Is this bullying?

Nurses General Nursing

Published

Where I work we still do paper charting, and don't see computers entering the picture for another couple of years. I can understand that, with the shape the economy is in, hospitals need to make sure they bill for everything they can. HOWEVER, to what extent should they go? We mark charge sheets for everything we do that can be billed...injections, IV fluids, etc. Lately we've been getting e-mails pointing out who missed what charges and how much that adds up to. The e-mail is sent to the entire staff. Night shift audits the charges and 'turns us in,' so to speak. If I catch a charge that night shift didn't mark, I just mark it and go on. This is part of 'that's why we're here 24 hours.' Not once have I seen anyone from night shift be fronted out for missing charges. I think this is affecting morale for some people...I know of one nurse who is interviewing elsewhere. My point...don't you think they should just send out a general e-mail listing the total missed instead of pointing fingers? I know they want to make us accountable, but come on! I think a general e-mail would foster an attitude of teamwork more than finger-pointing! And for the record, I'm not 'whining' just because I've been pointed at...this affects a lot of us here. No matter how hard we work, we're not perfect and can't catch everything. And I REFUSE to be so petty as to keep track of who on night shift missed what charges so they can be pointed out.

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Specializes in cardiac, ortho, med surg, oncology.

I don't consider this bullying as much as an attempt to shame and/or embarrass employees into compliance. I agree that a general email listing what the cost of non-charged items is costing the hospital is more appropriate. I also think that a personal email to those not making appropriate charges would be appropriate.

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Specializes in ER.

It's not bullying, just bad management.

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Specializes in Rodeo Nursing (Neuro).

Some patients live, some patients die, and this is true no matter what we do. Even the ones we "save" will die eventually. So, really, what matters is that they die with complete and accurate documentation. And we can tell their friends and loved ones, "Well, yes, that's a shame, but just look how good their chart looks!"

Argh. And, yes, if I was severely dyspnic, it would comfort me to know that at least my insurance company was being properly billed for my O2. One less thing to be anxious about.

I commend the OP for not being petty, but it's probably a mistake. If your co-workers had to worry more about their own charges, they'd have less time to scrutinize yours. NOT a happy way to be, but it must be what management wants.

Ain't it great, being a nurse?

ETA: Gee, negativity really does suck.

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Specializes in Hospice, Palliative Care, OB/GYN, Peds,.

It is amazing that in all my years of nursing the one thing that has not changed is that we are our own worst enemies, meaning nurses. We should support each other and be professional enough to confront one another rather than going to the boss and finger pointing. Sending a general notice of lost charges then talking to individuals would be the more acceptable way of dealing with this soooo important issue. I realize in the economy we are in that it is important to recoup charges, but patients still come first in my book. I sure hope that somehow this situation gets resolved for the better so you no one leaves. Has anyone gone to the boss and told her how this is affecting morale and how some people want to leave? Sometimes it is good to have a gripe session and clear the air. Good luck and it isn't like this everywhere so hang in there.:heartbeat

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Oh, I'm hangin' in there...not going anywhere! Despite this bull, I do love my job. My patients come first, and if I made one of them feel better at the expense of losing a few bucks for a sc injection, then oh well!

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Specializes in Hospice.

On the other hand, how many times do we complain about being dinged for something in an evaluation when we were never told it was a problem?

It's important that management be even-handed in handling feedback, true. If only certain people get "love notes", then I think you'd have a beef.

I also think that it's legitimate to wonder why these charges are a nurses' job ... seems like pretty expensive book-keeping and a waste of your time and energy.

But, the practice you described is feedback, nothing more.

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Specializes in IMCU.

This is not only poor management it is lazy management. If one email is sent to everyone then it should simply contain the "missed" billing items. However, if they are going to mention names they really need to do that privately and not by email.

IMO Although this may seem minor stuff like this affects the credibility of those named.

If they are really keeping track of such things, and they feel so strongly about it, they could simply speak privately with the persons concerned. Note I said "SPEAK with" because it is not appropriate to send emails about an individuals performance.

I agree with what the previous poster said...about this being feedback and being dinged in an evaluation when you had no idea that you were going wrong -- that isn't right either yet it happens all of the time.

Good luck.

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Specializes in ICU.
...if I was severely dyspnic, it would comfort me to know that at least my insurance company was being properly billed for my O2. One less thing to be anxious about.

Heh...I see what you did there. :lol2:

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Specializes in Cardiac, ER.

We started doing the whole charge sheet thing about a year and a half ago. I personally hate it,.and I don't think as a nurse I should be responsible for charges. We all took an hour long class where they spent most of the time warning us about fraud charges from improperly chargeing,..ie charging but not having adequate documentation to back up the charge. The people teaching the class have college degrees, and a huge amount of ongoing education to keep up with the changes/rules for charging Medicare/Medicaid/insurance companies. I don't have that degree or the ongoing education and don't feel I should be responsible for something that could land me or the hospital in court or cause the hospital to be fined huge amounts of money! I'm okay with one of these experts reminding me that I didn't chart a stop time for my IVPB antibiotic therefore the hospital was only allowed to charge for a push rather than the extra $350 for IVPB,....but I don't want to be responsible for the charges! I'm a nurse,..to be honest with you I don't want to have anything to do with charges or billing. I'm there to take care of pt's! Huge pet peeve of mine!

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Specializes in ICU, Telemetry.

As a night shifter, we get told to double check everything dayshift does -- meds, orders, everything. I had someone jump me one morning about xeroxing the orders they had given but never signed off on and giving them to the boss, and I told them the truth -- we're told we'll be written up if we don't, and they spot check behind US. So, your choices are to do an end of shift chart check, every shift, or deal with the occassional management fuss.

Believe me, I'd rather be trying to keep my psycho off his meds in the bed and out of the floor, or actually doing nursing stuff rather than going to check on whether Nurse N properly signed off all her orders...to me, that's what management's for, it shouldn't be my job to evaluate other nurses (in terms of their charting).

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Specializes in ..

I had no idea this was a nurse's job. What do the admin people do? Or the people in the billing department? Or the management people in general? Sit on the orifices and send stupid emails out?

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