At my current employer before I can send out records I must have the patients provider approve the request. If the patients provider is not there and it is urgent I can have the provider on-call review the chart. I can see both the pros and cons of this -- you know when someone is transferring care, but at the same time, could I just send records to Social Security and the jail when requested? Due to the length of time it takes to get an approval patients that are incarcerated are usually released before I get the records over there -- this can be an issue particularily for those on psych meds. The jail cannot give these medications without some sort of proof the patient takes these or even the dosage. Essentially I am wish I was allowed to THINK when doing my job.

Yesterday I received a release signed by a nurse investigating elder abuse. She also provided me with a a signed consent from the patients daughter stating that the nurse can access the records in the course of her investigation and a copy of the daughter's power of attorney. This patient has SEVERE dementia and her daughter makes her medical decisions. I also received a request for these same records from the county Seniors and People with Disabilities Department. All any of these people want is the last chart note and lab results from the past 2 weeks. The Lead Nurse has the chart and will not let me have it. The patient's provider was working at one of the other clinics yesterday and I tried to talk to the on-call provider about this and he went to the Lead Nurse. She is insistent that the release is not legal (how would she know?) and that this must wait for the patient's normal provider. Umm, hello? Elder abuse investigation, how about we cooperate for the sake of our patient that can't take care of herself? I feel these records should have been sent YESTERDAY when the requests were received, if there was a need to talk to the patient's doctor he was working and there is this thing called a phone.

I am almost betting that when I get to work the patients doctor will have put the chart on my desk to send records -- that is unless he thinks I am off today, then he will have had his MA send the records.

But seriously, why is this so difficult??? If only the Lead Nurse hadn't had the chart, then I would have been able to get the provider on-call to authorize this yesterday when I received it.