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Case Management
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AnonymouseRN has 12 years experience and specializes in Case Management.

AnonymouseRN's Latest Activity

  1. AnonymouseRN

    Discussion at nurse's station

    I appreciate you taking the time to reply. I actually had no idea that the CNA was listening until I got the call later on. I looked up once and saw her behind the nurse's station, saw her walk away and then continued talking not realizing that she was actively trying to hear us talk. She wasn't anywhere near us when we started, otherwise no way would I have willingly let anyone hear any of that. I guess I should've made that more clear.
  2. AnonymouseRN

    Discussion at nurse's station

    I have a sticky situation that I've never seen before and I'm looking for some insight. I'll try to stick to the facts. 1. I'm a case manager for a government agency and I coordinate, oversee and perform care for vulnerable -usally geriatric- patients in the community. 2. I've had this patient for several months now with pretty grievous abuse and repeated violations of patient responsibilities I outlined with the family when the patient was admitted. They agreed to our policies in writing and have been gently reminded multiple times since admission. 3. Pt. Is cared for by a grandchild with some serious anger issues. Constantly threatening and initiating legal action (not against us), refusing to allow patient to receive pain meds resulting in violent and aggressive behavior directed at us - I'm talking drawing blood-, granddaughter constantly screaming and cursing at us. 3. Our program manager refuses to discharge anyone, Including this one, with one FNP actually quitting our program because they couldn't stand the abuse anymore. 4. Pt. Revoked hospice at family request this weekend, again, as a result of gangrene escalating to sepsis to LE complicated by PVD and 100% dependence for bed mobility. 5. As is customary, I went to the hospital to coordinate care with the hospital staff and spoke with the patient's assigned nurse at the nurse's station. 6. While nurse and I were together, speaking in lowered voices in what I was confident was incidental disclosure....... 7. ....I was unaware that one of the CNA's working on the unit had come into the nurse's station and was hovering to eavesdrop on our discussion. 8. Charge nurse was saying some pretty crappy stuff and I was agreeing with and validating her frustrations. Not bad mouthing anyone, just listening to her vent and telling her that she wasn't the only one who'd dealt with all of the above referenced behavior from the patient's family. 9. Aforementioned CNA happened to be a close friend of patient's really angry family member. 10. I received a call this evening from said family member screaming at me, repeating the conversation the nurse and I had almost verbatim. She admitted that the CNA was her "best friend" and the CNA told her everything. I got the family member calmed down and rational somehow by the grace of God by the time the conversation was over but I'm pretty angry myself. I'm pissed that my boss allows us to be treated this way. I know it's "part of the job" especially at end of life. It is what it is but I as a former hospice administrator and an RN, I have a zero tolerance policy for yelling, threatening and otherwise abuse of staff. It's one thing to vent and work though grief. Quite another to threaten staff, scream, curse, and otherwise bully them and attempt to intimidate with fear. This CNA violated HIPAA. I'm concerned that this could somehow be turned against me and I take HIPAA pretty seriously because that's just what we do. Not sure how to proceed as far as telling my boss, who is very open in letting us know he doesn't care and doesn't appreciate us making waves. Lay low, be quiet and "grow the program" (increase pt. Census). How do I handle this? What should I have done differently ? Thanks in advance for insight. ***edit: I work in an Interdisciplinary care model very similar to hospice except that we care for patients across at every stage of disease and life, so we frequently discuss and care plan for patient and family behaviors and responses to interventions. Just to clarify that I wasn't gossiping or bad mouthing anyone. No name calling or any of that.

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