Scheduling drama

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Since I started in home health and hospice it’s gone from patients being OK with just knowing the day and whether it would be an a.m. or p.m. visit, to giving a two hour window, to now at best convincing them to allow a one hour window, but many patients seeming to think that the nurses are like Uber and they just push a button and we show up when it’s most convenient for them.

Is this something you all are noticing to? I was also wondering if it’s maybe regional, I’m in a big city and maybe people are more entitled and demanding here. I’m from here, so it’s not like I just moved somewhere and have an impression of people, I’m just trying to think of why this is happening.

It’s gotten to the point where I end up having to let the office know I’m not going to be able to see almost 25% of the patients that are assigned to me, due to the fact that the patients can’t make reasonable accommodations for my visit.

For example, I have a patient who only wants me to come at 10 AM, because she wants to be fully dressed for the visit and receive me in her kitchen, but doesn’t want to get up too early, then wants to have lunch at a specific time, and doesn’t prefer any visits in the afternoon, which she also has several reasons for. Based on my other visits and where she lives, I would end up having to drive 20 miles out of my way just to see her at this preferred time instead of seeing her in the early afternoon with another a cluster of visits in her area, or as my first visit to get hers out of the way. Her visit is not time specific, a couple of the other patients in her area are, that’s why it would need to be early afternoon, or like I said I’d be ok with seeing her first in my day. But she’s firm on 10 am only. This is for a simple wound care procedure 2x a week.

I used to give in when it was only one or two patients doing this, it now it’s the majority and it would be physically impossible for me to meet all of their scheduling demands. What do you guys say when patients are this demanding, and is your agency accommodating to you, or do they try to force you to accommodate the patients?

Zippy83

74 Posts

To clarify, if I did see her first thing in the morning it would be Monday/Thursday, or on Tuesday/Friday I can see her with that other cluster of patients in the area. Those were the options I gave her, both of which she declined. I just wanted to clarify that because otherwise it could seem like I’m saying I will either go in the morning early afternoon and might not make sense.

tjean5377

2 Posts

Specializes in med surg/onc/home care/LTC.

Give an inch and a mile is taken. If I can schedule my cluster I always do, you have given her options and she is adamant to have what she wants, PUT IT BACK TO YOUR SUPERVISOR and document CLEARLY she has refused your offers and flexibility. Maybe a per diem can see her at the time she wants once a week and you can see her once a week clustering in the morning. all patients cant have the times they want all the time. Can family do the dressing? also notify the physician if she refuses for the day to CYA. BE CRYSTAL CLEAR. "I WILL be there 2-4, as I work in efficient time sensitive geographical rotation, I am UNABLE to deviate do to all patients needs as I cover a large geographical area" Do not give wiggle room more than that. IF she refuses then cancel and document she does not want the time frame you provide. YOU ARE NOT A SERVANT.

Elfriede

257 Posts

Specializes in ambulant care. Has 40 years experience.

"Pt´s and the time" is a neverending story.

My favourite is :

"Quater to eight is much to late and 7.45 much to early !"