Mapleandhoney2468

Thank you all for your advice!! I feel much less alone with this. This was the worst part of my time with this patient so far. Things are better now but the drama never ends with this patient whether caused by the patient or other healthcare staff. Case manager and I had a serious talk with the patient and he has since turned his attitude around and is working with a therapist on the anger issues. I had issues with old doctor throwing a temper tantrum of sorts (the patient really brings the worst out of people). Unfortunately the new doctor was MIA with 1.6 stars on Google reviews so it has been impossible getting orders for scans, labs, and meds. I had patient switch to another new doctor with 4.6 stars on Google reviews so we’ll see how that goes. Honestly this one patient alone required the work I put in for three, but I feel good overall about how this one turned out. I really hated how on edge I was throughout the process though, but what really changed things for us was the patient finally choosing to let go of that toxic negativity when he realized he would eventually have no one to do anything medical for him if he didn’t quickly change his ways. Soon I will be moving far, far away from this patient and the patron saint of patience will live happily ever after…. Until the next nightmare patient ?

I’m a new grad HHRN working at an agency without great support, but fortunately have a mentor who doesn’t work for them who has been awesome, but even she is not sure what to do here. I have a patient who has scared away all his healthcare staff except for me. In other workplaces I was nicknamed the ‘patron saint of patience’ so perhaps this is why I’ve lasted longer than the rest or maybe I’m the stupid one for not dropping the patient 2 weeks after SOC which is what other HHRNs at my agency would have done. The patient got kicked out of his previous insurance for noncompliance, then home health doctor service for this insurance discharged him for verbal abuse, then PCP discharged him officially a few days ago for noncompliance. Patient is overly demanding (very specific about how he wants things or what kind of products are sent or how things are done and calls 1-2 x’s a day to all healthcare staff). Patient keeps asking me to do things out of my scope of practice or that do not adhere to the standards of practice, which I feel puts me in a very difficult spot and is not fair to me and of course I refuse. Both the case manager at patient’s insurance and I are at the ends of our ropes. The patient has now 2 noncompliance letters with this insurance. For at least the next 3 weeks, this patient will have no doctor at all until he sees his new PCP (that is if he actually agrees to leave his house to see new PCP). Do I still see this patient? I have no one to report patient’s reportable symptoms to. I’ve been very stressed by this situation and I want to remove myself from this toxic situation, but I don’t feel I can without ‘abandoning’ said patient as no one in their right mind will take over for me as his RN. I would leave current agency due to lack fo support except I don’t have enough experience to start at another more legitimate and better organized agency yet. Current boss says I can see patient and mentor is unsure but thinks no I can’t see patient. Insurance case manager says you don’t need the doctor to continue visits. I am getting a lot of different answers. Please advise.

I’m having the same problem. I have found two instances. One difficult patient had two bath aides show up only once and then fraudulently chart the rest of the visits. Another had a PT only show up once and then skip the rest of the visits. Both times I had no way to prove this and only the patient’s word for it. We are supposed to have a sign in sheet in the patient’s house, but the healthcare staff other than me often do not sign the form. I’m so frustrated that my patients are not getting the care that they are supposed to and I have no way to hold them accountable. Can we GPS these healthcare staff? That’s what I do. I always have a GPS running tracking all my mileage and all my locations of where I am so that I always have proof. I wish we could require the other staff to do the same. Even if Medicare investigates I doubt they will have any way to exact justice or prove these people indeed didn’t show up.