitude toward the apparent devastation and chaos surrounding him/her? While it's true that being a doctor doesn't mean you're a good businessperson most will take a stab at it or go to a seminar or hire outside help, such as an accountant. Actually, calls from creditors are the one thing I would refuse to deal with at all.

If the person is simply an incompetent manager you could probably suggest some ways to streamline things such as having the doctor call in their own patients when you're swamped. Lots of docs will actually do that without being asked. Also it's much easier for us to handle pharmacy callbacks than deal with irate patients waiting for their routine refills or "your test results are normal" because the doctor hasn't gotten around to it yet.

There are lots of tricks of the trade in ambulatory care to create a smooth-running environment assuming the person who's running the place cares-- perhaps he/she doesn't care. If they don't care about their own practice I sure wouldn't feel guilty for leaving!

Best wishes!

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1,136 Visitors; 59 Posts

I work an an RN in a walk in clinic also. I do all aspects of patient care. Including injections and blood draws. We are a small clinic and have 3 MAs and one other RN. The clinic manager wants me to 'learn the front desk'. I have resisted. I'm a nurse not a medical biller. The front desk receptionist is responsible for verifying insurance and collecting payments. The manager is adamant about payments and veryifying insurances. If a mistake is made she has a meltdown. I'm not putting myself in that situation. The ICD 10 is a horror show. Coding lab slips and referrals is difficult. If the doc is not doing his job calling patients and doing scripts there is nothing you can do. You can't force him to do his job and I would not be covering for him. Personally I would look for another job. Because he is not going to change and you are just going to remain frustrated stressed.

I left my previous job afrter 14 yrs when the doc wanted me to 'change a record to keep an employee at work when the patients ortho had clearly told me that he needed to be out of work. I refused and the doc threatened to fire me with not following her orders. I spoke with human resources and reached the conclusion that another situation would occur and I would never win. By the way the doc was ex-military and used to never being questioned. I told the doc that I don't change records. That's when I realized that it was going to be a permanent no win situation.

So you will have to come to your own conclusion as to what is worth to you. Your sanity or your job. I found a better job.

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canigraduate works as a RN.

1 Like; 3 Articles; 34,823 Visitors; 2,107 Posts

Ahhh. You're a martyr.

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Oedgar has 12 years experience and works as a OB/Gyn Office nurse.

8,678 Visitors; 248 Posts

When I was hired, the understanding was that the doc I was hired to work with was going to be moved to a new office in about a year's time. About 4 months in, I realized how toxic certain aspects of the work environment were, yet the relationship with my coworkers remained very good. The workload was nearly impossible but OtherNurse and I were friends and were a team.

I did not want to leave her in that chaos to have to train somebody else. She was in that office out of necessity, not choice. I kept waiting for the new clinic to be built, so I could make an easy exit, an amicable "I have decided to work less" and not go to new clinic kind of thing. Unfortunately, the move was constantly delayed and I hung in there an additional year. Really, the only things keeping me there were my concern for my older nurse friend, and wanting an easy exit. The way the place was (not) staffed and the lack of availability of even one prn nurse... my quitting really would have been just as bad as randomly walking out the door. As it was, it took forever for the replacement to be hired. Worst two years of my life, and I have been through some pretty bad things. I am now looking at HEDIS. Have one company that has replied to my online app. Anyone heard of Datafied?

Edited by Oedgar
typo

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hotflashion has 4 years experience as a BSN, RN and works as a Independent foot care nurse.

9,727 Visitors; 280 Posts

The rest of the story: Here it is more than 4 years later and I'm very happy where I landed. I told the receptionist what my experience had been in the office and she gave her notice. I stayed longer than I perhaps should have but I have to say that the experience has been  invauable in my current practice. As unpleasant as the working conditions were, I treated it as a way to get an education and get paid. The doctor was generous with his knowledge, I learned a lot, and I didn't go (further) into debt.

I now work independently as a private duty nurse making house calls or working at clinics, and the independent part is the only part that I don't like about what I do; I would rather be an employee. My ideal job is one where I work (as a nurse!) part time in the office and part time doing home calls and clinics. I do foot care. I'm a foot care nurse. But it seems that podiatrists don't want to do the routine care that I find so satisfying, nor do they want to employ nurses to do it. So, there is more than enough work out there for me, with much appreciation from and benefit to the people I care for.

Edited by hotflashion
improve wording

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