That is not how you address one on the telephone.. *vent*

[Forever Sunshine]

One of my residents was sent out to the hospital today. This evening I called over to the ER to check on how he was doing. I had to explain why I was calling about 4 different times to 4 different people.. and not one of them was polite. I was literally treated like a telemarketer.

I mean even when I'm having the worst of days.. I still manage to dig deep down and find a smidgeon of a good mood to at least smile and act humane to the person on the telephone.

Don't think thats asking for too much. My job is busy too.

[David13, MSN, RN]

It appears that, irrespective of HIPAA interpretation, we can all agree that rude telephone behavior by health care professionals should not be condoned.

[roxxy3773, RN, APRN]

When I worked for a rehab it was also our policy to call and get the admission diagnosis, I think it is pretty common.

[Double-Helix, BSN, RN]

Correct me if I'm wrong, but haven't nursing home residents already given permission for the the LTC facility to access their medical information? It sounds like we're saying that if a PCP refers a patient to a specialist, the PCP can't get the medical results without another release of information from the patient.

[eriksoln, BSN, RN]

we need to document the admitting diagnosis and time of admission when transferred to another facility in a nurses note. thats our resident.. we need to know whats going on with them also. facility's policy. i'm not asking for day-to-day updates but when they are admitted we contact them(sometimes they contact us and if they pass away the hospital also calls us). but if they refused to give me the information..(politely)... i would just of course document that and make my supervisor and don aware. impolitely, i would also be making the supervisor and don aware of their attitude as well as their refusal to inform me of the admitting diagnosis.

ok this isn't about making the call or whats being discussed.. its how we are treating each other.. as professionals on the phone.. and those nurses i talked to yesterday.. were not very professional.

thank you. that is my point here.

i'm not asking for a bow or to be addressed "your majesty" but a "hello" and "goodbye" would be appropriate.

it appears that, irrespective of hipaa interpretation, we can all agree that rude telephone behavior by health care professionals should not be condoned.

i don't think you can separate the two issues though, they are not islands. if the root of the "rudeness" is that they, like me, are nervous about whether they should be talking to you at all...............well. that is what i'm willing to bet, that more than a few of the rude ones have the same questions i have and instead of simply refusing to answer (politely), are being passive aggressive.

i do, from time to time, get that passive aggressive nippy nasty phone call. there are people who just are that way regardless of what's going on or who the caller is. but you are saying it happens very frequently, or at least it seems that way. what was it, like 5 different nurses in the same night? soooo.........i would follow that with.....its not just dumb luck that you keep getting connected with mrs./mr. nippy nasty. there is more too it. for me..........the "more" is..............a lot of them think they're not supposed to be talking to you.

correct me if i'm wrong, but haven't nursing home residents already given permission for the the ltc facility to access their medical information? it sounds like we're saying that if a pcp refers a patient to a specialist, the pcp can't get the medical results without another release of information from the patient.

not necessarily. once they are discharged, i imagine most permissions they gave are null/void. mind you, i said "i imagine" the permissions are null/void. i'm not certain if they are or not.

its not the same as seeing a specialist who then talks to the pcp. with this relation, it is understood the pcp is still the pcp. once a patient is d/c'd from ltc......they may or may not return. the ltc facility often holds the bed but that is their choice, there are no guarantees the pt is returning. close to 50% of the people i get from ltc facilities in fact are refusing to return to their former place of stay. they often blame their former facility for the downturn in health leading to them being admitted to the hospital. thats where my idea that the phone call is merely defensive charting comes from.

so, i would say it is more like.............someone going to see a specialist but at the same time is heavily considering a change in pcps.

[Callisonanne]

Nothing bothers me more than disrespectful phone calls. The more disrespectful you are the more I say "ohh thank you so much for being SO nice and helpful...have a LOVELY day"

[eriksoln, BSN, RN]

Nothing bothers me more than disrespectful phone calls. The more disrespectful you are the more I say "ohh thank you so much for being SO nice and helpful...have a LOVELY day"

There is a case manager on my unit like this. When nurses try to blow her off she reacts like this. Its funny to watch because you'd think it would come off as sarcasm, but it doesn't, she looks/acts like she is seriously complimenting them.

Then they are left standing there with this "Ummmm..........I don't have a response for that, I thought you wanted to fight" look.

[Altra, BSN, RN]

. once they are discharged, i imagine most permissions they gave are null/void. mind you, i said "i imagine" the permissions are null/void. i'm not certain if they are or not.

its not the same as seeing a specialist who then talks to the pcp. with this relation, it is understood the pcp is still the pcp. once a patient is d/c'd from ltc......they may or may not return. the ltc facility often holds the bed but that is their choice, there are no guarantees the pt is returning. close to 50% of the people i get from ltc facilities in fact are refusing to return to their former place of stay. they often blame their former facility for the downturn in health leading to them being admitted to the hospital. thats where my idea that the phone call is merely defensive charting comes from.

so, i would say it is more like.............someone going to see a specialist but at the same time is heavily considering a change in pcps.

i disagree. leaving the ltc because emergency evaluation/treatment is needed does not equal discharge. i'm not an expert -- but i'm sure an ltc nurse here could elaborate on the complicated regulations on bed holding, etc.

i perceive no problem at all, in terms of hipaa, in communicating with other health care professionals about patients who are in their care. in fact, i very much appreciate it when an ltc nurse calls the er to check on the status of one of their residents: it proves to me that they sent the patient out with a legitimate concern, rather than paring down their resident census because it's a holiday/weekend/a day with particularly short staffing.

(save the flames: it happens, and we all know it. if it doesn't happen where you work, good for you, and good for your residents)

[eriksoln, BSN, RN]

I disagree. Leaving the LTC because emergency evaluation/treatment is needed does not equal discharge. I'm not an expert -- but I'm sure an LTC nurse here could elaborate on the complicated regulations on bed holding, etc.

I perceive no problem at all, in terms of HIPAA, in communicating with other health care professionals about patients who are in their care. In fact, I very much appreciate it when an LTC nurse calls the ER to check on the status of one of their residents: it proves to me that they sent the patient out with a legitimate concern, rather than paring down their resident census because it's a holiday/weekend/a day with particularly short staffing.

(save the flames: it happens, and we all know it. If it doesn't happen where you work, good for you, and good for your residents)

Yes, it is very complicated. So you are saying its not the same as a D/C. That's interesting and would explain the phone calls AND how HIPAA is being respected if the patient is not fully D/C'd from the prior facility. Actually..............TBH, I wonder if Case Managers aren't the best to answer this.

You might be right about that too that it is not complete D/C. I've had staff from other facilities, on the clock with their facility, come to be a 1:1 sitter with a special needs patient (autistic plus MR patient who rose OOB frequently). So, obviously, they are still on the case........................in some way/shape/form.

[David13, MSN, RN]

I don't think you can separate the two issues though, they are not islands. If the root of the "rudeness" is that they, like me, are nervous about whether they should be talking to you at all...............well. That is what I'm willing to bet, that more than a few of the rude ones have the same questions I have and instead of simply refusing to answer (politely), are being passive aggressive.

I disagree. In my opinion, there really isn't an excuse for rudeness, particularly when speaking with other health care professionals. I can certainly understand being frustrated. However, as a professional, if one is unsure regarding what information can be released in terms of HIPAA and, as was said, this situation occurs frequently for a particular individual, becoming better informed of how HIPAA applies to the situation would be expected. The alternative, providing a rude response because one is "nervous" or unsure of the situation, really helps no one and is not appropriate or professional.

[Forever Sunshine, ASN, RN]

There is a case manager on my unit like this. When nurses try to blow her off she reacts like this. Its funny to watch because you'd think it would come off as sarcasm, but it doesn't, she looks/acts like she is seriously complimenting them.

Then they are left standing there with this "Ummmm..........I don't have a response for that, I thought you wanted to fight" look.

I did that too and then she hung up on me then. I said a very cheery "Thank YOU and have a great night!" and she hung up the phone... no goodbye lol.

[Freedom42]

I work ED. It drives me crazy when people answer phones and don't identify themselves. It's rude. There's no excuse for it, but on the other hand, I'd point out that the OP doesn't know if the nurse taking care of his/her patient is receiving her fourth ambulance in an hour, either. Maybe there's a code -- or two -- going on. Maybe every bed is full, the waiting room is 30 people deep, and patients are crashing. Yes, rudeness is inexcuseable. But I try to give folks the benefit of the doubt when I can't see what's going on. It is, after all, an emergency department.

When I worked LTC and had to call the ER I now work in, I'd let the secretary know that I was calling regarding Patient X, needed an admitting diagnosis, and would appreciate a chance to speak to the ER nurse when it was convenient. Could I leave my number? I didn't have to explain my issue over and over again, and I wasn't pulling a nurse away from an emergent situation to ask questions for which there might not yet be any answers. If the nurse was nearby, the secretary would ask if he/she had a moment to talk with me. Often the secretary can answer: he's still being evaluated, or yes, he's being admitted, I'll have the nurse call you.

[eriksoln, BSN, RN]

I disagree. In my opinion, there really isn't an excuse for rudeness, particularly when speaking with other health care professionals. I can certainly understand being frustrated. However, as a professional, if one is unsure regarding what information can be released in terms of HIPAA and, as was said, this situation occurs frequently for a particular individual, becoming better informed of how HIPAA applies to the situation would be expected. The alternative, providing a rude response because one is "nervous" or unsure of the situation, really helps no one and is not appropriate or professional.

Yeah, but the "become better informed" part isn't that easy. Not that I've really put any effort into solving the riddle, but I'm willing to guess.............there really is no answer to be found.

Fill a room with 100 "HIPAA experts" and you are bound to get......oh, pretty close to 100 different answers to whether HIPAA has been violated or not.

But, eh, rudeness probably isn't the best retort if you believe it is a violation. Could simply just state your problem and put it on the table............"Sorry, but I'm uncomfortable answering this question." Or, you could simply go to the patient and ask for their permission to talk to the LTC facility. That would at least help if later on the question of HIPPA violation comes up.