Staff splitting...how to deal?

[AngelfireRN, MSN, RN, APRN]

Hi, all. Wanting some input, please on a situation that's driving me bats at work.

Our policy on meds is clearly posted in several places on the walls and windows of our clinic..ie: by 2 pm for morning appointments, by 10 am the following day for afternoon appointments. In my tenure there, there MAY have been one case where that had to be enforced. All other days, we get the meds called in before lunch (noon) and before close of business. This has been the policy for 9 months running now.

The issue?

Entitled folks who think the rules don't apply. The reason we put the policy into play was the fact that we literally had patients coming back to the clinic fifteen (no exaggeration) minutes after they left, banging on the windows, screaming that their meds were not called in. The policy has cut down on a lot of that, as has informing the pharmacies that, should our patients act like the proverbial horse's patoot, thay may enforce the policy as they see fit.

However, as I said, there are the few that still think they ought not to have to wait, and thus the quandary. Most days, the med assistant and myself are the only two that call in meds (don't get me started on why the others in the office can't be bothered), and we have a schedule...she starts calling after the patients are all triaged, I start after I have seen everyone. If there's downtime between patients, we call in a few as we can.

I walked in today, and this lady (who's been a pain in the patella from the word go) was already fired up. Now, I'm pregnant, and I'll confess I'm hormonal, but she absolutely peeved me off. Started in by talking about how glad she was that we got a new drug testing person, because our old one was so mean. Never mind the fact that the last time her name dropped to be tested, she called said old one everything but a white girl.

I digress...as per my usual routine, I assured this lady that her meds would be called in by noon. She grumbled and groused, but I had a lobby full of patients, and told her that it was not fair to make all those patients wait while I called in one script, and that she would not like it if she had to wait while I did that for another patient. She sniffed and stomped out. As soon as she saw my OM go by, she starts yelling, shoves her way back in, and wheedles to the OM, couldn't she PLEEEAAAZZZEE call her meds in by 10:30. Of course, OM is just trying to get rid of her and says OK. (Thank God she didn't hand me that chart and tell me to do it, the mood I was in by that point, I think I'd have worn it out over her head.) Then the OM goes to lunch with a friend, no script called in, nothing.

So, when the lady comes barging back in about an hour later (for some cooked-up reason) she makes a snide comment to our receptionist about how her meds aren't called in. By this time, I'm done seeing folks, and have started to organize the charts by pharmacy to start the calling. She got her meds, as ordered by doc, before the time we promised them, but she did not get her way.

Aside from a complete overhaul (because these people will hunt and whine to anyone they see till they hear what they want to hear), what to do? I'm a tad tired of being the wicked witch for enforcing a policy that was instituted to stop exactly this sort of behavior. Thanks.

[JeneraterRN]

There is the old saying that you can't please everyone-it's old because it is true. Though you were professional, you can always count on someone to be a jerk. Personally, after that kind of behavior, I'd have told her that her name just went to the end of the call list, but that's just me.

[AngelfireRN, MSN, RN, APRN]

Jen, I didn't tell her that, but that's exactly where she went! I am so glad someone else thinks like me, lol!

[JeneraterRN]

Ha ha!!! Good nurse!

[evolvingrn, BSN, RN]

she didn't get the meds by the time your office promised them because your office manager said 'okay' .............if you as a staff stand united on your office policy it would work much better, otherwise it encourages this behavior

[AngelfireRN, MSN, RN, APRN]

She got her meds by the time the policy stated she would, and 3 hours early to boot. I go by policy, and I also had 30 other patients to see. OM never promised her a darn thing, all she said was OK, and that was just to get her out the door. If OM had promised her, then OM could call the meds in herself. I didn't promise her a blasted thing except that I'd have them in by noon, and I did.

I agree that a united front would be great, but when the OM is Doc's daughter, who says whatever to get them outta her face, and receptionist is Doc's son, who can't stand a conflict and runs to OM for every little thing (usually several times, because OM will tell him what to do, and then the patient will pitch a you-know-what), it's a bit difficult to wade through all the nepotism.

At the end of the day, I just work there. I dearly love the majority of my patients, but I'll be danged if I'm going to be a doormat. If they want to promise something, fine and dandy, so long as they're going to follow up.

Now, getting myself past it starching my Underoos...there's an issue for later in the day.

[JeneraterRN]

You know, you really don't have to put up with it. No one has to take that kind of donkey dung. You can say to the patient that if you are not able to treat staff in an appropriate manner, the door is right there (point with whichever finger you find appropriate).

[EmergencyNrse]

It's never about what you want it's what THEY want.

Unfortunately we are all in a customer service driven industry.

Needed here is some Leadership... showing some backbone. It's got to be difficult going through life without a spine.

Set standards. They need to be clear to all and they need to be honored. Exceptions show favoritism and will compromise your integrity. Be firm, respectful but unwavering. That respect has to be a two-way street. If you demonstrate consistency then the self-centered, privileged, demanding patients will come to realize that they must meet that standard or go away.

It's not an easy task and you're not alone but the most successful clinics have pretty strict policies. (I always remember the saying: Poor planning on your part does not constitute a crisis on mine)

[kool-aide, RN]

I agree that a united front would be great, but when the OM is Doc's daughter, who says whatever to get them outta her face, and receptionist is Doc's son, who can't stand a conflict and runs to OM for every little thing (usually several times, because OM will tell him what to do, and then the patient will pitch a you-know-what), it's a bit difficult to wade through all the nepotism.

Yikes, how's that family dynamic working out for you, Angel? lol Sounds like you handled the situation with grace.

[xtxrn, ASN, RN]

Good grief.... that sounds horrible I'd be visualizing the whole lot of them on wanted posters..... :)