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EMR is wonderful! My new job has next to no drama and it is wonderful to be working in a small office. To actually be provided the tools I need to complete the job, management that is available when needed and to have providers that actually are scheduled adequate time to spend with their patients.

The only drama so far has been one of the doctors threatening to walk out in the middle of seeing patients, but the office manager calmed him down and he finished the day. Even with his meltdown it wasn't that bad and I understand why it happened, he is an intensivist every other week, he is in charge of a department at the hospital, his recertification for the boards is next week, he hasn't had time to study, not to mention family pressure about never seeing him. The straw that broke the camels back was when his notepad kept powering off and the recorder for the transcription would not upload.

Oh, and can I mention in my new office people actually work as a team? Since I am buried under a couple hundred charts that need to be scanned in one MA has been doing the chart prep for me and the other helps scan records as she has time. It is nice that every one actually works together.

I miss a few people from the old clinic but I do not miss the lack of team work, the work load (ie being buried with work and no help) or the drama.

A week. It took a week for me to get the little old lady's chart back with an approval to send records for the elder abuse investigation. This is insane. These records should have gone out as soon as we received the requests but they didn't due to bureaucracy of the clinic. If this little old lady has continued to suffer or dies because of this I hope they at least feel guilty. I know I have annoyed the hell out of all members of management for this chart all day, every day so I know I advocated for getting these records sent. I just wish I could have done more.

This is one of the many reasons I looked for a new job. Luckily I am leaving this one that frustrates me so much Thursday. My new job will be for a specialist clinic owned by the hospital. Better pay, better benefits, EMR to learn (where I am now is on paper charts) and all new drama but hopefully on a much smaller scale.

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.

Introduction

There is a lot I can say about working in the records room. I really like the job itself because I feel as though I am actually helping and being part of the team.

Lately I have been rather cynical due to drama in the clinic I work in and I have felt the need to have an anonymous place to vent.