Patients making me feel dumb

[kmokay]

I work at a outpatient clinic as an ambulatory care assistant, I basically assist the doc in procedures, vitaling and putting patients in rooms, and paperwork. Well, I give one of the patients a list of medications we recieved for her to update. She asks me what a specific med is because she's not sure if she's taking it. and at this point we're extremely busy, just after lunch, i have five charts/patient to prep to be put in rooms, its clearly past their appt times and docs are angry. Instead of looking her med up for her, I simply tell her "I'm sorry, I'm not familiar with that drug, maybe its something you might want to speak with the doc about when he see him". She proceeds to reply with a "well you SHOULD know". This made me so angry. Its not my role to be familiar with all patient meds, I'm not a nurse, and I don't deal with medications. I do clerical work and vital patients. I wanted to say "no, YOU should know, if i was taking medications you can be damn sure I would know what they were". Instead, I just apologized. What would you have said to a patient like this, patients who expect you to know things beyond your scope of practice and get mad when you don't. another instance was today during gyn exam, I was assisting the doc. Fixing paperwork and getting supplies ready for the doc as he was doing the exam. He tells me he's needs to do a vulvar biopsy, so I proceed to get the supplies and paper work ready. The patient asks me where the biopsy was going to take place and I explain to her the region. Well she thens asks me which side, and I didn't know left or right because I wasn't watching the exam, I was getting things ready for the doc as he needed it. She then tells me, "isn't that your job" in a condescending type of way. I told her that I was not looking when he was examing and that my back was turned. Afterall, its not a collaboration, nor would i expect the doc to scoot over just so i can see , he does his thing and I do mine. I really wanted to say "no, its not my job. I was doing my job, sorry if I did not share the interest in scrutinizing your lady parts!" I just never know what to say to defend myself in these situations with patients, so i end up feeling dumb or like i'm not doing my job over things that aren't my fault.

[DaFreak71]

well no, we're not licensed, but we are patient care providers. My job is to assist in procedures, there are only a handful of nurses in the entire clinic that sees 700-800 patients daily. Without us, I don't see how the docs would be able to get very much done. So do have the right to be in the room. yes I do clerical work, but there is also direct patient care involved. And in the case that there is direct patient care is involved, I don't think there is any violation of hippa. but then again the rules of hippa are abundant. really i think that most of it comes from the fact that I look 15, I don't see my co-workers being spoken to this way. atleast not that i'm aware of, but then again i could just be oblivious.

I think whether or not you have the "right" to be in the room depends on the patient. If the patient knew you were a clerical worker would she have felt comfortable with you present during her gyn exam? I know I sure wouldn't. I realize your job duties include you being in the room, but that is more a result of your particular employer keeping their eyes on the bottom line by having clerical workers act as assistants. There is certainly no legal reason why you should not be in the room unless the patient does not want you there. I do wonder about the fact that many of us "old school" patients think that if you are assisting during a private exam or present during a private conversation, that you are a health care professional. It never really occured to me until my last experience at my old NP that anyone could enter the room regardless of what was happening. I didn't realize that I had to question the credentials of the staff in order to ensure I was only being tended to by professionals who were legally bound to uphold my right of privacy.

I'm sure you are very good at your job and you deserve to be treated with respect. As with any job that includes being around the general public, you're going to encounter rude people more often than if you worked in a lab setting, etc. I do believe that the patients who are responding to you as though they expect you to have basic information (like meds, procedures, etc) actually believe that you are a health care professional (as in licencensed and educated). The root of your problem is that the patients in your busy office assume you are licensed and educated in the field of health care. If they knew you were a clerical worker they would be less inclined to discuss highly personal issues with you present and most people would not be willing to undergo any type of exam that required nudity with you present. I believe that is not only well within the right of the patient, but extremely reasonable as well. In fact, it bothers me that most patients are under a false impression as to your role. I believe the patient has the right to know that you are not bound by any legal obligation to protect their privacy and that their conversations and exams are being witnessed by a clerical worker. This is clearly not your fault, it is a problem with big clinics utilizing people who will do the job for less pay than a health care professional. It's money baby.

As I said before, I don't doubt your integrity or your adherance to privacy issues. This is not personal against you. I'm sure you're a great employee. The problem is your employer who doesn't mind hoodwinking their patients by having clerical workers assisting with gyn exams just so they can save a few bucks. Ok, maybe alot of bucks.

Perhaps I give the general public too much credit for being consumer savvy. Maybe alot of them would not care to expose themselves to the clerical workers, but I will promise you that a good number of them would freak out hardcore and feel betrayed by the office/doctor/nurse.

[santhony44, MSN, RN, NP]

My clinic has LVN's and a Medical Office Assistant. While the MA isn't licensed, she is trained specifically to work in the office. That would include gyn exams, etc. She is held to the same standard regarding HIPAA as everyone else in the clinic.

You ccould answer these kinds of questions with "I don't know but I'll find out for you."

Of course both of these were terribly rude!

[Agnus]

I also agree with telling them that you aren't a nurse, therefore can't answer their question....I think they may think you are, and that's why they're so irritated when you don't know things. And then offering to get the MD/RN, or putting a note on the chart or something that the patient has questions about a procedure/meds/etc.

Excellent reply.

[jnette, ASN, EMT-I]

Excellent reply.

Ditto. I'm sure most of these patients are simply assuming you're a nurse.

I also agree with avoiding the "lisenced/unlisensed" bit... keep it simple.

Just smile and explain simply and tactfully that you're not a nurse and that you will find someone to answer their questions..... that should take care if it.

Wish you the best.. hang in there. It gets crazy sometimes.