Surprise mtg update

[OSman]

Infraction was that a nurse "felt I was annoyed and frustrated" by her. The long story short is as follows:

30 minutes after my patients scheduled appointment for suture removal they were still not seated. So I sat them myself, gathered my own supplies and removed sutures myself (can be difficult removing sutures in the mouth by ones self). As I was visiting with the patient, and basically done, the above nurse interrupted my visit not once but twice asking why I no longer wanted their help and if I needed the patient moved to a procedure room (in front of the patient). I wrote an email, kindly and calmly asking for that situation to never happen again. I've read the email several times now. It can in no way be perceived as hostile. But... that's what my meeting was about. There is obviously a background or inefficient work flow that I'm dealing with, but that is honest to god it. As the COS was explaining the situation to me, I asked if it sounded more ridiculous to him as he was actually verbalizing it for the first time. The message was lost and ultimately I'm the bad guy in the situation because I didn't do a good enough job making the inefficient nurse feel better about being bad at her job. Such is the culture of medicine now so it seems. We as a profession only have ourselves to blame as we basically gave our autonomy over to the administrators. When I say we I really mean our predecessors who cashed out and now our generation has to suffer the consequences.

nevertheless, I did not end up giving my notice. I will negotiate a few more minor details of my next situation and give my 60 day. My partner will be doing the same and that will be the end of the department. As the hospital has acquired more health systems over the past 6 months we have been noticeably more busy with facial trauma. As such, plans will be to gouge the hospital for call coverage as they will likely have a very hard time recruiting any replacement.

thanks again for everyone's advice. I hope we as a profession can figure out a way to take it back. Moving back to private sector, ASCs, etc is the best way I can think of.

[Bev]

1. Document everything!
2. Assume your emails will go to the COS.
3. Bite your tongue when you want to complain/vent about this nurse. Everything will get repeated.
4. Breathe!

[Tangler]

Hang in there. Sorry you are going through this. I recently experienced something somewhat similar. FU money is a good thing. Save $.

[MaxPower]

Thanks for the update. Sounds about right for what I expected—snowflake bad at their job who gets called out for it feels “threatened” and voices their displeasure to higher ups.

[Shant]

"She is correct. How do you in admin plan to address her behavior?"

[GastroMastro]

I like your use of the term ‘gouge’. I hope you follow through with it when they come asking for call coverage

[AR]

Infraction was that a nurse "felt I was annoyed and frustrated" by her. The long story short is as follows:

30 minutes after my patients scheduled appointment for suture removal they were still not seated. So I sat them myself, gathered my own supplies and removed sutures myself (can be difficult removing sutures in the mouth by ones self). As I was visiting with the patient, and basically done, the above nurse interrupted my visit not once but twice asking why I no longer wanted their help and if I needed the patient moved to a procedure room (in front of the patient). I wrote an email, kindly and calmly asking for that situation to never happen again. I've read the email several times now. It can in no way be perceived as hostile. But... that's what my meeting was about. There is obviously a background or inefficient work flow that I'm dealing with, but that is honest to god it. As the COS was explaining the situation to me, I asked if it sounded more ridiculous to him as he was actually verbalizing it for the first time. The message was lost and ultimately I'm the bad guy in the situation because I didn't do a good enough job making the inefficient nurse feel better about being bad at her job. Such is the culture of medicine now so it seems. We as a profession only have ourselves to blame as we basically gave our autonomy over to the administrators. When I say we I really mean our predecessors who cashed out and now our generation has to suffer the consequences.

nevertheless, I did not end up giving my notice. I will negotiate a few more minor details of my next situation and give my 60 day. My partner will be doing the same and that will be the end of the department. As the hospital has acquired more health systems over the past 6 months we have been noticeably more busy with facial trauma. As such, plans will be to gouge the hospital for call coverage as they will likely have a very hard time recruiting any replacement.

thanks again for everyone's advice. I hope we as a profession can figure out a way to take it back. Moving back to private sector, ASCs, etc is the best way I can think of.

Out of curiosity, why was the patient not taken back until 30 min after the appointment time.

I've been through a lot of similar situations, so I definitely feel for you. I'm happy for you that you have options and have found a good alternative.

With the way medicine is going, such alternatives are increasingly hard to find.

[CordMcNally]

What a joke...sorry you have to deal with such a system.

[Tim]

"Out of curiosity, why was the patient not taken back until 30 min after the appointment time."

• "the above nurse interrupted my visit not once but twice asking why I no longer wanted their help and if I needed the patient moved to a procedure room (in front of the patient). I wrote an email, kindly and calmly asking for that situation to never happen again."

There is a common theme here. Neither the nurse nor the physician are asked for an explanation. Those in charge, level criticism at individuals without seeking any explanation.
Everyone has a habit of "talking past the other" and making judgements on a personal level.

What can I do to help get patients roomed on time? I really do need your help, but.... It may not be the nurse. Or laziness. The hospital doesn't love the nurses back either.
The administrator likely sits on the nursing staff the same way as the physicians. Just a guess. Frustration on nurses and physicians both,

[doctorbone]

I would never survive in a hospital employed setting. I get annoyed if the patient isn’t roomed right away in an available room.

[GasFIRE]

OP - sorry you ended up in the administrative crosshairs for simply trying to do your job. In the future I suggest trying to incorporate patient satisfaction into the discussion. “My patient had already been delayed in the waiting room for 30 minutes past their appointment time. I didn’t want to take a chance on them giving us a poor evaluation on their patient survey.” Gotta talk to the priorities that administrators understand.

[AR]

OP - sorry you ended up in the administrative crosshairs for simply trying to do your job. In the future I suggest trying to incorporate patient satisfaction into the discussion. “My patient had already been delayed in the waiting room for 30 minutes past their appointment time. I didn’t want to take a chance on them giving us a poor evaluation on their patient survey.” Gotta talk to the priorities that administrators understand.

This is excellent advice and my default strategy if I find myself in such a situation.

[VagabondMD]

This is excellent advice and my default strategy if I find myself in such a situation.

Agree. Additionally, any time you can make it a quality or safety concern, you have won the point.

[wideopenspaces]

I'm so curious, what did they suggest you do instead?

[VagabondMD]

I'm so curious, what did they suggest you do instead?

In retrospect, even though the situation is frustrating, it would have been better to bring the issue to the attention of the nurse’s supervisor and maybe cc’ing the chief of service. I doubt that the OP is the direct boss. Even if he/she is the captain of the ship, he/she is probably not the boss, and directly disciplining the nurse is perceived as a breech of the chain of command.