So very frustrated at a recent experience that I had at my job. I work in a busy ED and occasionally we receive patients who are "referred" from an outside urgent care. I have personally received phone calls from a particular urgent care informing us that there is a patient coming over and they continue on by providing ALL protected information about this patient, after they have discharged them, and why they cannot treat them there. It is important to note that the urgent care completes their care of the patient and then discharges them from their system, the patient leaves and may or may not elect to come to our emergency department. The last phone call that I received from this urgent care went about the same as usual but at the end of the conversation the nurse on the other end of the phone call says and what is your name. I paused, as this is not a common request and stated, I have no problem providing my name, heck I answer the phone stating my name, but I must clarify that there is no RN-to-RN report occurring here as this is not a transfer and there is no transfer of medical authority and/or medical accountability between facilities, additionally providing all of the protected information about the patient could constitute a violation of HIPAA as we do not have a need to know since it is not a transfer. I brought this up to the nurse due to her requesting my name as it made me think she was charting it somewhere, which really seems like a bad idea for HER and HER ORGANIZATION to be documenting an inappropriate release of patient information.
So... you can probably imagine how this was received. The nurse didn't say anything to me regarding the issue, but was actually agreeable stating oh yes we are just providing info on the patient (smiles and warm fuzzies here), phone hangs up no big deal, and by the way the patient never came to our ED. Fast forward about two weeks I receive a phone call from my director stating she has a disturbing email about a phone call that occurred with an urgent care. For the sake of the readers time I will summarize, the email stated I did not want to give my name in addition to me be terse and maybe rude (can't remember), and the final sentence stated "should we not be sending patients to your ed any longer as you don't want info on them", a basic threat to pull business away. You, the reader, should know that I work for a for profit hospital and this last sentence had all the teeth to ensure my director would act, and act she did. I get a call, she is super matter of fact, basically telling me to just listen and don't say anything back to those who are calling us regardless of appropriateness as customer service is our goal and... well you can fill in the rest.
I am disturbed to my nursing core. I have been a nurse now for about 6 years, to some thats nothing and others thats a good amount of time. I haven't seen a lot of malicious behavior like this and I think it is why I am struggling with it. I guess my issue is when nurses cannot listen to constructive criticism without personalizing it and making it about the person communicating it. I get my directors response, she MUST act on this as it is threat to community business relationship and thats to be expected. What I don't get is the fabrication of scenario to elicit a response from my leadership, it really feels icky. I do know that the nurse I was speaking with has been a nurse for about two years, I offer this for context. I assure you that I was nice and pleasant in my conversation with the nurse, and cannot understand why she would paint our conversation in such a way. I can only assume her intellect was offended and she "reacted", instead of considering what she was actually doing, violating protected information (albeit trying to be helpful). I read a post on here by Riseupandnurse that stated due to nurses having to take whatever is dished out by admin, physicians, patients, families, etc, that there is a great deal of free floating anxiety and hostility and sometimes finds its release valve on an unsuspecting victim. Additionally, I feel that there is a great deal of insecurity that we all deal with and sometimes instead of recognizing this and overcoming how it makes us feel then learning from it, we fall victim to self preservation and restructure reality in order to ensure we are righteous and the other, perceived adversary, is wrong and we demonize them and their actions or intended message. When this occurs it is a hugely flawed weakness in psyche, that ultimately is self defeating and greatly inhibits personal growth.
I guess I am posting this for therapeutic purposes, and maybe some stimulating conversation can result.
