Mrs Doolittle

Many of my best friends are physicians: OB/GYN, Hospitalists, Surgeons and Internists. I'm married to an Anesthesiologist. They ALL work long and hard hours. I feel that we all work hard in our own areas of specialty, whether an MD, RN, LPN, CNA etc. Comparing our work to theirs is like comparing apples to oranges and futile.

I think 2300 hrs is late. The physician may have ordered the abx but if he's seeing a large number of pts per day, it may be asking a lot to ask for his total recall at that hour. No, he shouldn't have yelled at you but I think the med reconciliation could have waited until morning. I've grown a thick hide over the years. Nothing much bothers me these days. Many years ago a doc swore at me "the f word" when I had to call him for an emergency c-section. He had been up all night.... had probably just gotten into bed, when I called him back. I happened to see a card soon after that incident that said "50 ways to use the f word". I bought it and gave it to the doc who swore at me. I told him he should keep handy it incase he ran out of ideas in the middle of the night. My co-worker was being yelled at on the phone. In the middle of the ranting, she say "Dr Paul.... I love you". It got the doc to shut up and listen to her. I laughed so hard, my belly hurt. Last week I had to call a doc about taking on a pt who was going to a LTC facility and that I needed him to complete the forms. He whined and complained for about 5 minutes. I didn't argue but listened to him and then asked if he felt better, and told him I wish I could get him a cup of tea or coffee if he was having a rough day in the clinic. Then he say "thanks so much for letting me whine. Fax the forms, and I'll look over them later".

Do you have a Hospice physician you can discuss this with?

I was in an unoccupied pt's room getting it ready for an admission when I was slapped hard on the back. The room is small. There is no way someone could have snuck in w/o me knowing... besides, my back was to a wall. I froze and when I finally built up the courage to walk out, I turned to look and saw nothing. Another night, I it looked like one of my co-workers was going into the supply room. I walked in after her to ask if I could do anything to help.... and there was no one. There was only one way in or out. Close to that time, I was walking the hall making rounds. I walked by a room and saw my co-worker bent over a pt. I went to the nurse's station and there she was! There was only 2 of us, so when I asked her where she was the last 45 seconds, she said she had been there for the last 15 minutes charting. We 2 chickens walked back to that room but there was no one in the pt's room. Other nurses began to complain of odd sightings so our supervisor called in the Hawaiian priest to have the floor blessed.

It would be beneficial if you knew what the CM's role was. Having Utilization Review experience would also definitely help. If you want something low key, where you can leave exactly at 1700, then this is not for you. There is constant pressure to keep LOS down. Pts, their family and docs are notorious for changing their minds at the last second. Be prepared to do a 180, 30 minutes before the end of your day on Friday. The traits we like to see in CMs are: organization. Your desk can be a wreck but hopefully your brain has everything in order. Must be able to multi-task to the extreme. I mean about like 5 'projects' stewing all at the same time on many days :sstrs:. You need to have a plan A, B and sometimes D and E! You need to be able to smooth talk docs into what you want. You need to be able to think outside the box and quickly :thnkg:. You may have a 35 pt load and your buddy may have 18, but if she's not done at 1630 and you are.... you roll up your sleeve and dive in. No man left behind is our dept rule. I am blessed that our small 4 person dept is a well greased, tight unit where we get along marvelously. We are also friends and nsg school classmates etc. We've had some personnel in the past who disappeared during the day. One just never answered her pages. Claimed her pager didn't work even after being replaced numerous times. I offered her my pager since it works every single time! Some did not react to the stress very well and locked themselves in the bathroom for 45 min and longer, several times throughout the day! One didn't actually see their pts but claimed to have done so in their charting. She was busted when she claimed the husband provided excellent home care. Well... the demographics were not updated and the pt's spouse had died several years ago. Pt had no other family and was living alone