I gave a lot of money to this place

[ShayRN]

This is the one thing I do NOT like about Hospice. Tonight, had a patient transferred in from an area hospital. The woman has end stage cancer. She is absolutely Hospice appropriate. However, the family is in NO WAY shape or form ready for her to be in hospice. She is still a full code, they want all her meds to stay the same and asked when her AM labs would be drawn. I asked them exactly what it was they wanted. They really would like more treatment, but the doctors told them nothing more could or would be done for her. We discussed hospital and acute care vrs. hospice and comfort care. She was admitted respite care so that the family could have time to decide whether or not to place her or to take her home. They thought she was coming in as an inpatient for symptom management. I reviewed the two types of services with them as well. The decision was made to have her admitted, then discuss all options with the medical director and social worker on Monday. (Did I mention the great planning that had this woman transferred at 6pm on a Friday night? They KNEW this was going to be a problem:banghead:) So in comes patient's sister after I finally got through to the spouse and children. "What do you MEAN she can't stay past 5 days? We cleared all this with "Mrs. Big whig" at your main office. Don't you understand who I am? I have donated a lot of money to this place and I demand that you take care of my sister:rolleyes:" My reply? Ma'am, "Mrs. Big whig" doesn't have the authority to make those kinds of decisions, her title is in marketing. The doctor and social worker will be in Monday to help straighten everything out. Futhermore, while our organization does appreciate all donations that will not encourage us to make fraudulant claims to insurance companies. If we did that then they would shut us down and we could help nobody. ALSO, I have cared for a US Senator's father and I have cared for the homeless, they all get treated with the same respect.

She was not happy with me, her hand was on her hip and she was jabbing her finger in my face. Finally the patient's spouse had to tell her to stop it. She then left the building and promptly called "Mrs. Big Whig" and left a message on her cell phone. I got a call at 11:30 at night. How dare I say she has No Authority, she IS a director. I replied, I wasn't being disrespectful, I was being honest. You do NOT have the authority to decide if someone is admitted GIP or repite care. Further, I hope the money she gave was worth all the energy and time I have spent admitting this patient tonight while the rest of my patients got neglected. I was informed in no uncertain terms it wasn't about the money it was about the patient. Blahhhh, sometimes I just want to tell them all where to go. I just want to take care of my patients and make them as comfortable as I can.

[RNsRWe, ASN, RN]

Well, if it helps any, there's lots of us HERE who can understand!

I'm also a big fan of the "don't you know how important I am" brigade. I usually bite my tongue, but sometimes it's just impossible, isn't it? :) I had a patient making a big deal out of his daughter, the manager of a big local bank branch. Like it would matter to me. Kept it up so that I had to tell him I'm sorry, but I've never heard of your daughter and I don't use that bank! But it doesn't matter, we don't consult banks for medical care anyway

Or how about when a PITA patient insisted on informing me (three times during his initial assessment) that his daughter was a nurse, she used to be a big deal manager at this very hospital (15 years ago), and she would be PERSONALLY overseeing his chart very closely. Umm...ok. You think you're important, I get that. But you're now annoying me, so....just had to tell him that since his daughter's a nurse, he must understand that I know what I'M doing, and that she is free to request copies of his chart through his physician. I would NOT be handing it over to her, nor would anyone else. And, furthermore, I have no idea who his daughter is since her employment at this hospital was before my time (ha!) but I hope that she's enjoying retirement now--so much has changed since the days of old when she worked here (dig dig). Before anyone slams me, know it's not a matter of disrespect to "old-time" nurses , just trying to keep a patient who tried to pull a rank that wasn't there from running range on me.

Anyway...to the OP: some days are just like this, aren't they? You did the best you could, and it sounds like it was pretty good to me! Karma will get Miss Thing eventually. Wouldn't it be nice if during her next hospitalization, she had to wait her turn behind someone who was more important than she?

[Batman24]

It's a shame when anyone oversteps their boundaries like this because all this woman in marketing did is make it harder on all involved. They made false promises to a family that is already going through a very stressful time and didn't need more added to it. Better to be upfront and honest so the family knows where things stand.

This is something I would take up with my CN so it doesn't happen again. It's unfair to the medical staff, social workers, families, and most importantly the dying patient. Shameful.

[mauxtav8r]

My husband is fond of saying, after hearing people say they are in charge "If you are in charge, you don't have to tell people, they already know. If you have to tell them, then you aren't in charge no matter what your title."

[oramar]

Sorry you had to deal with these idiots. You did a great job though. It almost seems like certain members of the patients family are trying to make the illness about them and their needs. Oblivious to the fact that they are not the one dying.

[Tweety, BSN, RN]

Sounds like you handled it appropriately. What a frustrating experience. I hate when people try to throw their weight around with the "I know so and so" but what I hate worse is when "so and so" caters to them and the rules that apply to every other patient suddenly doesn't apply to their friend/relative.

[RNSC]

Don't you understand who I am?

I wish I had the nerve to quote "The Waiter" from the Waiter Rant to people like that. "Don't you know who you are?":chuckle because I do. At least the important people in the family know and understand whats going on.

[jellybean_1]

most annoying people, been there, I always tel we treat all of our patients the same respect , and if thay are not happy I usually give them #s of management.

social worker...any other #s they would like....

[rph3664]

I wish I had the nerve to quote "The Waiter" from the Waiter Rant to people like that. "Don't you know who you are?":chuckle because I do. At least the important people in the family know and understand whats going on.

This may be an urban legend, but I heard about a man who pulled this at an airport, and the ticket agent got on the intercom and said, "There is a man in the building who does not know who he is. If you can identify him, please report to Gate 17."

The man said "F you!" and she replied, "You'll have to wait in line for that as well."

[towntalker]

i know this isn't any comfort but these people don't go away, next year this person with a differant name and face will be ranting and raving about the same thing

it is easier on the ulcers to try and not let stuff sink in anymore than you can help it

about the admitting person there needs to be a meeting with her with and settle the matter before the next person comes in with false expections

[TiredMD]

The decision was made to have her admitted, then discuss all options with the medical director and social worker on Monday. (Did I mention the great planning that had this woman transferred at 6pm on a Friday night? . . .

The doctor and social worker will be in Monday to help straighten everything out.

"The decision was made"? Who made it? Who wrote the admit orders? And why wasn't her physician seeing her over the weekend?

This is whole thing was a waste of your time. And the "director" needed a backhand slap for confusing her marketing degree with a medical degree . . .

[suzanne4, RN]

And as mentioned above, it does not matter the state, each and every patient that is admitted to a facility is entitled to be seen by their physician that admitted them within 24 hours, or their designee.

But things do not have to wait until Monday to get sorted out, that is a most definite. And if the patient was admitted, and there is no reason for them to be admitted, then the lovely facility eats all of the costs. Insurance is not required to reimburse them for this visit.

And perhaps the money for the visit should come from this marketing director's pay. Then we will see how quickly she does this sort of thing again.

She needs to be admonished by administration first thing Monday morning. And if this patient was so special, why was this director not there greeting her in person when she arrived Friday night late?

And a hospital cannot accept a transfer without a physician's order either, so where was the admitting physician with all of this? And why was approval given for this patient to be sent to the hospital late on a Friday?

Sounds like people playing the system and nothing more than that.