Recently, it seems like we've had a flurry of facilities whose staff has been unwilling, for one reason or another, to speak with our nurse advocates over the phone. Last week, I was asked to intervene in a case where our nurse advocate was having difficulty getting information DESPITE a signed authorization and consent on the chart. It was Friday afternoon–notoriously a sketchy time in many industries for cooperation (after all, it's almost 5PM somewhere!) but I was hopeful that I might connect with the CNO (chief nursing officer) and move things forward. What an optimist I am.
I WAS lucky enough to actually get the CNO on the phone, but that was where my luck stopped. Upon introducing myself and explaining why I was calling, she launched into a voice-raising tirade that her nurses "were not going to give any medical information over the phone." I was surprised by the energy behind her resistance. Even when I calmly pointed out that the patient had signed an authorization and had identified us as able to speak with staff on her behalf, she would not relent. Did I mention it was Friday afternoon?
Not in the mood to argue with her, I tried my best to de-escalate and get off the phone knowing I was not going to change her mind. When she persisted, I did consider ever so briefly that I wanted to say, "OK, so your nurses won't give medical information. What information WILL they give?? Flight information?" Just to poke her into realizing the absurdity of what she was saying. After all, it's a hospital!
As it turned out, I finally did speak with the hospital attorney who agreed that the signed consent did give us the ability to speak with the nursing staff AND the physician staff on the patient's behalf. We did get the information we needed to help the patient and her family. And I gently suggested to the attorney that she might want to speak to her Chief Nursing Officer and update her on the legal guidelines that her nursing staff SHOULD be following.
It makes me sad when nurses block other nurses (or anyone for that matter) when there is no good reason other than obstructing the flow of communication. And we wonder why healthcare needs reforming!
…and then we wonder why patients have trouble themselves obtaining information on their own plan of care etc etc.