Question regarding where I stand with my job (long, but with paragraphs!)

Nurses General Nursing

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Specializes in LTC.

I am a nurse in an ambulatory care hospital associated specialty clinic. I'm very new to this position and a fairly new nurse. We do in office invasive procedures regularly. I am in a quandary as to where I stand/did I do the right thing/what's going to happen on Monday.

Situation: pt sent to us by PCP for an issue that was rather urgent, a possibly cancerous mass. In office my provider choose to send pt for diagnostic imaging. Pt returned, MD waiting, needed an invasive procedure for dx purposes post imaging (pt may need surgery, the procedure will tell us). Prepped pt for invasive procedure. For this procedure pt is draped from the waist down. Doctor was over time for the day, due for a holiday party with spouse. Provider was happy to stay/concerned for pt.

Pt begins procedure with provider, as per protocol, I wait outside the door in case I'm needed, but give privacy for the procedure. The receptionist comes back with the providers spouse, who's trying to retrieve a holiday card for the party from the providers office. Spouse can't find it. I'm asked to pop into the procedure and ask where the card is. I refuse. The procedure is in process, the pt is in a vulnerable position and I feel it's inappropriate.

The providers spouse keeps clock watching/asking how long the procedure will take, spouse is going to be late ect ect. Receptionist says she will just crack the door and ask. I say no, please wait until the procedure is done. She does it anyway.

I wait until the pt is gone, and go to the receptionist and ask her how she would have felt if that had been her, naked on a table, in pain, and scared about having cancer, and someone popped in a room. She said that it was not a big deal and that's how things are done in that office. I'm making a mountain out of a molehill. I don't understand their clinic ect ect. Continually argued the point until I simply walked away in sheer frustration.

I'm not familiar with ambulatory care. I'm not used to what goes on. I felt it was wrong. I felt doing that violated the privacy and dignity of my pt. I felt an obligation to protect my pt, and correct the receptionist to protect future pts. I'm not rude or mean, and I wasn't in this situation but the receptionist was very confrontational with me about the issue. I felt in the moment very right, but now, I'm unsure. Really unsure.

So, was I wrong, and am I getting fired/in trouble/chewed out for telling the receptionist not to do that? What should I have done or what could I have done better?

Specializes in Medical-Surgical/Float Pool/Stepdown.

Your duty is to the Pt period. It was inappropriate for the receptionist to interrupt during the time that they did IMHO. I also personally hope that they get reprimanded for their unprofessional ism and insensitivity.

Specializes in LTC.

Thank you, that's reassuring. She really made me feel in the wrong for telling her to please not do that.

It's never a good idea to interrupt when there are sharp objects involved.

If it was a communication from the spouse's wife, I'm not sure I would have had a problem with it. The way you're presenting things makes it sound like the door would be flung open in front of a large crowd and the patient would be cowering, in tears, naked. In reality, things were probably much less dramatic.

What was the patient's reaction to the situation?

In any case, your heart was probably in the right place. I don't see this as a fireable type of "offense", but not getting along with others could very well turn out to be. Was there conflict with this receptionist before this incident?

Specializes in LTC.
If it was a communication from the spouse's wife, I'm not sure I would have had a problem with it. The way you're presenting things makes it sound like the door would be flung open in front of a large crowd and the patient would be cowering, in tears, naked. In reality, things were probably much less dramatic.

What was the patient's reaction to the situation?

In any case, your heart was probably in the right place. I don't see this as a fireable type of "offense", but not getting along with others could very well turn out to be. Was there conflict with this receptionist before this incident?

No, I don't mean to present it that way, the door was cracked, the question was asked and answered. The pt was upset, but r/t dx most likely. I have had few interactions with the receptionist before this.

Like I said, in the moment I felt it was inappropriate. Now, because I'm unfamiliar with the setting, I'm unsure. I know that I wouldn't want that done to me, but that's not a reliable barometer of what's okay and what's not. I know the nurse who has been orienting me stressed the importance of privacy for these procedures as they have a good deal of discomfort associated with them, and they are intimate. She was angry it had happened as well (she was in the sterilization room when this happened), but her reaction was of the "that's why I'm leaving" variety.

ETA: I generally have very few problems with coworkers. This is very new to me, to say something to someone and be kind of chewed out about it. I'm used to working with people who act in a rather different manner when I approach them with issues. I have a very quiet personality and measure my words carefully, so most people tend to listen to me when I actually do speak up.

Specializes in Allergy/ENT, Occ Health, LTC/Skilled.

I think you did the right think and I wouldn't apologize for it. A holiday card does not trump patient privacy. If it were an urgent matter, one could deal with that discreetly as possible, but it was more than fine for it to wait. I'm a very private person so I am always trying to protect that for my patients the best I can. If they reprimand you, they are idiots and you need to start job hunting. Visual privacy should be as well protected as document privacy but for some reason the same rules don't always apply.

Specializes in ICU.

Next time you see her tell her - I wont tell you how to answer the phone and you dont tell me how to function as a nurse. I am in charge of this area, not you. Dont ever walk in on a procedure again.

Specializes in LTC.
Next time you see her tell her - I wont tell you how to answer the phone and you dont tell me how to function as a nurse. I am in charge of this area, not you. Dont ever walk in on a procedure again.

Though I might think those kinds of things, I tend to be rather quiet, so they rarely come out if my myth.

Specializes in ICU.

Why do these office types want to pick fights with nurses?? Why is it so hard for them to accept that we have different roles and responsibilities??

It stops them in their tracks if

you say- the last time I checked you weren't a nurse.

Being quiet is something you need to get over or people like this will walk all over you.

You need to figure out how to tell her to stay in her lane.

I agree with you, holiday card, grocery list.. that doesn't justify interrupting any medical procedure.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

I don't see why you would be fired in this situation but neither do I regard the issue as "right way, wrong way". Every office has it's informal rules and regulations. Ask the provider to tell you under what circumstances you should interrupt. A common ground rule could be when a call for a phone consult is returned by a specialist.

If you knock softly on the door and crack the door, say "excuse me" and keep it short and sweet I don't think the dignity issue is a major concern. You're in a hallway, and there is no need to walk all the way into the room.

I figure if it's the type of place in which "Where is the Christmas card?" is acceptable established patients are often familiar with the provider's style and either don't care or find some other quality in that provider that keeps them coming back. If they're not, and you don't violate the ground rules already given, it's between the provider and the patient at that point.

Best wishes to you!

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