My hospital is restricting visitors and holding open forums for frontline staff to discuss concerns (remotely) with administration. More has been done on the outpatient side as well which doesn’t impact me. We also downgraded isolation to droplet/contact from airborne unless it’s during an invasive airway procedure. My biggest frustration is the lack of testing ability granted by the state DPH, I understand that it’s due to lack of tests but it’s frustrating and negligent. If we’re expected to care for patients who may later eventually result positive but were denied testing we’ll be no better off than the nursing home in Kirkland with a large Covid + staff. The best we’re promised is workman’s comp, maybe, If anyone requires quarantine or ends up positive. I feel like I’m a constant ball of anxiety.
Our hospital released a memo yesterday that staff 65+ and those with “documented medical conditions at higher risk of covid” may be eligible for unpaid leave. My boss said all I need to start the process is a letter from my doc, then we can meet together with HR
I reached out to my GI; the NP responded to my email request for a letter (just stating I’m under their care to receive immunosuppressant therapy).
The NP responded to my email saying she didn’t think it was time to take a LOA yet, which seemed like a “no” to the letter request. Never mind that we have community spread, current COVID patients at my hospital, and the doors are still open at my hospital for SLPs to be called in as “essential” per the discretion of treating MD.
I responded that I wasn’t requesting a LOA letter but instead just a letter to document the immunosuppressant therapy I receive under their care. No response.
I cried out of frustration yesterday and I’m still upset today. It feels like HR is taking this more seriously than my actual healthcare providers.
That’s really fucking annoying. I always fill out any paperwork or doctors notes anytime someone asks me. If someone asks me to say they can’t go to work for 2 weeks I happily write it. I really don’t care, it’s no skin off my back. I hope you get your letter ASAP.
ETA: and my work says to talk to a manager if you have health concerns. They aren’t requiring a doctors note. It’s also doubly annoying when employers put paperwork burden on doctors and patients in many instances.
Our hospital released a memo yesterday that staff 65+ and those with “documented medical conditions at higher risk of covid” may be eligible for unpaid leave. My boss said all I need to start the process is a letter from my doc, then we can meet together with HR
I reached out to my GI; the NP responded to my email request for a letter (just stating I’m under their care to receive immunosuppressant therapy).
The NP responded to my email saying she didn’t think it was time to take a LOA yet, which seemed like a “no” to the letter request. Never mind that we have community spread, current COVID patients at my hospital, and the doors are still open at my hospital for SLPs to be called in as “essential” per the discretion of treating MD.
I responded that I wasn’t requesting a LOA letter but instead just a letter to document the immunosuppressant therapy I receive under their care. No response.
I cried out of frustration yesterday and I’m still upset today. It feels like HR is taking this more seriously than my actual healthcare providers.
That’s really fucking annoying. I always fill out any paperwork or doctors notes anytime someone asks me. If someone asks me to say they can’t go to work for 2 weeks I happily write it. I really don’t care, it’s no skin off my back. I hope you get your letter ASAP.
ETA: and my work says to talk to a manager if you have health concerns. They aren’t requiring a doctors note. It’s also doubly annoying when employers put paperwork burden on doctors and patients in many instances.
Is this true of STD paperwork as well?
I have an employee who frequently gives me doctor's notes, but unless the STD or FML forms are approved by our benefits coordination company, I don't really care what the doctor's note says. Our benefits company (we farm it out) decides based on the doctor's form if you qualify for FML or STD.
^^ that is all for extended or repeated medical absences. If it's a one day thing and you just want to use PTO for a sick day, a doctor's note is also meaningless because I'll just approve your PTO.
That’s really fucking annoying. I always fill out any paperwork or doctors notes anytime someone asks me. If someone asks me to say they can’t go to work for 2 weeks I happily write it. I really don’t care, it’s no skin off my back. I hope you get your letter ASAP.
ETA: and my work says to talk to a manager if you have health concerns. They aren’t requiring a doctors note. It’s also doubly annoying when employers put paperwork burden on doctors and patients in many instances.
Is this true of STD paperwork as well?
I have an employee who frequently gives me doctor's notes, but unless the STD or FML forms are approved by our benefits coordination company, I don't really care what the doctor's note says. Our benefits company (we farm it out) decides based on the doctor's form if you qualify for FML or STD.
^^ that is all for extended or repeated medical absences. If it's a one day thing and you just want to use PTO for a sick day, a doctor's note is also meaningless because I'll just approve your PTO.
Is what true? If it’s "official" paperwork then I fill it out truthfully or how the patient asks me too. I mean if I have no documentation that the patient has ever been diagnosed with something then no I won’t put a random diagnosis on their paperwork. But if they have a diagnosis and say they’ll need restricted hours at work or need to sit down then I put that in. Or for some of the questions I write in I don’t know because they ask ridiculous things. In my experience most people aren’t trying to game the system so I don’t feel like I should be the gatekeeper to their well-being.
Our hospital released a memo yesterday that staff 65+ and those with “documented medical conditions at higher risk of covid” may be eligible for unpaid leave. My boss said all I need to start the process is a letter from my doc, then we can meet together with HR
I reached out to my GI; the NP responded to my email request for a letter (just stating I’m under their care to receive immunosuppressant therapy).
The NP responded to my email saying she didn’t think it was time to take a LOA yet, which seemed like a “no” to the letter request. Never mind that we have community spread, current COVID patients at my hospital, and the doors are still open at my hospital for SLPs to be called in as “essential” per the discretion of treating MD.
I responded that I wasn’t requesting a LOA letter but instead just a letter to document the immunosuppressant therapy I receive under their care. No response.
I cried out of frustration yesterday and I’m still upset today. It feels like HR is taking this more seriously than my actual healthcare providers.
That’s really fucking annoying. I always fill out any paperwork or doctors notes anytime someone asks me. If someone asks me to say they can’t go to work for 2 weeks I happily write it. I really don’t care, it’s no skin off my back. I hope you get your letter ASAP.
ETA: and my work says to talk to a manager if you have health concerns. They aren’t requiring a doctors note. It’s also doubly annoying when employers put paperwork burden on doctors and patients in many instances.
Thanks for sharing your perspective. I know I have heightened anxiety about this situation in general so I wasn’t sure if my response was an overreaction. It’s all triply annoying because I had an employment physical with a staff physician in May of 2019 where I disclosed my immune status and they have all the info on my meds etc.
With the way things are progressing, it seems like risk can drastically change every day or so. I have a boss and HR team that are willing to explore this... and I’m hitting a road block from my own GI team?? It feels twisted.
I have an employee who frequently gives me doctor's notes, but unless the STD or FML forms are approved by our benefits coordination company, I don't really care what the doctor's note says. Our benefits company (we farm it out) decides based on the doctor's form if you qualify for FML or STD.
^^ that is all for extended or repeated medical absences. If it's a one day thing and you just want to use PTO for a sick day, a doctor's note is also meaningless because I'll just approve your PTO.
Is what true? If it’s "official" paperwork then I fill it out truthfully or how the patient asks me too. I mean if I have no documentation that the patient has ever been diagnosed with something then no I won’t put a random diagnosis on their paperwork. But if they have a diagnosis and say they’ll need restricted hours at work or need to sit down then I put that in. Or for some of the questions I write in I don’t know because they ask ridiculous things. In my experience most people aren’t trying to game the system so I don’t feel like I should be the gatekeeper to their well-being.
I meant,for STD paperwork do you fill in whatever they say.
I find it interesting because you don't want company doctors being the gatekeepers, but I didn't expect hat physicians fill out whatever the patient says. I guess I think as a company we should pay for the physician's time to accurately assess the specific questions we need answered.
Is what true? If it’s "official" paperwork then I fill it out truthfully or how the patient asks me too. I mean if I have no documentation that the patient has ever been diagnosed with something then no I won’t put a random diagnosis on their paperwork. But if they have a diagnosis and say they’ll need restricted hours at work or need to sit down then I put that in. Or for some of the questions I write in I don’t know because they ask ridiculous things. In my experience most people aren’t trying to game the system so I don’t feel like I should be the gatekeeper to their well-being.
I meant,for STD paperwork do you fill in whatever they say.
I find it interesting because you don't want company doctors being the gatekeepers, but I didn't expect hat physicians fill out whatever the patient says. I guess I think as a company we should pay for the physician's time to accurately assess the specific questions we need answered.
Well I mean some of the questions are like "how many hours off per week will this patient need due to their illness?" I don't have a crystal ball. It's easy if someone is getting PT for X amount of time so can say they have a PT appt every Thurs at 3pm. But most illnesses aren't black and white. Someone might have a flare and we can't predict that. And patients shouldn't have to rush to the doctor for a flare for a chronic illness they can manage at home, so I don't always know when a patient might be having a flare. So for that I go by what the patient tells me. They'll tell me yeah I typically have to take off 2 times per month for a flare and I don't question them, I just write it down.
For things like how much can a patient lift. Well I don't have dumbbells in my office to figure out how much a patient can lift. In an ideal world patients would be able to get PT, OT, etc to deeply assess all these things, but people can't take more time off work to go to all these appointments and then get the reports to give back to me. Not realistic in today's landscape. So I do the best I can based on my medical opinion and what the patient is telling me is happening in their lives.
Also, I'm not a specialist. A lot of specialists have started refusing to fill out paperwork for patients which makes me so angry. Therefore it is left to us to fill out the paperwork for a condition we're not 100% managing. We get so much paperwork for so many things. Sorry paperwork has just gotten out of control the past few years!
If you're talking about your company paying an occupational physician through a certain company to do these specific assessments then I guess that's a different situation. But I'm not occupational med and exactly no one is paying me extra to spend hours per week on paperwork, therefore I fill it out accurately with my medical expertise and the patients input.
Post by wanderingback on Mar 14, 2020 20:04:20 GMT -5
tacom, no not unreasonable at all. If someone wants me to list their diagnosis or a class of medication they're on I do it in a heartbeat. Those are actually the easiest letters/paperwork to complete!
If you work in a hospital, do you know if they’re canceled elective surgical cases?
Some of the adult hospitals in town have.
I think we will be moving to do the same tomorrow.
I do not work in a hospital but I know that I have two different friends who had elective surgery at two different hospitals on Thursday and both of them were the last electives their hosp did. My countu is currently shut down except for essential businesses so I’m sure that factors into it.
I just read this thread for the first time. michelle, saying health care workers know what we signed up for is really shitty. No. We didn't sign up to get verbally, or physically abused by patients which happens way too often. We sure as hell didn't sign up to work without proper protective gear and expecting someone to do so is what I think is unethical.
I know that hospital administration is thinking of the financial hit canceling procedures will inevitably lead to.
@@@@
I have staff that aren't coming to work for many reasons, not really of fear of getting the virus (yet) but more for not having options for childcare.
H has to see patients. He is setting up televisits for those patents that can be seen that way.
I have to keep the clinic I am in running and seeing patients. I'm more in the management side of nursing and not as much hands on bedside care. now. We have plans made up in the instance of having staff decreasing by 25%. It will be an incredible mental and physical load for staff.
I just read this thread for the first time. michelle , saying health care workers know what we signed up for is really shitty. No. We didn't sign up to get verbally, or physically abused by patients which happens way too often. We sure as hell didn't sign up to work without proper protective gear and expecting someone to do so is what I think is unethical.
Can I like this a million times?
Maybe some day I'll share the story where I was assaulted at the bedside. HR's response? "Why did you shut the door to the room?" Because the female patient was getting bathed. Forgive me if I don't trust HR.
I just read this thread for the first time. michelle , saying health care workers know what we signed up for is really shitty. No. We didn't sign up to get verbally, or physically abused by patients which happens way too often. We sure as hell didn't sign up to work without proper protective gear and expecting someone to do so is what I think is unethical.
Standing ovation!!! (I glossed over her post or I would've said something originally, thank you for saying something)
My mom is the same (RN, outpatient clinic manager) but she was a flight nurse for years. She got stuck on a pt transport of a COVID patient a couple days ago and is now in quarantine. Rural medicine = all hands on deck = she was the only one with the requisite training and experience to life flight the patient. Her employer is covering all the medical care and required leave time but she's 63 and I'm hoping she finally decides enough's enough.
I am a flight nurse.
My boss has stated we will absolutely NOT be transporting any COVID patients or suspected COVID patients. Well that's fine and dandy but the pt could have COVID and not tested, or it could be community acquired and thus not hit the testing criteria. We don't think our boss really thought this through.
The hospital has limited visiting to 2 people, no one under 18, no one with respiratory symptoms. No volunteers. No students. NICU has limited visitors to parents only.
Your boss sounds like he shouldn't really be a boss. What's he going to do, send all the potential COVID cases (incl those who might be something else like regular pneumonia or fungal pneumonia) home to die?
I just read this thread for the first time. michelle, saying health care workers know what we signed up for is really shitty. No. We didn't sign up to get verbally, or physically abused by patients which happens way too often. We sure as hell didn't sign up to work without proper protective gear and expecting someone to do so is what I think is unethical.
This!!
@@@@@@ I hate how nurses are just expected to take abuse and smile. A dad of a patient threatened me when we were alone in a room and they assigned me to that same patient the next two days. I wish I'd stood up for myself and refused the assignment.
I just read this thread for the first time. michelle, saying health care workers know what we signed up for is really shitty. No. We didn't sign up to get verbally, or physically abused by patients which happens way too often. We sure as hell didn't sign up to work without proper protective gear and expecting someone to do so is what I think is unethical.
This!!
@@@@@@ I hate how nurses are just expected to take abuse and smile. A dad of a patient threatened me when we were alone in a room and they assigned me to that same patient the next two days. I wish I'd stood up for myself and refused the assignment.
It’s definitely not a nursing only thing. Doctors, medical assistants, care techs, etc all unfortunately deal with it :/ It’s definitely not something talked about enough in school and it’s horrible when you don’t have administration backing you. I think as women especially we need to get better about having clear messaging for patients like this. I’ve gotten a little better over the years and am more firm and leave the room, but it’s definitely hard with racist, sexist and just mean comments. Ugh.
My boss has stated we will absolutely NOT be transporting any COVID patients or suspected COVID patients. Well that's fine and dandy but the pt could have COVID and not tested, or it could be community acquired and thus not hit the testing criteria. We don't think our boss really thought this through.
The hospital has limited visiting to 2 people, no one under 18, no one with respiratory symptoms. No volunteers. No students. NICU has limited visitors to parents only.
Your boss sounds like he shouldn't really be a boss. What's he going to do, send all the potential COVID cases (incl those who might be something else like regular pneumonia or fungal pneumonia) home to die?
@@@@@@ I hate how nurses are just expected to take abuse and smile. A dad of a patient threatened me when we were alone in a room and they assigned me to that same patient the next two days. I wish I'd stood up for myself and refused the assignment.
It’s definitely not a nursing only thing. Doctors, medical assistants, care techs, etc all unfortunately deal with it :/ It’s definitely not something talked about enough in school and it’s horrible when you don’t have administration backing you. I think as women especially we need to get better about having clear messaging for patients like this. I’ve gotten a little better over the years and am more firm and leave the room, but it’s definitely hard with racist, sexist and just mean comments. Ugh.
I hope you’re staying safe!
Thank you. You are 100% right, I should have included all of the medical staff. It is really hard to feel like you can stand up for yourself when you are taught to care for others. I am sorry that you have to deal with that as well. You stay safe too
Post by wanderingback on Mar 15, 2020 16:36:32 GMT -5
My clinic is encouraging us to call patients for all non-essential appointments to do the appointment over the phone. I do wonder what the financial implications of this are going to be since we don't get paid for phone calls.
@@@@thankfully they clarified that abortion care is considered essential care and we'll be keeping those appointments (some institutions have been trying to say the opposite :/)
We've rearranged clinic to have a respiratory only floor, we're going to take turns seeing patients there. Things are changing rapidly and I'm glad we have plans in place.
My clinic is encouraging us to call patients for all non-essential appointments to do the appointment over the phone. I do wonder what the financial implications of this are going to be since we don't get paid for phone calls.
@@@@thankfully they clarified that abortion care is considered essential care and we'll be keeping those appointments (some institutions have been trying to say the opposite :/)
We've rearranged clinic to have a respiratory only floor, we're going to take turns seeing patients there. Things are changing rapidly and I'm glad we have plans in place.
Has your state authorized emergency reimbursement for tele-appointments? Both the state where I live and the state where I work have done that in Medicaid and all major insurance carriers.
My clinic is encouraging us to call patients for all non-essential appointments to do the appointment over the phone. I do wonder what the financial implications of this are going to be since we don't get paid for phone calls.
@@@@thankfully they clarified that abortion care is considered essential care and we'll be keeping those appointments (some institutions have been trying to say the opposite :/)
We've rearranged clinic to have a respiratory only floor, we're going to take turns seeing patients there. Things are changing rapidly and I'm glad we have plans in place.
Has your state authorized emergency reimbursement for tele-appointments? Both the state where I live and the state where I work have done that in Medicaid and all major insurance carriers.
Yes I believe so, we got an email from the DOH. Thanks for checking. Unfortuntely that doesn’t help a lot of our patients though whom don’t have internet access/smart phones/ongoing phone plans. The majority are low income. So for now we’re just making it work with phone calls. Our EHR is trying to set up telehealth this week for those who are able to utilize it.
Has your state authorized emergency reimbursement for tele-appointments? Both the state where I live and the state where I work have done that in Medicaid and all major insurance carriers.
Yes I believe so, we got an email from the DOH. Thanks for checking. Unfortuntely that doesn’t help a lot of our patients though whom don’t have internet access/smart phones/ongoing phone plans. The majority are low income. So for now we’re just making it work with phone calls. Our EHR is trying to set up telehealth this week for those who are able to utilize it.
Ugh yes, that is absolutely a challenge. Hopefully by moving the patients who are able to virtual appts it will at least help reduce the number of people coming through for the time being. Good luck, this is such a trying situation for you all on the front lines.