Intimidation By Supervisor

[Aviationurse]

i am new to hh working partime until i can get full time position in hosp. can u refuse to take a patient that was recert and dr wanted to reopen the case? i refused bec the patient refused everything on day one of visit and on ff up. he dont want anybody to go to see his apt , wont answer phone/ cell phone/ or calls from doorman when i am there, says "no " to all the questions i asked, refused to have wound assessment and blood draw, angry, argumentative,have to wait 35 minutes for him to come down in lobby, tells staff "i want to be left alone" "i dont need u" "give me your time sheet so i can sign" and zooms out of lobby in his motorized wheel chair 5 mins after he sees me..he is 49 years old and independent with everything. is it recert when patient is discharged and reopened per dr in clinic?

my hh agency insists i go there. a week after this patient is discharged..i refused...i said i am not going to go there and drive one and a half each way and pt REFUSING everything and just signs my time sheet...whatam i there for?

the hh agency gives me the crappy patient bec they said im new and this is part of my "initiation"....:eek:i refused to be intimidated by this hh agency...they know i am awaiting full time position elsewhere and that they thought they can just pull crap on me . any advice greatly appreciated...:yeah:

[certwndnrs]

The patient has the right to refuse care. If he refuses the visit when you call him then do a missed visit, this is proper nursing practice. It seems your agency wants you to harrass this patient. I would call the doctor myself and tell him that this patient refuses care. You are right in refusing. The agency is setting itself up for a liability issue if they continue this type of practice. There is also an issue of medicare fraud, if you aren't providing a nursing skill then the visit is non-billable. If he doesn't receive 5 visits during his cert, he becomes a LUPA. I would have to question the morals of the agency and why they insist on harrassing this patient who has refused service on numerous occasions. They are tampering with his rights. :imbar

[Aviationurse]

hello certwndnrs

1. this is a for profit agency and first the don supports my situation then changes after talking with dr. the dr. said that the patient agreed to be visited but i dont favor that bec this patient want "nothing" done from x2 ealier visits . i dont get support from this hh agency. when i initially told them of my situation..all they care about is if the patient "signed " my time sheet....

2. what is lupa? can my hh agency fire me for refusing to take this case?they only gave me max x4 patients a week to visit since i refused to re open this case and they cant find anybody interested to visit this patient who is located far and in the middle of gang banger area.

3. this patient is private insurance...would it be considered medicare fraud?

4. this agency wants money from insurance and they used me as a live bait bec i currently have no full time work (pscyh background)....:argue::no:

thanks for your help and advice hh experts....u rock...

[iluvivt, BSN, RN]

I would also tell them I feel unsafe in going to that area and I am sure they have protocols in place to protect their workers. Why would they re-accept a non-compliant patient.....Oh yeah...the bucks....I would not go either and your agency has the right to not accept the case...so now that they have i say send the manager or supervisor that accepted the non-compliant patient in a really bad neighborhood out to do the visit.

[Aviationurse]

the patient is a pay per visit (private insurance)and the don wants me to still go there bec the doctor is asking her that visits should continue bec the patient "AGREED" to the doctor ..per DON she dont want to upset this doctor or else she wont "get any referrals."..aint that something? all about the megabucks ...she continues to call and intimidate me all day to go back and see this patient ....:smokin:i would file a missed visit though if i go there and patient refused to answer call from doorman or cellphone..

thanks for your kind advice...:banghead:

[caliotter3]

You have every right to refuse certain clients. That is part of the claim of "flexibility" that hh holds. Your supervisors can make you miserable about refusing clients only if you let them. However, I wouldn't be refusing clients left and right either. Only do so for valid reasons. I would suggest that in the future that you not tell an employer that you are waiting for something else. Somehow, this info usually comes back to bite a person. The employer does not need to know your future plans to work somewhere else until it becomes a reality, if it becomes a reality.