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[GapRN]

I had a patient from a SNF who had a unique Dx that I really wanted to follow. I had no experience with this Dx and I could only get orders from nurses memory. The SNF MD said he only transcribed orders from hospital and would not giver orders AND could not identify hospital MDs, nor  could the SNF's medical record dept.  I had no orders for a week and was not comfortable with what I heard via word of mouth but supposedly it was a daily dressing change and SOMETHING had to be done. I tried to have CG do it to CYA but they could not. They started crying, not just from freaky intervention, but general stress and I needed to jump in. I sent pt to ER after for S/Sx probably resulting from delayed Tx.

FINALLY a hospital CM called me and it looked like I could get orders, talk to MDs etc, but my boss was freaked out since we had followed this complex case for a week with no orders and he wanted to refuse referral. Like I said, I really wanted to follow, and more important, I felt responsible to be pt advocate as family was stressed and we had build good rapport.  My boss got increasingly agitated - coordinating with CM took most of a day and my boss really wanted to dump the pt. I really don't understand because the process of resuming care would have addressed our concerns and we would be legit, AND I would get to follow this cool case, AND we could support this family in a tight spot.

 

Here's my question: We use Google Chats to text about pts. Suddenly, my boss removed me from the chat thread. There is information in the thread that I want. I have pending documentation for this pt that was created for me AFTER I was removed from case. Do I have any right to demand I be added back to the conversation?

 

On a side note - any idea why my boss is angry? His concerns would have been addressed if we just continued the conversation with the CM. I thought I was going above and beyond. Instead, I seem to have been secretly blacklisted. The scheduler has not been sending new pts my way and when they do, it is one time visits, covering for other nurses, or obvious social disasters that will take tons of time and likely be non-admit.