Patients who call the clinic 1 day before meds run out for refills

Trauma Columnist · Aug 27, 2012

Electronic medical records. Our EMR for our practice has a eprescription that comes straight to the dashboard of each provider. The providers are then responsible to push the "refill" "deny" etc. button.

SHGR, MSN, RN, CNS · Aug 28, 2012

If you want patients to follow your policy, you have to adhere to your policy. If you drop everything, yes they will continue to exhibit the behavior.

I tend to be the "drop everything to do this just this once" nurse every time, and it gets old. Then recently the tables were turned. I ran out of meds (thinking I had more to last me) and the staff adhered to their policy, to the letter: a visit was needed, and no, they couldn't squeeze me in. Not so nice to be on the other end. But, I'll never make that mistake again. Lesson learned.

JZ_RN · Aug 28, 2012

I wish this could work but with our patient population many of the medications need reassessment before refilling and the patients move, switch pharmacies, switch phones, etc. If they had every refill pop up they'd spend 8 hours a day just going through them. Many meds are one time scripts only anyways, like ATBs and creams and such.

JZ_RN · Aug 28, 2012

We do follow the policy, I have never not followed it, However, then they show up at the clinic screaming and throwing fits and threatening to sue, and it's just getting old. They have time to come moan at the clinic but not enough time to call us 2 weeks ahead of time?

I put a sign on my personal office door to greet these people- Lack of planning on your part does not constitute an emergency on your part. I also explicitly write on discharge summaries- call 2 weeks in advance for refills, narcotics and scheduled meds are not refilled by phone, only at appointments. You'd think they'd get it but no.

SHGR, MSN, RN, CNS · Aug 28, 2012

We do follow the policy, I have never not followed it, However, then they show up at the clinic screaming and throwing fits and threatening to sue, and it's just getting old. They have time to come moan at the clinic but not enough time to call us 2 weeks ahead of time?
I put a sign on my personal office door to greet these people- Lack of planning on your part does not constitute an emergency on your part. I also explicitly write on discharge summaries- call 2 weeks in advance for refills, narcotics and scheduled meds are not refilled by phone, only at appointments. You'd think they'd get it but no.

I love that sign!!! It's so true. But wow, we must work at very similar clinics. The "We are not a walk-in clinic" on our door works just as well. It applies to "everyone but me", right? It's part of the chaotic lifestyle many people are accustomed to. Everything is an emergency, I need it now, etc. Same thing with forms. The one thing that has helped a lot is just getting all staff on the same page. "Our policy is (48 hours/ five days.)" "I'm sorry, but that is our policy." When people hear it enough, it starts to sink in. We have had fewer problems, partially because of scripts.

JZ_RN · Aug 28, 2012

Perhaps at the next staff meeting I will suggest making script signs for all the computers at the customer c are desk, so when they take calls they can tell people who say, I sent my form yesterday, is it done? Where is it? that we in fact may not do it for 2 weeks, which is our policy!

JZ_RN · Aug 28, 2012

I also want them to stop dropping angry people right to my phone line when I'm with patients. And I also want them to stop telling patients to just "come in and the nurse will address your issues" Uh... No, I won't, I am already addressing the issues of patients who have appointments. If you have an emergency go to the ER jeez. Sorry for the vent lol!

agrayRN, MSN, APRN, NP · Aug 31, 2012

I wish I could say there is a way to prevent it, but I don't think there is. If the MD would adhere to the policy, then it might work. But as long as the MD will fill it on short notice, the patient will know this and will continue their behavior. It happens all the time in our office - people are like, "I'll be taking my last dose today" or "I have to have these today because I am flying out tonight." I'm just like seriously?

agrayRN, MSN, APRN, NP · Aug 31, 2012

I also want them to stop dropping angry people right to my phone line when I'm with patients. And I also want them to stop telling patients to just "come in and the nurse will address your issues" Uh... No, I won't, I am already addressing the issues of patients who have appointments. If you have an emergency go to the ER jeez. Sorry for the vent lol!

I so agree! I love getting calls to my line, when I don't even know the call is from an external source. The phone will usually ring twice when it is external, once when internal. But if an internal source forwards the call, it just rings once. So I answer the phone informally, thinking it's a co-worker, and it turns out to be a patient. Ugh!

And when patients just drop into the office thinking they should be helped ASAP....

xoemmylouox, ASN, RN · Sep 2, 2012

Well I would be glad if we got 1 days notices. We have patients that demand refills same day/within hours. Some even expect it ASAP. People have no clue and/or don't care.

JZ_RN · Sep 3, 2012

My favorite is patients who expect the doctor to just "come and talk to them" or just "look at this" or "give them an rx" when they show up at the clinic with no appointment. If you had an appointment and had to wait an extra 5 minutes (which we all know will be half an hour) for every jerk who just walked in and "wanted to see the doctor" how mad would you be having to be later and later, waiting and waiting? But that's "my doctor" why can't he/she just talk to me? Because they are all these people's doctors, too, and they have been waiting and have appointments.

Do people honestly not realize they aren't the only and most important person in the world?