Nurses in a doctors office frustrated me today, am I out of line?

Altra, BSN, RN · Jun 30, 2006

I feel badly that it worked out this way for you & your family Shay, but I think I have to go with the office staff on this one ... they're constantly needing to schedule cases ASAP. Whoever you spoke to on the phone had no business giving you the impression that the time slot could be "held" for you if that was not the case.

Just curious, why the elective tonsilectomy? (If it could potentially wait a year, it surely falls into the elective category)

ktwlpn, LPN · Jun 30, 2006

My daughter was scheduled for a tonsilectomy on Aug the 2. I start a new job on the 25th of July. My husband was planning on taking an hour off of work to be home by the time I left for work the two weeks she was healing. So I called yesterday to speak with the nurse from the surgeons office and she told me that she understood the reason I wanted to switch days and that she had July 18th open for the surgery. (At least for the first week, we would be there, then my mom could come over the second week) I told her let me go to work to make sure I could get my schedule changed tonight and I will call you back tomarrow. No problem, she said, I will leave her chart with a note on top and you can call if you get your schedule switched. I got someone to work for me on that day, called today and the nurse I spoke with wasn't there. They refused to switch the date. Told me they were booked, they saw patients every day and just because it was there yesterday, doesn't mean it will be there today. She did not leave a note or my daughter's chart out like she said she would. Now I am stuck, they are refusing to move the surgery up, so it just cannot be done. I refuse to leave my daughter without one of her parents there the day after surgery. I asked to speak with the doctor and they refused to put him on the phone. I am going to try to call back Monday, when I have calmed down a bit. I just want to know if it can wait until next summer, when I can take the entire two weeks off for her recovery. I already cancelled ther Aug. 2 surgery, so if for sure won't be getting done this year. HELP, was I out of line for being so upset?

You'll never know if the nurse really put the note on the chart or not...I think I would be upset also but I would have been a bit more pro-active.I think when I interviewed for the new job I would have talked to them about the upcoming surgery and need for time off and gotten something in writing regarding how it would be handled (like time off but without pay since you won't have accrued time-or pushed the start date a few weeks) I also would have called work right away-not waited until my shift to discuss the matter...Kids rebound fast-if your mom can be with her the second week I'm sure that would be great for them both...I would think if she is having infections then the surgery needs to be done sooner-not next summer because it is more conveneient.She can end up with emergency surgery this winter and miss school,too.....I think you should call the office Monday and get her scheduled asap before the school year starts and then call work and let them know what it going on...If the new employer won't work with you over something like this then do you really want to work there? Good Luck

LoriChr · Jun 30, 2006

I am so sorry you had this happen. I work for a general surgeon and know full well the frustations of surgery scheduling. As the OP stated, the nurse had no business promising you surgery time would be open. Schedules change constantly and quickly. At least in my experience, it is pretty rare to "hold" spots.

But I am also bothered by her obvious lack of follow-though. I work part-time and am very upfront with my patients when I will be out of the office. If I know something will be happening on my day off, I make sure at least one of my co-workers know what is going on.

No one is perfect and unforseen things happen. But it sounds like that office nurse dropped the ball several times here.

caroladybelle, BSN, RN · Jun 30, 2006

There are several problems here.

Surgery dates are not dependant on one person's schedule, but require assistance of several professionals/departments. That is, there is more than just one MDs schedule involved. So while the surgeon may have have a space available on their schedule, if there is not a corresponding anesthesia provider, space in the OR suite of the MDs choice, etc., the date cannot be changed as desired. While the nurse can validly say that the surgeon has space available, until the OR time and anesthesia coverage is confirmed, it means little. While it is upsetting that you were under the impression that surgery was a go for that date, and you should not have been given that impression, as far as actual availability, the nurse has little to do with that. In most cases, surgery schedules are filled up in order, and there would only rarely be an earlier opening, so a note being left would make little difference.

Another issue is was it a nurse that was did this? In the most MD offices, there are few to no nurses actually working. Even if you ask for the "nurse", often you will be speaking to an MA. And MAs/office personnel are the ones who frequently set up times for appointments/procedures. Though admittedly surgeons who do in office procedures may be more likely to have an actual nurse in the office.

As far as "refusing to put the surgeon" on the phone, few if any of us "refuse" to get the MDs....in most cases, it is the MD that declines to drop everything to get on the phone. They may be with a patient, speaking with an associate/fellow MD, doing a procedure, or .....in surgery/prepping for surgery. They cannot and in most cases, should not drop all these things to go to the phone to deal an issue that is not an emergency. And while you may consider this an emergency, in the broad scope...it is actually an annoying inconvenience. And they do need to do through assessments and concentrate on procedures as little disruption as necessary.

Would you like for the surgeon to stop in the middle of your child's surgery/or assessing your child for serious illness.....to get yelled at by an upset parent about inability to move up a surgery....something that the MD can do little about while s/he is trying to care for his young patient? Do you really want the surgeon to have that distraction?

As such many MDs will return calls about non lifethreatening issues later, after they have time to assess the situation, and they decline to accept any non emergent calls while they are occupied with patients.

MDs also have a life. It can be very stressful to care for young ill children. They need their lunch/family/personal time undisturbed, unless there is a lifethreatening emergency....they deserve that so that can continue to function. As such, unless there is a lifethreatening emergency (and this was not one), they often leave instructions for the staff to take a message.

I know that you are upset and that this is distressing, and I regret that you feel badly about nurses because of this. But do try to understand that there is more than the "nurse" involved in this issue and try to bear with it. I would think that you will probably hear from the MD after hours or on a break, once s/he has assessed what can be done.

I do feel that there was a lack of follow through and this should be brought to attention of whoever the ultimate supervisor is.

ShayRN · Jun 30, 2006

Believe me, I don't feel badly about nurses because of this, I feel less respect for the nurses in this office. Yes, they are nurses, of that I am sure. (I asked if I was speaking to an RN, as I am one, I know that is something I need to clarify.) I am upset that something was told to me wasn't followed through with, I am upset I was lied to about an opening and mostly I am upset that I can't be home with my daughter the day after her surgery. But, as an update, the office called a few minutes ago. They must have done some follow-up on their end and she will be having surgery on the 18th. Yes, it is elective. She had 11 days of missed school last year, 9 of them was because of strept throat. The doctor said 4 episodes over a year was borderline, but with my dh and I both having ours out as children and my history of sleep apnea he was recommending the procedure. So that was why I thought it could wait a year.

ShayRN · Jun 30, 2006

I think I would be upset also but I would have been a bit more pro-active.I think when I interviewed for the new job I would have talked to them about the upcoming surgery and need for time off and gotten something in writing regarding how it would be handled (like time off but without pay since you won't have accrued time-or pushed the start date a few weeks) If the new employer won't work with you over something like this then do you really want to work there? Good Luck

I did talk to them, and was told it really wasn't possible as it is a new facility that is opening in September, I completely understand. Yes, I do want to work there, it is my dream job. I appreciated him being upfront about it from the begininng. I am a very reasonable person to deal with, as long as you are honest and upfront.

jmgrn65, RN · Jun 30, 2006

Just because they said they were a nurse doesn't make them, unfortantely is very common for MA's to say they are the nurse. Like the op said there are very few nurses in a doctors office they don't like to pay the wages of a nurse.

caroladybelle, BSN, RN · Jun 30, 2006

I had a feeling that they will call back once everything had been sussed out, and I am glad for you and your child.

PANurseRN1 · Jul 1, 2006

I can't tell you how many times I have been yelled at by patients/family members who are outraged because their surgical time doesn't suit for one reason or another.

Which is why our policy is pretty much, "Sorry, this is the time we have available. If it doesn't suit you, you'll need to reschedule." If someone has a really good reason and maintains his/her composure and treats us with respect, we may try to accommodate a request, but on the whole, surgical times are set in stone.

We simply could not function if we changed surgical times every time someone wanted a different time. How does that work? If we do it for you, then that means we have to "bump" other people. Is that fair?

I really have next to no sympathy here. I've been yelled at one too many times by people who think what's going on in their lives supercedes everyone else. It was wrong of the "nurse" to promise a different time, but you were way out of bounds accusing her of being a liar. You don't really know all of the details.

If your daughter had that many episodes over one year, that would clearly indicate the procedure couldn't wait another year. I'm sorry, but this came across like the "dream job" was more important than your daughter.