I work for a company which I will not name here, but I need your advice.
I am a nurse and I work for a DME company.
I had a patient refuse their oxygen. The patient is a smoker, in his home, doesn't feel short of breath, yet overnight pulse ox shows less than 88% for over 20 minutes. I educated him on his low o2, and what effects this could have on him should he not follow MD orders. The patient still refused. I had him sign a refusal letter and was later told by my boss that we need to first talk to the doctor to see if the doctor wants us to keep it in their home until we get another overnight pulse ox. The patient told me even if it's low again "I DON"T WANT IT" I was told that "my job is to make the pt compliant" as "this is what the doctor is expecting us to do". I told them ABSOLUTELY NOT...that my job was to be a caring nurse, patient advocate and that I would inform the patient of their rights, inform them of possible outcomes should they not follow doctors orders, but that they have the right to refuse treatment.
The sales rep at the company will set up oxygen in a heartbeat, because he gets paid for every o2 set up...but I have this one patient who refused it 4 weeks ago, they said the patient is to set up an appt with the doctor before we pull the o2...and guess what...this company is billing medicare for a service the patient refused...they are telling me we can wait on the doctor to tell us what to do...I thought the patient has the right to refuse regardless of what the doctor wants. Am I correct, or am I missing something? Is this a form of medicare fraud?
I love the patients I go and visit and the stress is very low normally, so I don't want to quit...
