He Says/ She says, Who's in Charge?

[AngelfireRN, MSN, RN, APRN]

I have a question, guys, and I want brutal honesty...I don't want to quit my job. I love it. But I will leave if this mess continues.

As I have mentioned, I work in a clinic that dispenses controlled substances. As such, we do frequent and random drug screens. We operate on a three-strike policy. You fail 3 screens (except in the event of an illegal drug), you're out.

Last week, it was brought to our attention that one patient in particular had multiple failures, and notations were made in the chart that stated that this patient was reporting the unprescribed meds as being from the ER. The decision was made to screen again and to inform the patient that meds would be held until we saw what the screen showed.

When the patient arrived, we did the screen, and I phoned my OM with the results. She said to tell the patient that we would not be prescribing a certain med, but to dispense the others. The patient became irate and stated that they knew where they could obtain meds and that they would get them from there. I excused myself and explained the situation to my doc, who said the patient was not to receive any meds at all.

I arrived at clinic today, and was met with OM, who told me that the patient was in before my arrival, accompanied by a family member who apparently was a local LEO. The patient was apparently in a state and said that I completely ignored their complaints and that I accused them of being a drug addict. I was told that I should have dispensed the meds, regardless of what my doc said. Basically, I was told, "You do what I say, don't listen to Doc."

SO, end result, the patient came in a whined to the doc, got pacified and got her refills. They even went so far as to close me in a room so that the patient 'would not have to lay eyes on me".

The kicker? The WHOLE LOBBY heard this tirade that went down. Every last one of my morning patients made it a point to tell me. And every last one hugged my neck and told me they had my back.

I'm so flipping mad right now I can barely eat. I had witness to the fact that I was not dismissive to the patient, a staff member was within earshot (as always happens with discussions about med misuse/failed drug screens) and backed me up. I didn't raise my voice, I was not mean. I don't candy-coat, and I am pretty straightforward, but this patient apparently is of the opinion that I sit at the right hand of Satan himself now.

My documentation saved my butt. I documented every discussion about every failed screen and about the statement regarding getting meds elsewhere.

My OM is Doc's daughter. Lately, the push is on to keep patients for revenue, which I get. But I feel that we're excusing way more than we used to in the name of money, and I feel that people will get the impression that , if they throw a big enough fit and get law enforcement involved, that we'll cave. I don't want to be a party to that.

It fries my bacon that they catered to this person that way. I feel devalued as an employee and as a professional, especially since the whole conversation was at their instruction. And the whole closing me in a room thing just capped it. That, and the fact that I overheard OM and Doc discussing the 'need to keep patrons'. I get that part, but where is the line drawn?

So, what would y'all do? I truly don't want to quit, but I also am not sure who is running the show anymore. Thanks for reading my tirade.

[SycamoreGuy]

It sounds like you are stuck between the Dr. and daughter. Not a good place to be. I would be seeking other employment. But, short of that you could try to address the issue with the two and say that you need to know who's in charge and they need to respect that or you walk.

[NPAlby]

Quit. If keeping patients is their priority then things will only get worse. And then to "hide" you so the patient/drug seeker wouldnt have to see you??!! That was so disrepsctful to you as a professional. That alone would have made me quit.

[mammac5]

Quit as soon as possible. If you can afford it, quit before you have time to find a new job. Being in a family situation is a no-win for you. And why the heck is an office manager telling you how to treat your patients?!?!?!

Run for the nearest exit and don't look back.

[BCgradnurse, MSN, RN, NP]

Quit ASAP. You've told us about multiple issues over time and things don't seem to get better. Both the OM and MD threw you under the bus. It also sounds like this clinic is on its way to becoming a pill mill. Don't jeopardize your license by staying there.

[donsterRN, ASN, BSN]

And why the heck is an office manager telling you how to treat your patients?!?!?!

Yes, this.

[VivaLasViejas, ASN, RN]

What a pile of horse-pucky. In your place, I'd hand in my two weeks' notice tomorrow---the behavior of your co-workers was abominable, to say nothing of unprofessional. Git while the gittin's good!

[sharpeimom]

You worked much much to hard and long for your license and advanced practice status to risk losing them, so start looking around.

Besides, feeling this frustrated all the time isn't worth it. It really isn't.

[nitasarn]

Quit!

[donsterRN, ASN, BSN]

I don't know you except for your postings here, but I do know you don't have to take that crap. I'm jumping on the "I QUIT" bandwagon...

[UTVOL3]

I arrived at clinic today, and was met with OM, who told me that the patient was in before my arrival, accompanied by a family member who apparently was a local LEO.

I am not familiar with the typical goings-on at facilities such as yours. What does bringing a LEO along do for the patient? Can they really show up with a police officer and demand meds?

I agree with the others. Highly unprofessional and disrespectful of your OM.

[AngelfireRN, MSN, RN, APRN]

I am not familiar with the typical goings-on at facilities such as yours. What does bringing a LEO along do for the patient? Can they really show up with a police officer and demand meds?

I agree with the others. Highly unprofessional and disrespectful of your OM.

Unless it was to give them clout, I'm at a loss. Muscle? At any rate, it worked. And they know I am not happy. The only thing that saved me from completely walking out when they shut that door was the fact that I had a lobby full of patients who depend on me. Who are now actively begging me to stay.

Yes, word is out. The grapevine is very well-oiled at clinic. The lobbyful that saw the initial rumpus got it started...those that saw how they put arms around this person and convoyed them into Doc's office kept it going.

That will be the only consideration in what should be a run for the door. My patients. 95% of whom I love.

I don't mind so much about the fact that this person is a seeker, a liar, and a nut. I deal with that every day. Not a lot of people could. The NP that replaced me could not.

I do take offense at being undermined, being disrespected, and at having them be treated like dadblasted royalty because their entourage made it a point to wear a police jacket.

This sucks.