Now, if ALL places were run like this...tell me what you think!

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Hey guys!!

I was reading a few threads on 'customer service' running amok, and wanted to share how things owrk at my current clinic. I swear, if all places would impart these rules/guidelines, the world of nursing would be so much better to work in.

First, I work in a general medicine clinic. My collaborating doc is well known for treating pain, but we are NOT a pain clinic. The patients get schooled on this at the first office visit, if not before. My OM, (the doc's daughter) is a gem, she is PHENOMENAL! She (well, all of us, really) has a zero-tolerance policy for bull, and once you're on her list, you're on it.

*We don't tolerate abuse. Period. If you come in and raise sand, you're out. Dismissed from the practice as a patient. If you have a friend or family member come in and raise sand for you, you're still out. If you bring a friend to your office visit, and that friend steals someone's wallet in the waiting room, you're still out. You brought them.

*We talk to each other. Actually had one lady tell me when I was new that the doc always gave her extra meds "in case she had a bad day". When I baked and said I'd have to verify that, she proceeded to tell me that our MA knew how to call them in, and no, he didn't write down the extra pills, just added them in when the script was called to the pharmacy. So, staff-splitting does NOT work.

*Behavior really does count. We have a 200-person strong waiting list to be a patient here. I databased it myself, from a tattered little book. Every time someone calls or comes by to ask where they are on the list, I can tell with a click of a mouse. People who come in and flip an attitude or demand to be seen immediately either get bumped to the bottom of the list, or taken off of it altogether. Posted a story relating to THAT on my other thread about things you'd love to tell patients. We even drew up a memo detailing the rules, that we hand out when someone comes by to add their name. For the ones that phone their order in, I call personally and explain the details.

* We keep records. Since we do prescribe controlled substances, if we hear or see that a patient has been arrested for DUI, selling, possession, or other offenses, we dismiss. If we get a call that someone is selling, we dismiss. If someone fails a drug screen, we dismiss. We have a closet full of dismissed charts, all carefully organized and databased (I love my computer) with names, reasons for dismissal, etc. You'd be amazed at what people will try to sneak back in. Different hair, different NAME, fit-throwing, wheedling, threats, etc. This souldn't be a surprise. All our patients are required to sign a behavior contract when they come to the clinic, that clearly states what comprises grounds for dismissal.

We have no doorknob leading from the lobby to the clinic proper. It was removed. We had people coming in without permission for 'sidewalk consults', demanding pain shots, and one lovely lady who proceeded to stand there, even though it was quite obvious that my OM was on the phone, shaking her pill bottle in her face and screaming, "WHERE are my %^&* refills?!?!?" Yep, bye-bye, sweetie!

We have a medication policy, as we call all prescriptions in. The meds are guaranteed by a certain time, period. No, you don't get an early call in without a darn good reason, and some people get REALLY creative. No problem, they get moved to the bottom of the pile. Every time they come back in (some of these people must LIVE at the pharmacy) wanting to know why they haven't gotten their meds yet, to the bottom they go. May sound mean, but they get the point after a while.

Point being, we just DO NOT reward bad behavior. There's no sense in it. Sure, we may lose a patient here and there that doesn't want to comply with the rules, but there are dozens ready to fill their spot in the chart rack. We're not outright mean, we just refuse to take abuse lying down.

So, my question...if it works for us, why on Earth can hospitals and other places make it work, too? Set policies and adhere to them, that's really all it is. Why is this phenomenon so difficult to replicate? They sure don't care to policy the staff to death, so I know it's not that. Why not go in the other direction?

Where did she say that a patient should get whatever they demand? I think it's the sitting in the doc's office for 3 hours that she dislikes and the eye-rolling receptionist.

Being painted with the same brush as rudies and druggies is what gets me. The OP didn't make clear, at least to me, that she was talking about drug abusers. It sounded like she was saying that any patient, whatever their problem, who so much as sighs too deeply will be thrown out. And the attitude that underlies her OP is just plain haughty.

She and her colleagues need to know what it's like to have to crawl and beg for help - personal firsthand experience is a real eye-opener.

This is the same impression I got as well. I knew the OP had to have dealt with *some* drug seekers by stating it was NOT a pain clinic, but in no way was the post directed only at drug seekin behaviors.

1. to say that only drug seekers are rude and aggressive= wrong

2. To say that all people that are desperate for pain meds are drug seekers= wrong

3. To deny the fact that some people become addicted o pain killers because of completely legit reasons= wrong

4. To say that all people arrested for drug offenses are drug seekers= wrong (example: a friends mother was arrested for a drug related offense because she was carrying her script drugs AND her script in her purse when going on a weekend away. The officer couldn't "make out" the doctors signature and there was no way to get in touch with her doctor at the time for confirmation= she gets arrested and is labeled as a druggie!!)

5. To assume that you are so amazing and ethical that you will never be unfortunate enough to become addicted to drugs= wrong ( as previously stated let's hope you are never put in the position to be dependent on something that is a hell of a lot easier to get on than get off)

I could go on and on but it really won't do any good. Why? Because instead of trying to see where the "disagreers" are coming from most people would just like to assume we don't know what we talking about because we have a different opinion.

As I stated before, I am glad this works for the OPs place. Good for them. That doesn't mean I should think it should be the norm.

I will go to the bottom of the pile now, I gotta get my welfare check anyway :)

Btw, forgot to add. Anyone ever wonder if the reason so many people on welfare are addicted to drugs is because when we go to the doctor for help the doctor puts us on whatever will keep us quiet for the longest so they don't have to take a pay cut when we come in for other treatments?

It wasn't meant to change your life. It was meant to point out that there IS a reason you are in this profession (see your examples) and that every profession has to deal with the same bs (again see your examples). You don't get a free pass because you went to school and became a nurse.

I'm not sure where I said I expected a free pass. :confused: Sounds like someone has a chip on their shoulder.

How many nurses, doctors, techs, aides, psychologists, medical receptionists etc etc do you think might have gone to a restaurant and the waitress brought them the wrong food, or they had to wait a little longer than they would like for a refill, or any number of problems that can occur an they caught an attitude with her? Oh but she is just an uneducated, minimum wage POS that deserves it?

Again, chip, meet shoulder.

The issue isn't about whether people are rude to other people. I think we can all agree this happens daily, in every walk of life.

I, for one, think it is refreshing to see a medical practice that holds its clientele accountable for their own behavior, just as I think anyone who treats waitstaff at a restaurant poorly should be held accountable.

Btw, forgot to add. Anyone ever wonder if the reason so many people on welfare are addicted to drugs is because when we go to the doctor for help the doctor puts us on whatever will keep us quiet for the longest so they don't have to take a pay cut when we come in for other treatments?

So you're addicted to pain medication and it's all your doctor's fault?

1. to say that only drug seekers are rude and aggressive= wrong

2. To say that all people that are desperate for pain meds are drug seekers= wrong

3. To deny the fact that some people become addicted o pain killers because of completely legit reasons= wrong

4. To say that all people arrested for drug offenses are drug seekers= wrong (example: a friends mother was arrested for a drug related offense because she was carrying her script drugs AND her script in her purse when going on a weekend away. The officer couldn't "make out" the doctors signature and there was no way to get in touch with her doctor at the time for confirmation= she gets arrested and is labeled as a druggie!!)

5. To assume that you are so amazing and ethical that you will never be unfortunate enough to become addicted to drugs= wrong ( as previously stated let's hope you are never put in the position to be dependent on something that is a hell of a lot easier to get on than get off)

I don't see where anybody said any of those things. I think you are personalizing this a tad much.

So you're addicted to pain medication and it's all your doctor's fault?

I didn't say I was addicted to pain medicine.

I am saying that welfare patients shouldn't be given a choice between be addicted to pain medicine, or live in pain.

I'm not saying this is the case for everyone. I'm not saying all people on pain meds get addicted. I'm not saying that all people on pain meds don't realize that they are starting to have a problem before it spirals out of control. And no, I'm not saying any other words you would like to put into my mouth.

I didn't say I was addicted to pain medicine.

I am saying that welfare patients shouldn't be given a choice between be addicted to pain medicine, or live in pain.

I'm not saying this is the case for everyone. I'm not saying all people on pain meds get addicted. I'm not saying that all people on pain meds don't realize that they are starting to have a problem before it spirals out of control. And no, I'm not saying any other words you would like to put into my mouth.

Sweetie, nobody's saying anything about welfare patients being forced to do anything other than behave in a civilized manner if they want to be clients of this particular clinic, and nobody is singling out welfare recipients except you. It's about how people BEHAVE, not whether they are dependent, addicted, or displaying behaviors of pseudo addiction. One can be narcotic dependent and still treat others courteously, and still have a basic understanding of concepts like business hours.

Specializes in Nurse Leader specializing in Labor & Delivery.

Eh. Perhaps I'm just too much of a bleeding heart liberal. But I found the sanctimony in the OP to be pretty distasteful. But then, I've always enjoyed working with underserved populations. Sometimes that includes drug users.

Sweetie, nobody's saying anything about welfare patients being forced to do anything other than behave in a civilized manner if they want to be clients of this particular clinic, and nobody is singling out welfare recipients except you. It's about how people BEHAVE, not whether they are dependent, addicted, or displaying behaviors of pseudo addiction. One can be narcotic dependent and still treat others courteously, and still have a basic understanding of concepts like business hours.

I understand. Thank you for your comments. :bow:

Eh. Perhaps I'm just too much of a bleeding heart liberal. But I found the sanctimony in the OP to be pretty distasteful. But then, I've always enjoyed working with underserved populations. Sometimes that includes drug users.

Yeah, I'm about as left of center as one can get, but I didn't find the OP to be sanctimonious.

I know what it's like to live on the streets, to be on welfare, and to be a single mother.

I, too, enjoy working with underserved populations. Would you believe I volunteer with a clinic that does just this? Also, I have a soft spot for the poorest of the poor who come through my ED. I don't care if they're going to pay or not, that's for the bean counters to worry about. I think every citizen has a right to access to medical care.

However, I do think it's completely appropriate to expect people to behave like civilized human beings, barring any pathophysiology with a behavioral component. Even the drunk who's been living on the streets for 20 years knows how to say "please" and "thank you", and understands the concept of rules.

Specializes in Nurse Leader specializing in Labor & Delivery.
However, I do think it's completely appropriate to expect people to behave like civilized human beings, barring any pathophysiology with a behavioral component. Even the drunk who's been living on the streets for 20 years knows how to say "please" and "thank you", and understands the concept of rules.

I think it's an appropriate expectation. I was responding more to some of the specifics in the OP.

Eh. Perhaps I'm just too much of a bleeding heart liberal. But I found the sanctimony in the OP to be pretty distasteful. But then, I've always enjoyed working with underserved populations. Sometimes that includes drug users.

i'm a liberal too...

but something has to be done with those who go through life acting entitled, manipulating the system and anyone else along the way.

i think you folks know what i'm talking about.

this has nothing to do with those who are civil, considerate and responsible.

if a civilian had an emergent need for a refill on their meds, i'm pretty sure s/he would be accomodated...

unless/until a pattern had emerged otherwise.

i totally respect what the op is talking about.

have no idea why some are taking this totally out of context.

these type of actions are long overdue.

leslie

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