Thinking ahead / Work Avoidance

[KalipsoRed21, BSN, RN]

So, I work at a crazy clinic. There are 9 surgical specialties that operate out of this clinic. On any given day we can have 2 - 3 different specialties running clinic simultaneously out of 8 rooms. We generally only have 20-30 patients a day, but we are having to do things like presurgical information & scheduling, set up & assist with procedures (cyst excisions/ cystoscopes), and preform nurse visits like wound checks and education/troubleshooting Foley catheters (or monthly catheter exchanges.) My co-workers are a young MA (this is her second MA position after working 9 months) and an LVN (20 + years in the field but her prior position was insurance based and at a computer). I am the one with the strongest clinical skills but a poor understanding of insurance and authorization needs. 
 

My co-workers are hard workers, but there is this thing they do that drives me batty. So for instance, I am usually the one up for clinical stuff and therefore they often leave Foley insertions/ cath exchanges for me, but they are capable of preforming most of the visits I do. We stagger start times. I walked in the other day and a patient had been scheduled for a voiding trial at 8am. I get there at 8:30. They had brought all the other scheduled patients back....even the ones that were scheduled for 8:15 and 8:30, but not the patient who was scheduled at 8am for a voiding trial. I know it is mostly because they didn't want to do it. And while that aggravates me, what aggravates me more is that they didn't bring the patient back to a room, get him checked in and pull out the supplies. I mean now this guy is not only not super happy about having a voiding trial, but he has seen 4 other people go ahead of him and he had an appointment at 8am. So why can my co-workers not tell that they should room him so he could at least know he wasn't being ignored...oh, yeah because they were just ignoring him because they didn't want to do it. 
And when pressed they just went on about how they were really busy rooming for the doctors but he was a nurse visit so they had to do for the doctors first. 
 

Yesterday a patient called at 4pm wanting to know why his colonoscopy got cancelled. We don't control that, but because our clinic is seen as part of the surgery process we are often included in emails on such things. My co-workers went on about how they hadn't gotten an order for Dominoes leaving the man on hold. I got frustrated and kind of loudly and curtly told them to put their conversation on hold and check the emails to see what was going on. (I was in the middle of doing something for another patient on hold.) So then everyone was complaining about how we aren't the surgery center and the patient shouldn't even be calling us (I'm like does it matter, he's calling and we can at least try to see what we can find out....the poor man had already taken his bowel prep and everything.). Finally someone found out that his insurance didn't have authorization (but in a weird way because it was TriCare). I had finished what I was doing and could help. So I started asking questions, because if I had to be the person to tell the man it was cancelled I wanted to be sure I could explain exactly to him why. All my co-workers were like "the billing department should have done that, you should just tell him to call them". The billing department normally does call...they had called and told him it was cancelled....he just had more questions. Turned out it was a small error on our office support staff that caused the lack of authorization and with some aggressive phone calling we were able to get it settled and him his procedure back on track. My co-workers feel this was excessive action on my part. I feel like this is what we should be doing...trouble shooting. 
I have shared these stories with my boss. She has no real suggestions to help. But I just get so frustrated with the lack of service they are willing to provide...,it is just so dumb.

 

But to be honest the service here in Texas has sucked ever since I moved back. I'd take healthcare in a blue state any day. I am surrounded by people who provide services in a manner that was occurring 10 years ago where I was living. The evolution....and apparently the law suits have not occurred here yet....so the service is just so very bad; but none of them can see it, including my boss.