Non-clinical management telling a Nurse how to be a Nurse

[SweetLoriRedRN]

:angryfireGotta vent!!! I work in an outpatient office setting. Today, while trying to tend to 2-3 pending patient situations, I asked the lady in Medical Records to call a physician's office and ask for a copy of an EKG. Now this EKG had already been interpreted by the physician that did it. AND the NP had ALREADY talked with the physician about the results. The office manager heard my request. She wanted to know WHY I was asking Medical Records to do this. "That is the nurse's job," she said. Now this task requires NO nursing judgement. I ended up calling for the EKG, never once spoke to a healthcare professional. Phone call took 10 minutes. I talked to someone in MEDICAL RECORDS!!! I get so disgusted with those NON-CLINICAL manager types without ANY nursing experience telling me what nurse's job is. I do understand that I need to make these types of calls sometimes, BUT DON'T tell me that only "the nurse" can do it.

Thanks for listening!!

[diane227, LPN, RN]

You must get used to this because as you will find as you advance in your career that anything someone else does not want to do becomes your job. I work on the 3-11 shift at my hospital. We have the CS people who bring us supplies but they do not act as runners in that they will not go look for things. If we are out of a certain item and they don't have it in CS then they will not go to other units to find it. That is now my job. So as the charge nurse, along with all my other duties, I have to go from floor to floor to find toner for the copy machine. I went to college for 5 years to learn how to do this and they pay me well to do it. But patient care is lagging behind because I can't get my charts and the mars to the nurses because I am off the floor looking for toner. So what if a med is late? So what if this stat med takes two hours to give? Who cares?

[mamamerlee, LPN]

SweetLori - - they are not telling you how to be a nurse - they are trying to expand your role to the clerical sphere. In a day or two, sit down privately with the office manager, and ask for a clearer explanation of your job description, and gently explain the FINANCIAL reasons why the med records person should be asking for med records. i.e. clerk - small bucks, RN bigger bucks. Also, you-patient care, clerk-no patient care. Try to stay calm, speak VERY quietly. Write down what you need to say before the meeting, try to get all your points across in as calm a way as you can. Do not apologize.

Diane - - document, document, document. In a brief, factual email to your manager, state what happened. As the charge nurse, you were expected to be available to your staff and patients, not searching for supplies on other units. You may want to say something like 'On Tuesday October 20, our unit ran out of XXXXX. When I called CS, they said they were out of it, and would not be able to track any down. I asked if someone could check some other floors, and they were not able to accommodate my request. This meant that I had to leave my unit to go elsewhere in the building. I am concerned that these instances may leave my unit unexpectedly short-handed. Also, I am aware that utilizing my time for this non-nursing activity may not be cost-effective for the hospital. Do we need to increase our par levels for XXXX? I would like to avoid further instances when patient care could be compromised.'

Both - Always try to offer a solution to a problem when you can. Stay calm, and keep utilizing FINACIAL reasons why an RN should not be doing non-RN tasks, and the possiblity of patient care compromise.

[Lacie, BSN, RN]

SweetLori - - they are not telling you how to be a nurse - they are trying to expand your role to the clerical sphere. In a day or two, sit down privately with the office manager, and ask for a clearer explanation of your job description, and gently explain the FINANCIAL reasons why the med records person should be asking for med records. i.e. clerk - small bucks, RN bigger bucks. Also, you-patient care, clerk-no patient care. Try to stay calm, speak VERY quietly. Write down what you need to say before the meeting, try to get all your points across in as calm a way as you can. Do not apologize.

Diane - - document, document, document. In a brief, factual email to your manager, state what happened. As the charge nurse, you were expected to be available to your staff and patients, not searching for supplies on other units. You may want to say something like 'On Tuesday October 20, our unit ran out of XXXXX. When I called CS, they said they were out of it, and would not be able to track any down. I asked if someone could check some other floors, and they were not able to accommodate my request. This meant that I had to leave my unit to go elsewhere in the building. I am concerned that these instances may leave my unit unexpectedly short-handed. Also, I am aware that utilizing my time for this non-nursing activity may not be cost-effective for the hospital. Do we need to increase our par levels for XXXX? I would like to avoid further instances when patient care could be compromised.'

Both - Always try to offer a solution to a problem when you can. Stay calm, and keep utilizing FINACIAL reasons why an RN should not be doing non-RN tasks, and the possiblity of patient care compromise.

Great advice given here!! You will find this situation just about anywhere you go. I just left a DON position in which the secretary would drive us absolutely crazy at times. Outpatient chronic dialysis and if she felt someone wasnt moving fast enough she would come out give everyone "the Look" and then complain we werent moving fast enough lol. She didnt have a clue clinically what it was like if a machine went down or another patient was crashing but just to get them in, on, done, and out. If one of the techs had a moment to take a breath and sat down she would be complaining they werent working. She would call the administator located at a sister unit and tell her all "the problems" she was viewing and her opinion on it. Bad thing was the administrator listened (lord knows that was a mess). I have since left the job but I'm sure things havent changed. Over the years no matter where I have worked, there is always that one person who isnt medical yet knows it all.

[CASTLEGATES]

I enjoy criticizing surgeries when I couldn't do them...it's fun and gives me a sense of superiority in my infantile mind. Armchair critics rule!

[systoly]

Why ask medical records? Perhaps, because it's a medical record. And if you disagree, how about doing it as part of being a contributing member of the team. I still haven't quite figured out why, but nurse seems to be synonymous for dump stuff here. I know one reason is we are to quick to say ok, I know I used to be guilty of this.

[wooh, BSN, RN]

Yep, if nobody else wants to do it, it's the nurse's job. Because we all have to work together. Why "we all have to work together" isn't an excuse to tell a non-nurse to do something, I don't understand. But if I complain about doing a job that could just as easily be done by housekeeping, dietary, respiratory, supply, secretary, anyone that's not a nurse, I get told "We all have to work together to take care of the patient."

[SweetLoriRedRN]

SweetLori - - they are not telling you how to be a nurse - they are trying to expand your role to the clerical sphere. In a day or two, sit down privately with the office manager, and ask for a clearer explanation of your job description, and gently explain the FINANCIAL reasons why the med records person should be asking for med records. i.e. clerk - small bucks, RN bigger bucks. Also, you-patient care, clerk-no patient care. Try to stay calm, speak VERY quietly. Write down what you need to say before the meeting, try to get all your points across in as calm a way as you can. Do not apologize.

Diane - - document, document, document. In a brief, factual email to your manager, state what happened. As the charge nurse, you were expected to be available to your staff and patients, not searching for supplies on other units. You may want to say something like 'On Tuesday October 20, our unit ran out of XXXXX. When I called CS, they said they were out of it, and would not be able to track any down. I asked if someone could check some other floors, and they were not able to accommodate my request. This meant that I had to leave my unit to go elsewhere in the building. I am concerned that these instances may leave my unit unexpectedly short-handed. Also, I am aware that utilizing my time for this non-nursing activity may not be cost-effective for the hospital. Do we need to increase our par levels for XXXX? I would like to avoid further instances when patient care could be compromised.'

Both - Always try to offer a solution to a problem when you can. Stay calm, and keep utilizing FINACIAL reasons why an RN should not be doing non-RN tasks, and the possiblity of patient care compromise.

Mamamerlee,

I hadn't yet thought of the FINANCIAL impact of an RN performing clerical duties. One of the reasons the office manager had an issue is because the Medical Records clerk had said something to her about being behind in her work and having "too much" to do. And speaking in financial terms, staff was very recently cut to SAVE money. One of whom was a more experienced Med Records clerk. I OFTEN get behind and feel I have so much to do. BUT I cope with it and do it!!!!! If patient care isn't an isssue, I'm sure none of us mind helping the clerical staff or ANY other staff member that is in need.

[SweetLoriRedRN]

Great advice given here!! You will find this situation just about anywhere you go. I just left a DON position in which the secretary would drive us absolutely crazy at times. Outpatient chronic dialysis and if she felt someone wasnt moving fast enough she would come out give everyone "the Look" and then complain we werent moving fast enough lol. She didnt have a clue clinically what it was like if a machine went down or another patient was crashing but just to get them in, on, done, and out. If one of the techs had a moment to take a breath and sat down she would be complaining they werent working. She would call the administator located at a sister unit and tell her all "the problems" she was viewing and her opinion on it. Bad thing was the administrator listened (lord knows that was a mess). I have since left the job but I'm sure things havent changed. Over the years no matter where I have worked, there is always that one person who isnt medical yet knows it all.

I wish the roles could be reversed!! I understand that those in the nonmedical role surely get overwhelmed and stressed also, but they aren't responsible for the patient AND they don't have to worry about protecting and keeping a license.

[SweetLoriRedRN]

Why ask medical records? Perhaps, because it's a medical record. And if you disagree, how about doing it as part of being a contributing member of the team. I still haven't quite figured out why, but nurse seems to be synonymous for dump stuff here. I know one reason is we are to quick to say ok, I know I used to be guilty of this.

Jack of All Trades!!!! That's what we are!!! I don't mind even if I have to clean the toilet.......as long as patient care doesn't suffer.

[SweetLoriRedRN]

Yep, if nobody else wants to do it, it's the nurse's job. Because we all have to work together. Why "we all have to work together" isn't an excuse to tell a non-nurse to do something, I don't understand. But if I complain about doing a job that could just as easily be done by housekeeping, dietary, respiratory, supply, secretary, anyone that's not a nurse, I get told "We all have to work together to take care of the patient."

I'm glad to help anyone in time of need. But help me PLEASE if I need it.......shouldn't the Golden Rule apply here??? I suppose in a PERFECT world this would be the case....

[november17, ASN, RN]

RN big bucks. .

HAHAHA

I just spit water all over my monitor!

"RN" "Big" (or Bigger) and "Bucks" - none of these three words really belong in the same sentence. I mean, you can mix and match any two, but not all three.